Special Issue "Physical Activity, Exercise Testing and Clinical Assessment in Sports Medicine"

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Sports Medicine".

Deadline for manuscript submissions: 31 May 2022 | Viewed by 15300

Special Issue Editor

Dr. David Rodríguez-Sanz
E-Mail
Guest Editor
Faculty of Nursing, Podiatry and Physical Therapy, Universidad Complutense de Madrid, Madrid, Spain
Interests: sports; injuries; muscle; tendon; foot
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Special Issue Information

Dear Colleagues,

Physical activity and exercise testing are two key points in sports medicine. Sports medicine is a field of medicine concerned with the prevention and treatment of injuries and disorders that are related to participation in sports. Clinical assessment in sports medicine can solve so many questions about diagnosis, treatment, and prognosis about health in sports.

Physical activity could be defined as any bodily movement produced by skeletal muscles that requires energy expenditure. Physical activity refers to all movement including during leisure time, for transport to get to and from places, or as part of a person’s work. Both moderate- and vigorous-intensity physical activity improve health. Regular physical activity is proven to help prevent and manage noncommunicable diseases such as heart disease, stroke, diabetes, and several cancers. It also helps prevent hypertension, maintain healthy body weight, and can improve mental health, quality of life, and well-being. Exercise could be defined a subset of physical activity that is planned, structured, and repetitive and has as a final or an intermediate objective the improvement or maintenance of physical fitness. Gait and posture analysis, clinical assessment, biomechanical analysis, reliability and repeatability research, force platform and electromyography analysis are key points in order to achieve a better knowledge in this area.

This Special Issue promotes new research procedures about physical activity, exercise testing, and clinical assessment in sports medicine in order to achieve the right health interventions in sport.

Dr. David Rodríguez-Sanz
Guest Editor

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Keywords

  • Physical activity
  • Exercise
  • Clinical assessment
  • Biomechanics
  • Sports

Published Papers (18 papers)

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Article
Cardiopulmonary Exercise Testing and Cardiac Biomarker Measurements in Young Football Players: A Pilot Study
J. Clin. Med. 2022, 11(10), 2772; https://doi.org/10.3390/jcm11102772 - 14 May 2022
Viewed by 249
Abstract
Constant and intense physical activity causes physiological adaptive changes in the human body, but it can also become a trigger for adverse events, such as sudden cardiac arrest or sudden cardiac death. Our main objective was to assess the use of combined cardiopulmonary [...] Read more.
Constant and intense physical activity causes physiological adaptive changes in the human body, but it can also become a trigger for adverse events, such as sudden cardiac arrest or sudden cardiac death. Our main objective was to assess the use of combined cardiopulmonary exercise testing (CPET) and cardiac biomarker determinants in young professional athletes. We conducted a study which involved the full examination of 19 football players, all male, aged between 18 and 20 years old. They underwent standard clinical and paraclinical evaluation, a 12-lead electrocardiogram (ECG), and transthoracic echocardiography (TTE). Afterwards, a tailored CPET was performed and peripheral venous blood samples were taken before and 3 h after the test in order to determine five biomarker levels at rest and post-effort. The measured biomarkers were cardiac troponin I (cTnI), myoglobin (Myo), the MB isoenzyme of creatine-kinase (CK-MB), the N-terminal prohormone of brain natriuretic peptide (NT-proBNP) and D-dimers. While cTnI and NT-proBNP levels were undetectable both at rest and post-effort in all subjects, the variations in Myo, CK-MB and D-dimers showed significant correlations with CPET parameters. This highlights the potential use of combined CPET and biomarker determinants to evaluate professional athletes, and encourages further research on larger study groups. Full article
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Article
Acute Effects of Sedentary Behavior on Ankle Torque Assessed with a Custom-Made Electronic Dynamometer
J. Clin. Med. 2022, 11(9), 2474; https://doi.org/10.3390/jcm11092474 - 28 Apr 2022
Viewed by 271
Abstract
Inactivity negatively influences general health, and sedentary behaviour is known to impact the musculoskeletal system. The aim of the study was to assess the impact of time spent in active and sedentary behaviour on foot muscle strength. In this observational study, we compared [...] Read more.
