Search Results (24)

Background/Objectives: To analyse postoperative pain trajectories after anterior cruciate ligament (ACL) reconstruction using data from a digital rehabilitation system, and to determine (i) whether combined ligament injuries are perceived as more painful than isolated ACL tears, (ii) which patient characteristics are associated with clinically relevant pain (visual analogue scale [VAS] > 5), and (iii) whether higher early pain is associated with later discontinuation of digital monitoring. Methods: This retrospective cohort study used routine data recorded by a validated sensor-based home rehabilitation system in patients after ACL reconstruction. This approach has previously been used to analyse functional recovery trajectories. All patients with ACL-related indications who performed at least one postoperative test were included and classified into four groups: isolated ACL rupture, ACL + meniscus, ACL + collateral ligament, and ACL + collateral ligament + meniscus. Pain during exercises and tests was recorded on a 0–10 VAS. High pain was defined as VAS > 5. Group comparison between indication types, anthropometric and activity-related variables and the proportion of high-pain events were performed using chi-square tests. Early pain (first postoperative month) was analysed in relation to the presence of later tests (≥3 months) to explore associations with discontinuation of digital monitoring. Results: Combined ligament injuries showed a significantly higher proportion of high-pain events during rehabilitation compared with isolated ACL ruptures (5.8% vs. 2.4%, overall p < 0.001). In particular, combined ligament injuries with ACL + collateral ligament rupture were associated with a greater share of VAS > 5 ratings in the early rehabilitation phases. No relevant association was observed between sex or BMI category and the occurrence of high pain, while age group showed an overall association without a consistent directional pattern. Sport activity level showed a strong relationship with high pain (p < 0.001). Early pain demonstrated a small but statistically significant negative correlation with later test participation (r = −0.15, approximately 2% of variance, p = 0.0076); however, this association was attenuated and no longer statistically significant when analysed using mixed-effects models accounting for within-patient clustering, indicating that patients with higher early pain tended to discontinue digital monitoring. Conclusions: Digital routine data after ACL reconstruction suggest that (i) combined ACL–collateral ligament injuries are perceived as more painful than isolated ACL tears, (ii) high postoperative pain is more closely related to activity level and injury pattern than to sex or BMI, while age group shows an overall but non-directional association, and (iii) higher early pain shows a weak bivariate correlation with digital disengagement that was not confirmed in mixed-effects models. Pain is therefore an exploratory marker warranting further investigation, rather than a confirmed independent predictor of adherence in app-based rehabilitation. Full article

Background/Objectives: Physical activity behaviours are established early in life and tend to track across developmental stages. However, the role of continuity of sport participation across multiple developmental periods in shaping current physical activity levels remains insufficiently understood. This study aimed to examine the association between continuity of sport participation across developmental stages and current physical activity levels in university students, and to assess whether this association followed a graded pattern and differed by sex. Methods: A cross-sectional study was conducted among 796 fourth-year undergraduate students enrolled in a Primary School Education degree program at the University of Turin. Data were collected using an anonymous online survey. Current physical activity was assessed using the International Physical Activity Questionnaire—Short Form (IPAQ-SF) and categorised as non-active, sufficiently active, or active. Sport participation across six developmental stages was retrospectively assessed and summarised into a three-level continuity variable (discontinuous, intermediate, continuous). Associations were examined using chi-square tests and ordinal logistic regression models adjusted for sex, age, and body mass index (BMI). Predicted probabilities were estimated to aid interpretation. Results: Continuity of sport participation was significantly associated with current physical activity levels (χ²(6) = 67.55, p < 0.001), with a graded pattern evident. In adjusted models, discontinuous participation (OR = 0.24, 95% CI 0.14–0.39) and intermediate participation (OR = 0.62, 95% CI 0.46–0.82) were associated with lower odds of belonging to higher physical activity categories than continuous participation. Predicted probabilities showed a clear dose–response pattern, with progressively higher likelihoods of being active as continuity increased. This pattern was consistent across sexes, although males exhibited higher overall activity levels. Conclusions: Greater continuity of sport participation across developmental stages is associated with higher current physical activity levels. Promoting sustained engagement in sport may support the development of active lifestyles across the lifespan. Full article

