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Exercise, Injury and Rehabilitation: Integrated Perspectives in Sports Medicine

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A Special Issue of Journal of Clinical Medicine (ISSN 2077-0383) belonging to the section "Sports Medicine".

Deadline for manuscript submissions: 5 April 2027 | Viewed by 16532

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Editors

Dr. Cíntia França

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Guest Editor

1. Department of Physical Education and Sport, University of Madeira, 9020-105 Funchal, Portugal
2. LARSyS, Interactive Technologies Institute, 9020-105 Funchal, Portugal
Interests: youth sports; physical activity; performance; health; wellbeing
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Dr. Élvio Gouveia

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Guest Editor

Department of Physical Education and Sport, University of Madeira, 9020-105 Funchal, Portugal
Interests: sport medicine; sports training; physical activity; physical fitness; assistive technologies
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Special Issue Information

Dear Colleagues,

The dynamic interplay between exercise, injury, and rehabilitation is central to sports medicine and essential for optimizing patient outcomes. Understanding the clinical mechanisms of injury and the most effective rehabilitation strategies is vital for promoting safe physical activity and long-term musculoskeletal health for all, from elite athletes to recreational exercisers.

This Special Issue, titled “Exercise, Injury and Rehabilitation: Integrated Perspectives in Sports Medicine”, invites contributions that explore clinical approaches to injury prevention, diagnostic techniques, therapeutic interventions, and post-injury rehabilitation. Special focus will be placed on multidisciplinary insights at the intersection of technologies, exercise physiology, and biomechanics.

We welcome original research, clinical trials, and reviews that bridge the gap between physical activity, injury risk, and recovery within the broader context of clinical medicine.

Dr. Cíntia França
Dr. Élvio Gouveia
Guest Editors

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

sports medicine
biomechanics
injury prevention
exercise physiology
sports performance
load management
exercise prescription
return to play
recovery

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Published Papers (7 papers)

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Research

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13 pages, 907 KB

Open AccessArticle

Accuracy of the My Jump Lab App for Two Methods of Single-Leg Countermovement Jump Height Assessment

by Jarosław Kabaciński and Michał Murawa

J. Clin. Med. 2026, 15(18), 7052; https://doi.org/10.3390/jcm15187052 - 11 Sep 2026

Abstract

Background/Objectives: The My Jump Lab app can be used to examine inter-limb asymmetry during the countermovement jump (CMJ), both in healthy athletes and in athletes undergoing rehabilitation post-injury. However, the correct assessment of jump height (JH) using this application requires high measurement accuracy, similar to the method of double integration of vertical ground reaction force values. This study aimed to determine the validity and reliability of the My Jump Lab app for estimating jump height (JH) during the single-leg countermovement jump (CMJ). Methods: Twenty-two healthy male adults performed single-leg CMJs for the dominant lower extremity (D) and non-dominant lower extremity (ND). The AMTI force platform and an iPhone 13 smartphone were used. JH during the CMJ was estimated based on the displacement of the jumper’s center of mass (force platform), the jumper’s flight time (smartphone and My Jump Lab), and the flight time of the reflective marker placed on the jumper’s sacrum (smartphone and My Jump Lab-M). Results: The assessment of the concurrent validity showed (1) poor agreement between the My Jump Lab and the force platform for the ND and D (p < 0.001) and (2) moderate (ND) and good (D) agreement between the My Jump Lab-M and the force platform (p < 0.001). Conclusions: The results of the single-leg CMJ height estimation revealed the greater accuracy of the My Jump Lab-M method compared with the My Jump Lab method. However, due to the good agreement between My Jump Lab-M and the gold standard, this new method may not provide an objective assessment of the height in this vertical jump. Therefore, the most accurate method of double integration of vertical ground reaction force values is recommended for the single-leg CMJ test. Full article

(This article belongs to the Special Issue Exercise, Injury and Rehabilitation: Integrated Perspectives in Sports Medicine)

