Journal of Functional Morphology and Kinesiology — Open Access Journal

In this study, we examine the structure of postural variability in six elite-level recurve archers using the uncontrolled manifold concept. Previous research showed equivocal results for the relationship between postural control and shooting accuracy, but these studies were mainly limited to a descriptive approach to postural variability/stability and did not take the simultaneous movements of the upper limb joints into account. In this study, we show that the goal-equivalent variability which stabilizes the orientation of the arrow in space is significantly larger than that of the non-goal-equivalent variability in arrows of high accuracy (score 9 or 10). Conversely, arrows of lower accuracy (score 6, 7, or 8) failed to reach significant thresholds throughout the majority of the aiming phase. This analysis reveals that it is not necessary (or even possible) for elite archers to minimize the movements of all degrees of freedom during aiming, but rather that the structure of variability of the redundant kinematic chain is exploited so that the relevant performance variable (orientation of the arrow) is stabilized. Full article

Physical activity and exercise are important adjuncts to medical treatment for overall health in individuals with traumatic brain injury (TBI); however, many individuals do not partake in the recommended weekly exercise. The objective of this study was to investigate the barriers to exercise after TBI and determine whether these barriers varied by age. The sample was 172 adults with moderate to severe TBI who completed Barriers to Physical Exercise and Disability (B-PED) survey. Lack of interest, motivation, and energy as well as cost, lack of counseling on exercise by a physician, not having home equipment, and being too lazy were reported as barriers to exercise by all age groups. Those aged 35 to 54-years-old were more likely to report that cost, lack of transportation, having health concerns, not knowing where to exercise, and fear of leaving the home as barriers to exercise than those aged 18 to 34-years-old or 55-years-old and older. Overall, adults with TBI report multiple barriers to exercise, and these barriers vary by age. Full article

Introduction: Renal transplant recipients (RTRs) are at high cardiovascular risk (CV) compared to the general population, especially after surgical treatment. The literature supports the role of supervised exercise intervention; however no data are available regarding the effects of unsupervised exercise programs. We investigated whether a home exercise program could reduce CV risk in RTR based on possible changes in renal and cardiometabolic parameters and myocardial performance measured by echocardiography. Methods: From a large cohort of 60 RTRs, 30 RTRs (12 females and 18 males 48.3 ± 12.3 years) participated in individualized and unsupervised training programs for 6 months, at moderate intensity. Cardiometabolic risk factors, anthropometric parameters, lipid and glycemic blood sample profiles were studied as was myocardial performance from the 2D echo examination at T0, and T6 months. Results: The lipid profile remained in the range of a low level of risk, although there was no significant improvement, whereas myocardial performance, in particular the EF, was significantly improved. Conclusions: A home exercise program for at least 6 months produces positive effects on myocardial function and helps maintain a low cardiovascular risk profile. The trend supports the importance of highlighting the role of a correct reconditioning of lifestyle in RTR, from the exercise program without supervision to moderate intensity, where well tolerated. Full article

Little is known about the internal and external loads experienced during resistance exercise, or the subsequent fatigue-related response, across different age groups. This study compared the internal (heart rate, OMNI ratings of perceived exertion (RPE), session RPE) and external loads (peak velocity and power and volume load) during high volume squatting exercise (10 × 10 at 60% one-repetition maximum (1RM)) and the fatigue-related response (maximal voluntary contraction (MVC), voluntary activation (VA), resting doublet force, peak power, and blood lactate) in young (n = 9; age 22.3 ± 1.7 years) and middle-aged (n = 9; age 39.9 ± 6.2 years) resistance-trained males. All internal load variables and peak velocity illustrated unclear differences between groups during exercise. Peak power and volume load were likely higher in the young group compared to their middle-aged counterparts. The unclear differences in MVC, VA and blood lactate between groups after exercise were accompanied by very likely greater decrements in resting doublet force and peak power at 20 and 80% 1RM in the middle-aged group compared to the young group. These data indicate that internal load is not different between young and middle-aged resistance-trained males, though certain external load measures and the fatigue response are. Full article

Open tibial fractures represent the most frequent fractures of long bones, comprising approximately 1.9% of all fractures. Although locked intramedullary nailing is the gold standard for treating closed and unstable tibia diaphyseal fractures, for most exposed fractures, an external fixator can first be used, followed by conversion through an intramedullary nail. The present report describes the case of a 17-year-old male who presented with a complex multi-segmented displaced tibia fracture, type 42-C3, with exposure of IIIB type according to the Gustilo–Anderson classification, and with an attached disrupted fracture of peroneal malleolus, type 44-B2. External fixation was the preferred treatment method. Before the definitive surgical treatment, the patient had a second accident that caused refracture and damage to the soft tissues and external fixation system. This prolonged the time estimated for the conversion from the external fixator to the intramedullary nail. The reported case shows the use of various treatment steps with different timelines and an intervention with vacuum-assisted closure therapy for soft tissue healing as well as subsequent intramedullary nailing in order to reach the definitive healing of a non-compliant patient. These combined methods achieved an acceptable reduction and good stability of such a complex fracture. Full article

