J. Funct. Morphol. Kinesiol., Volume 8, Issue 1 (March 2023) – 35 articles

This study examined the reliability, potential bias, and practical differences between the GymAware Powertool (GA), Tendo Power Analyzer (TENDO), and Push Band 2.0 (PUSH) during the jump shrug (JS) and hang high pull (HHP) performed across a spectrum of loads. Fifteen resistance-trained men performed JS and HHP repetitions with 20, 40, 60, 80, and 100% of their 1RM hang power clean, and mean (MBV) and peak barbell velocity (PBV) were determined by each velocity measurement device. Least-products regression and Bland–Altman plots were used to examine instances of proportional, fixed, and systematic bias between the TENDO and PUSH compared to the GA. Hedge’s g effect sizes were also calculated to determine any meaningful differences between devices. The GA and TENDO displayed excellent reliability and acceptable variability during the JS and HHP while the PUSH showed instances of poor–moderate reliability and unacceptable variability at various loads. While the TENDO and PUSH showed instances of various bias, the TENDO device demonstrated greater validity when compared to the GA. Trivial–small differences were shown between the GA and TENDO during the JS and HHP exercises while trivial–moderate differences existed between GA and PUSH during the JS. However, despite trivial–small effects between the GA and PUSH devices at 20 and 40% 1RM during the HHP, practically meaningful differences existed at 60, 80, and 100%, indicating that the PUSH velocity outputs were not accurate. The TENDO appears to be more reliable and valid than the PUSH when measuring MBV and PBV during the JS and HHP. Full article

Previous studies have shown that listening to preferred music during resistance and endurance exercises improves performance. However, it is unknown if these phenomena translate to short-duration explosive exercises. The purpose of this study was to investigate the influences of preferred and non-preferred music on countermovement jump (CMJ) performance, isometric mid-thigh pull (IMTP), and psychological responses to music during explosive movements. Physically active females (age 18–25) volunteered to take part in the study. In a counterbalanced, crossover design, participants completed three trials: (1) no music (NM), (2) non-preferred (NP), and (3) preferred (PV) music. Participants completed three maximal IMTP tests on a force-plate-equipped IMTP apparatus with an immovable bar. Attempts lasted 5 s and were separated by 3 min of rest. Furthermore, participants completed three single maximal CMJ attempts separated by 3 min of rest on force plates. All attempts were averaged for analysis. At the commencement of IMTP and CMJ testing, participants were asked to rate how motivated and psyched up they felt during the exercise portion using a visual analog scale. For isometric performance, listening to PM resulted in increased peak force (p = 0.039; d = 0.41) and rate of force development at 200 ms (p = 0.023; d = 0.91) compared with NP. For CMJ, there were no differences between conditions for jump height (p = 0.912; η² = 0.007) or peak power during the propulsive phase (p = 0.460; η² = 0.003). Levels of motivation were significantly higher with PM compared with NM (p < 0.001; d = 2.3) and NP (p = 0.001; d = 2.0). Feelings of being psyched up were significantly higher with PM compared with NM (p < 0.001; d = 4.2) and NP (p = 0.001; d = 2.8). Findings suggest that preferred music enhances isometric strength and increases motivation and feelings of being psyched up. Thus, PM may be used as an ergogenic aid during short-duration maximal-effort activities. Full article

Post-COVID-19 pandemic, most universities changed their educational model from online courses to onsite learning, allowing students to attend regular face-to-face classes. These changes can cause stress in students, which affects physical fitness. The aim of this study was to investigate the relationship between stress levels and physical fitness in female university students. The participants were 101 female university students, 18–23 years of age. All participants completed the Suan Prung Stress Test-60 (SPST-60). The physical fitness test included body composition, cardiorespiratory fitness, as well as musculoskeletal fitness. Multiple linear regression analysis was used to determine the associations between SPST-60 scores and physical fitness. A p-value < 0.05 was considered statistically significant. We found a negative correlation between the sources of stress scores, here environment, and maximal oxygen consumption (β = −0.291; 95% CI, −0.551, −0.031). We also found that symptoms of stress scores in the parasympathetic and sympathetic nervous systems were positively associated with waist-hip circumference ratio (WHR) (β = 0.010; 95% CI, 0.002, 0.017 and β = 0.006; 95% CI, 0.000, 0.012, respectively). Moreover, the symptoms of stress, here emotion, were positively associated with the WHR (β = 0.005; 95 %CI, 0.001, 0.009) and negatively associated with upper extremity muscle strength (β = −0.005; 95% CI, −0.009, 0.000). The results of this study confirmed the associations between stress levels in the post-COVID-19 pandemic era and WHR, maximal oxygen consumption, and upper extremity muscle strength. As a result, stress reduction or prevention alternatives should be considered in order to maintain physical fitness and prevent stress disorders. Full article

