Search Results (421)

Background and Clinical Significance: This case highlights the management of chronic extensor carpi ulnaris (ECU) tenosynovitis in a patient exposed to non-traditional wrist-loading activities. Exercise therapy rehabilitation is well established in shoulder and knee tendinopathies, although it remains less well described for wrist tendinopathies beyond De Quervain’s disease. Moreover, the patient’s active engagement in non-traditional, wrist-intensive sports such as handstands, slacklining, and yoga may have contributed to the development and persistence of chronic extensor carpi ulnaris (ECU) tenosynovitis. Unlike more common ECU injuries observed in tennis or golf players, this case demonstrates how ECU tenosynovitis can develop in less conventional sports. It adds to the scientific literature by showing that chronic ECU tenosynovitis can be effectively managed through non-surgical rehabilitation tailored to the specific needs of the patient, in particular by using exercise therapy. Case Presentation: The patient presented with chronic left wrist pain, especially during ulnar deviation and resisted ECU testing, following two traumatic events. Examination revealed limited range of motion caused by pain, particularly in flexion, extension, and both ulnar and radial deviations. Ultrasound imaging confirmed ECU tenosynovitis with mild inflammation of other wrist tendons and a small synovial cyst on radio-scapho-lunate level. ECU stability during forearm rotation was confirmed both clinically and by ultrasound.  The diagnosis of chronic ECU tenosynovitis was managed conservatively with a targeted rehabilitation program focused on isometric strengthening and progressive resistance exercises. Over one month, the patient demonstrated marked improvement in wrist strength, pain reduction, and functional capacity, allowing for a gradual return to sporting activities. Conclusions: The main takeaway from this case is that chronic ECU tenosynovitis can be successfully managed through individualized, conservative treatment based on exercise therapy. Early intervention, patient adherence, and rehabilitation tailored to the athlete’s specific demands are crucial for recovery, even in chronic cases, without the need for surgical intervention. Full article

Background: Astragali radix is a traditional herb known for its antioxidant, anti-inflammatory, and immunomodulatory properties and has gained attention for its potential to support post-exercise recovery. However, the effects of long-term supplementation coupled with resistance training are not well understood. Methods: Twenty-four moderately active participants were recruited and randomly assigned to the Astragali radix supplementation (ASTRA, n = 13) or placebo (PLA, n = 11) group. All participants underwent 8 weeks of regular resistance training (3 sessions/week) and 2 weeks of intensified training (6 sessions/week). Results: Before (BAS), after 8 weeks of resistance training (RT), and at the end of the intensified training (IT), knee extensors’ maximal voluntary isometric contraction torque (MVIT), and leg press and leg extension one repetition max (1RM) were measured. Blood samples were collected to analyze inflammatory markers and testosterone. From BAS to after RT, MVIT, 1RM leg press, and 1RM leg extension increased in both ASTRA and PLA, with no differences between groups. After IT, MVIT, 1RM leg press and 1RM leg extension decreased in both ASTRA and PLA. CPK levels and myoglobin concentration increased while cortisol decreased significantly from BAS to IT, but no group differences were detected. TNF-α and IL-6 showed significant time × supplementation interactions, with lower values after IT in ASTRA compared to PLA. Conclusions: Astragali radix supplementation did not lead to additional benefits in muscle during the period of resistance training, nor did it prevent the decline in force following the intensified training period. However, Astragali radix supplementation prevented the increase in some inflammatory biomarkers, specifically TNF-α and IL-6, during the intensified period of training. Full article