Inactivity negatively influences general health, and sedentary behaviour is known to impact the musculoskeletal system. The aim of the study was to assess the impact of time spent in active and sedentary behaviour on foot muscle strength. In this observational study, we compared the acute effects of one day of prolonged sitting and one day of low-to-moderate level of activity on ankle torque in one group of eight healthy participants. Peak ankle torque was measured using a portable custom-made electronic dynamometer. Three consecutive maximal voluntary isometric contractions for bilateral plantar flexor and dorsiflexor muscles were captured at different moments in time. The average peak torque significant statistically decreased at 6 h (p = 0.019) in both static and active behaviours, with a higher average peak torque in the active behaviour (p < 0.001). Age, gender, body mass index and average steps did not have any significant influence on the average value of maximal voluntary isometric contraction. The more time participants maintained either static or active behaviour, the less force was observed during ankle torque testation. The static behaviour represented by the sitting position was associated with a higher reduction in the average peak ankle torque during a maximal voluntary isometric contraction when compared to the active behaviour. Full article
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Article
Dynamic Ultrasound Assessment of the Anterior Tibial Translation for Anterior Cruciate Ligament Tears Diagnostic
J. Clin. Med. 2022, 11(8), 2152; https://doi.org/10.3390/jcm11082152 - 12 Apr 2022
Viewed by 295
Abstract
The aim of our study was to investigate the accuracy of dynamic ultrasound assessment of the anterior tibial translation, in diagnosing anterior cruciate ligament tears, and to assess its test–retest reliability. Twenty-three patients (32 ± 8.42 years; 69.56% males) with a history of [...] Read more.
The aim of our study was to investigate the accuracy of dynamic ultrasound assessment of the anterior tibial translation, in diagnosing anterior cruciate ligament tears, and to assess its test–retest reliability. Twenty-three patients (32 ± 8.42 years; 69.56% males) with a history of knee trauma and knee instability participated in the study. Knee ultrasound was performed by an experienced orthopedic surgeon. The anterior tibial translation was measured in both knees and differences between the injured and uninjured knee were calculated. Side-to-side differences > 1 mm were considered a positive diagnosis of an ACL tear. The anterior tibial translation values were 3.34 ± 1.48 mm in injured knees and 0.86 ± 0.78 mm in uninjured knees. Side-to-side differences > 1 mm were found in 22 cases (95.65%). The diagnosis accuracy was 91.30% (95%CI: 71.96–98.92%) and sensitivity 95.45% (95%CI: 77.15–99.88%). The intraclass correlation coefficient showed an excellent test–retest reliability (ICC3,1 = 0.97 for the side-to-side difference in anterior tibial translation). The study highlights the accuracy and reliability of the dynamic ultrasound assessment of the anterior tibial translation in the diagnosis of unilateral anterior cruciate ligament tears. Ultrasound assessment is an accessible imaging tool that can provide valuable information and should be used together with physical examination in suspected cases of ACL injuries. Full article
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Article
Blood Pressure and Heart Rate Responses to an Isokinetic Testing Protocol in Professional Soccer Players
J. Clin. Med. 2022, 11(6), 1539; https://doi.org/10.3390/jcm11061539 - 11 Mar 2022
Viewed by 371
Abstract
The aim of this study was to determine blood pressure (BP) and heart rate (HR) responses triggered during an isokinetic testing protocol in professional soccer players and compare cardiovascular parameters at completion of this isokinetic protocol with those during a treadmill test. Using [...] Read more.
The aim of this study was to determine blood pressure (BP) and heart rate (HR) responses triggered during an isokinetic testing protocol in professional soccer players and compare cardiovascular parameters at completion of this isokinetic protocol with those during a treadmill test. Using purposive sampling, 63 professional soccer players were recruited. Cardiovascular responses were measured noninvasively during a bilateral testing protocol of knee flexion and extension. Treadmill ergospirometry following an incremental speed protocol was performed to analyze the same cardiovascular parameters at rest and at completion of this test. There were significant differences in diastolic blood pressure (DBP) and HR according to field position. The parameters presented high homogeneity at both competitive levels. Systolic blood pressure, mean arterial pressure, HR, and rate pressure product at completion of the treadmill test were significantly higher than those at completion of the isokinetic protocol. Intermittent isokinetic testing protocol of the knee triggers normal and safe BP and HR responses in healthy professional soccer players. The HR of the defenders was higher than those of the forwards and midfielders but was independent of the competitive level. The values of cardiovascular parameters at isokinetic protocol completion were lower than those during the treadmill test. Full article
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Article
Mechanical Hyperalgesia but Not Forward Shoulder Posture Is Associated with Shoulder Pain in Volleyball Players: A Cross-Sectional Study
J. Clin. Med. 2022, 11(6), 1472; https://doi.org/10.3390/jcm11061472 - 08 Mar 2022
Viewed by 361
Abstract
Shoulder antepulsion, altered scapular kinematics and imbalance of muscle activity are commonly associated with shoulder pain. This study aimed to observe if there is an association between the forward shoulder angle (FSA) and the pectoralis minor length index (PMI) in volleyball players with [...] Read more.
