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16 pages, 285 KB

Open AccessArticle

Relationships Between Hematological Variables and Bone Metabolism in Elite Female Trail Runners

by Marta Carrasco-Marginet, Silvia Puigarnau, Javier Espasa-Labrador, Álex Cebrián-Ponce, Fabrizio Gravina-Cognetti, Nil Piñol-Granadino and Alfredo Irurtia

Healthcare 2026, 14(2), 200; https://doi.org/10.3390/healthcare14020200 - 13 Jan 2026

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Abstract

Background: This study investigated the relationships between hematological and bone metabolism variables in 35 elite female trail runners, focusing on identifying key hematological correlates of bone health. Methods: Forty-four hematological variables, including biochemical, hormonal, metabolic, liver enzyme, and iron profiles, as well as [...] Read more.

Background: This study investigated the relationships between hematological and bone metabolism variables in 35 elite female trail runners, focusing on identifying key hematological correlates of bone health. Methods: Forty-four hematological variables, including biochemical, hormonal, metabolic, liver enzyme, and iron profiles, as well as complete blood count and platelet indices, were analyzed. Bone mineral density (BMD) and bone mineral content (BMC) were assessed at multiple skeletal regions via dual-energy X-ray absorptiometry (DXA). A cross-sectional design was employed, utilizing descriptive statistics, correlation analyses, and multiple linear regression to analyze the associations between hematological markers and BMC and BMD. Results: Significant but moderate associations were identified: magnesium consistently emerged as a negatively associated factor, particularly associated with BMC and BMD in the lumbar spine (L1–L4) and whole-body, potentially reflecting hypothesized mineral mobilization during chronic physical stress. Follicle-stimulating hormone showed positive associations with BMD, suggesting a potential protective association in bone turnover regulation. Additionally, calcium and thyroid hormones were linked to regional bone properties, highlighting site-specific skeletal vulnerabilities. Conclusions: These findings suggest a complex interplay between mineral homeostasis and hormonal balance that may be related to skeletal integrity in elite female trail runners. This work provides a foundation for developing evidence-based guidelines to support the health and performance of female endurance athletes. Further research is warranted to confirm these results through longitudinal evaluations. Full article

(This article belongs to the Special Issue From Prevention to Recovery in Sports Injury Management)

20 pages, 813 KB

Open AccessArticle

Artificial Intelligence in Sub-Elite Youth Football Players: Predicting Recovery Through Machine Learning Integration of Physical, Technical, Tactical and Maturational Data

by Pedro Afonso, Pedro Forte, Luís Branquinho, Ricardo Ferraz, Nuno Domingues Garrido and José Eduardo Teixeira

Healthcare 2025, 13(24), 3301; https://doi.org/10.3390/healthcare13243301 - 16 Dec 2025

Viewed by 848

Abstract

Background: Monitoring training load and recovery is essential for performance optimization and injury prevention in youth football. However, predicting subjective recovery in preadolescent athletes remains challenging due to biological variability and the multidimensional nature of training responses. This exploratory study examined whether supervised [...] Read more.

Background: Monitoring training load and recovery is essential for performance optimization and injury prevention in youth football. However, predicting subjective recovery in preadolescent athletes remains challenging due to biological variability and the multidimensional nature of training responses. This exploratory study examined whether supervised machine learning (ML) models could predict Total Quality of Recovery (TQR) using integrated external load, internal load, anthropometric and maturational variables collected over one competitive microcycle. Methods: Forty male sub-elite U11 and U13 football players (age 10.3 ± 0.7 years; height 1.43 ± 0.08 m; body mass 38.6 ± 6.2 kg; BMI 18.7 ± 2.1 kg/m²) completed a microcycle comprising four training sessions (MD-4 to MD-1) and one official match (MD). A total of 158 performance-related variables were extracted, including external load (GPS-derived metrics), internal load (RPE and sRPE), heart rate indicators (U13 only), anthropometric and maturational measures, and tactical–cognitive indices (FUT-SAT). After preprocessing and aggregation at the player level, five supervised ML algorithms—K-Nearest Neighbors (KNN), Support Vector Machine (SVM), Decision Tree (DT), Random Forest (RF), and Gradient Boosting (GB)—were trained using a 70/30 train–test split and 5-fold cross-validation to classify TQR into Low, Moderate, and High categories. Results: Tree-based models (DT, GB) demonstrated the highest predictive performance, whereas linear and distance-based approaches (SVM, KNN) showed lower discriminative ability. Anthropometric and maturational factors emerged as the most influential predictors of TQR, with external and internal load contributing modestly. Predictive accuracy was moderate, reflecting the developmental variability characteristics of this age group. Conclusions: Using combined physiological, mechanical, and maturational data, these ML-based monitoring systems can simulate subjective recovery in young football players, offering potential as decision-support tools in youth sub-elite football and encouraging a more holistic and individualized approach to training and recovery management. Full article