Background: This study aimed to investigate the extent and time course of peripheral neuromuscular fatigue of the knee extensors following different concurrent training protocols in recreationally active men. Methods: In a randomized, counterbalanced, crossover design, ten participants completed one exercise session of three concurrent exercise protocols in consecutive weeks and in similar resting conditions: traditional concurrent training (TCT), sprint interval training (SIT), and high-intensity resistance circuit training (HRC). Maximal voluntary isometric contraction (MVIC) and electrically evoked tetanic force of the knee extensors were assessed before, immediately after, and at 24 and 48 h following each exercise session. Linear mixed models were used to examine the differences among exercise modalities and time points. Results: No significant changes were found in MVIC force following HRC and TCT at any time point (p > 0.05), while significant declines were observed post-exercise (p = 0.015), 24 h (p = 0.001) and at 48 h (p = 0.003) after SIT. Moreover, MVIC force was significantly lower for SIT than HRC at 48 h (p = 0.001). Tetanic force significantly declined in SIT from pre-exercise to post-exercise (p = 0.034), with significant differences when compared to HRC (p = 0.003) and TCT (p = 0.003). HRC and TCT induced no knee extensor fatigue, contrary to a single session of SIT. Conclusions: Peripheral fatigue seemed to prevail following SIT in comparison with HRC and TCT, as seen by the decreased tetanic force in the former only. From an applied perspective, practitioners should carefully plan training activities to be performed the days following a SIT session, as force-generating capacity may be impaired for up to 48 h. Full article

High-intensity or repetitive exercise induces metabolic stress and neuromuscular fatigue in skeletal muscle. Using a within-subjects repeated-measures crossover design, eight male amateur swimmers completed five experimental sessions at one-week intervals. Following an isokinetic fatigue protocol, five recovery interventions were applied in a randomized order: control (NT), foam roller (FR), vibration foam roller (VFR), and whole-body vibration at 12 Hz (WBV-12) and 20 Hz (WBV-20). The isokinetic fatigue protocol produced a significant reduction in bilateral extensor peak torque (229.2 ± 37.8%BW to 189.8 ± 27.5%BW; t(7) = 4.19, p = 0.004, d = 1.48), confirming successful fatigue induction. Outcome measures included visual analog scale (VAS) scores, blood lactate concentration, and knee extensor/flexor peak torque (%BW) assessed at three time points. A two-way repeated-measures ANOVA (intervention × time) revealed significant main effects of recovery methods at the post-recovery time point for VAS scores (F(4,28) = 5.98, p = 0.001, η²g = 0.248), blood lactate (F(4,28) = 5.12, p = 0.003, η²g = 0.226), and isokinetic peak torque (F(4,28) = 10.75, p < 0.001, η²g = 0.226). Post hoc Bonferroni analysis indicated that VFR and WBV-20 produced significantly higher lactate recovery rates than NT. Active recovery interventions produced lower perceived fatigue scores and greater lactate reductions than passive rest; however, individual Bonferroni pairwise comparisons for VAS and blood lactate did not reach adjusted significance, and these findings should be considered preliminary. WBV-20 demonstrated statistically confirmed superiority in isokinetic muscle function recovery (Bonferroni p < 0.05 vs. NT, FR, and VFR), suggesting its potential as an effective post-exercise recovery strategy for neuromuscular restoration. Full article

The purpose of this study was to compare knee joint biomechanical characteristics and movement strategies according to the direction of the forward lunge in badminton and to provide practical insights for training and injury prevention. Eighteen female recreational badminton players performed forward lunges in three directions: center (CFL), left (LFL), and right (RFL). Knee joint angles and moments, center of mass (COM) velocity, ground reaction forces (GRF), and knee extensor and flexor muscle forces were analyzed. In addition, continuous biomechanical variables were examined using statistical non-parametric mapping (SnPM). The results showed that LFL demonstrated the fastest approach COM velocity and greater knee flexion moments at initial contact, along with the greatest knee flexor muscle force, which may be indicative of enhanced joint stabilization demand. RFL exhibited a smaller knee flexion angle and lower vertical ground reaction force but showed the greatest posterior braking force and the fastest recovery COM velocity, which may be indicative of greater movement efficiency. CFL showed significantly greater knee adduction angles and internal rotation moments, suggesting elevated rotational loading at the knee that may be associated with increased injury risk. These findings highlight direction-specific knee joint biomechanical characteristics during badminton forward lunges and may provide useful information for developing targeted training and injury prevention approaches. Full article