There is a paucity of studies describing the physical match demands of elite international women’s rugby union, which limits coaches’ ability to effectively prepare players for the physical demands required to compete at the elite level. Global positioning system technologies were used to measure the physical match demands of 53 international female rugby union players during three consecutive Women’s Six Nations Championships (2020–2022), resulting in 260 individual match performances. Mixed-linear modelling was used to investigate differences in physical match demands between positions. Significant effects (p < 0.05) of the position were observed for all variables, with the exception of relative distances (m.min⁻¹) at velocities of 1.01–3.00 m·s⁻¹ (p = 0.094) and 3.01–5.00 m·s⁻¹ (p = 0.216). This study provides valuable data on the physical match demands of elite international women’s rugby union match play that may aid practitioners in the physical preparation of players to compete at this level. Training methodologies for elite-level female rugby union players should consider the unique demands across positional groups with specific considerations of high-velocity running and collision frequency. Full article

Rehabilitation interventions are crucial in promoting neuroplasticity after spinal cord injury (SCI). We provided rehabilitation with a single-joint hybrid assistive limb (HAL-SJ) ankle joint unit (HAL-T) in a patient with incomplete SCI. The patient had incomplete paraplegia and SCI (neurological injury height: L1, ASIA Impairment Scale: C, ASIA motor score (R/L) L4:0/0, S1:1/0) following a rupture fracture of the first lumbar vertebra. The HAL-T consisted of a combination of ankle plantar dorsiflexion exercises in the sitting position, knee flexion, and extension exercises in the standing position, and stepping exercises in the standing position with HAL assistance. The plantar dorsiflexion angles of the left and right ankle joints and electromyograms of the tibialis anterior and gastrocnemius muscles were measured and compared using a three-dimensional motion analyzer and surface electromyography before and after HAL-T intervention. Phasic electromyographic activity was developed in the left tibialis anterior muscle during plantar dorsiflexion of the ankle joint after the intervention. No changes were observed in the left and right ankle joint angles. We experienced a case in which intervention using HAL-SJ induced muscle potentials in a patient with a spinal cord injury who was unable to perform voluntary ankle movements due to severe motor–sensory dysfunction. Full article

Previous data suggest a correlation between the cross-sectional area of Type II muscle fibers and the degree of non-linearity of the EMG amplitude–force relationship (AFR). In this study we investigated whether the AFR of back muscles could be altered systematically by using different training modalities. We investigated 38 healthy male subjects (aged 19–31 years) who regularly performed either strength or endurance training (ST and ET, n = 13 each) or were physically inactive (controls (C), n = 12). Graded submaximal forces on the back were applied by defined forward tilts in a full-body training device. Surface EMG was measured utilizing a monopolar 4 × 4 quadratic electrode scheme in the lower back area. The polynomial AFR slopes were determined. Between-group tests revealed significant differences for ET vs. ST and C vs. ST comparisons at the medial and caudal electrode positions, but not for ET vs. C. Further, systematic main effects of the “electrode position” could be proven for ET and C groups with decreasing x² coefficients from cranial to caudal and lateral to medial. For ST, there was no systematic main effect of the “electrode position”. The results point towards training-related changes to the fiber-type composition of muscles in the strength-trained participants, particularly for their paravertebral region. Full article

The International Knee Documentation Committee Subjective Knee Form (IKDC2000) and the Knee Injury and Osteoarthritis Outcome Score (KOOS) are knee-specific measures. However, their association with a return to sports after anterior cruciate ligament reconstruction (ACLR) is unknown. This study aimed to investigate the association between the IKDC2000 and the KOOS subscales and the return to the same pre-injury level of sport two years after ACLR. Forty athletes that were two years post-ACLR participated in this study. Athletes provided demographic information, filled out the IKDC2000 and KOOS subscales, and indicated whether they returned to any sport and whether they returned to the same pre-injury level (same duration, intensity, and frequency). In this study, 29 (72.5%) athletes returned to play any sport and eight (20%) returned to the same pre-injury level. The IKDC2000 (r: 0.306, p = 0.041) and KOOS quality of life (KOOS-QOL) (r: 0.294, p = 0.046) significantly correlated with the return to any sport, but it was age (r: −0.364, p = 0.021), BMI (r: −0.342, p = 0.031), IKDC2000 (r: 0.447, p = 0.002), KOOS-pain (r: 0.317, p = 0.046), KOOS sport and recreation function (KOOS-sport/rec)(r: 0.371, p = 0.018), and KOOS QOL (r: 0.580, p > 0.001) that significantly correlated with a return to the same pre-injury level. High KOOS-QOL and IKDC2000 scores were associated with returning to any sport, and high KOOS-pain, KOOS-sport/rec, KOOS-QOL, and IKDC2000 scores were all associated with returning to the same pre-injury level of sport. Full article