The rate of force development (RFD) is vital for power athletes. Lean body mass (LBM) is considered to be an essential contributor to RFD, nevertheless high RFD may be achieved by athletes with either high or low LBM. The aim of the study was to describe the relationship between lower-body LBM and RFD, and to compare RFD in taekwondo athletes and track and field (T&F) throwers, the latter having higher LBM when compared to taekwondo athletes. Nine taekwondo athletes and nine T&F throwers were evaluated for countermovement jumping, isometric leg press and leg extension RFD, vastus lateralis (VL), and medial gastrocnemius muscle architecture and body composition. Lower body LBM was correlated with RFD 0–250 ms (r = 0.81, p = 0.016). Taekwondo athletes had lower LBM and jumping power per LBM. RFD was similar between groups at 30–50 ms, but higher for throwers at 80–250 ms. RFD adjusted for VL thickness was higher in taekwondo athletes at 30 ms, but higher in throwers at 200–250 ms. These results suggest that lower body LBM is correlated with RFD in power trained athletes. RFD adjusted for VL thickness might be more relevant to evaluate in power athletes with low LBM, while late RFD might be more relevant to evaluate in athletes with higher LBM. Full article

We are glad to introduce the ninth Journal Club. This edition is focused on several relevant studies published in the last few years in the field of Exercise-Induced Immune Response, chosen by our Editorial Board members and their colleagues. We hope to stimulate your curiosity in this field and to share with you the passion for sport seen also from the scientific point of view. The Editorial Board members wish you an inspiring lecture. Full article

The role of an athlete’s dietary intake (both timing and food type) goes beyond simply providing fuel to support the body’s vital processes. Nutritional choices also have an impact on the metabolic adaptations to training. Over the past 20 years, research has suggested that strategically reducing carbohydrate (CHO) availability during an athlete’s training can modify the metabolic responses in lieu of simply maintaining a high CHO diet. Several methods have been explored to manipulate CHO availability and include: Low-carb, high-fat (LCHF) diets, performing two-a-day training without glycogen restoration between sessions, and a “sleep-low” approach entailing a glycogen-depleting session in the evening without consuming CHO until after a morning training session performed in an overnight fasted state. Each of these methods can confer beneficial metabolic adaptations for the endurance athlete including increases in mitochondrial enzyme activity, mitochondrial content, and rates of fat oxidation, yet data showing a direct performance benefit is still unclear. Full article

Exercise is one of the main rehabilitative interventions, commonly used to improve performance and motor learning. During the application of attentional focus strategies, External Focus of Attention (EFA) aiming at the movement effect has been reported to have more efficacy than Internal Focus of Attention (IFA) aiming at movement characteristics in healthy subjects. There are not many studies that compare the EFA and IFA instructions in people with Musculoskeletal (MSK) and Central Nervous System disorders (CNS). The purpose of this systematic review is to determine if IFA or EFA, in patients with CNS or MSK, may improve performance and have some effects on motor learning. Databases used for research: PubMed, CINAHL, Cochrane Library, PEDro, PsycINFO, SCOPUS. Inclusion criteria: Randomized Controlled Trial, quasi-Randomized Controlled Trial, enrolled subjects with CNS or with MSK and compared the efficacy of EFA and IFA. The studies suggest that the EFA is better than IFA in affecting the movement execution in patients with MSK, while conflicted findings emerge in presence of CNS disorders. Studies included in the qualitative analysis showed heterogeneous methodological features in study design and conductance, so results must be interpreted with caution. Full article

The prevalence of chronic illness among middle-aged and older adults is increasing worldwide as the population continues to age. One way to prevent the continued increase and subsequent negative outcomes of chronic illness is to increase the number of individuals who engage in exercise. Thus, it is important to examine which factors predict engagement in exercise in middle-aged and older adults. As a result, the current study examined the relationship between physical health, psychological well-being, and engagement in exercise in a sample of middle-aged and older German adults. We found that increased age was associated with less frequent engagement in exercise. We also found that physical health mediated the relationship between psychological well-being and engagement in exercise. Finally, we found that age did not moderate the relationship between subjective well-being and engagement in exercise, suggesting that the role of physical health as a mediator was similar in older adults compared to middle-aged adults. These findings have important implications for interventions seeking to promote exercise among adults. Full article

