Search Results (382)

The ongoing secular changes in human movement development means that an assessment of primitive reflexes is now required not only in disabled but also in neurotypical children. This study had three aims: (1) presenting the TASHUN test battery as suitable for the assessment of primitive reflex activity in normal children and child athletes; (2) analyzing reflex characteristics of neurotypical children; (3) verifying validity and reliability of tests. Spearman’s rank correlation and ROC analysis were used for validation. Intraclass Correlation Coefficient and RM ANOVA analyzed reliability. The test on 242 schoolgirls has demonstrated that retained primitive reflexes are present in almost every individual (84.7–95.7%). Correlations showed strong positive association, with all values exceeding 0.8, and ROC analysis demonstrated excellent predictive strength (AUC values over 0.9). Interobserver reliability showed excellent agreement (ICC values above 0.9). No significant offset was present among the scoring by evaluators. Therefore, testing for primitive reflexes is necessary in neurotypical children in order to obtain a realistic image about the physiology of reflexes and their role in motor development. Our screening could be useful for practicing sport professionals, researchers and academics, to identify deficiencies, to further explore reflexes and to train future PE teachers and trainers. Full article

Background: Individuals with intellectual disability face an increased risk of mental health issues compared to the general population. Despite the proven efficacy of physical activity (PA) in improving anxiety and depression in the general population, little is known about this relationship in adults with intellectual disability and the factors that influence it. The purpose of the study was to determine whether a correlation exists between PA and perceived levels of anxiety and depression, and assess gender disparities in PA and mental health. Method: People with intellectual disability were recruited from day centers and sports events. The amount of PA was evaluated through the International Physical Activity Questionnaire. Perceived mental health was assessed through the Zung Self-Rating Anxiety (ZAS) and Depression Scale (ZDS). Results: In total, 99 adults (34 females, aged 33 ± 12) participated in the study. A gender disparity was found in anxiety levels, while depression, PA, and type of sport participation did not differ between males and females. Multiple regression analysis highlights how the depression score was significantly predicted by gender (β = −3.57, p = 0.015), intellectual disability level (β =−3.08, p < 0.008), and PA (β =−0.10, p= 0.001), while anxiety was influenced by gender (β = −4.48, p = 0.003) and intellectual disability level (β = −3.23, p = 0.007). Conclusions: These findings underscore the relevance of physical activity as a factor associated with lower depressive symptoms in adults with intellectual disability, highlighting its potential role in mental health promotion within this population. Full article

Background: The perceived importance of physical practice and its contribution to students’ academic success have evolved considerably throughout the history of the modern educational system. Aim: The purpose of this study was to understand the relationship between physical fitness (measured as VO₂max) and cognitive abilities (attention and concentration) and academic performance in different subjects: sciences, letters, language, arts, and physical education. Method: Fifty Spanish male students who participated in extracurricular sports activities (mean age (SD): 11.59 ± 1.30; range: 9–15 years) were included in the analysis. The 6 min walk test was used to assess physical fitness (6MWT), while for selective attention and concentration, the students completed the D2 test, which is usually considered to analyse the visual ability to select the most relevant stimulus of an exercise and ignore precisely the most irrelevant stimuli. Results: Correlation the individual contribution analyses revealed no significant associations between VO₂max and academic performance in sciences (r = 0.04, p = 0.77), humanities (r = 0.00, p = 0.98), language (r = 0.03, p = 0.83), or arts (r = 0.04, p = 0.76). Similarly, no relationship was found between VO₂max and overall academic performance (r = 0.10, p = 0.46), or cognitive abilities. However, a small positive correlation was observed between VO₂max and physical education scores. Conclusions: Physical fitness showed no significant association with cognitive abilities or academic performance in most subjects, although a small positive correlation with physical education scores was observed. These findings emphasise the importance of promoting physical activity for its health and physical benefits. However, future research should explore broader cognitive outcomes and include more diverse and representative samples. Full article