Shoulder antepulsion, altered scapular kinematics and imbalance of muscle activity are commonly associated with shoulder pain. This study aimed to observe if there is an association between the forward shoulder angle (FSA) and the pectoralis minor length index (PMI) in volleyball players with and without shoulder pain. Furthermore, this study observed if there is an association between shoulder posture and upper limb mechanical hyperalgesia in volleyball players with and without shoulder pain. Methods: a cross-sectional study was conducted in the Physiotherapy and Pain Research Center in Alcalá de Henares (Spain). A total of 56 volleyball players met the inclusion criteria and agreed to enter the study. Subjects were divided into two groups: shoulder pain group (SPG) and control group (without pain). The following measurements of the dominant sides of the players were collected: FSA, PMI, and pressure pain threshold (PPT) in serratus anterior, lower trapezius, infraspinatus, teres minor, upper trapezius, levator scapulae, pectoralis major, radial nerve, cubital nerve, and median nerve. Results: The Spearman’s Rho revealed no significant correlations were found between FSA and PMI. Moreover, Spearman’s Rho test revealed in the SPG a negative moderate correlation between FSA and Infraspinatus-PPT (Rho = −0.43; p = 0.02); FSA and levator scapulae-PPT (Rho = −0.55; p < 0.01); FSA and pectoralis major-PPT (Rho = −0.41; p = 0.02); PMI and cubital nerve-PPT (Rho = −0.44; p = 0.01). Conclusions: No association was found between the forward shoulder angle and the pectoralis minor index in volleyball players with and without shoulder pain. There is a moderate negative association between shoulder forward angle and muscle mechanical hyperalgesia in volleyball players with shoulder pain, but no such associations were found in volleyball players without shoulder pain. Treatment of the infraspinatus, levator scapulae, pectoralis major, and pectoralis minor muscles could improve shoulder pain and ulnar nerve mechanosensitivity. Full article
Article
Anatomical and Neuromuscular Factors Associated to Non-Contact Anterior Cruciate Ligament Injury
J. Clin. Med. 2022, 11(5), 1402; https://doi.org/10.3390/jcm11051402 - 03 Mar 2022
Viewed by 684
Abstract
The majority of anterior cruciate ligament (ACL) injuries occur during non-contact mechanisms. Knowledge of the risk factors would be relevant to help prevent athletes’ injuries. We aimed to study risk factors associated with non-contact ACL injuries in a population of athletes after ACL [...] Read more.
The majority of anterior cruciate ligament (ACL) injuries occur during non-contact mechanisms. Knowledge of the risk factors would be relevant to help prevent athletes’ injuries. We aimed to study risk factors associated with non-contact ACL injuries in a population of athletes after ACL reconstruction. From a cohort of 307 athletes, two populations were compared according to the non-contact or contact mechanism of ACL injury. Gender, age and body mass index (BMI) were reported. Passive knee alignment (valgus and extension), knee laxity (KT-1000 test), and isokinetic knee strength were measured on the non-injured limb. The relationship between these factors and the non-contact sport mechanism was established with models using logistic regression analysis for the population and after selection of gender and cut-offs of age, BMI and knee laxity calculated from Receiver Operating Characteristics curve area and Youden index. Age, BMI, antero-posterior laxity, isokinetic knee strength, passive knee valgus and passive knee extension were associated with non-contact ACL injury. According to the multivariate model, a non-contact ACL injury was associated with non-modifiable factors, age (OR: 1.05; p = 0.001), passive knee extension (OR: 1.14; p = 0.001), and with one modifiable factor (Hamstring strength: OR: 0.27; p = 0.01). For women, only passive knee valgus was reported (OR: 1.27; p = 0.01). Age, passive knee extension and weak Hamstring strength were associated with a non-contact ACL injury. Hamstring strengthening could be proposed to prevent ACL injury in young male athletes or in case of knee laxity. Full article
Article
Postural Stability in Single-Leg Quiet Stance in Highly Trained Athletes: Sex and Sport Differences
J. Clin. Med. 2022, 11(4), 1009; https://doi.org/10.3390/jcm11041009 - 15 Feb 2022
Viewed by 344
Abstract
This study aimed to determine if there is a difference in postural stability in highly trained adolescents and young adult athletes regarding sex and sport. The participants were young athletes (n = 464) from seven different sports. We considered the center of [...] Read more.