Cancer is the second leading cause of death, and the most common diagnosis among the general population is breast and colon cancer. Recently, an increasing number of new cases of invasive breast and colon cancer have been estimated, and more people die from these diseases. In addition to the genetic pattern, diet and lifestyle including smoking, alcohol consumption, and sedentary behaviour have also been identified as potential risks factors. Recent studies of cancer survivors have shown the beneficial effects of regular physical activity to reduce the prevalence of comorbidity, muscle atrophy, weight changes, reduced aerobic capacity, fatigue, depression, and reduced quality of life. Dedicated and individual programs are crucial for achieving the goals of improving quality of life and reducing comorbidities. A multidisciplinary approach is fundamental: lifestyle assessment, including estimating the level of physical activity, as well as nutritional habits, may be the first step. A periodic cardiovascular examination is crucial for detecting asymptomatic early myocardial failure. According to current ACSM guidelines, different levels of exercise (low-moderate 40% and moderate up to 60% of the maximal HR) may be prescribed, and patients enrolled may follow the exercise program if in the absence of contraindications. The current paper reports observations from our clinical practice and provides practical strategies that bridge contemporary, published guidelines into practice within a multi-disciplinary team working with cancer survivors in Italy. Full article

As only a small group of children fulfil the guidelines for physical activity, interventions are necessary to promote active lifestyles. We examined the effects of a sports-oriented primary school (N = 79) in comparison to a regular primary school (N = 90) on students’ physical literacy and cognitive performance. To evaluate the implementation of the sports-oriented school curriculum a process evaluation was conducted, in which the school curriculum was analysed and guideline-based interviews were carried out with the schoolteachers and the school director. To measure students’ physical literacy and cognitive performance several tests were used. Small positive effects of the sports-oriented primary school on students’ physical literacy were shown in standing long jump and attitudes towards physical activity. There were no differences between the groups regarding cognitive performance. This study provides the first insights on how a sports-oriented school can promote students’ physical literacy in the future. The results are in line with previous research that shows that when children spend more time in physical education and overall physical activities at school, no negative consequences result for their cognitive performance. In future, long-term evaluations of the effects of sports-oriented schools are required to receive valid results on the effects on students. Full article

During the aging process, skeletal muscle performance and physiology undergoes alterations leading to decrements in functional capacity, health-span, and independence. Background: The utility and implementation of age-specific exercise is a paramount research agenda focusing on ameliorating the loss of both skeletal muscle performance and physiology; yet, to date, no consensus exists as to the most appropriate mechanical loading protocol design or overall exercise prescription that best meets this need. Thus, the purpose of this review is to highlight the most optimal type of exercise presently available and provide the most current, evidence-based findings for its efficacy. The hypothesis that high-intensity, stretch-shortening contractions (SSCs)—a form of “resistance-type exercise” training—present as the preferred exercise mode for serving as an intervention-based modality to attenuate dynapenia, sarcopenia, and decreased muscle quality with aging, even restoring the overall youthful phenotype, will be demonstrated. Conclusions: Appreciating the fundamental evidence supporting the use of high-intensity SSCs in positively impacting aging skeletal muscle’s responsivity and their use as a specific and sensitive countermeasure is crucial. Moreover, from an applied perspective, SSCs may improve skeletal muscle quality and rejuvenate health-span and, ultimately, lead to augmented functional capacity, independence, and quality of life concomitant with decreased morbidity. Full article

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a genetic disorder with an autosomal dominant inheritance and incomplete penetrance. It predominantly affects the right ventricle (RV), predisposing to the origin of ventricular arrhythmias and sudden death (SD). The structural basis of the disease consists of the progressive loss of myocardium with fibro-adipose replacement. ARVC is a “desmosomes” disease involving mutations of proteins such as placoglobin, desmoplachine, placophylline, desmoglein, and desmocollin. In the “classical” form, the disease mainly implicates the RV chamber, while the left ventricle (LV) is involved in advanced stages. Genotype-phenotype correlation studies have identified some phenotypic variants characterized by an early participation of the LV, which can proceed in parallel toward the two ventricles (“biventricular” variant) or prevails over the RV (variant to “left dominance”). These data led to the evolution of the initial definition of ARVC, which is currently considered a genetic disease of both ventricles and, therefore, deserves the denomination “arrhythmogenic cardiomyopathy”. Many aspects of diagnosis, treatment, and indications for a correct lifestyle are important in sports medicine. This paper will discuss the clinical management of ARVC, with particular reference to diagnosis, risk stratification, therapy, and indications for physical activity. Full article