(This article belongs to the Special Issue From Prevention to Recovery in Sports Injury Management)

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22 pages, 1599 KB

Open AccessArticle

Feasibility and Preliminary Response of a Novel Training Program on Mobility Parameters in Adolescents with Movement Disorders

by Phuong T. M. Quach, Gordon Fisher, Byron Lai, Christopher M. Modlesky, Christopher P. Hurt, Collin D. Bowersock, Ali Boolani and Harshvardhan Singh

Healthcare 2025, 13(24), 3251; https://doi.org/10.3390/healthcare13243251 - 11 Dec 2025

Viewed by 597

Abstract

Background: There is a critical need for feasible, non-equipment based, safe, and cost-effective exercise interventions to promote muscle strength, dynamic postural balance, and independent mobility in adolescents with cerebral palsy (CP) or spina bifida (SB). Objectives: This study aimed to examine [...] Read more.

Background: There is a critical need for feasible, non-equipment based, safe, and cost-effective exercise interventions to promote muscle strength, dynamic postural balance, and independent mobility in adolescents with cerebral palsy (CP) or spina bifida (SB). Objectives: This study aimed to examine the feasibility and preliminary response of a novel exercise program: Functionally Loaded High-Intensity Circuit Training (FUNHIT) and conventional High-Intensity Circuit Training (HIT) in adolescents with CP/SB. Methods: Enrolled participants were allocated to FUNHIT or HIT or Controls in our randomized control trial. The interventions were delivered 2×/week × 4 weeks. Feasibility was assessed through process, operational, and scientific metrics. Outcome measures included maximum walking speed, Four Square Step Test (FSST), Timed Up and Go (TUG) and its dual-task variants, Lateral Step-Up Test (LSUT), Fear of Falling (FoF) and physical activity (PA) questionnaires. Results: We tested 5 participants (1 CP, 4 SB) in our study. Recruitment and retention rates were acceptable (63% enrollment, 100% retention and adherence). FUNHIT (n = 2) participants showed improvements in maximum walking speed (8–12%), FSST (15–29%), LSUT (22–33%), and TUG (4%). The HIT participant (n = 1) demonstrated improved TUG dual-task performance (40%) and FSST (30%) only. Control participants (n = 2) had varied changes (from 0–24%) in mobility, strength, balance. No adverse events were reported. Participants successfully followed (100%) the prescribed exercise dosage over the four-week period. Conclusions: FUNHIT and HIT are feasible and safe interventions for adolescents with ambulatory CP and SB who retain motor function, showing promising preliminary improvements in muscle strength, dynamic balance, and independent mobility. Our findings need to be validated in larger samples. Full article

(This article belongs to the Special Issue From Prevention to Recovery in Sports Injury Management)

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18 pages, 1946 KB

Open AccessArticle

Effects of Kinesiology Tape on Quadriceps Muscle Strength in Female Futsal Players: A Longitudinal Pilot Randomized Controlled Trial

by Norah A. Alshehri, Sarah A. Alshehri, Ahmed M. Abdelsalam, Nadia M. I. M. Gouda, Abdulrahman M. Alshehri, Abdullah A. Alrasheed, Joud S. Almutairi, Dina S. Almunif and Khalid F. Alsadhan

Healthcare 2025, 13(23), 3035; https://doi.org/10.3390/healthcare13233035 - 24 Nov 2025

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Abstract

Background/Objective: Kinesiology tape (KT) is commonly used in sports medicine and rehabilitation, but its impact on muscle strength over time remains unclear. Female futsal athletes experience high quadriceps demands and are at risk of anterior cruciate ligament injury; however, this population remains understudied. [...] Read more.