Background: The use of implantable cardioverter defibrillators (ICDs) in elite athletes following sudden cardiac arrest (SCA) or the diagnosis of high-risk cardiac conditions presents a complex interplay of medical, psychological, and legal challenges. Despite evolving guidelines, data on clinical outcomes and return-to-sport (RTS) trajectories in elite athletes remain limited. Objective: To describe the clinical profiles, management strategies, and career outcomes of elite athletes who received ICDs. Methods: A retrospective multilingual media and literature search was performed up to January 2026 to identify elite athletes with ICDs. Inclusion criteria required evidence of professional or Olympic-level competition, confirmed ICD implantation, and sufficient clinical and career data. Cases were analyzed for demographics, underlying diagnosis, prevention type, post-ICD outcomes, and RTS status. Results: Thirty-seven elite athletes were identified (mean age 25.8 ± 4.3 years). The most common sport was football (n = 25). Hypertrophic cardiomyopathy, non-ischemic LV scar, and arrhythmogenic cardiomyopathy were the most frequent diagnoses, although 49% of etiologies remained unspecified. ICDs were implanted for secondary prevention in 70% of cases. Following ICD implantation, 25 athletes (68%) completed RTS, including 24 (65%) at the professional level. Among these, nine experienced shocks, and four ultimately discontinued competition. The sole fatality occurred in an athlete who had voluntarily explanted the ICD. Conclusions: A substantial proportion of elite athletes with ICDs successfully return to high-level sport, but clinical outcomes, risk tolerance, and legal frameworks remain variable. These findings support continued shifts towards personalized shared decision making and highlight the need for standardized, sport-specific RTS protocols, long-term registries, and psychosocial support in this population. Full article

Background: First rib stress fractures (FRSFs) are exceptionally rare in skeletally immature athletes and are frequently overlooked because their symptoms mimic more common scapular conditions such as scapular dyskinesis or thoracic outlet syndrome. Early and accurate identification is critical to avoid delayed union, prolonged disability, and misdirected management. Case Presentation: We report a 12-year-old elite baseball pitcher with progressive scapular winging and audible snapping during pitching. Unlike typical posterior-type fractures near the costotransverse joint, imaging revealed a cortical discontinuity precisely at the serratus anterior enthesis, consistent with repetitive traction enthesopathy. High-resolution musculoskeletal ultrasound (MSK-US) identified cortical disruption with periosteal edema, and dynamic ultrasound reproduced the patient’s snapping and pain in real time, establishing a direct clinical–imaging correlation. Conservative three-phase rehabilitation (scapular stabilization, serratus anterior activation, and structured return-to-throwing) led to complete union and pain-free return to sport within 12 weeks. Discussion: This case highlights the superior diagnostic efficacy of MSK-US for FRSFs in adolescents. The posterior scanning approach facilitated bilateral comparison and growth plate assessment. Dynamic examination provided a functional correlation beyond static imaging, identifying a novel snapping mechanism. This underscores the value of MSK-US in visualizing not just anatomy but also pathophysiology. Conclusions: This is among the youngest documented cases of first rib stress fracture diagnosed with dynamic ultrasound. Its novelty lies in the following: (1) occurrence at the serratus anterior enthesis, (2) reproduction of snapping during provocative maneuvers, and (3) expansion of the etiological spectrum of scapular dyskinesis to include rib pathology. Dynamic ultrasound should be considered a frontline modality for adolescent throwers with unexplained periscapular pain. Full article

Mental health challenges significantly impact NCAA Division III student athletes, often leading them to discontinue their sport. Unlike Division I athletes, they have limited institutional support, making it harder to balance academic and athletic demands. This qualitative study examines the mental health barriers influencing 21 former Division III athletes’ decisions to withdraw. Key themes include stress, burnout, identity loss, inadequate institutional support and external pressures like academics and finances. The findings highlight the need for better mental health resources, reduced stigma, and stronger institutional support. Addressing these challenges can improve athlete well-being and retention in Division III programs. Full article

The draping of textile semi-finished products for complex geometries is still prone to errors, e.g., wrinkles, gaps, and fiber undulations, leading to reduced mechanical properties of the composite. Reinforcing textiles made from carbon fiber (CF) rovings (i.e., endless continuous fibers) can be draped mainly based on their ability to deform under in-plane shearing. However, CF rovings are hardly stretchable in the fiber direction. These limited degrees of freedom make the production of complex shell-shaped geometries from standard CF-roving fabrics challenging. Contrary to continuous rovings, this paper investigates the processing of spun yarns made of recycled carbon fibers (rCFs), which are discontinuous staple fibers with defined lengths. rCFs are obtained from end-of-life composites or production waste, making them a sustainable alternative to virgin carbon fibers in the high-performance components of, e.g., automobiles, boats, or sporting goods. These staple fiber-spun yarns are considerably more stretchable, which is due to the ability of the individual fibers to slide against each other when deformed, resulting in improved formability of fabrics made from rCF yarns, enabling the draping of much more complex structures. This study aims to develop and characterize woven fabrics based on previous studies of rCF yarns for thermoset composites. In order to investigate staple fiber-spun yarns, a previous micro-scale modeling approach is extended. The formability of fabrics made from those rCF yarns is investigated through experimental forming tests and meso-scale simulations. Full article