Background/Objectives: Patellar instability in adolescents is a significant cause of short- and long-term morbidity and disability. Traditionally, patients with first-time patellar dislocation are managed nonoperatively, although most studies are not focusing on the adolescent athletic population. The primary objective of the current study was to compare patient-reported outcomes and complications in adolescent athletes who underwent surgery either after the first patellar dislocation or after the recurrence of the dislocation with a minimum postoperative follow-up of 48 months (48–75 months). Methods: A total of 39 adolescent athletes who underwent medial patellofemoral ligament (MPFL) reconstruction (Group A, after the first dislocation, and Group B, recurrent patella dislocation) were included in this study. In all the patients, the same MPFL reconstruction technique was applied using a semitendinosus autograft. The graft was fixed on the patella using a transverse tunnel and adjustable loop button fixation and, in the femur, using a tunnel and absorbable screw fixation. The tunnel was drilled obliquely to prevent penetration of the distal femoral physis. The preoperative and postoperative clinical and functional evaluations of the patients were conducted via the visual analog scale (VAS), the Lysholm Knee Scoring System, the Kujala Anterior Knee Pain Scale, and the Pediatric International Knee Documentation Committee (Pedi-IKDC), and the return to sports score was assessed via the Tegner Activity Scale (TAS). Results: At the latest follow-up, both groups demonstrated significant improvement in the Lysholm scores, with Group A achieving a mean of 92.57 ± 6.21 and Group B achieving a mean of 90.53 ± 8.21 (p = 0.062). Postoperatively, Group A achieved a mean Kujala score of 94.21 ± 9.23, whereas Group B reached 92.76 ± 12.39, with no statistically significant difference (p = 0.08). The Pedi-IKDC score improved postoperatively in both groups. In Group A, it increased from 67.98 ± 12.29 to 93.65 ± 4.1, and in Group B, from 56.21 ± 13.6 to 91.67 ± 6.21 (p = 0.067). The preoperative visual analog scale (VAS) score for pain was significantly lower in Group A (3.1 ± 1.13) than in Group B (4.2 ± 3.01, p < 0.01). At the latest follow-up, the VAS scores improved in both groups, with Group A reporting a mean score of 0.47 ± 1.01 and Group B 0.97 ± 1.32 (p = 0.083). The Tegner activity scores were similar between the groups preoperatively, with Group A at 7.72 ± 1.65 and Group B at 7.45 ± 2.09 (p = 0.076). Postoperatively, Group A had a mean score of 7.28 ± 2.15, whereas Group B had a mean score of 6.79 ± 3.70 (p = 0.065). The mean time to return to sports was significantly shorter in Group A (5.1 ± 1.3 months) than in Group B (7.6 ± 2.1 months) (p < 0.01). Overall, 84.61% of the patients returned to their previous activity level. Specifically, 95.2% (20/21) of patients in Group A achieved this outcome, whereas 72.22% (13/18) achieved it in Group B. Patient satisfaction was generally high, with 76% (16/21) of patients in Group A reporting being satisfied or very satisfied, compared with 77% (14/18) in Group B. Conclusions: MPFL reconstruction is a safe and effective procedure for both acute and recurrent patellar dislocation in adolescent athletes. While patients who underwent acute reconstruction returned to sport more quickly and showed higher absolute postoperative scores, the greatest overall improvement from preoperative to final follow-up was observed in those treated for recurrent instability. Both surgical approaches demonstrated high satisfaction rates and minimal complications, supporting MPFL reconstruction as a reliable option in both acute and recurrent cases. Full article

Background and Objectives: Sesamoiditis is a painful and functionally limiting condition that affects the sesamoid bones of the hallux, frequently seen in athletic populations. Despite its clinical relevance, there are no standardised guidelines for its conservative management. This systematic review aims to evaluate the effectiveness of conservative treatments for sesamoiditis by summarising individual-level data from published studies. Materials and Methods: A comprehensive literature search was conducted in PubMed/MEDLINE, Scopus, ISI/Web of Science, and PEDro (Physiotherapy Evidence Database) up to December 2024 in accordance with PRISMA 2020 guidelines and following a protocol specifically devised for rare or underrepresented medical conditions. Eligible studies included case reports and case series involving patients aged ≥16 years who were conservatively treated for clinically and/or radiologically diagnosed sesamoiditis. Data on patient demographics, diagnosis, type and duration of treatment, pain- (Visual Analogue Scale (VAS) and Numeric Rating Scale (NRS)) and function-related (Foot and Ankle Ability Measure (FAAM) and Foot and Ankle Outcome Score (FAOS)) outcomes, and return to activity were extracted. Study quality was assessed using Joanna Briggs Institute (JBI) critical appraisal tools. Pooled effect sizes were computed where applicable. Results: Out of 2380 initial records, 11 studies comprising 59 patients (29 females) were included. Treatments varied widely, including orthotics, corticosteroid injections, physical therapy, and biologic approaches such as concentrated bone marrow aspirate (CBMA). VAS scores improved in 66% of cases. NRS scores returned to baseline in some patients after initial improvement, revealing recurrence. FAAM and FAOS subscales showed functional improvements, particularly in sports-specific domains. Return to activity varied: in a case series, 45.4% resumed pain-free sports participation, while others remained symptomatic. Conclusions: Conservative treatment options for sesamoiditis showed variable effectiveness with promising outcomes in selected patients. Corticosteroid injections and orthotics appeared beneficial, but high recurrence and limited functional recovery persisted in some cases. Standardised treatment protocols and high-quality prospective studies are needed to improve clinical decision-making and optimise non-surgical management. Full article