Background/Objective: Kinesiology tape (KT) is commonly used in sports medicine and rehabilitation, but its impact on muscle strength over time remains unclear. Female futsal athletes experience high quadriceps demands and are at risk of anterior cruciate ligament injury; however, this population remains understudied. The purpose of this study was to investigate the longitudinal effect of repeated kinesiology taping applications on quadriceps muscle strength and lower limb function in female futsal players. Method: A longitudinal pilot randomized controlled trial was conducted during the Saudi Universities Sports Federation Futsal Championship. Twelve female athletes (aged 19–25 years) were randomly allocated to a KT (n = 6) or control group (n = 6). The KT protocol followed the standardized quadriceps facilitation guidelines and was applied repeatedly over 30 days. We measured isometric strength (hand-held dynamometer), eccentric/concentric torque and power (Biodex System), and functional performance (single-leg hop). Nonparametric tests (Wilcoxon signed-rank and Mann–Whitney U) and mixed ANOVA were used for analysis. Result: Post-intervention, the KT group demonstrated significant improvements in isometric strength (p = 0.03, r = 0.90), eccentric/concentric strength (p = 0.03, r = 0.90), and lower limb function (p = 0.03, r = 0.90). The between-group comparisons showed significant advantages for the KT group in isometric (p = 0.01, r = 0.83) and eccentric/concentric strength (p < 0.05, r = 0.67–0.74), but not in lower limb function (p = 0.20, r = 0.37). Conclusions: Repeated kinesiology taping over a 30-day period led to statistically greater longitudinal improvements in quadriceps muscle strength but did not affect functional performance. Kinesiology taping represents a non-invasive, low-cost treatment option for quadriceps strength measures in sports characterized by higher demands on the quadriceps, especially for female athletes with contributing injury risks. Further trials with more participants and a longer follow-up should be conducted. Full article

(This article belongs to the Special Issue From Prevention to Recovery in Sports Injury Management)

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10 pages, 251 KB

Open AccessArticle

Ligament Injuries in Professional Male Handball Players: A 6-Year Longitudinal Study

by Luis Manuel Martínez-Aranda, Sergio García-Esteban, Manuel Sanz-Matesanz and Javier Raya-González

Healthcare 2024, 12(2), 201; https://doi.org/10.3390/healthcare12020201 - 15 Jan 2024

Cited by 2 | Viewed by 2640

Abstract

Handball is a sport that involves high-intensity actions throughout the game, such as sprints, jumps, landings, and high-speed, repeated throws. This, along with competitive and tactical factors, congested schedules, and the need to maintain a high level of performance throughout the season, contributes [...] Read more.

Handball is a sport that involves high-intensity actions throughout the game, such as sprints, jumps, landings, and high-speed, repeated throws. This, along with competitive and tactical factors, congested schedules, and the need to maintain a high level of performance throughout the season, contributes to a high injury rate. This study aimed to analyse ligament injuries in a professional handball team over six consecutive seasons. A total of 68 elite male Spanish handball players participated, with 54 time-loss injuries (i.e., injuries involving at least one day of absence) observed during this study period. Ligament injury information was recorded following the International Olympic Committee consensus statement. The overall incidence was 0.89 ligament injuries per 1000 h of exposure. Additionally, a higher incidence and burden of ligament injuries was observed during match-play compared to training. Most ligament injuries were classified as minor or moderate (i.e., 79.63% of the total), and 46.29% were reinjuries. A significantly higher incidence of ligament injuries was suffered in the lower limbs compared to the upper limbs (0.81 vs. 0.08 ligament injuries per 1000 h; p < 0.001). Specifically, the highest incidence was observed in the anterior talofibular ligament of the ankle (0.57 injuries per 1000 h of exposure), while the greatest burden was related to the anterior cruciate ligament (24.08 absence days per 1000 h of exposure). This study provides an overview of ligament injuries among professional handball players, highlighting the need to implement strategies with positive effects during competition (e.g., specific activation strategies or training programmes based on strength and balance) and to reduce injury recurrences. Full article

(This article belongs to the Special Issue From Prevention to Recovery in Sports Injury Management)

14 pages, 4496 KB

Open AccessArticle

Effectiveness of a Preventative Program for Groin Pain Syndrome in Elite Youth Soccer Players: A Prospective, Randomized, Controlled, Single-Blind Study

by Filippo Cotellessa, Luca Puce, Matteo Formica, Maria Cesarina May, Carlo Trompetto, Marco Perrone, Andrea Bertulessi, Vittorio Anfossi, Roberto Modenesi, Lucio Marinelli, Nicola Luigi Bragazzi and Laura Mori

Healthcare 2023, 11(17), 2367; https://doi.org/10.3390/healthcare11172367 - 22 Aug 2023

Cited by 5 | Viewed by 7593

Abstract

Groin pain syndrome (GPS) is a prevalent issue in soccer. This study assessed the effectiveness of a new preventive protocol on GPS for youth soccer players. The protocol included targeted stretching and strengthening exercises for the adductor and core muscles from preseason to [...] Read more.