This study aimed to determine if there is a difference in postural stability in highly trained adolescents and young adult athletes regarding sex and sport. The participants were young athletes (n = 464) from seven different sports. We considered the center of pressure (CoP) velocity (total, anterior–posterior (AP) and medial–lateral (ML)), CoP amplitude (AP and ML), and CoP frequency (AP and ML), as assessed by single-leg quiet stance test. Significant interactions were found between sex and sport for all CoP variables (p < 0.02). Additionally, a significant main effect of sport was also found in all CoP variables (p = 0.01). Regarding sex, significant effects were found for all CoP amplitude variables (p = 0.01), as well as for CoP velocity variables, except for CoP ML (p = 0.06). Moreover, there was no sex effect for CoP frequency AP (p = 0.18). The results of the current study confirm the claim that the criteria for optimal postural strategies for elite athletes likely depend on a given sport. Full article
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Article
Blood Biomarkers Variations across the Pre-Season and Interactions with Training Load: A Study in Professional Soccer Players
J. Clin. Med. 2021, 10(23), 5576; https://doi.org/10.3390/jcm10235576 - 27 Nov 2021
Cited by 1 | Viewed by 702
Abstract
Background: Pre-season training in soccer can induce changes in biological markers in the circulation. However, relationships between chosen hematological and biochemical blood parameters and training load have not been measured. Objective: Analyze the blood measures changes and their relationships with training loads changes [...] Read more.
Background: Pre-season training in soccer can induce changes in biological markers in the circulation. However, relationships between chosen hematological and biochemical blood parameters and training load have not been measured. Objective: Analyze the blood measures changes and their relationships with training loads changes after pre-season training. Methodology: Twenty-five professional soccer players were assessed by training load measures (derived from rate of perceived exertion- known as RPE) during the pre-season period. Additionally, blood samples were collected for hematological and biochemical analyses. Results: For hematological parameters, significant increases were found for platelets (PLT) (dif: 6.42; p = 0.006; d = −0.36), while significant decreases were found for absolute neutrophils count (ANC) (dif: −3.98; p = 0.006; d = 0.11), and absolute monocytes count (AMC) (dif: −16.98; p = 0.001; d = 0.78) after the pre-season period. For biochemical parameters, there were significant increases in creatinine (dif: 5.15; p = 0.001; d = −0.46), alkaline phosphatase (ALP) (dif: 12.55; p = 0.001; d = −0.84), C-reactive protein (CRP) (dif: 15.15; p = 0.001; d = −0.67), cortisol (dif: 2.85; p = 0.001; d = −0.28), and testosterone (dif: 5.38; p = 0.001; d = −0.52), whereas there were significant decreases in calcium (dif: −1.31; p = 0.007; d =0.49) and calcium corrected (dif: −2.18; p = 0.015; d = 0.82) after the pre-season period. Moreover, the Hooper Index (dif: 13.22; p = 0.01; d = 0.78), and all derived RPE measures increased after pre-season period. Moderate-to-very large positive and negative correlations (r range: 0.50–0.73) were found between the training load and hematological measures percentage of changes. Moderate-to-large positive and negative correlations (r range: 0.50–0.60) were found between training load and biochemical measures percentage of changes. Conclusions: The results indicated heavy physical loads during the pre-season, leading to a decrease in immune functions. Given the significant relationships between blood and training load measures, monitoring hematological and biochemical measures allow coaches to minimize injury risk, overreaching, and overtraining. Full article
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Article
Effects of Acute Psychological and Physiological Stress on Rock Climbers
J. Clin. Med. 2021, 10(21), 5013; https://doi.org/10.3390/jcm10215013 - 28 Oct 2021
Viewed by 580
Abstract
Background: The aim of this study was to assess the effects that psychological and physiological stressors have on indoor rock climbers, as well as to identify sex differences. Methods: 14 intermediate rock climbers participated in the study, 10 males and 4 females. Mean [...] Read more.