Sleep is critical for cognitive and psychomotor performance in demanding decision-making contexts such as sports officiating. Given the lack of research in the field, the cognitive complexity, and the high-pressure environment of judo refereeing, this study aimed to evaluate the sleep quality of active judo referees and examine differences based on gender, age, refereeing experience, and athletic background. This cross-sectional study included 73 active Turkish judo referees (42 male, 31 female; age = 29.8 ± 11.0 years). Participants completed the Pittsburgh Sleep Quality Index (PSQI), and data were analysed using t-tests, ANOVA, correlation, regression, and mediation analyses. Data showed a mean sleep time of 7:43 + 1:27 and a total PSQI score of 7.21 + 3.53, and participants had been referees for a mean of 6.58 + 8.12 years. The overall sleep quality was suboptimal, with female referees reporting significantly poorer sleep than males. No significant differences in PSQI scores were found across referee seniority levels or educational levels. Correlation analysis showed significant negative associations between PSQI scores and both age and refereeing experience. The final hierarchical regression model with the age, gender, and athletic background significantly predicted PSQI scores. Mediation analysis further revealed that referee qualification level indirectly influenced sleep quality through age. The study is the first one in this area of judo referring, and it highlights poor sleep quality among judo referees, regardless of experience or qualification level, with gender, age, and athletic background emerging as key predictors. The lack of sleep education in both athletic and refereeing careers suggests a need for targeted interventions, especially for younger and female referees, to improve performance and prevent health issues. Further research is needed to explore these relationships over time and in elite-level referees. Full article

Background/Objectives: The most common limb-salvage procedure for end-stage ankle arthropathy with severe bone defect is arthrodesis. Successful fusion requires rigid metal fixation, effective filling of the bone defect space, and maximal securing of the contact area between the tibia and talus. In cases with severe bone defect, sufficient grafting using autogenous bone alone is limited, and there is still controversy regarding the effectiveness of allogeneic or xenogeneic bone grafting. This study aimed to evaluate the intermediate-term clinical outcomes after shortening arthrodesis using fibular osteotomy for ankle arthropathy with severe bone defect. Methods: Twenty-two patients with shortening ankle arthrodesis were followed up ≥ 3 years. All operations were performed by one senior surgeon and consisted of internal fixation with anterior fusion plate, fibular osteotomy, and autogenous bone grafting. The causes of ankle joint destruction were failed total ankle arthroplasty (7 cases), neglected ankle fracture (6 cases), delayed diagnosis of degenerative arthritis (5 cases), avascular necrosis of talus (2 cases), and diabetic neuroarthropathy (2 cases). Clinical outcomes including daily living and sport activities were evaluated with the Foot and Ankle Outcome Score (FAOS) and the Foot and Ankle Ability Measure (FAAM). Radiological evaluation included fusion rate, time to fusion, leg length discrepancy, and degenerative change in adjacent joints. Results: The FAOS and FAAM scores significantly improved from a mean of 21.8 and 23.5 points preoperatively to 82.2 and 83.4 points at final follow-up, respectively (p < 0.001). Visual analogue scale for pain during walking significantly improved from a mean of 7.7 points preoperatively to 1.4 points at final follow-up (p < 0.001). The average time to complete fusion was 16.2 weeks, and was achieved in all patients. The average difference in leg length compared to the contralateral side was 11.5 mm based on physical examination, and 13.8 mm based on radiological examination. During the average follow-up of 56.2 months, no additional surgery was required due to progression of degenerative arthritis in the adjacent joints, and no cases required the use of height-increasing insoles in daily life. Conclusions: Shortening ankle arthrodesis using fibular osteotomy and anterior fusion plate demonstrated satisfactory intermediate-term clinical outcomes and excellent fusion rate. Advantages of this procedure included rigid fixation, preservation of the subtalar joint, effective filling of the bone defect space, and maximal securing of the contact area for fusion. The leg length discrepancy, which was concerned to be a main shortage, resulted in no significant clinical symptoms or discomfort in most patients. Full article