Background: Extracapsular femoral neck fractures (eFNF) are the third most common type of fracture in traumatology. Intramedullary nailing (IMN) is one of the most frequently used ortho-pedic treatments for eFNF. Blood loss is one of the main complications of this treatment. This study aimed to identify and evaluate the perioperative risk factors that lead to blood transfusion in frail patients with eFNF who undergo IMN. Methods: From July 2020 to December 2020, 170 eFNF-affected patients who were treated with IMN were enrolled and divided into two groups according to blood transfusion: NBT (71 patients who did not need a blood transfusion), and BT (72 patients who needed blood transfusion). Gender, age, BMI, pre-operative hemoglobin levels, in-ternational normalized ratio (INR) level, number of blood units transfused, length of hospital stay, surgery duration, type of anesthesia, pre-operative ASA score, Charlson Comorbidity Index, and mortality rate were assessed. Results: Cohorts differed only for pre-operatively Hb and surgery time (p < 0.05). Conclusion: Patients who have a lower preoperative Hb level and longer surgery time have a high blood-transfusion risk and should be closely followed peri-operatively. Full article

Extensive literature reports an increase in physical disorders (pain, pathologies, dysfunctions) and mental malaise/uneasiness (stress, burnout) affecting dental professionals in relation to fast and pressing rhythms of work, long working hours, increasingly demanding patients, ever-evolving technologies, etc. This project has been conceived to bring the science of yoga around the world to dental professionals as a preventive (occupational) medicine and to provide knowledge and means for self-care. Yoga is a concentrative self-discipline of the mind, senses, and physical body, that requires regular daily exercise (or meditation), attention, intention, and disciplined action. M&M: The study aimed to design a Yoga protocol specifically devised for dental professionals (dentists, dental hygienists, and dental assistants) including positions (āsana) to be practiced/used in the dental office. The protocol is targeted for the upper body, namely neck, upper back, chest, shoulder girdle, and wrists, being areas greatly affected by work-related musculoskeletal disorders. This paper represents a yoga-based guideline for the self-cure of musculoskeletal disorders among dental professionals. Results: The protocol includes both sitting (Upavistha position) and standing (Utthana or Sama position) āsana, with twisting (Parivrtta), side bending (Parsva), flexion and forward bending (Pashima), and extension and arching (Purva) āsana to mobilize and decompress, and to provide nourishment and oxygen to the musculo-articular system. The paper delivers different concepts and theories developed and deepened by the authors and introduces and spreads yoga as a medical science among dental professionals for the prevention and treatment of work-related musculoskeletal disorders. We articulate notions ranging from stretching out using the vinyāsa method (breath-driven movement) and inward-focused attention to contemplative/concentrative science, interoceptive attention, self-awareness, the mind–body connection, and receptive attitude. The theory of “muscles are bone ties” is coined and delivered with regard to tensegrity musculoskeletal fascial structures connecting, pulling together, and nearing the bone segments where they are anchored. The paper describes over 60 āsana envisaged to be performed on dental stools or using the walls of a dental office or a dental unit chair. A detailed guideline on the work-related disorders that can find relief with the protocol is provided, including the description of breath control for the practice of āsana in vinyāsa. The foundations of the technique reside in the Iyengar Yoga method and Parināma Yoga method. Conclusions: This paper represents a guideline for self-cure in the prevention or treatment of musculoskeletal disorders affecting dental professionals. Yoga is a powerful concentrative self-discipline able to provide physical and mental well-being, representing great help and support in daily life and business for dental professionals. Yógāsana restores retracted and stiff muscles, giving relief to the strained and tired limbs of dental professionals. Yoga is not intended for flexible or physically performing persons but for people who decide to take care of themselves. The practice of specific āsana represents a powerful tool for the prevention or treatment of MSDs related to poor posture, forward head, chronic neck tension (and related headache), depressed chest, compressive disorders on wrists and shoulders as carpal tunnel, impingement syndromes, outlet syndrome, subacromial pain syndrome and spinal disc pathologies. Yoga, as an integrative science in medicine and public health, represents a powerful tool for the prevention and treatment of occupational musculoskeletal disorders and an extraordinary path for the self-care of dental professionals, sitting job workers, and healthcare providers suffering from occupational biomechanical stresses and awkward postures. Full article

Balance has been positioned as an important performance skill in sport. Differences in postural control have been found between levels of expertise. However, this statement remains unanswered in some cyclic sports. This work aimed to describe the one-leg balance performance of a sample of elite BMX riders—racing and freestyle—compared to a control group formed by recreational athletes. The center of pressure (COP) of nineteen international BMX riders (freestyle, n = 7; racing, n = 12) and twenty physically active adults was analyzed in a 30-s one-leg stance test on both legs. COP dispersion and velocity variables were analyzed. Non-linear dynamics of postural sway were evaluated through Fuzzy Entropy and Detrended Fluctuation Analysis. BMX athletes did not show differences between legs in any of the variables. The control group did show differences between the dominant and non-dominant leg in the magnitude of variability of the COP in the mediolateral axis. Group comparison revealed non-significant differences. International BMX athletes did not show better balance parameters than the control group in a one-leg stance balance task. The adaptations derived from BMX practice do not have a significant impact in one-leg stance balance performance. Full article