Dynamic muscular endurance, the ability to lift a submaximal load until task failure, is a common measure in both cross-sectional and training studies. However, the repeatability of low-load muscular endurance in the knee extensors has not been well established. Establishing reliability metrics is essential to ensure that observed differences reflect true physiological changes rather than measurement error. The purpose of this study was to quantify the repeatability of low-load dynamic knee extensions performed to task failure. Forty healthy adults completed three visits, each consisting of one set of knee extensions at 20%, 30%, and 40% of one repetition maximum (1RM) to assess relative muscular endurance, and three sets at 20% 1RM on the contralateral leg to assess the impact of fatigue within a single session (fatigue curve). Intraclass correlation coefficients (ICCs), standard error of the measurement, and smallest detectable difference (SDD) were calculated. Repeatability ranged from moderate to excellent across conditions (ICC = 0.77–0.94). Lower loads and later sets demonstrated reduced repeatability compared with heavier loads and earlier sets. These results indicate that researchers and practitioners should consider load and fatigue curve effects in protocol design and SDDs when interpreting the meaningfulness of individual changes in knee extension muscular endurance. Full article

Objective: The present study aimed to compare muscle thickness and physical performance in different functional tests predicting falls between older adults with low and high fall risk. Methods: Seventy-one community-dwelling older women (74.5 ± 8.5 years old) volunteered for this study. The Berg Balance Scale (BBS) was used to stratify the sample as low and high risk for fall (BBS cutoff = ≥ 50 points). The performance in the Timed Up and Go Test (TUGT), 5-repetition sit-to-stand test (5xSST), 3 m walk test (3mWT), and 3 m backward walk test (3mBWT) was assessed. The elbow flexor and knee extensor muscle thickness were obtained by ultrasound (USD). A linear mixed model analysis was used to determine between-group differences in functional mobility and muscle thickness, and Bayesian analysis was applied to check the probability to replicate the same results (i.e., the magnitude of the evidence). Results: The low-fall-risk group exhibited significantly better performance only in 3mWT (mean difference = 0.84 s [95% CI: 0.40 to 1.29 s]; p = 0.001) and 3mBWT (mean difference = 1.54 s [95% CI: 0.21 to 2.85 s]; p = 0.024). The Bayes Factor (BF) for performance on the 3mWT and 3mBWT shows that the low-fall-risk group has a probability of 98.7% (BF10 = 77.3) and 99.7% (BF10 = 368), respectively, of performing better than the high-fall-risk group. Conclusions: Based on inferential and Bayesian analysis, the performance in 3mWT and that in 3mBWT were classified as very strong to excellent instruments, respectively, for differentiating older women with high fall risk. Full article

This study compared the kinematic and neuromuscular characteristics of the tennis forehand drive between high-performance (HP) and intermediate (INT) players. Eighteen right-handed male players (HP: n = 9; INT: n = 9) performed cross-court forehands while three-dimensional motion capture and surface electromyography (EMG) were recorded from the dominant upper limb and trunk. Kinematic and EMG data were time-normalized to the forward swing. One-dimensional statistical parametric mapping two-sample t-tests were used to compare joint angles, angular and linear velocities, and EMG amplitude waveforms between groups. Bonferroni-corrected significance levels were set at α = 0.0017 for kinematic variables and α = 0.0063 for EMG data. HP players exhibited greater racket linear velocity during the final part of the forward swing, accompanied by higher shoulder, elbow and wrist linear velocities, whereas hip linear velocity did not differ between groups. Joint angles were broadly similar, with SPM revealing only slightly greater early knee flexion in HP players. In contrast, HP players showed higher hip and knee angular velocities and greater wrist angular velocities in both flexion/extension and radial/ulnar deviation towards impact. EMG patterns were generally comparable, but HP players displayed higher biceps brachii activation in two significant clusters during the mid-to-late forward swing and greater triceps brachii activation in the late forward swing. No significant differences were observed for deltoid, pectoralis major, latissimus dorsi, flexor carpi radialis or extensor carpi radialis. These findings indicate that superior forehand performance in HP players is associated primarily with refined segmental coordination, greater lower-limb and distal segment velocities, and locally increased elbow muscle activation, rather than with widespread increases in upper-limb or trunk muscle activity. Full article