Introduction: Postural control integrates information from the visual, vestibular, and proprioceptive systems, controlling the body position in space. Global Posture Reeducation (GPR) is a clinically well-accepted method that mainly addresses the proprioceptive component of this postural system. Although the GPR presents relevant evidence, the postural morphotypology prevalence in the general population is not yet known. Objective: To investigate the morphotypological profile prevalence of individuals evaluated with the GPR method by proprioceptive and muscular rebalancing (GPR/PMR). Methodology: A retrospective cross-sectional study was performed (prevalence analysis) of patients evaluated by the GPR/PMR method at the Physiotherapy School Clinic of the Serra dos Órgãos University Center. The morphotypological evaluation data were collected and stored in a spreadsheet using the Microsoft Office Excel® program, where the prevalence of each morphotypology (opening, closing, and mixed) was calculated. Results: A total of 123 evaluation sheets were analyzed, of which 50 were men (41%) and 74 were women (59%) with a mean age of 46 years. In the morphotypological diagnosis, the following values were observed: closing (n = 107; 87%); opening (n = 6; 5%) and mixed (n = 9; 7%). The postural diagnosis in closing (87%) presented a statistically significant difference, when compared to the morphotypologies in opening (p < 0.0001) and mixed (p < 0.0001). Few subjects in the sample (n = 5), presented a relation between the mixed work position (standing and sitting) and the mixed morphotypology (p < 0.005). Conclusion: The morphotypological profile of the analyzed population appears to be in closing and does not correlate with the individual’s work position. Full article

We determined the effects of an acute bout of free-weight resistance exercise (ARE) on cardiovascular hemodynamics and endothelial function in resistance-trained individuals. Nineteen young, healthy, resistance-trained individuals performed two randomized sessions consisting of ARE or a quiet control (CON). The ARE consisted of three sets of 10 repetitions at 75% 1-repetition maximum for the squat, bench press, and deadlift. Cardiovascular hemodynamics was assessed using finger photoplethysmography. Forearm blood flow (FBF), and vasodilatory capacity markers, were assessed using venous occlusion plethysmography. Forearm vascular conductance was calculated by the division of mean FBF by mean arterial pressure. A two-way ANOVA was used to compare the effects of condition (ARE, CON) across time (rest, recovery). There were significant (p ≤ 0.05) decreases in mean arterial pressure and total peripheral resistance across conditions and time. There were significant condition-by-time interactions (p ≤ 0.05) for heart rate, stroke volume, and cardiac output after the ARE compared to the CON and rest. FBF was significantly (p = 0.001) increased during the recovery from ARE, as well as vasodilatory capacity markers such as peak blood flow (p = 0.05) and reactive hyperemia-induced blood flow (p = 0.0001). These data suggest that whole-body free-weight exercises acutely reduced blood pressure while simultaneously augmenting FBF, and vasodilatory capacity markers. Full article

Osteosarcopenic obesity (OSO) is described as the simultaneous presence of osteopenia/osteoporosis, sarcopenia, and increased adiposity. Over time, older adults with OSO syndrome might be at greater risk for loss of physical function and bone fractures. Furthermore, a sedentary lifestyle, inadequate nutrition, pharmaceutical drugs, and chronic conditions encompass the multifactorial nature of OSO syndrome. Physical activity and a healthy diet play a crucial role in management and treatment of OSO syndrome. Research has shown that even low-intensity physical activity or daily habitual activity can maintain bone mineral density, muscle strength, and improve muscle quality, and reduce adiposity. However, older adults with high risk of fall and injuries require tailored exercise intensity. Also, balanced daily intake of vitamin D, calcium, and protein is important in prevention and treatment of OSO syndrome in postmenopausal women. Effective measurement of bone mass, muscle mass, and strength is required when detecting OSO syndrome and to evaluate the balance, strength and endurance of elder individuals and severity of the condition. Full article

Background: Posterior gleno-humeral joint (GHJ) dislocation is a rare injury accounting for 2.7–3% of all shoulder dislocations. Early detection is the key for an effective treatment. Poor clinical outcomes or prosthetic solutions depend on the severity of the lesions at the time of trauma and worsening of the McLaughlin lesion during the months when the dislocation remains unrecognized or untreated. The aim of the study is to report our experience in treating, and clinically and radiographically evaluate the outcomes of, four neglected posterior GHJ dislocations. Methods: Four patients with inveterate posterior dislocation of the shoulder were evaluated. In three cases, the technique of McLaughlin was performed, and in one case, plication of the subscapularis tendon was performed. During the follow up, patients were clinically evaluated using the Constant shoulder score; an imaging investigation, using X-ray integrated with computed tomography(CT) and magnetic resonance imaging (MRI), was assessed. Results: Following the Constant criteria, treated shoulders reported an excellent outcome with an average score of 91. The mean score of untreated shoulders was 92.5. The humeral appearance that resulted was radiographically well-structured. Surgical treatment with McLaughlin lesion or transposition of the subscapularis were satisfactory from a subjective and objective point of view. To perform surgery soon as possible after the traumatic episode is considered a positive prognostic factor. Full article