This study examined the relationship between abnormal gait pattern and physical activity level one year later in patients with knee osteoarthritis (KOA) and determined the clinical utility of the abnormal gait pattern examination. Initially, the patients’ abnormal gait pattern was assessed using seven items, based on the scoring system reported in a previous study. The grading was based on a three-criteria system with 0: no abnormality, 1: moderately abnormal, and 2: severely abnormal. The patients were then classified into three groups according to physical activity level one year after gait pattern examination: low, intermediate, and high physical activity groups, respectively. Cut-off values for physical activity levels were calculated based on abnormal gait pattern examinations results. On follow-ups with 24 of the 46 subjects, age, abnormal gait pattern, and gait speed showed significant differences among the three groups according to the amount of physical activity. Effect size of abnormal gait pattern was higher than age and gait speed. Patients with KOA with physical activity < 2700 steps/day and <4400 steps/day at one year had abnormal gait pattern examination scores of ≥8 and ≥5, respectively. Abnormal gait pattern is associated with future physical activity. The results suggested that abnormal gait pattern examinations in patients with KOA could be used to screen for the possibility of physical activity being <4400 steps one year later. Full article

Individuals with lower-limb amputations may have a significant strength deficit. This deficit may be related to the stump length and can lead to changes in gait, reduced energy efficiency, walking resistance, altered joint load, and increased risk of osteoarthritis and chronic low back pain. This systematic review used the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) guidelines to examine the effects of resistance training in lower limb amputees. Interventions with resistance training and other training methods were sufficient to achieve muscle strength gain in muscles of the lower limbs, improved balance, and improvements in gait pattern and speed when walking. However, it was impossible to determine from the results whether resistance training was mainly responsible for these benefits or even whether the positive effects presented would be observed with only this training method. When combined with other exercises, interventions with resistance training made possible gains for this population. Accordingly, it is noteworthy that the main finding of this systematic review is that the effects may be different according to the level of amputation, with mainly transtibial and transfemoral amputations studied. Full article

Background: Wearable inertial sensors are poorly used in soccer to monitor external load (EL) indicators. However, these devices could be useful for improving sports performance and potentially reducing the risk of injury. The aim of this study was to investigate the EL indicators (i.e., cinematic, mechanical, and metabolic) differences between playing positions (i.e., central backs, external strikers, fullbacks, midfielders, and wide midfielder) during the first half time of four official matches (OMs). Methods: 13 young professional soccer players (Under-19; age: 18.5 ± 0.4 years; height: 177 ± 6 cm; weight: 67 ± 4.8 kg) were monitored through a wearable inertial sensor (TalentPlayers TPDev, firmware version 1.3) during the season 2021–2022. Participants’ EL indicators were recorded during the first half time of four OMs. Results: significant differences were detected in all the EL indicators between playing positions except for two of them (i.e., distance traveled in the various metabolic power zones (<10 w) and the number of direction changes to the right >30° and with speed >2 m). Pairwise comparisons showed differences in EL indicators between playing positions. Conclusions: Young professional soccer players showed different loads and performances during OMs in relation to playing positions. Coaches should consider the different physical demands related to playing positions in order to design the most appropriate training program. Full article

Firefighters often complete air management courses (AMC) to assess the ability to tolerate personal protective equipment, appropriately manage the breathing system and assess occupational performance. Little information is known relative to the physiological demands of AMCs, nor how to assess work efficiency in order to characterize occupational performance and evaluate progress. Purpose: To assess the physiological demands of an AMC and examine differences across BMI categories. A secondary aim was to develop an equation to assess work efficiency in firefighters. Methods: Fifty-seven firefighters (Women, n = 4; age: 37.2 ± 8.4 yr.; height: 182.0 ± 6.9 cm; body mass: 90.8 ± 13.1 kg; BMI: 27.8 ± 3.6 kg·m⁻²) completed an AMC per routine evaluation while wearing a department issued self-contained breathing apparatus and full protective gear. Course completion time, starting pounds per square inch (PSI) on the air cylinder, changes in PSI, and distance traveled were recorded. All firefighters were equipped with a wearable sensor integrated with a triaxial accelerometer and telemetry to assess movement kinematics, heart rate, energy expenditure, and training impulse. The AMC consisted of an initial section involving a hose line advance, rescue (body drag), stair climb, ladder raise, and forcible entry. This section was followed by a repeating loop, which consisted of a stair climb, search, hoist, and recovery walk. Firefighters repeated the course loop until the self-contained breathing apparatus air supply pressure reached 200 PSI, at which time they were instructed to lay down until the PSI reached zero. Results: Average completion time was 22.8 ± 1.4 min, with a mean distance of 1.4 ± 0.3 km and an average velocity of 2.4 ± 1.2 m·s⁻¹. Throughout the AMC, the mean heart rate was 158.7 ± 11.5 bpm equating to 86.8 ± 6.3% of the age-predicted max heart rate and a training impulse of 55 ± 3 AU. Mean energy expenditure was 464 ± 86 kcals and work efficiency was 49.8 ± 14.9 km·PSI⁻¹·s. Regression analysis determined that fat-free mass index (R² = 0.315; β = −5.069), body fat percentage (R² = 0.139; β = −0.853), fat-free mass (R² = 0.176; β = −0.744), weight (R² = 0.329; β = −0.681), and age (R² = 0.096; β = −0.571) were significant predictors of work efficiency. Conclusions: The AMC is a highly aerobic task with near-maximal heart rates reached throughout the course. Smaller and leaner individuals achieved a higher degree of work efficiency during the AMC. Full article