Background/Objectives: Sports-related bone fractures are a common challenge in sports medicine, requiring accurate and timely diagnosis to prevent long-term complications and enable effective treatment. Conventional diagnostic methods often rely on manual interpretation, which is prone to errors and inefficiencies, particularly for subtle and localized fractures. This study aims to develop a lightweight and efficient deep learning-based framework to improve the accuracy and computational efficiency of fracture detection, tailored to the needs of sports medicine. Methods: We proposed a novel fracture detection framework based on the DenseNet121 architecture, incorporating modifications to the initial convolutional block and final layers for optimized feature extraction. Additionally, a Canny edge detector was integrated to enhance the model ability to detect localized structural discontinuities. A custom-curated dataset of radiographic images focused on common sports-related fractures was used, with preprocessing techniques such as contrast enhancement, normalization, and data augmentation applied to ensure robust model performance. The model was evaluated against state-of-the-art methods using metrics such as accuracy, recall, precision, and computational complexity. Results: The proposed model achieved a state-of-the-art accuracy of 90.3%, surpassing benchmarks like ResNet-50, VGG-16, and EfficientNet-B0. It demonstrated superior sensitivity (recall: 0.89) and specificity (precision: 0.875) while maintaining the lowest computational complexity (FLOPs: 0.54 G, Params: 14.78 M). These results highlight its suitability for real-time clinical deployment. Conclusions: The proposed lightweight framework offers a scalable, accurate, and efficient solution for fracture detection, addressing critical challenges in sports medicine. By enabling rapid and reliable diagnostics, it has the potential to improve clinical workflows and outcomes for athletes. Future work will focus on expanding the model applications to other imaging modalities and fracture types. Full article

Background/Objectives: Neural processes involved in visual detection, decision-making, and motor plan execution are believed to play a key role in the avoidance of sport-related injuries, but very little evidence exists to guide the development of training activities for the optimization of brain function. Immersive virtual reality provides a means to precisely measure the amount of time that elapses from visual stimulus presentation to the initiation of a motor response (i.e., perceptual latency) or its completion (i.e., response time). Methods: The median value of a metric quantifying both the speed and accuracy (i.e., the rate correct per second of response time) of 50 high school female soccer players was used to assign those who exhibited suboptimal performance to a training program. Training sessions required less than 5 min and the number of sessions completed over a 7-week period ranged from 3 to 13 (median = 5). Results: Among 42 players available for follow-up assessment at 8 weeks after the first practice session (training n = 19; comparison n = 23), the results of regression-discontinuity analyses demonstrated statistically significant differences (p < 0.05) for metrics representing fast/accurate movement initiation (i.e., the rate correct score for perceptual latency, p = 0.016) and across-trial consistency (i.e., perceptual latency variability, p = 0.027). From the first practice session to the end of the soccer season, 12 injuries were sustained by 10 players (four concussions and eight musculoskeletal injuries). A time-to-event analysis demonstrated strong associations with perceptual latency variability ≥ 0.143 (Hazard Ratio = 15.43, p = 0.011) and a lifetime history of at least one concussion (Hazard Ratio = 8.84, p = 0.008). Conclusions: The strong association of movement initiation consistency with the avoidance of concussion or musculoskeletal injury suggests that the training program may have a highly beneficial far-transfer effect. Full article