Objectives/Background: Aerobic exercise serves as a fundamental component in improving metabolic health. However, because obese middle-aged women often find it difficult to maintain long-term exercise participation, more efficient alternative strategies, such as whole-body electromyostimulation (WB-EMS), need to be explored. This study investigated the effects of aerobic exercise combined with WB-EMS on muscle and pulmonary functioning and metabolic health indicators in obese middle-aged women in South Korea, where obesity rates have been steadily increasing. Methods: Women aged 40–65 years with a body mass index ≥25 kg/m² who met at least three diagnostic criteria for metabolic syndrome were recruited. Of the 45 recruits, 36 completed the study. Participants were randomly assigned to a control (CON), aerobic exercise (EXG), or aerobic exercise with WB-EMS (WEG) group. The intervention consisted of a 12-week aerobic program performed three times per week for 40 min per session, with WB-EMS applied during the main exercise period. Muscle function, pulmonary function, and metabolic health indicators were assessed. Data were analyzed using two-way repeated-measures analysis of variance. Statistical significance was set at p < 0.05. Results: Significant group × time interaction effects were observed for muscle strength outcomes, with knee extensor and flexor peak torque at 60°/s (p < 0.001 for the right and left knee extensors; p = 0.001 for right knee flexors; p < 0.001 for left knee flexors). Post hoc comparisons indicated greater improvements in the WEG than in both the CON and EXG. Forced vital capacity (FVC) showed significant group × time interactions and time main effects (both p < 0.001), whereas forced expiratory volume in one second (FEV₁) and the FEV₁/FVC ratio showed no significant group, time, or interaction effects (all p > 0.05). Regarding metabolic health, BMI and waist-to-hip ratio showed significant time effects, indicating overall reductions following the intervention without significant interaction effects. Low-density lipoprotein cholesterol (p = 0.004) and fasting plasma glucose (p = 0.004) showed significant group × time interaction effects; however, post hoc analyses revealed no significant differences between the WEG and EXG. No consistent additional metabolic benefits of WB-EMS beyond aerobic exercise alone were observed. Conclusions: The 12-week aerobic exercise program improved muscle strength, pulmonary function, and selected metabolic indicators in obese middle-aged women. Aerobic exercise combined with WB-EMS provided additional benefits primarily for muscle strength compared with aerobic exercise alone, without conferring additional metabolic advantages. Full article

Background and Objectives: Present assessment methods have not effectively mitigated the risk of recurrent anterior cruciate ligament (ACL) injury following reconstruction (ACLR), suggesting that critical neuromuscular deficits may be underdiagnosed. This study aimed to compare limb asymmetries across strength, concentric and eccentric power, and deceleration metrics during return-to-sport (RTS) testing in professional athletes post-ACLR. Materials and Methods: Forty-four participants (33 males, 11 females; age 22.5 ± 5.8 years, body mass 75.9 ± 13.0 kg, height 180.5 ± 8.38 cm) (mean ± SD) with a unilateral reconstructed ACL (BTB = 33, HT = 11 graft) were included. They underwent isokinetic testing of knee flexor and extensor strength and bilateral countermovement jump (CMJ) assessments to measure concentric and eccentric peak power and deceleration metrics. Limb symmetry indices (LSI) were calculated for each parameter. Welch’s ANOVA and Games–Howell post hoc tests were used to compare LSIs among parameters. Results: Welch’s ANOVA showed that limb symmetry differed significantly across the measured neuromuscular parameters (F = 12,59, p < 0.001). Knee flexor strength LSI was significantly higher than knee extensor strength LSI (p = 0.003; d = 1.18), concentric peak power LSI (p < 0.001, d = 1.44), eccentric peak power LSI (p = 0.001, d = 1.71), and deceleration LSI (p = 0.001, d = 2.09). In addition, deceleration LSI was significantly lower than knee extensor strength LSI (p = 0.001, d = 1.34) and concentric peak power LSI (p = 0.007, d = 1.10). No significant difference was found between concentric and eccentric peak power, nor between knee extensor strength and either concentric or eccentric peak power LSIs. Conclusions: The findings of this study revealed significantly greater asymmetries in load absorption capacity compared to strength and concentric power measures at return-to-sport time frame in professional athletes post-ACLR. Full article