Evaluating force–velocity characteristics on dry-land is of the utmost importance in swimming, because higher levels of these bio-motor abilities positively affect in-water performance. However, the wide range of possible technical specializations presents an opportunity for a more categorized approach that has yet to be seized. Therefore, the aim of this study was to identify feasible differences in maximum force–velocity exertion based on swimmers’ stroke and distance specialization. To this scope, 96 young male swimmers competing at the regional level were divided into 12 groups, one for each stroke (butterfly, backstroke, breaststroke, and front crawl) and distance (50 m, 100 m, and 200 m). They performed two single pull-up tests, 5-min before and after competing in a federal swimming race. We assessed force (N) and velocity (m/s) exertion via linear encoder. There were no significant differences between pre-post maximum force–velocity exertions, despite the decreasing trend. Force-parameters highly correlated with each other and with the swimming performance time. Moreover, both force (t = −3.60, p < 0.001) and velocity (t = −3.90, p < 0.001) were significant predictors of swimming race time. Sprinters (both 50 m and 100 m) of all strokes could exert significantly higher force–velocity compared to 200 m swimmers (e.g., 0.96 ± 0.06 m/s performed by sprinters vs. 0.66 ± 0.03 m/s performed by 200 m swimmers). Moreover, breaststroke sprinters presented significantly lower force–velocity compared to sprinters specialized in the other strokes (e.g., 1047.83 ± 61.33 N performed by breaststroke sprinters vs. 1263.62 ± 161.23 N performed by butterfly sprinters). This study could provide the foundation for future research regarding the role of stroke and distance specializations in modeling swimmers’ force–velocity abilities, thus influencing paramount elements for specific training and improvement towards competitions. Full article

Individual differences in the appropriate percentage of 1-RM for a given repetition range could be a result of variation in anthropometrics and/or sex. Strength endurance is the term used to describe the ability to perform a number of repetitions prior to failure (AMRAP) in sub-maximal lifts and is important in determining the appropriate load for the targeted repetition range. Earlier research investigating the association of AMRAP performance and anthropometric variables was often performed in a sample of pooled sexes or one sex only or by utilizing tests with low ecological validity. As such, this randomized cross-over study investigates the association of anthropometrics with different measures of strength (maximal and relative strength and AMRAP) in the squat and bench press for resistance-trained males (n = 19, 24.3 ± 3.5 years, 182 ± 7.3 cm, 87.1 ± 13.3 kg) and females (n = 17, 22.1 ± 3 years, 166.1 ± 3.7 cm, 65.5 ± 5.6 kg) and whether the association differs between the sexes. Participants were tested for 1-RM strength and AMRAP performance, with 60% of 1-RM in the squat and bench press. Correlational analysis revealed that for all participants, lean mass and body height were associated with 1-RM strength in the squat and bench press (0.66, p ≤ 0.01), while body height was inversely associated with AMRAP performance (r ≤ −0.36, p ≤ 0.02). Females had lower maximal and relative strength with a greater AMRAP performance. In the AMRAP squat, thigh length was inversely associated with performance in males, while fat percentage was inversely associated with performance in females. It was concluded that associations between strength performance and anthropometric variables differed for males and females in fat percentage, lean mass, and thigh length. Full article

Despite progress made in recent decades, gender bias is still present in scientific publication authorship. The underrepresentation of women and overrepresentation of men has already been reported in the medical fields but little is known in the fields of exercise sciences and rehabilitation. This study examines trends in authorship by gender in this field in the last 5 years. All randomized controlled trials published in indexed journals from April 2017 to March 2022 through the widely inclusive Medline dataset using the MeSH term “exercise therapy” were collected, and the gender of the first and last authors was identified through names, pronouns and photographs. Year of publication, country of affiliation of the first author, and ranking of the journal were also collected. A chi-squared test for trends and logistic regression models were performed to analyze the odds of a woman being a first or last author. The analysis was performed on a total of 5259 articles. Overall, 47% had a woman as the first author and 33% had a woman as the last author, with a similar trend over five years. The trend in women’s authorship varied by geographical area, with the higher representation of women authors in Oceania (first: 53.1%; last: 38.8%), North-Central America (first: 45.3%; last: 37.2%), and Europe (first: 47.2%; last: 33.3%). The logistic regression models (p < 0.001) indicated that women have lower odds of being authors in prominent authorship positions in higher-ranked journals. In conclusion, over the last five years, in the field of exercise and rehabilitation research, women and men are almost equally represented as first authors, in contrast with other medical areas. However, gender bias, unfavoring women, still exists, especially in the last authorship position, regardless of geographical area and journal ranking. Full article