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32 pages, 724 KB

Open AccessArticle

The Effect of the Experimental Training Program ‘Grappler Quest’ on the Motor Fitness of Brazilian Jiu-Jitsu Athletes

by Wojciech Wąsacz, Łukasz Rydzik, Tomasz Pałka, Paweł Ostrowski and Tadeusz Ambroży

J. Clin. Med. 2026, 15(13), 5176; https://doi.org/10.3390/jcm15135176 - 2 Jul 2026

Viewed by 470

Abstract

Background/Objectives: Despite the growing popularity of specialised training interventions aimed at developing motor abilities relevant to combat sports, scientific evidence regarding their effectiveness in Brazilian Jiu-Jitsu (BJJ) remains limited. This study aimed to estimate the effects of the experimental Grappler Quest (GQ) training program on the motor fitness profile of BJJ athletes and to explore whether training experience was associated with the magnitude of training-related changes. Methods: In this randomised trial, 44 competitive male BJJ athletes were allocated to an experimental group (EXP; n = 22) or a control group (CON; n = 22). Both groups followed an 8-week training protocol: the EXP group performed the structured GQ program, consisting of small circuit-based workouts, including resistance, plyometric, gymnastic, and BJJ-related exercises, whereas the CON group followed a standard BJJ training cycle. The motor profile was assessed before and after the intervention (pretest vs. posttest) using selected motor tests. The prespecified primary outcomes were strength-endurance performance in the bench press and squat performed with 50% body mass. Other motor-performance outcomes were treated as secondary or exploratory. Associations between training experience and intervention-related changes were analysed exploratorily. Results: ANCOVA of adjusted post-intervention means indicated between-group differences favouring the EXP group. Large effects were observed for the primary strength-endurance outcomes: bench press at 50% body mass (η² = 0.52) and squat at 50% body mass (η² = 0.40). Large effects were also observed for selected secondary outcomes, including pull-ups with a judogi (η² = 0.39), trunk flexibility (η² = 0.49), and maximal straddle sitting position (η² = 0.37) (all p < 0.001). After Benjamini–Hochberg false discovery rate adjustment, most between-group differences remained statistically significant, although secondary outcomes should be interpreted cautiously. In EXP, improvements were observed across multiple outcomes, including 1RM bench press (mean gain

\tilde{x}

= 5.23 kg), 1RM squat (

\tilde{x}

= 4.27 kg), pull-ups (

\tilde{x}

= 1.91 reps), judo-gi hangs (bent arms

\tilde{x}

= 3.91 s; straight arms

\tilde{x}

= 4.90 s), and flamingo balance (

\tilde{x}

= 4.59 s) (all p < 0.001). In the EXP group, exploratory correlations suggested that shorter training experience was generally associated with greater conditioning-related improvements, whereas flexibility and balance showed the opposite pattern. Conclusions: The GQ intervention package was associated with greater improvements in the motor fitness profile than standard BJJ training. The findings support the potential usefulness of structured circuit-based conditioning as an adjunct to standard BJJ practice, particularly for strength-endurance development. However, the study does not allow the isolated effect of the specific GQ exercise content to be separated from the effect of adding a structured conditioning block, and no direct conclusions can be drawn regarding injury prevention or return-to-play outcomes. Full article

(This article belongs to the Special Issue Exercise, Injury and Rehabilitation: Integrated Perspectives in Sports Medicine)

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29 pages, 3432 KB

Open AccessArticle

Effects of Repeated Contrast Therapy on Forearm Microcirculatory and Neuromechanical Recovery After Climbing-Specific Fatigue in Amateur Climbers: A Randomized Controlled Trial

by Magdalena Hagner-Derengowska, Bartłomiej Kacprzak, Anna Michalska, Agnieszka Połaniecka, Carla Gonçalves and Robert Trybulski