Background: The aim of this study was to assess the effects that psychological and physiological stressors have on indoor rock climbers, as well as to identify sex differences. Methods: 14 intermediate rock climbers participated in the study, 10 males and 4 females. Mean age was 31 ± 8 years for males and 21 ± 2 years for females. Day 1 consisted of test familiarization and baseline measurements. Day 2 included two test conditions, startle and fatigue, separated by 20 min. In the startle condition, participants had to lead climb a route, and a loud audio stimulus was presented near the top of the climb. In the fatigue condition, participants were required to climb as fast as they could until muscular failure. The competitive state anxiety inventory second review (CSAI-2R) questionnaire was used to assess somatic anxiety, cognitive anxiety, and self-confidence. The four-square step test (FSST) was used to assess motor control, and cortisol levels were acquired via passive drool (PD). Results: Cortisol concentrations were highest in the pre-startle condition (1.72 μg/dL ± 0.66), and values decreased post-startle (1.67 μg/dL ± 0.74) and post-fatigue (1.42 μg/dL ± 0.72). However, cortisol concentrations increased post-startle in females (1.57 μg/dL ± 0.96). Somatic anxiety in males was significantly higher post-startle (16.36 ± 5.54) than pre-startle (14.23 ± 5.09). Females had significantly higher somatic anxiety post-startle (18.00 ± 8.76), and they had lower self-confidence levels (30.00 ± 5.89) than males. Conclusions: There are differences in the way that males and females prepare and respond to stressful situations. Furthermore, time of day may have had a significant impact on cortisol concentrations. Full article
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Article
The Effect of Submaximal Exercise Followed by Short-Term Cold-Water Immersion on the Inflammatory State in Healthy Recreational Athletes: A Cross-Over Study
J. Clin. Med. 2021, 10(18), 4239; https://doi.org/10.3390/jcm10184239 - 18 Sep 2021
Viewed by 904
Abstract
Cold-water immersion (CWI) after exercise is a method used by sportsmen to improve recovery. The aim of the study was to assess the effect of a 3 min CWI on the inflammatory state by measuring levels of interleukin 6 (IL-6), interleukin 10 (IL-10), [...] Read more.
Cold-water immersion (CWI) after exercise is a method used by sportsmen to improve recovery. The aim of the study was to assess the effect of a 3 min CWI on the inflammatory state by measuring levels of interleukin 6 (IL-6), interleukin 10 (IL-10), tumor necrosis factor α (TNF-α), and transforming growth factor β1 (TGF-β1), and activities of α1-antitrypsin (AAT) and lysosomal enzymes, including arylsulfatase (ASA), acid phosphatase (AcP), and cathepsin D (CTS D), in the blood of healthy recreational athletes. Male volunteers (n = 22, age 25 ± 4.8 yr) performed a 30 min submaximal aerobic exercise, followed by a 20 min rest at room temperature (RT-REST) or a 20 min rest at room temperature with an initial 3 min 8 °C water bath (CWI-REST). Blood samples were taken at baseline, immediately after exercise, and after 20 min of recovery. The IL-6, IL-10, and TNF-α levels and the AAT activity increased significantly immediately after exercise. The IL-6 level was significantly higher after CWI-REST than after RT-REST. No changes in the activities of the lysosomal enzymes were observed. The effect of a 3 min CWI on the level of inflammatory markers during post-exercise recovery was limited. Thus, it might be considered as a widely available method of regeneration for recreational athletes. Full article
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Article
Composite Score of Readiness (CSR) as Holistic Profiling of Functional Deficits in Footballers Following ACL Reconstruction
J. Clin. Med. 2021, 10(16), 3570; https://doi.org/10.3390/jcm10163570 - 13 Aug 2021
Cited by 1 | Viewed by 989
Abstract
Background: The decision to return to sport (RTS) after anterior cruciate ligament (ACL) reconstruction is difficult; thus, coaching staff require a readable, easy-to-use, and holistic indication of an athlete’s readiness to play. Purpose: To present the Composite Score of Readiness (CSR) as a [...] Read more.