Orthognathic surgery (OS) can present many complications that affect patients’ rehabilitation. However, there have been no systematic reviews that assessed the effectiveness of physiotherapy interventions in the postsurgical rehabilitation of OS patients. The aim of this systematic review was to analyze the effectiveness of physiotherapy after OS. The inclusion criteria were randomized clinical trials (RCTs) of patients who underwent OS and who received therapeutic interventions that included any physiotherapy modality. Temporomandibular joint disorders were excluded. After the filtering process, five RCTs were selected from the 1152 initially obtained (two had acceptable methodological quality; three had insufficient methodological quality). The results obtained showed that the effects of the physiotherapy interventions studied in this systematic review on the variables of range of motion, pain, edema and masticatory muscle strength were limited. Only laser therapy and LED showed a moderate level of evidence in the postoperative neurosensory rehabilitation of the inferior alveolar nerve compared with a placebo LED intervention. Full article

This study aimed to evaluate the mechanism of progression involved in knee osteoarthritis (OA). We used the computed tomography-based finite element method (CT-FEM) of quantitative X-ray CT imaging to calculate and create a model of the load response phase, wherein the greatest burden is placed on the knee joint while walking. Weight gain was simulated by asking a male individual with a normal gait to carry sandbags on both shoulders. We developed a CT-FEM model that incorporated walking characteristics of individuals. Upon simulating changes owing to a weight gain of approximately 20%, the equivalent stress increased extensively in both medial and lower leg aspects of the femur and increased medio-posteriorly by approximately 230%. As the varus angle increased, stress on the surface of the femoral cartilage did not change significantly. However, the equivalent stress on the surface of the subchondral femur was distributed over a wider area, increasing by approximately 170% in the medio-posterior direction. The range of equivalent stress affecting the lower-leg end of the knee joint widened, and stress on the posterior medial side also increased significantly. It was reconfirmed that weight gain and varus enhancement increase knee-joint stress and cause the progression of OA. Full article

The purpose of the present study was to quantify the morphometric characteristics of three tendon autografts (hamstring tendons (HT), quadriceps tendon (QT), and patellar tendon (PT)) used in anterior cruciate ligament (ACL) reconstruction. For this purpose, knee magnetic resonance imaging (MRI) was obtained in 100 consecutive patients (50 males and 50 females) with an acute, isolated ACL tear without any other knee pathology were used. The level of the physical activity of the participants was determined using the Tegner scale. Measurements of the tendons’ dimensions (PT and QT tendon length, perimeter, cross-sectional area (CSA), and maximum mediolateral and anteroposterior dimensions) were performed perpendicular to their long axes. Higher values were recorded as regards the mean perimeter and CSA of the QT in comparison with the PT and the HT (perimeter QT: 96.52 ± 30.43 mm vs. PT: 63.87 ± 8.45 mm, HT: 28.01 ± 3.73 mm, F = 404.629, p < 0.001; CSA QT: 231.88 ± 92.82 mm² vs. PT: 108.35 ± 28.98 mm², HT: 26.42 ± 7.15 mm², F = 342.415, p < 0.001). The length of the PT was shorter in comparison with the QT (53.1 ± 7.8 vs. 71.7 ± 8.6 mm, respectively, t = −11.243, p < 0.001). The three tendons showed significant differences in relation to sex, tendon type, and position as regards the perimeter, CSA, and the mediolateral dimensions but not for the maximum anteroposterior dimension. Full article

The present study investigated the excitation of the biceps brachii and anterior deltoid during bilateral biceps curl performed using the straight vs. EZ barbell and with or without flexing the arms. Ten competitive bodybuilders performed bilateral biceps curl in non-exhaustive 6-rep sets using 8-RM in four variations: using the straight barbell flexing (ST_flex) or not flexing the arms (ST_no-flex) or the EZ barbell flexing (EZ_flex) or not flexing the arms (EZ_no-flex). The ascending and descending phases were separately analyzed using the normalized root mean square (nRMS) collected using surface electro-myography. For the biceps brachii, during the ascending phase, a greater nRMS was observed in ST_no-flex vs. EZ_no-flex (+1.8%, effect size [ES]: 0.74), in ST_flex vs. ST_no-flex (+17.7%, ES: 3.93) and in EZ_flex vs. EZ_no-flex (+20.3%, ES: 5.87). During the descending phase, a greater nRMS was observed in ST_flex vs. EZ_flex (+3.8%, ES: 1.15), in ST_no-flex vs. ST_flex (+2.8%, ES: 0.86) and in EZ_no-flex vs. EZ_flex (+8.1%, ES: 1.81). The anterior deltoid showed distinct excitation based on the arm flexion/no-flexion. A slight advantage in biceps brachii excitation appears when using the straight vs. EZ barbell. Flexing or not flexing the arms seems to uniquely excite the biceps brachii and anterior deltoid. Practitioners should consider including different bilateral biceps barbell curls in their routine to vary the neural and mechanical stimuli. Full article