Background: Physical inactivity among adolescents, particularly females in conservative societies like Saudi Arabia, poses significant risks to both physical and psychological health. Cultural norms, environmental constraints, and limited access to gender-appropriate sports facilities further exacerbate the problem. Understanding these factors is essential for developing effective, context-sensitive interventions. Aim: This study aimed to examine the relationship between daily physical activity behaviours and health outcomes, both physical and psychological, among adolescent females in Saudi Arabia. This paper also explores the impact of socio-environmental variables such as income, household size, and urban/rural residence on activity levels and wellbeing. Methods: A cross-sectional survey of 636 adolescent females aged 13–21 was conducted using validated instruments. The Physical Activity Questionnaire for Adolescents (PAQ-A) measured physical activity levels, and the Self-Rated Health (SRH) assessed psychological wellbeing and health-related quality of life. The analysis employed an Ordinal Logistic Model (OLM) guided by the Social Ecological Model (SEM) to assess predictors of physical activity participation. Results: The OLM results indicated that higher income levels, smaller household size, urban residence, and older age categories were significantly associated with higher levels of physical activity (p < 0.05). Participants with higher PAQ-A scores reported better psychological health and quality of life. The model showed a good fit, with a pseudo-R² of 0.36. Cultural and environmental barriers, particularly in rural areas, were identified as significant deterrents to participation. Conclusions: The findings highlight the urgent need for culturally adapted, gender-sensitive health promotion programs that target both individual and structural barriers to physical activity among adolescent girls in Saudi Arabia. Enhanced societal support and accessible sports infrastructure could significantly improve health outcomes and quality of life. Full article

Inclusive Education emphasizes equal opportunities for all students by reducing or eliminating barriers that hinder participation and learning, encompassing cultural, social, practical, and political dimensions. In this context, the development of positive attitudes towards disability is a key component for the success of inclusive educational practices, particularly in adapted physical education. Following a prior analysis of the impact of academic curricula on attitudes toward disability, the need to implement training programs focused on attitudes toward disability becomes evident. The aim of this study is to analyze how a training program, with a specific focus on attitudes toward disability, affect the attitudes among university students. A quasi-experimental approach with a control group was employed to evaluate the impact of the training. A total of 137 University students from Extremadura, across Physical Activity and Sport Science and Early Childhood Education programs within the same educational department, participated in this study. The Spanish Attitudes Toward People with Disabilities Scale for Professionals was administered to students at the beginning, after the theoretical intervention, and after having a guided contact with people with disability. Results revealed improvements in attitudes in the social relationships and normalized life dimensions, as well as in the total score, particularly among students from Early Childhood Education. No significant changes were observed in the intervention program dimension. Within-group analysis indicated significant longitudinal improvements in normalized life for both experimental groups, Sports Science and Early Childhood Education students, and in the total score for Early Childhood Education students by the end of the intervention. These findings highlight the importance of targeted training interventions in promoting inclusive attitudes, especially when direct contact with individuals with disabilities is incorporated. Full article

Background: Hallux rigidus (HR) is a common forefoot disorder, and surgical treatment is typically guided by the severity of the condition, as defined by the Coughlin and Shurnas four-grade classification. This study aimed to compare clinical and functional outcomes in patients undergoing first metatarsophalangeal joint arthrodesis (FMTPJA) with or without the use of an interfragmentary (IF) screw in addition to a dorsal plate. Methods: We retrospectively evaluated a cohort of patients who underwent surgery with a FMTPJA, dividing patients in two groups: patients who underwent FMTPJA through dorsal plate associated with an interfragmentary screw (WIS group) and patients who underwent FMTPJA through dorsal plate without an interfragmentary screw (WOIS group). The primary outcomes were analyzed using the FAAM score and FAAM sport score. Secondary outcomes included VAS, patient satisfaction, recovery time to return to sports, and the level of postoperative sports activity compared to preoperative levels. Results: In paired analyses, the WOIS group showed statistically significant improvements in both the FAAM and FAAM sport scores (p = 0.01). In contrast, the WIS group showed significant improvement only in the FAAM sport score (p = 0.01), while the FAAM score did not reach statistical significance (p = 0.42). Multivariate analysis revealed that a higher preoperative FAAM score predicted a higher postoperative FAAM score (p = 0.75), while the use of an IF screw was associated with a lower expected postoperative FAAM score (p = 0.25). Increased BMI and older age were significantly associated with lower postoperative FAAM scores. Conclusions: Both surgical techniques led to significant clinical improvements. However, patients in the WOIS group showed a trend toward faster recovery and higher postoperative sports activity levels, particularly in the athletic population. Although no statistically significant differences were found between groups overall, these findings suggest potential benefits of avoiding an IF screw in selected patients. Further prospective studies are warranted to better delineate the clinical impact of screw usage in FMTPJA. Full article