Background: The decision to return to sport (RTS) after anterior cruciate ligament (ACL) reconstruction is difficult; thus, coaching staff require a readable, easy-to-use, and holistic indication of an athlete’s readiness to play. Purpose: To present the Composite Score of Readiness (CSR) as a method providing a single score for RTS tests after ACL reconstruction. Methods: The study comprised 65 male football players (age 18–25 years), divided into three groups: ACL group—subjects after ACL rupture and reconstruction, Mild Injury (MI) group—subjects after mild lower limb injuries, and Control (C) group—subjects without injuries. The CSR was calculated based on three performed tests (Y-balance test, Functional Movement Screen, and Tuck Jump Assessment) and expressed as the sum of z-scores. The CSR index allows highlighting an athlete’s functional deficits across tests relative to the evaluated group. Results: The CSR indicated that relative to the group of athletes under the study, similar functional deficits were present. Comparing athletes following ACL reconstruction to both the MI and C groups, in the majority of subjects, the CSR index was below zero. The correlation between CSR and raw tests results indicated that the CSR is most strongly determined by YBT. Conclusion: The CSR is a simple way to differentiate people after serious injuries (with large functional deficits) from people without injuries or with only small deficits. Because the CSR is a single number, it allows us to more easily interpret the value of functional deficits in athletes, compared to rating those deficits based on raw tests results. Full article
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Article
Impact of a Breathing Intervention on Engagement of Abdominal, Thoracic, and Subclavian Musculature during Exercise, a Randomized Trial
J. Clin. Med. 2021, 10(16), 3514; https://doi.org/10.3390/jcm10163514 - 10 Aug 2021
Cited by 3 | Viewed by 1250
Abstract
Background: Breathing technique may influence endurance exercise performance by reducing overall breathing work and delaying respiratory muscle fatigue. We investigated whether a two-month yoga-based breathing intervention could affect breathing characteristics during exercise. Methods: Forty-six endurance runners (age = 16.6 ± 1.2 years) were [...] Read more.
Background: Breathing technique may influence endurance exercise performance by reducing overall breathing work and delaying respiratory muscle fatigue. We investigated whether a two-month yoga-based breathing intervention could affect breathing characteristics during exercise. Methods: Forty-six endurance runners (age = 16.6 ± 1.2 years) were randomized to either a breathing intervention or control group. The contribution of abdominal, thoracic, and subclavian musculature to respiration and ventilation parameters during three different intensities on a cycle ergometer was assessed pre- and post-intervention. Results: Post-intervention, abdominal, thoracic, and subclavian ventilatory contributions were altered at 2 W·kg−1 (27:23:50 to 31:28:41), 3 W·kg−1 (26:22:52 to 28:31:41), and 4 W·kg−1 (24:24:52 to 27:30:43), whereas minimal changes were observed in the control group. More specifically, a significant (p < 0.05) increase in abdominal contribution was observed at rest and during low intensity work (i.e., 2 and 3 W·kg−1), and a decrease in respiratory rate and increase of tidal volume were observed in the experimental group. Conclusions: These data highlight an increased reliance on more efficient abdominal and thoracic musculature, and less recruitment of subclavian musculature, in young endurance athletes during exercise following a two-month yoga-based breathing intervention. More efficient ventilatory muscular recruitment may benefit endurance performance by reducing energy demand and thus optimize energy requirements for mechanical work. Full article
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Article
Risk Factors for Non-Contact Lower-Limb Injury: A Retrospective Survey in Pediatric-Age Athletes
J. Clin. Med. 2021, 10(14), 3171; https://doi.org/10.3390/jcm10143171 - 19 Jul 2021
Cited by 1 | Viewed by 606
Abstract
Background: Risk factors for non-contact lower-limb injury in pediatric-age athletes and the effects of lateral dominance in sport (laterally vs. non-laterally dominant sports) on injury have not been investigated. Purpose: To identify risk factors for non-contact lower-limb injury in pediatric-age athletes. Methods: Parents [...] Read more.