Groin pain syndrome (GPS) is a prevalent issue in soccer. This study assessed the effectiveness of a new preventive protocol on GPS for youth soccer players. The protocol included targeted stretching and strengthening exercises for the adductor and core muscles from preseason to midseason. A questionnaire and two pain provocation tests were used for the evaluation. Mild GPS required positive results in at least two evaluations, while severe GPS was associated with pain incompatible with engagement in any activity confirmed by diagnostic ultrasound. Forty-two elite male athletes (aged 16.9 ± 0.7 years) participated in the study, with half of them assigned to the usual training (control group) and the remaining athletes undergoing the preventive protocol (treatment group) for 24 weeks. GPS rates were 14.3% (three diagnoses: two mild, one severe) in the treatment group and 28.6% (six diagnoses: three mild, three severe) in the control group. Toward the end of the season, three players, one from the treatment group and two from the control group had to stop playing due to severe GPS problems. In addition, one player in the control group stopped midseason. Even though the reduction in the risk of developing GPS was not significant (relative risk of 0.50 ([95%CI 0.14 to 1.74], p = 0.2759), the halved incidence of severe GPS and the increased muscle strength related to the treatment (p = 0.0277) are encouraging data for future studies. Full article

(This article belongs to the Special Issue From Prevention to Recovery in Sports Injury Management)

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11 pages, 699 KB

Open AccessArticle

Effects of Rearfoot Eversion on Foot Plantar Pressure and Spatiotemporal Gait Parameters in Adolescent Athletes

by Hironori Fujishita, Yasunari Ikuta, Noriaki Maeda, Makoto Komiya, Masanori Morikawa, Satoshi Arima, Tetsuhiko Sakamitsu, Hiromune Obayashi, Kouki Fukuhara, Kai Ushio and Nobuo Adachi

Healthcare 2023, 11(13), 1842; https://doi.org/10.3390/healthcare11131842 - 25 Jun 2023

Cited by 7 | Viewed by 3722

Abstract

Background: Foot malalignment can augment the risk of lower-extremity injuries and lead to musculoskeletal disorders. This study aimed to clarify the contribution of rearfoot alignment to plantar pressure distribution and spatiotemporal parameters during gait in healthy adolescent athletes. Methods: This retrospective study included [...] Read more.

Background: Foot malalignment can augment the risk of lower-extremity injuries and lead to musculoskeletal disorders. This study aimed to clarify the contribution of rearfoot alignment to plantar pressure distribution and spatiotemporal parameters during gait in healthy adolescent athletes. Methods: This retrospective study included 39 adolescent athletes who were divided into the rearfoot eversion and control groups according to a leg heel angle of 7°. A total of 78 legs were analyzed (45 and 33 legs in the rearfoot eversion [women, 53.3%] and control groups [women, 48.5%], respectively). Gait was assessed using an in-shoe plantar pressure measuring system and a wearable inertial sensor. Results: The foot plantar pressure distribution in the hallux was higher in the rearfoot eversion group than that in the control group (p = 0.034). Spatiotemporal parameters showed that the foot pitch angle at heel strike was significantly larger in the rearfoot eversion group than that in the control group (24.5° vs. 21.7°; p = 0.015). Total sagittal range of motion of the ankle during the stance phase of gait was significantly larger in the rearfoot eversion group than that in the control group (102.5 ± 7.1° vs. 95.6 ± 15.8°; p = 0.020). Logistic regression analysis revealed that plantar pressure at the hallux and medial heel and foot pitch angle at heel strike were significantly associated with rearfoot eversion. Conclusions: Our findings suggest that rearfoot eversion affects the gait patterns of adolescent athletes. Notably, leg heel angle assessment, which is a simple and quick procedure, should be considered as an alternative screening tool for estimating plantar pressure and spatiotemporal gait parameters to prevent sports-related and overuse injuries in adolescent athletes. Full article