J. Clin. Med. 2026, 15(13), 4970; https://doi.org/10.3390/jcm15134970 - 25 Jun 2026

Viewed by 406

Abstract

Objective: To determine whether contrast therapy improves recovery after climbing-specific forearm fatigue in amateur climbers. Methods: In a randomized repeated-measures trial, 40 climbers were allocated to passive recovery (n = 20) or Game Ready contrast therapy (n = 20). Both groups completed a fixed-task intermittent fingerboard protocol on a 20 mm edge using a half-crimp grip, with 7 s of work and 3 s of rest for five sets; the load was not individualized to climbing-specific maximal finger-flexor force. The intervention group received bilateral forearm treatment consisting of alternating 1 min cold (3 °C) and heat (45 °C) phases combined with pneumatic compression ranging from 15 to 75 mmHg. Sessions lasted 20 min and were administered immediately after post-fatigue testing, at 24 h and 48 h, and then three times weekly on alternate days for 8 weeks, for a total of 27 sessions. Outcomes were assessed at baseline, immediately after fatigue, at 24 h and 48 h, and after 8 weeks. Outcomes included perfusion, reactive hyperemia, stiffness, pressure pain threshold, grip strength, perceived recovery, creatine kinase, and interleukin-6. Results: Immediate post-fatigue responses were comparable. Contrast therapy produced greater 24 h and 48 h resting perfusion responses (+7.28 percentage points, 95% CI 6.58 to 7.98; +7.62, 95% CI 6.94 to 8.31; both adjusted p < 0.001). At week 8, peak hyperemic perfusion improved more with contrast therapy (+6.21 PU, 95% CI 5.62 to 6.79; p < 0.001). Recovery favored contrast therapy for stiffness at 48 h (−71.7 N/m, 95% CI −75.6 to −67.8), pressure pain threshold at week 8 (+8.1 N/cm², 95% CI 7.3 to 8.8), and grip strength at 48 h (+7.8 kgf, 95% CI 7.3 to 8.3; all p < 0.001). CK and IL-6 differences were transient, and no serious adverse events or intervention-related discontinuations were recorded. Conclusions: Contrast therapy was associated with more favorable cutaneous perfusion, post-occlusive reactive hyperemia-derived, and neuromechanical recovery outcomes, whereas biochemical differences were limited and time-dependent. The vascular findings do not establish improved endothelial function or nitric-oxide-mediated vasodilation because these mechanisms were not directly assessed. Trial registration: ISRCTN49499065 on 23 June 2025. Full article

(This article belongs to the Special Issue Exercise, Injury and Rehabilitation: Integrated Perspectives in Sports Medicine)

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19 pages, 1686 KB

Open AccessArticle

Effect of Otago Exercise Program Combined with Neuromuscular Electrical Stimulation on Chronic Ankle Instability in Older Adults: A Pilot Randomized Controlled Trial

by Yunong Zhang, Min-Chul Shin, Ye Tao, Kexiang Yang and Shuting Liu

J. Clin. Med. 2026, 15(5), 1968; https://doi.org/10.3390/jcm15051968 - 4 Mar 2026

Cited by 1 | Viewed by 819

Abstract

Background: Chronic ankle instability (CAI) is a common functional disorder in older adults, affecting their balance and quality of life. Therefore, finding effective ways to enhance ankle stability and function under safe conditions remains a key issue for healthy aging. Objective: This study aims to explore the effects of the Otago Exercise Program (OEP) combined with Neuromuscular Electrical Stimulation (NMES) on ankle stability, the pain index, and balance ability in older adults aged 60 and above with CAI. Methods: This study is a single-blind pilot randomized controlled trial, including 36 eligible older adults with CAI, with 34 completing the trial. Participants were randomly assigned to the OEP group, the combined group (OEP + NMES), and the control group. The intervention period lasted 8 weeks. Evaluation measures included the Cumberland Ankle Instability Tool (CAIT), Visual Analog Scale (VAS), Eyes-closed Single-Leg Stance Test (UST), and the Modified Star Excursion Balance Test (mSEBT), with assessments conducted before the intervention, at week 4, and at week 8. Result: After the intervention, all three groups showed significant improvements in CAIT, VAS, UST, and mSEBT scores (p < 0.05), with a large group × time effect observed for the primary outcome CAIT (partial η² = 0.414). The combined group (OEP + NMES) demonstrated the most significant improvement in CAIT and UST scores (p < 0.05) and outperformed the other two groups in dynamic balance in the posteromedial and posterolateral directions. Conclusions: The combined intervention of OEP and NMES significantly improves ankle stability, both static and dynamic balance abilities, and alleviates pain in older adults with CAI. This combined approach offers a safe and effective rehabilitation strategy for the older adults, with promising clinical application prospects. Full article