Abstract: Urban greenspaces have been essential in supporting residents’ well-being during the COVID-19 pandemic, particularly under strict lockdown measures. However, the impact of changing containment policies on residents’ perceived greenspace quality remains insufficiently explored. This study utilized online survey data collected between 11 October and 29 December 2022, in Shanghai, coinciding with the major policy shift on 5 December 2022. A probability proportionate to size sampling was adopted to survey residents aged 18 and above who had lived in the city for at least six months, yielding a total of 577 valid responses. We assessed residents’ perceived greenspace quality using 20 park- and community-level variables, focusing on both overall quality and specific features of greenspaces. A regression discontinuity design (RDD) was applied to evaluate how the lifting of the COVID-19 policies influenced residents’ perceptions of parks and community greenspaces. Our RDD estimation indicates no statistically significant change in residents’ overall perceived quality of parks after the policy shift, except for increased satisfaction with specific features such as plant diversity, maintenance, seating areas, trails, and large open spaces. In contrast, residents who responded after the policy shift reported a significantly higher perceived quality of community greenspaces compared to those who completed the survey before the shift (0.609 score difference, p < 0.01), with notable increases in satisfaction regarding plant diversity, maintenance, and seating areas. Perception of plant quantity remained unchanged in both types of greenspaces. Residents expressed greater satisfaction with sports facilities in parks, while community greenspaces were preferred for their water features and esthetic qualities. By adopting an RDD with a unique dataset, this study contributes empirical evidence to the current ongoing debate on the role of urban greenspace during the later stages of COVID-19. Specifically, it examines how changes in public health policy and the resulting increase in mobility might affect residents’ perceived greenspace quality. The findings can assist decision-makers and urban planners in developing more adaptive strategies to address the diverse needs of residents for greenspaces during the transitional period of a public health crisis. Full article

In this work, we propose an algorithm for the detection, measurement and classification of discontinuities in signals captured with noise. Our approach is based on the Harten’s subcell-resolution approximation adapted to the presence of noise. This technique has several advantages over other algorithms. The first is that there is a theory that allows us to ensure that discontinuities will be detected as long as we choose a sufficiently small discretization parameter size. The second is that we can consider different types of discretizations such as point values or cell-averages. In this work, we will consider the latter, as it is better adapted to functions with small oscillations, such as those caused by noise, and also allows us to find not only the discontinuities of the function, jumps in functions or edges in images, but also those of the derivative, corners. This also constitutes an advantage over classical procedures that only focus on jumps or edges. We present an application related to heart rate measurements used in sport as a physical indicator. With our algorithm, we are able to identify the different phases of exercise (rest, activation, effort and recovery) based on heart rate measurements. This information can be used to determine the rotation timing of players during a game, identifying when they are in a rest phase. Moreover, over time, we can obtain information to monitor the athlete’s physical progression based on the slope size between zones. Finally, we should mention that regions where heart rate measurements are abnormal indicate a possible cardiac anomaly. Full article

Background: Traumatic spinal cord injury (SCI) is a neurological disorder that causes a traumatic anatomical discontinuity of the spinal cord. SCI can lead to paraplegia, spastic, or motor impairments. Go-karting for people with SCI is an adapted sport that is becoming increasingly popular. The purpose of this case report is to shed light on the effects of driving a go-kart on a patient with SCI-related spasticity and to deepen understanding of the possible related role of whole-body vibration (WBV) and neuroendocrine reaction. Methods: The patient was a 50-year-old male with a spastic paraplegia due to traumatic SCI. He regularly practiced go-kart racing, reporting a transient reduction in spasticity. He was evaluated before (T0), immediately after (T1), 2 weeks after (T2), and 4 weeks after (T3) a go-kart driving session. On both sides, long adductor, femoral bicep, and medial and lateral gastrocnemius spasticity was assessed using the Modified Ashworth Scale (MAS), and tone and stiffness were assessed using MyotonPro. Results: It was observed that a go-kart driving session could reduce muscle spasticity, tone, and stiffness. Conclusions: Go-kart driving can be a valid tool to obtain results similar to those of WBV and hormone production in the reduction of spasticity. Full article

Most studies suggest that COVID-19 has adversely affected the quality of life and mental health, including eating disorders. However, studies have yet to examine longitudinally the impact of COVID-19 on eating disorder symptomatic individuals. This study aims to examine longitudinally the impact of the COVID-19 pandemic on the lifestyle and eating disorder symptoms of a symptomatic group of community-dwelling women. These women (n = 171) were enrolled in a longitudinal study, completed a COVID-19 modular self-report (post or Qualtrics, 2020/21), and participated in the current study. This study examined a 15th year follow-up. In 2020, 40% were tested for COVID-19. Of these, 87% had negative results; 5.3% self-isolated at home; 20.5% stopped working/studying in person; 28% continued online work/study; and 28% stopped work/studying in person. The pandemic affected sporting activities, music, and club activities (32.7% discontinued); 38% socialized in person; 16% socialized online; and 10% completely stopped socializing. Findings showed that the respondents showed no significant changes in levels of psychological distress (K10: 21.4 ± 9.8 vs. 19.0 ± 7.1, p < 0.171), and impaired quality of life (SF12: 50.9 ± 8.0 vs. 48.3 ± 9.5, p < 0.055) at 15-year follow-up. Eating disorder symptoms increased over time (EDE-Q global: 2.1 ± 1.4 vs. 2.9 ± 1.4, p < 0.013). Observed worsening of eating disorder-related symptoms during the COVID-19 pandemic may be due to interrupted eating patterns, exercise restrictions and the absence of social support. Provision and access to interventions to support those affected by eating disorders are a high priority, especially during these times. Full article