(This article belongs to the Special Issue From Prevention to Recovery in Sports Injury Management)

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11 pages, 738 KB

Open AccessArticle

Relationship between Isokinetic Trunk Muscle Strength and Return to Sports Competition after Conservative Therapy in Fresh Cases of Lumbar Spondylolysis: A Retrospective Observational Study

by Yuji Hamada, Yu Okubo, Hiroshi Hattori, Takeshi Nazuka, Yuto Kikuchi and Kiyokazu Akasaka

Healthcare 2023, 11(4), 625; https://doi.org/10.3390/healthcare11040625 - 20 Feb 2023

Cited by 3 | Viewed by 3036

Abstract

This study aimed to clarify the relationship between isokinetic trunk muscle strength and return to sporting activities in fresh cases of lumbar spondylolysis treated with conservative therapy. Patients included a total of ten men (age: 13.5 ± 1.7) who were instructed by their [...] Read more.

This study aimed to clarify the relationship between isokinetic trunk muscle strength and return to sporting activities in fresh cases of lumbar spondylolysis treated with conservative therapy. Patients included a total of ten men (age: 13.5 ± 1.7) who were instructed by their attending physicians to stop exercising and who met the eligibility criteria. Isokinetic trunk muscle strength was measured immediately after exercising for the first time (First) and one month (1M). Flexion and extension and maximum torque/body weight ratio were significantly lower First compared to 1M at all angular velocities (p < 0.05). Maximum torque generation time was significantly lower for First at 120°/s and 180°/s than at 1M (p < 0.05). Correlations with the number of days to return to sports competition were detected at 60°/s for maximum torque generation time (p < 0.05, r = 0.65). Following conservative treatment for lumbar spondylolysis, it was considered necessary to focus on trunk flexion and extension muscle strength and contraction speed of trunk flexors at the beginning of the exercise period. It was suggested that trunk extension muscle strength in the extension range might be one of the critical factors for returning to sports. Full article

(This article belongs to the Special Issue From Prevention to Recovery in Sports Injury Management)

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11 pages, 1678 KB

Open AccessArticle

Muscle Activity Characteristics of the Pronator Teres during Throwing in Baseball Pitchers: A Pilot Study

by Akihiro Tamura and Masami Saito

Healthcare 2023, 11(4), 618; https://doi.org/10.3390/healthcare11040618 - 19 Feb 2023

Cited by 2 | Viewed by 3813

Abstract

The pronator teres muscle is a major dynamic stabilizer of elbow valgus stress during throwing. This study aims to investigate pronator teres muscle activation during breaking ball pitching in baseball pitchers. Twelve male college baseball players with more than eight years of baseball [...] Read more.

The pronator teres muscle is a major dynamic stabilizer of elbow valgus stress during throwing. This study aims to investigate pronator teres muscle activation during breaking ball pitching in baseball pitchers. Twelve male college baseball players with more than eight years of baseball experience were included in this study. A wireless surface electromyography (EMG) system was used to measure the activation of the forearm muscles and record EMG data during fastball and curveball pitching. Peak pronator teres muscle activation during curveball pitching was greater than that during fastball pitching (p = 0.03). There was no difference in the muscle activation of the other forearm muscles (p > 0.05). These results indicate that increased muscle activity in the pronator teres may contribute to stiffness and induce pronator teres syndrome or medial elbow injuries related to the overuse of the pronator teres, especially during curveball pitching. Controlling curveball throws contributes to player coaching and conditioning for the prevention of elbow joint disorders and pronator teres syndrome. Full article

(This article belongs to the Special Issue From Prevention to Recovery in Sports Injury Management)

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10 pages, 2204 KB

Open AccessArticle

Changes in Medial Elbow Joint Parameters Due to Selective Contraction of the Forearm Flexor–Pronator Muscles

by Hiroshi Hattori, Kiyokazu Akasaka, Takahiro Otsudo, Yutaka Sawada and Toby Hall

Healthcare 2023, 11(4), 586; https://doi.org/10.3390/healthcare11040586 - 15 Feb 2023

Cited by 3 | Viewed by 2615

Abstract

The harder the forearm flexor–pronator muscles (FPMs) relative to the ulnar collateral ligament (UCL), the less likely it is for UCL laxity to occur with repeated pitching. This study aimed to clarify what selective contraction of the forearm muscles makes FPMs harder relative [...] Read more.