(This article belongs to the Special Issue Exercise, Injury and Rehabilitation: Integrated Perspectives in Sports Medicine)

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17 pages, 329 KB

Open AccessArticle

Machine Learning-Based Prediction of Muscle Injury Risk in Professional Football: A Four-Year Longitudinal Study

by Francisco Martins, Hugo Sarmento, Élvio Rúbio Gouveia, Paulo Saveca and Krzysztof Przednowek

J. Clin. Med. 2025, 14(22), 8039; https://doi.org/10.3390/jcm14228039 - 13 Nov 2025

Cited by 6 | Viewed by 5291

Abstract

Background: Professional football requires more attention in planning work regimens that balance players’ sports performance optimization and reduce their injury probability. Machine learning applied to sports science has focused on predicting these events and identifying their risk factors. Our study aims to (i) analyze the differences between injury incidence during training and matches and (ii) build and classify different predictive models of risk based on players’ internal and external loads across four sports seasons. Methods: This investigation involved 96 male football players (26.2 ± 4.2 years; 181.1 ± 6.1 cm; 74.5 ± 7.1 kg) representing a single professional football club across four analyzed seasons. The research was designed according to three methodological sets of assessments: (i) average season performance, (ii) two weeks’ performance before the event, and (iii) four weeks’ performance before the event. We applied machine learning classification methods to build and classify different predictive injury risk models for each dataset. The dependent variable is categorical, representing the occurrence of a time-loss muscle injury (N = 97). The independent variables include players’ information and external (GPS-derived) and internal (RPE) workload variables. Results: The Kstar classifier with the four-week window dataset achieved the best predictive performance, presenting an Area Under the Precision–Recall Curve (AUC-PR) of 83% and a balanced accuracy of 72%. Conclusions: In practical terms, this methodology provides technical staff with more reliable data to inform modifications to playing and training regimens. Future research should focus on understanding the technical staff’s qualitative vision of predictive models’ in-field applicability. Full article

(This article belongs to the Special Issue Exercise, Injury and Rehabilitation: Integrated Perspectives in Sports Medicine)

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31 pages, 12410 KB

Open AccessSystematic Review

The Effect of Graft Type on Vertical Jump Performance After Anterior Cruciate Ligament Reconstruction: A Systematic Review

by Krzysztof Kasicki, Grzegorz Błażejewski, Łukasz Rydzik, Piotr Wróbel, Monika Nowak and Tadeusz Ambroży