Background: Risk factors for non-contact lower-limb injury in pediatric-age athletes and the effects of lateral dominance in sport (laterally vs. non-laterally dominant sports) on injury have not been investigated. Purpose: To identify risk factors for non-contact lower-limb injury in pediatric-age athletes. Methods: Parents and/or legal guardians of 2269 athletes aged between 6–17 years were recruited. Each participant completed an online questionnaire that contained 10 questions about the athlete’s training and non-contact lower-limb injury in the preceding 12 months. Results: The multivariate logistic regression model determined that lateral dominance in sport (adjusted OR (laterally vs. non-laterally dominant sports), 1.38; 95% CI, 1.10–1.75; p = 0.006), leg preference (adjusted OR (right vs. left-leg preference), 0.71; 95% CI, 0.53–0.95; p = 0.023), increased age (adjusted OR, 1.21; 95% CI, 1.16–1.26; p = 0.000), training intensity (adjusted OR, 1.77; 95% CI, 1.43–2.19; p = 0.000), and training frequency (adjusted OR, 1.36; 95% CI, 1.25–1.48; p = 0.000) were significantly associated with non-contact lower-limb injury in pediatric-age athletes. Length of training (p = 0.396) and sex (p = 0.310) were not associated with a non-contact lower-limb injury. Conclusions: Specializing in laterally dominant sports, left-leg preference, increase in age, training intensity, and training frequency indicated an increased risk of non-contact lower-limb injury in pediatric-age athletes. Future research should take into account exposure time and previous injury. Full article
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Article
Effects of Whole-Body Vibration and Balance Training on Female Athletes with Chronic Ankle Instability
J. Clin. Med. 2021, 10(11), 2380; https://doi.org/10.3390/jcm10112380 - 28 May 2021
Cited by 3 | Viewed by 1466
Abstract
We explored the effects of 6-week whole-body vibration (WBV) and balance training programs on female athletes with chronic ankle instability (CAI). This randomized controlled study involved female athletes with dominant-leg CAI. The participants were randomly divided into three groups: WBV training (Group A), [...] Read more.
We explored the effects of 6-week whole-body vibration (WBV) and balance training programs on female athletes with chronic ankle instability (CAI). This randomized controlled study involved female athletes with dominant-leg CAI. The participants were randomly divided into three groups: WBV training (Group A), balance training (Group B), and nontraining (control group; Group C). Groups A and B performed three exercise movements (double-leg stance, one-legged stance, and tandem stance) in 6-week training programs by using a vibration platform and balance ball, respectively. The Star Excursion Balance Test (SEBT), a joint position sense test, and an isokinetic strength test were conducted. In total, 63 female athletes with dominant-leg CAI were divided into three study groups (all n = 21). All of them completed the study. We observed time-by-group interactions in the SEBT (p = 0.001) and isokinetic strength test at 30°/s of concentric contraction (CON) of ankle inversion (p = 0.04). Compared with the control group, participants of the two exercise training programs improved in dynamic balance, active repositioning, and 30°/s of CON and eccentric contraction of the ankle invertor in the SEBT, joint position sense test, and isokinetic strength test, respectively. Furthermore, the effect sizes for the assessed outcomes in Groups A and B ranged from very small to small. Female athletes who participated in 6-week training programs incorporating a vibration platform or balance ball exhibited very small or small effect sizes for CAI in the SEBT, joint position sense test, and isokinetic strength test. No differences were observed in the variables between the two exercise training programs. Full article
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Article
Accuracy and Repeatability of Spatiotemporal Gait Parameters Measured with an Inertial Measurement Unit
J. Clin. Med. 2021, 10(9), 1804; https://doi.org/10.3390/jcm10091804 - 21 Apr 2021
Cited by 1 | Viewed by 564
Abstract
In recent years, interest in finding alternatives for the evaluation of mobility has increased. Inertial measurement units (IMUs) stand out for their portability, size, and low price. The objective of this study was to examine the accuracy and repeatability of a commercially available [...] Read more.
In recent years, interest in finding alternatives for the evaluation of mobility has increased. Inertial measurement units (IMUs) stand out for their portability, size, and low price. The objective of this study was to examine the accuracy and repeatability of a commercially available IMU under controlled conditions in healthy subjects. A total of 36 subjects, including 17 males and 19 females were analyzed with a Wiva Science IMU in a corridor test while walking for 10 m and in a threadmill at 1.6 km/h, 2.4 km/h, 3.2 km/h, 4 km/h, and 4.8 km/h for one minute. We found no difference when we compared the variables at 4 km/h and 4.8 km/h. However, we found greater differences and errors at 1.6 km/h, 2.4 km/h and 3.2 km/h, and the latter one (1.6 km/h) generated more error. The main conclusion is that the Wiva Science IMU is reliable at high speeds but loses reliability at low speeds. Full article
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Article
Judo Injuries Frequency in Europe’s Top-Level Competitions in the Period 2005–2020
J. Clin. Med. 2021, 10(4), 852; https://doi.org/10.3390/jcm10040852 - 19 Feb 2021
Cited by 8 | Viewed by 1653
Abstract
Background: The present study assesses the frequency of injury in Europe’s top-level judokas, during top-level competitions, and defines risk factors. Methods: The members of the EJU Medical Commission collected injury data over the period of 2005 to 2020 using the EJU Injury Registration [...] Read more.