The harder the forearm flexor–pronator muscles (FPMs) relative to the ulnar collateral ligament (UCL), the less likely it is for UCL laxity to occur with repeated pitching. This study aimed to clarify what selective contraction of the forearm muscles makes FPMs harder relative to UCL. The study evaluated 20 elbows of male college students. Participants selectively contracted the forearm muscles in eight conditions under gravity stress. The medial elbow joint width and the strain ratio indicating tissue hardness of the UCL and FPMs during contraction were evaluated using an ultrasound system. Contraction of all FPMs (in particular flexor digitorum superficialis [FDS] and pronator teres [PT]) decreased the medial elbow joint width compared to rest (p < 0.05). UCL hardens due to the contraction involving the FDS muscle (p < 0.05). FPMs harden due to the contraction of flexor carpi ulnaris (FCU) and FDS (p < 0.05). In the ratio of strain ratio UCL/FPMs, there was no significant difference between rest and each contraction task (p > 0.05). However, contractions composed of FCU and PT tended to harden FPMs relative to the UCL. FCU and PT activation may be effective in UCL injury prevention. Full article

(This article belongs to the Special Issue From Prevention to Recovery in Sports Injury Management)

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10 pages, 540 KB

Open AccessArticle

Efficacy of Injury Prevention Using Functional Movement Screen Training in High-School Baseball Players: Secondary Outcomes of a Randomized Controlled Trial

by Kenta Suzuki, Yasuaki Mizoguchi, Fumihiko Kimura, Yutaka Sawada and Kiyokazu Akasaka

Healthcare 2022, 10(12), 2409; https://doi.org/10.3390/healthcare10122409 - 30 Nov 2022

Cited by 6 | Viewed by 5205

Abstract

This study of a randomized controlled trial aimed to clarify the effect of functional movement screen (FMS) training on the FMS score and the number of injuries in high-school baseball players. Accordingly, 71 high-school baseball players (age: 15–17 years) were randomized into an [...] Read more.

This study of a randomized controlled trial aimed to clarify the effect of functional movement screen (FMS) training on the FMS score and the number of injuries in high-school baseball players. Accordingly, 71 high-school baseball players (age: 15–17 years) were randomized into an intervention group (n = 37; FMS training 4 times per week for 12 weeks on the ground of each team) or a control group (n = 34; team practice without limits). No significant differences were observed in terms of the participant characteristics of the two groups. The FMS score of the intervention group significantly increased after 12 weeks of training compared with the control group. However, there was no difference between the groups in terms of the FMS score after 24 weeks. Injuries in the intervention group were significantly reduced after 24 weeks. The time lost due to noncontact injuries (12 weeks/follow-up) was 56.5 h/113 h in the intervention group and 33 h/325.5 h in the control group. Injuries were found all over the body. Based on these results, FMS training was proven to reduce injury in high-school baseball players. Although continued training is required to improve FMS scores, the number of injuries decreased after training. Full article

(This article belongs to the Special Issue From Prevention to Recovery in Sports Injury Management)

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12 pages, 300 KB

Open AccessArticle

Prevalence of Glenohumeral Internal Rotation Deficit and Sex Differences in Range of Motion of Adolescent Volleyball Players: A Case-Control Study

by Yasuaki Mizoguchi, Kenta Suzuki, Naoki Shimada, Hiroyuki Naka, Fumihiko Kimura and Kiyokazu Akasaka

Healthcare 2022, 10(11), 2263; https://doi.org/10.3390/healthcare10112263 - 11 Nov 2022

Cited by 7 | Viewed by 4403

Abstract

Shoulder range of motion (ROM) adaptation is common observed among volleyball players, but studies on the shoulder joint function of adolescent athletes are lacking. This study aimed to clarify the prevalence of glenohumeral internal rotation deficit (GIRD) among adolescent players and differences in [...] Read more.