This study aimed to investigate the effects of playing position and contextual factors (match outcome, final score difference, match location, travel duration, number of scored and conceded goals) on the internal match load, players’ perceived recovery and players’ well-being. The session-RPE (s-RPE), Perceived Recovery Scale (PRS) and Hooper Index (HI) of 17 male elite water polo players were monitored during all matches (regular season and play-out) of the 2021/22 Italian Serie A1 championship. Three separate, mixed linear models for repeated measures showed significant main effects: drawn compared to won matches led to higher s-RPE values (mean ± SE = 277 ± 17.6 vs. 237.3 ± 20.6), while longer travel duration (estimate = −0.148) and goals scored (estimate = −3.598) led to lower s-RPE values; balanced compared to unbalanced matches led to higher PRS values (mean ± SE = 6.8 ± 0.3 vs. 5.1 ± 0.4), while playing time (estimate = −0.041) and goals scored (estimate = −0.180) led to lower PRS values; higher scores of the HI were registered for regular season compared to the play-out (mean ± SE = 15.6 ± 0.9 vs. 13.5 ± 0.8). This study marks the importance of ecological and non-invasive monitoring tools to assess internal match load, recovery and the well-being of elite water polo players. Full article

Agility is a fitness-skill-related component that should be a part of the standard physiological testing for soccer players and one of the key performance indicators in soccer. The present study aimed to assess the reliability of the CRAST as a research tool in the study of soccer skills. Twenty-one university soccer players (chronological age: 19.3 ± 1.4 years; body mass: 69.6 ± 8.2 kg; stature: 173.5 ± 6.5 cm; federated training experience: 9.7 ± 3.6 years) volunteered for the testing protocol. The CRAST requires players to complete random courses six times as quickly as possible. In addition, the CRAST requires players to control and dribble the markers (four different colors: green, yellow, blue, and red). The soccer players completed three trials, each separated by one week. The first trial accounted for familiarization; the second and third were considered for analysis. The correlation for overall performance was very strong. The reliability of the CRAST was slightly better for total time than that for the penalty score (0.95 vs. 0.93). The TEM and the associated CV range of 7.04%–7.54% were for the penalty score and the total time, respectively. For both measurements, the ICC values also represent excellent reliability, as both values were over 0.900. The CRAST is a reliable protocol for assessing agility in soccer players. Full article

The crucial criteria when assessing technical performance in artistic gymnastics is the higher elevation of the gymnast’s body and a stable landing (i.e., stick-landing). The purpose of this study was to compare kinetic and kinematic parameters during the landing phase of standing back somersaults (SBS) following three technical arm-swing performed during the preparatory phase in high-level male gymnasts. The three different arm-swing pertain to three “gymnastics schools”, i.e., Russian, Chinese, and Romanian. Six high-level male gymnasts participated in this study. Three arm-swing with different angles (i.e., SBS_270°, SBS_180°, and SBS_90°) were randomly performed. A 3D kinetic and kinematic analysis was conducted. Results showed significant variation in the landing angle (p = 0.009) across the three arm-swing techniques. The SBS_90° arm-swing resulted in the closest angle to the vertical. Additionally, the SBS_90° arm-swing technique induced the lowest horizontal and vertical force values upon landing compared to the other arm-swing techniques (SBS_270°: p = 0.023 and 0.009, respectively; SBS_180°: p = 0.004 and 0.080, respectively). The same was noted for the horizontal velocity (p = 0.021) with the lowest values noted for the SBS_90° arm-swing technique. However, the best opening angle was observed during the SBS_270° technique, since it presented the best vertical displacement. In conclusion, the SBS with a SBS_90° arm-swing seems to favor a better absorption of the ground reaction force upon landing by reducing the intensity of the impact with the ground and by affording a landing angle closer to the vertical in high-level male gymnasts. Full article

Chronic kidney disease (CKD) leads to gradual muscle mass loss, which is strongly associated with lower functional capacity, which limits a patient’s daily activities. The aim of the present study is to examine the effects of a 4-month intradialytic exercise program on the functional capacity and body composition of kidney transplant (KT) candidates. Twenty-nine male patients on hemodialysis (HD) waiting for a kidney transplant, with a mean age of 53.86 ± 9.56 years old and BMI 27.11 ± 5.55 kg/m², were randomly assigned into the following two groups: A (n_A = 15 HD patients), who followed a 4-month intradialytic exercise program combining aerobic and resistance training, with a supervised, progressively increasing workload, and B (n_B = 14 HD patients), who continued to receive usual care. At baseline and the end of the study, the KT candidates underwent a 6-min walking distance (6-MWD), and a 10-repetition sit-to-stand test (10-STS) to access physical function, a handgrip strength (HGS) test to evaluate the muscle strength of the non-fistula hand. Moreover, the bioelectrical impedance analysis (BIA) was performed to assess body composition indices, such as body fat (BF), body fat mass index (BFMI), fat-free mass index (FFMI), body cell mass (BCM), basal metabolic rate (BMR), extracellular water (ECW), intracellular water (ICW), total body water (TBW) and phase angle (PhA). Following the exercise program, group A showed favorable improvements in HGS (from 26.59 ± 9.23 to 28.61 ± 9.58 kg, p < 0.05) and 6-MWD (from 427.07 ± 7.66 to 468.16 ± 11.39 m, p < 0.05). Intergroup results from 6-MWD showed a statistically significant difference (Δp = 0.04), at the end of the study. Moreover, group A results from BIA revealed a significant increase of BMR by 2.4% (p < 0.05), ECW by 3.6% (p = 0.01), ICW by 3.8% (p = 0.01), TBW by 4.1% (p = 0.01), lean mass by 2.7% (p = 0.01), and PhA by 13.3% (p = 0.04), while a reduction in BF by 5.0% (p = 0.01) and BFMI by 6.6% (p = 0.03) was also noticed. At the end of the study, group A showed statistical differences in BMR (Δp = 0.01), BMR/BW (Δp = 0.01), dry lean (Δp = 0.01), and PhA (Δp = 0.03), compared to the group B. Linear regression analysis in group A after training showed positive correlations between HGS and both PhA (r = 0.52, p = 0.04) and FFMI (r = 0.64, p = 0.01), and a strong negative correlation between 6-MWT and BF (r = −0.61, p = 0.01). In conclusion, a 4-month intradialytic exercise program can enhance body composition and some physical parameters in HD patients awaiting kidney transplantation. Full article