Background: The present study assesses the frequency of injury in Europe’s top-level judokas, during top-level competitions, and defines risk factors. Methods: The members of the EJU Medical Commission collected injury data over the period of 2005 to 2020 using the EJU Injury Registration Form at Europe’s top judoka tournaments. Results: Over the 15 years of the study, 128 top-level competitions with 28,297 competitors were included; 699 injuries were registered. Of all competitors, 2.5% needed medical treatment. The knee (17.4%), shoulder (15.7%), and elbow (14.2%) were the most common anatomical locations of injury. Sprains (42.2%) were by far the most frequent injury type, followed by contusions (23.1%). Of all contestants, 0.48% suffered an injury which needed transportation to hospital. There was a statistically significant higher frequency of elbow injuries in female athletes (p < 0.01). Heavy-weight judokas suffered a remarkably low number of elbow injuries, with more knee and shoulder injuries. Light-weight judokas were more prone to elbow injuries. Conclusions: We found there was a low injury rate in top-level competitors, with a greater frequency of elbow injuries in female judokas. During the 15 years of injury collection data, an injury incidence of 2.5% was found, with a remarkable high injury rate in the women’s −52 kg category, and statistically significantly more elbow injuries in women overall. Full article
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Cardiopulmonary Exercise Test Parameters in Athletic Population: A Review
J. Clin. Med. 2021, 10(21), 5073; https://doi.org/10.3390/jcm10215073 - 29 Oct 2021
Cited by 1 | Viewed by 1148
Abstract
Although still underutilized, cardiopulmonary exercise testing (CPET) allows the most accurate and reproducible measurement of cardiorespiratory fitness and performance in athletes. It provides functional physiologic indices which are key variables in the assessment of athletes in different disciplines. CPET is valuable in clinical [...] Read more.
Although still underutilized, cardiopulmonary exercise testing (CPET) allows the most accurate and reproducible measurement of cardiorespiratory fitness and performance in athletes. It provides functional physiologic indices which are key variables in the assessment of athletes in different disciplines. CPET is valuable in clinical and physiological investigation of individuals with loss of performance or minor symptoms that might indicate subclinical cardiovascular, pulmonary or musculoskeletal disorders. Highly trained athletes have improved CPET values, so having just normal values may hide a medical disorder. In the present review, applications of CPET in athletes with special attention on physiological parameters such as VO2max, ventilatory thresholds, oxygen pulse, and ventilatory equivalent for oxygen and exercise economy in the assessment of athletic performance are discussed. The role of CPET in the evaluation of possible latent diseases and overtraining syndrome, as well as CPET-based exercise prescription, are outlined. Full article
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Criterion-Related Validity of Field-Based Fitness Tests in Adults: A Systematic Review
J. Clin. Med. 2021, 10(16), 3743; https://doi.org/10.3390/jcm10163743 - 23 Aug 2021
Viewed by 986
Abstract
We comprehensively assessed the criterion-related validity of existing field-based fitness tests used to indicate adult health (19–64 years, with no known pathologies). The medical electronic databases MEDLINE (via PubMed) and Web of Science (all databases) were screened for studies published up to July [...] Read more.
We comprehensively assessed the criterion-related validity of existing field-based fitness tests used to indicate adult health (19–64 years, with no known pathologies). The medical electronic databases MEDLINE (via PubMed) and Web of Science (all databases) were screened for studies published up to July 2020. Each original study’s methodological quality was classified as high, low and very low, according to the number of participants, the description of the study population, statistical analysis and systematic reviews which were appraised via the AMSTAR rating scale. Three evidence levels were constructed (strong, moderate and limited evidence) according to the number of studies and the consistency of the findings. We identified 101 original studies (50 of high quality) and five systematic reviews examining the criterion-related validity of field-based fitness tests in adults. Strong evidence indicated that the 20 m shuttle run, 1.5-mile, 12 min run/walk, YMCA step, 2 km walk and 6 min walk test are valid for estimating cardiorespiratory fitness; the handgrip strength test is valid for assessing hand maximal isometric strength; and the Biering–Sørensen test to evaluate the endurance strength of hip and back muscles; however, the sit-and reach test, and its different versions, and the toe-to-touch test are not valid for assessing hamstring and lower back flexibility. We found moderate evidence supporting that the 20 m square shuttle run test is a valid test for estimating cardiorespiratory fitness. Other field-based fitness tests presented limited evidence, mainly due to few studies. We developed an evidence-based proposal of the most valid field-based fitness tests in healthy adults aged 19–64 years old. Full article
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