Shoulder range of motion (ROM) adaptation is common observed among volleyball players, but studies on the shoulder joint function of adolescent athletes are lacking. This study aimed to clarify the prevalence of glenohumeral internal rotation deficit (GIRD) among adolescent players and differences in ROM based on sex. A questionnaire survey and ROM measurements of the shoulder joint and trunk using a plastic goniometer were conducted on 123 volleyball players (63 males and 60 females; mean age, 15.8 years). The prevalence of GIRD was investigated for internal rotation differences of >10° and total rotation motion of <5°. Questionnaire items and ROM were compared between GIRD and non-GIRD patients, and sex differences in ROM were also presented. Of the participants, 38.2% (n = 47/123) had GIRD. The GIRD group showed a decrease in external rotation on the dominant side (p = 0.003, 1 − beta = 0.84), but this was not associated with a history of shoulder injury. Sex differences in shoulder ROM showed hypomobility in males and hypermobility in females. However, there was no association between shoulder injury and GIRD among adolescent players. There are sex differences in ROM, which should be considered in future studies. Full article

(This article belongs to the Special Issue From Prevention to Recovery in Sports Injury Management)

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22 pages, 1333 KB

Open AccessSystematic Review

Gait Biomechanical Differences in the Anterior Cruciate Ligament Reconstructed and Contralateral Limb: A Systematic Review with Meta-Analysis

by Heidar Sajedi, Elif Aydın, Mehmet Şirin Güler, Selahattin Akpınar, Ali Esmaeili, AmirAli Jafarnezhadgero and Kate E. Webster

Healthcare 2025, 13(24), 3304; https://doi.org/10.3390/healthcare13243304 - 16 Dec 2025

Viewed by 492

Abstract

Background: In this systematic review with meta-analysis, we aimed to compare the kinematic and kinetic variables of the involved limb with the contralateral limb in individuals who had undergone an anterior cruciate ligament reconstruction (ACLR) recorded during walking from short-term (<6 months) to [...] Read more.

Background: In this systematic review with meta-analysis, we aimed to compare the kinematic and kinetic variables of the involved limb with the contralateral limb in individuals who had undergone an anterior cruciate ligament reconstruction (ACLR) recorded during walking from short-term (<6 months) to mid-term (6–<12 months) and long-term (≥12 months) periods after surgery. Methods: Five electronic databases (Scopus, PubMed, EMBASE, PEDro, CENTRAL) were systematically searched for articles potentially eligible for inclusion from inception until November 2025. Biomechanical gait patterns were assessed short-term (<6 months), mid-term (6–<12 months), and long-term (≥12 months) post-surgery. Gait biomechanics were extracted from the included articles. Comparisons were made between the affected limb and the contralateral limb. Standardized mean differences (SMDs) with 95% confidence intervals (CI) were computed using a random-effects model. Results: The systematic search revealed 3522 hits, and according to a priori defined in-/exclusion criteria, 32 studies with male and female individuals aged 18–55 years involving 1026 participants were included. Meta-analysis indicated that the peak knee flexion angle was significantly lower in the ACLR compared to the contralateral limb (19 studies: small SMDs = −0.39, 95% CI −0.58 to −0.19, p < 0.0001, I² = 66%). More specifically, the peak knee flexion angle was 2.63° (95% CI −3.81 to −1.44) lower in the ACLR compared to the contralateral limb. The analysis of time post-surgery revealed significant differences in the short-term (four studies: large SMDs = −1.14, 95% CI −1.61 to −0.67, p < 0.00001, I² = 56%) and mid-term (five studies: small SMDs = −0.52, 95% CI −0.74 to −0.29, p < 0.0001, I² = 0%) periods after surgery but not for the long-term follow-up (10 studies: small SMDs = −0.10, 95% CI −0.27 to 0.07, p = 0.26, I² = 32%). Meta-analysis indicated that the peak knee flexion moment was significantly lower in the ACLR compared to the contralateral limb (11 studies: small SMDs = −0.37, 95% CI −0.59 to −0.14, p = 0.0001, I² = 46%). A lower peak knee flexion moment was observed in the ACLR limb for both less than 12 months (three studies: moderate SMDs = −0.76, 95% CI −1.44 to −0.07, p = 0.03, I² = 66%) and over 12 months (eight studies: small SMDs = −0.25, 95% CI −0.43 to −0.07, p = 0.01, I² = 46%) after surgery time points compared to the contralateral limb. Conclusion: These findings suggest a time-dependent compensatory mechanism, where protective adaptations (e.g., reduced flexion/extension moments) may initially offload the reconstructed limb, with some asymmetries resolving over time. Clinically, these results underscore the need for rehabilitation strategies tailored to address phase-specific deficits, promoting symmetrical loading and functional recovery. Full article

(This article belongs to the Special Issue From Prevention to Recovery in Sports Injury Management)

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