The diagnosis and treatment of cancer are associated with impairment at the physical and at psychological level. In addition, side effects are a potentially treatment-limiting factor that may necessitate dose reduction, delay, or even discontinuation of therapy, with negative consequences for outcome and mean survival. Numerous studies have shown that physical activity and sports and exercise therapy programs are not only practicable but also recommendable for oncologic patients during the acute phase and in the aftercare. Furthermore, nutrition plays an important role in all stages of tumor therapy. A timely integration of a nutrition therapy and physical activity in the form of physiotherapy and sports therapy serves to prevent and reduce treatment-associated side effects. Evidence-based recommendations on cancer prevention through nutrition therapy, physical activity, and sports and exercise therapy should be integrated into treatment plans for oncology patients as well as in health care services for the general population. Individual counselling by trained nutrition and exercise specialists may be advisable to receive concrete recommendations on the respective tumor entity or specific side effects. This mini review is based on a selective literature search in the PubMed database and Cochrane Central Register of Controlled Trials on the subjects of healthy diet and physical activity in primary prevention and follow-up about cancer. Full article

(1) Background: Physical exercise has been suggested to promote disease progression in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC). We aimed to investigate the exercise performance and ventricular function of ARVC patients during follow-up, while taking into account their adherence to exercise restriction recommendations. (2) Methods: This retrospective study included 49 patients (33 male, 67%) who had an exercise test at baseline and after 4.2 ± 1.6 years. Of the 49 ARVC patients, 27 (55%) were athletes, while 22 (45%) were non-athletes. Of the athletes, 12 (44%) continued intensive sports activity (non-adherent), while 15 (56%) stopped intensive physical activity upon recommendation (adherent). The maximum workload in Watts (W), percentage of the target workload (W%), and double product (DP) factor were measured for all patients. (3) Results: The non-adherent cohort had a significant decrease in physical performance (W at baseline vs. follow-up, p = 0.012; W% at baseline vs. follow-up, p = 0.025; DP-factor at baseline vs. follow-up, p = 0.012) over time. Left ventricular (LV) function (LV ejection fraction at baseline vs. follow-up, p = 0.082) showed a decreasing trend in the non-adherent cohort, while the performance of the adherent cohort remained at a similar level. (4) Conclusions: If intensive sports activities are not discontinued, exercise capacity and left ventricular function of athletes with ARVC deteriorates during follow-up. All patients with ARVC need to strictly adhere to the recommendation to cease intense sports activity in order to halt disease progression. Full article

Mobile health (mHealth) apps have great potential to improve health outcomes. Given that mHealth apps have become ubiquitous, there is limited focus on their abandonment. Data concerning crucial metrics, including reasons for adoption and discontinued use, are limited. This study aims to gain broad insights into utilization of mHealth and game-like features promoting user engagement. We conducted a cross-sectional survey of 209 mHealth users worldwide. The 17-item survey assessed sociodemographics, as well as the key motivators for mHealth uptake and discontinued use. Our findings show that sports and fitness activity tracking were the most common categories of health apps, with most users engaging with them at least several times a week. Interestingly, the most downloaded mHealth apps among younger adults include MyFitnessPal, Fitbit, Nike Run Club, and Samsung Health. Critical drivers of abandonment of mHealth apps were amotivation, loss of interest, and experimenting with different apps to identify the most suitable tool. Additionally, the financial cost of mHealth apps is crucial, with most participants advocating for free or more affordable apps. The study findings suggest that while many individuals utilize mHealth, several factors drive their abandonment. Moreover, data indicate that mHealth developers need to consider gamification strategies to sustain user commitment, as well as psychological variables, such as intrinsic motivation. Full article