Background: In revision total knee arthroplasty (rTKA), clinical focus is mainly on the femoral and tibial components, while patellar complications are often underemphasized. However, patellar bone deficiency is a significant issue that can negatively affect surgical outcomes, especially in septic revisions. Objective: This review provides an overview of contemporary approaches to the evaluation and treatment of patellar bone loss in rTKA, emphasizing preoperative planning, classification frameworks, and treatment options. Methods: A narrative review of the literature was conducted. Studies published between 2000 and 2024 addressing preoperative assessment, surgical techniques, and outcomes in the management of patellar bone loss in rTKA were screened. Discussion: A recent consensus has addressed the evaluation, classification, and treatment of significant bone loss after total knee arthroplasty (TKA), providing specific recommendations for the management of patellar bone loss and extensor mechanism involvement in cases of severe bone deficiency. In this review, the principal surgical strategies described in the literature are summarized, including patellar component retention or revision, the use of biconvex inlay and trabecular metal implants, bone grafting, various augmentation techniques, resection arthroplasty, gull-wing osteotomy, and patellectomy. Conclusions: Despite various surgical strategies, no consensus exists on a universally superior approach. Ongoing research is essential to establishing standardized, evidence-based protocols for effective management of patellar bone loss in rTKA. Full article

Background: Type 2 diabetes mellitus (T2DM) is linked to accelerated losses in muscle function. The aim of the present investigation was to evaluate the effect of chronic higher-protein intake on isokinetic knee performance in the older adults with type 2 diabetes mellitus (T2DM). Methods: Thirty adults (15 men and 15 women) aged 60–80 years with non-insulin-treated T2DM and sarcopenia-related deficits were randomized for 12 weeks to a higher-protein diet (1.2–1.5 g·kg⁻¹·day⁻¹) or a recommended protein diet (0.8–1.0 g·kg⁻¹·day⁻¹), with meal plans designed to maintain body mass. Protein was increased mainly through Mediterranean-style protein sources while diet was monitored using repeated 3-day recalls. Isokinetic knee extensors and flexors peak torque (angular velocity 60°/s) was assessed at baseline and at week 6 and at the end of the 12th week of intervention. Fatigability (20 maximal contractions at an angular velocity at 180°/s) and DXA body composition were assessed at baseline and at the end of the 12th week of intervention. Data were analyzed using two-way repeated-measures ANOVA with repeated measures on time (2 groups × 3 time points), followed by post hoc analysis when significant difference was occurred. Results: Thirty participants completed the trial. Energy intake and body mass remained stable in both groups. At the end of week 12, peak torque declined in the control group (p < 0.05) but remained stable in the higher-protein group. The fatigue index worsened over time in controls but was preserved in the higher protein group, resulting in a significant group d7 time interaction at week 12 (p < 0.05) (post hoc between-group difference at week 12, p < 0.05). Fat-free mass and blood pressure did not change. In fat mass, a decrease was observed with higher protein intake, whereas it remained stable in the control group. Conclusions: Higher protein intake for 12 weeks preserved knee muscle performance in older adults with T2DM without weight gain, supporting dietary protein optimization to counter functional decline. Full article