Rotator cuff tear arthropathy (CTA) is the most common reason for reverse total shoulder arthroplasty (RSA). There is minimal understanding of the natural progression of osteoarthritis of the shoulder and of the morphologic differences between men and women and between younger and older patients. This trial comprised 309 patients (342 shoulders) who underwent RSA due to CTA in the period between January 2009 and September 2019. The patients were divided into gender and age groups. Preoperative X-rays, computed tomography and magnetic resonance imaging were conducted using various classifications to describe the morphology of the CTA. Of all 342 analyzed shoulders, 209 were right and 133 were left shoulders. A total of 257 female shoulders and 85 male shoulders were assessed. Both mean age and age distribution were significantly different (74.37 years in female and 70.11 years in male patients, p = 0.001; 70.2% female patients in the age group <75.5 years and 80.1% in the age group >75.5 years, p = 0.045). A larger extent of progression of the fatty infiltration was detected both in the female cohort (p = 0.006) and in the older age group (p = 0.001). Additionally, older patients had significantly higher levels of muscle retraction (Patte; p = 0.003), a lower acromiohumeral distance (p = 0.042) and more advanced CTA (Seebauer; p = 0.006). Full article

Literature reports superior performance when focusing one’s attention during a movement on environmental effects of that movement (external focus, EF) compared to focusing on the moving body (internal focus, IF). Nevertheless, IF instructions still play an important role in the daily practice of coaches, trainers, and therapists. The current review compiles evidence for focus-of-attention concepts on movement form corrections and technique training. Reviews on the topic and selected additional papers addressing the effect of attentional focus on movement form or on kinetic, kinematic or muscle activity data were included. Both EF and IF instructions affect movement form. The reviews revealed that IF instructions seem to be better applicable to direct movement form changes than EF instructions. In contrast, EF instructions better facilitate optimization within the whole-body coordination, often resulting in better performance outcomes not directly linked to movement pattern changes. Several studies discuss focus-of-attention effects in the context of the optimal feedback control theory expanding on the constrained action hypothesis. In summary, EF and IF instructions both affect form and performance of movements, however, their relative efficacy is situation dependent. The often-purported superiority of EF over IF instructions cannot be generalized to all application contexts. Full article

Physical activity (PA) is a non-invasive, cost-effective means of reducing chronic disease. Most US citizens fail to meet PA guidelines, and individuals experiencing chronic stress are less likely to be physically active. To better understand the barriers to maintaining active lifestyles, we sought to determine the extent to which short- versus long-term PA increases stress- and aversion-related markers in wild-type (WT) and low voluntary running (LVR) rats, a unique genetic model of low physical activity motivation. Here, we tested the effects of 1 and 4 weeks of voluntary wheel-running on physiological, behavioral, and molecular measures of stress and Hypothalamic Pituitary Adrenal (HPA)-axis responsiveness (corticosterone levels, adrenal wet weights, and fecal boli counts). We further determined measures of aversion-related signaling (kappa opioid receptor, dynorphin, and corticotropin releasing hormone mRNA expression) in the basolateral amygdala (BLA), a brain region well characterized for its role in anxiety and aversion. Compared to sedentary values, 1, but not 4 weeks of voluntary wheel-running increased adrenal wet weights and plasma corticosterone levels, suggesting that HPA responsiveness normalizes following long-term PA. BLA mRNA expression of prodynorphin (Pdyn) was significantly elevated in WT and LVR rats following 1 week of wheel-running compared to sedentary levels, suggesting that aversion-related signaling is elevated following short- but not long-term wheel-running. In all, it appears that the stress effects of acute PA may increase molecular markers associated with aversion in the BLA, and that LVR rats may be more sensitive to these effects, providing a potential neural mechanism for their low PA motivation. Full article