J. Clin. Med. 2026, 15(17), 6588; https://doi.org/10.3390/jcm15176588 - 26 Aug 2026

Viewed by 244

Abstract

Background: Anterior cruciate ligament reconstruction (ACLR) is the standard of care for ACL injuries, and graft choice may influence the recovery of function assessed with vertical jump tests. Objective: To evaluate the effect of graft type on vertical jump performance in adults after ACLR and to synthesise the differences between grafts. Material and Methods: This systematic review was conducted in accordance with the PRISMA 2020 and SWiM guidelines. The following databases were searched: Scopus, Web of Science, PubMed, MEDLINE and SPORTDiscus (EBSCOhost), up to 31 January 2026. Studies with an unambiguously defined graft type and objective jump tests (CMJ, SL CMJ/SL VJ, DVJ/DJ, SJ) were included. Risk of bias was assessed using the RoB 2, ROBINS-I, JBI and MINORS tools, and the certainty of evidence using the GRADE approach. Because of substantial clinical and methodological heterogeneity, a structured narrative synthesis was performed in accordance with the SWiM guidelines; no pooled analysis was undertaken. Results: Forty-seven studies (>3400 participants) were included. BPTB was associated with greater eccentric-phase asymmetry in the bilateral CMJ in the early/intermediate phase compared with HT, with equalisation after 9–12 months. QT provided jump height comparable to HT but a more favourable dynamic valgus profile. Autograft and allograft did not differ in jump performance. Deficits followed a biphasic course: normalisation of symmetry after approximately 2 years, with reduced height/power for up to 5 years. Conclusions: Forty-two of the studies (89.4%) were non-randomised, and the certainty of evidence was low for one clinical question and very low for all others. Studies comparing BPTB with HT showed an association suggesting greater eccentric-phase asymmetry in the bilateral CMJ in the early and intermediate phase after BPTB, but findings were inconsistent and two studies reported no difference. Evidence suggesting that these differences equalise after 9–12 months derives from between-study comparisons. Jump height did not differ between QT and HT; a single study of 26 patients reported smaller dynamic valgus after QT. Autograft and allograft did not differ in vertical jump performance. Registration: This review was registered in the PROSPERO database and is available under the number CRD420261386307. Full article

(This article belongs to the Special Issue Exercise, Injury and Rehabilitation: Integrated Perspectives in Sports Medicine)

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16 pages, 595 KB

Open AccessSystematic Review

Effects of Barefoot and Minimalist Footwear Strength-Oriented Training on Foot Structure and Function in Athletic Populations: A Systematic Review

by Celia Rodríguez-Longobardo, Miguel Ángel Gómez-Ruano and Lorena Canosa-Carro

J. Clin. Med. 2025, 14(21), 7629; https://doi.org/10.3390/jcm14217629 - 28 Oct 2025

Cited by 2 | Viewed by 8106

Abstract

Background/Objectives: The popularity of barefoot and minimalist footwear training has increased in recent years, yet its impact on foot strength, morphology, and functional outcomes remains unclear, particularly in strength-training contexts beyond running-focused studies. Although some biomechanical and anecdotal evidence exists, no systematic review has specifically addressed the effects of foot-specific strength training interventions performed barefoot or with minimalist footwear. This review aimed to evaluate the effects of barefoot and minimalist footwear strength training interventions on foot muscle structure, force production, and neuromuscular function in healthy and athletic adults. Methods: A systematic review was conducted in accordance with the PRISMA and PICOS guidelines (PROSPERO number CRD420251134329). Comprehensive database searches were performed in July 2025. Eligible studies included barefoot or minimalist strength interventions in healthy and sportive adults, assessing outcomes related to foot muscle morphology, strength, functional performance, or neuromuscular adaptations. Methodological quality was evaluated using the PEDro and MINORS scales. Results: Seven studies involving 213 participants met the inclusion criteria. Most interventions led to significant improvements in intrinsic and extrinsic foot muscle volume, medial arch function, toe flexor strength, and neuromuscular control. Adaptations were particularly evident in interventions combining strength, balance, and agility exercises over multiple weeks. However, heterogeneity in protocols and outcome measures limited comparability. Some studies reported morphological gains without proportional improvements in strength or function. Conclusions: Barefoot and minimalist strength training can elicit beneficial morphological and functional adaptations in the foot. Nevertheless, inconsistencies in study design, small sample sizes, absence of follow-up assessment and lack of standardized protocols highlight the need for high-quality research to guide training recommendations beyond running-focused populations. Full article

(This article belongs to the Special Issue Exercise, Injury and Rehabilitation: Integrated Perspectives in Sports Medicine)

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