This study compared collegiate sprinters from two common admission routes in China to identify pathway-associated differences that may inform subsequent training for athletes entering via the Physical Education College Entrance Examination pathway. Twenty male collegiate sprinters were allocated to a Sports Independent Enrollment group and a Physical Education College Entrance Examination group, with ten participants in each. Participants completed isokinetic knee testing, drop jump tests, static balance tests, and drop jump electromyography assessment. Isokinetic outcomes were largely comparable between groups, although the Sports Independent Enrollment group showed faster time to reach peak torque in the nondominant-side knee extensors. In drop jumps, the Sports Independent Enrollment group demonstrated higher reactive strength, shorter ground contact time, greater leg stiffness normalized to body weight, and shorter propulsion duration. Electromyography patterns differed between groups across movement phases. Balance differences were mainly observed under the single-leg eyes-closed condition in unadjusted comparisons, but none remained significant after false discovery rate adjustment. Overall, between-group differences were more evident in rapid force production and neuromuscular control than in the magnitude of isokinetic strength. These findings provide practical targets for designing subsequent training priorities for athletes entering through the Physical Education College Entrance Examination pathway. Full article

Background: Self-myofascial release (SMFR) is a treatment whose main benefits are enhanced recovery and increased flexibility without impairing athletic performance. Previous research has often targeted the posterior myofascial chain (superficial back line, SBL), which runs from the plantar fascia to the posterior cranium and is commonly linked to hamstring-related outcomes. However, its potential influence on knee extensor force production remains unclear and would likely be indirect. Many SMFR tools have entered the market in recent years, with Auramat^® being one of them, yet it has not been investigated to date. Therefore, this study aimed to determine the effects of Auramat^® (AUR) on posterior-chain flexibility and knee extensor (KE) function and to compare them with those of a traditional warm-up (TW). Methods: This study was a randomised, counterbalanced, cross-over design where 20 recreationally active participants (12 males, 8 females; age = 27.20 ± 4.98 years) attended the laboratory 3 times over a 2-week period. The first week consisted of a familiarisation session during which participants performed several tests. In the second week, the groups that were randomly assigned at AUR or TW conditions performed the two intervention protocols separated by 48 h. The pre-post ratings of perceived exertion (RPE), maximal voluntary isometric contraction (MVIC), straight leg raise test (SLRT) and rate of force development (RFD) were measured. All tests were performed on the dominant limb. Results: There was no significant difference in RFD and MVIC for conditions (p = 0.91), time (p = 0.24), or condition × time (p = 0.41). Both conditions improved posterior chain flexibility (p ≤ 0.01) with a larger effect in TW (d = 2.03; ↑ 7.81%) compared to the AUR condition (d = 0.89; ↑ 3.69%). RPE for TW showed significant higher RPE values compared to the AUR condition (p ≤ 0.01; ES = 2.32; TW = 4.3 ± 1.45 vs. AUR = 1.55 ± 0.82). Conclusions: Both SMFR with AUR and TW increased flexibility without any significant reduction in KE force production. Practitioners may use TW in a session where the aim is an increase in flexibility and AUR when the time is limited and the increase in fatigue can be relevant, due to the lower RPE reported. In any case, these results should be taken with caution since even the AUR was more time-efficient; the findings are preliminary owing to the small sample and absence of a control condition. Full article

Padel has gained considerable popularity in recent years; however, the characteristics of padel-related injuries characteristics and epidemiological estimates remain poorly defined. This scoping review aimed to describe the epidemiology, incidence, and prevalence of injuries in padel reported following PRISMA extension for scoping reviews (PRISMA-ScR) guidelines. The literature search was conducted between January and June 2025, and studies published within the last five years were eligible for inclusion. Studies were identified through PubMed, SCOPUS, and SPORTDiscus. Methodological quality was assessed using the Newcastle–Ottawa Scale (NOS) for observational and cohort studies and AMSTAR-II for systematic reviews. Fourteen studies including 3581 players were analyzed. In the upper limbs, the elbow was the most commonly injured region, followed by the shoulder, with a predominance of tendinous injuries, particularly involving the extensor carpi radialis brevis tendon. In the lower limbs, the knee and ankle were the most affected joints, with ligament injuries being the most frequent, mainly involving the anterior cruciate ligament and the posterior talofibular ligament, respectively. Padel shows a high incidence and prevalence of injuries, with limited evidence regarding treatment. This review provides a structured overview of injury patterns in padel that may inform clinicians and coaches when prioritizing prevention and conditioning strategies, while highlighting the need for prospective, standardized injury surveillance and padel-specific intervention research. Full article