Background: Internal hemipelvectomies are rare procedures for primary musculoskeletal sarcomas of the bony pelvis. There is a sparse amount of data on functional outcomes and activity levels in postoperative patients. The aim of this study was to investigate functional outcomes, including sport activity levels, and the impact of tumor grade, resection margins, adjuvant therapies, pelvic reconstruction, and patient age at the time of surgery. Methods: Patients who underwent internal hemipelvectomy at our clinic between 1995 and 2019, with a minimum follow-up of 12 months, were assessed using the Musculoskeletal Tumor Society Score (MSTS), the Toronto Extremity Salvage Score (TESS), the Oxford Hip Score (OHS), and the University of Los Angeles Activity Scale (UCLA AS). Results: Our cross-sectional study included 29 patients (14 male, 15 female; 15 with chondrosarcoma, 8 with Ewing’s sarcoma, 2 with osteosarcoma, 2 with chordoma, and 2 with other sarcomas) with a median follow-up of 8.7 years (range: 12 months to 25.4 years; interquartile range (IQR): 13.1 years). The median MSTS was 16 (range: 1–30; IQR: 9), median TESS was 75.8% (range: 12.9–100%; IQR: 31.7%), median OHS was 35 (range: 10–48; IQR: 16), and median UCLA AS was 5 (range: 1–9; IQR: 3). Tumor grade, resection margins, chemotherapy, radiation therapy, and pelvic reconstruction had no significant effect on functional outcomes. Patient age at the time of surgery had a statistically significant effect on all measured outcome parameters, although all parameters exhibited a wide range and large IQR, likely reflecting the small, heterogeneous patient cohort. Conclusions: Surviving patients who underwent internal hemipelvectomy for primary musculoskeletal sarcomas of the pelvic bone demonstrated overall moderate to good functional outcomes and moderate sport activity levels. Full article

(1) Background: Pain experiences are shaped by both physical injury and psychological distress, posing challenges for orthopedic care. While surgery may alleviate injury-related distress, the extent of psychological improvement post surgery remains unclear. Thus, the purpose of this study was to evaluate changes in general and pain-specific psychological distress after surgical intervention for musculoskeletal injury. (2) Methods: A retrospective review was conducted on 133 patients who underwent musculoskeletal surgery between February 2020 and August 2022 by a single sports medicine fellowship-trained surgeon. Psychological distress was assessed using the Optimal Screening for Prediction of Referral and Outcome Yellow-Flag (OSPRO-YF) tool, both before and at least six months after surgery. Pre- and postoperative scores were compared using paired t-tests, and clinically meaningful changes were evaluated using a distribution-based minimal clinically important difference (MCID) threshold. (3) Results: Significant reductions were found in total OSPRO-YF scores and several subdomains including fear avoidance (physical activity and work), kinesiophobia, and pain anxiety. However, 88% of patients showed no meaningful change in overall psychological distress. In patients with high baseline distress, over 20% showed meaningful improvement in six subdomains. (4) Conclusions: Psychological distress often persists after musculoskeletal surgery. Targeted psychological interventions may benefit patients with high preoperative distress. Full article

Background: The rising prevalence of childhood obesity (CO) has been strongly linked to physical inactivity and sedentary behavior. Early development of functional movement skills (FMS) is crucial for fostering active lifestyles and preventing CO. Methods: We assessed the FMS of 102 children aged 3–5 using the MOBAK test battery. Parents completed a Likert-scale questionnaire evaluating their perception of their child’s motor competence. Results: A total of 102 children and 92 parents participated. Although 61.1% of children engaged in regular sports activities, only 20.5% reached a satisfactory MOBAK total score (Score 3). Significant gender differences emerged in locomotor skills (Score 2) and overall performance (Score 3), with p-values < 0.026 and <0.016, respectively. A significant negative correlation between BMI and Score 2 was observed (p < 0.030). Parents significantly overestimated their children’s FMS (p = 0.0001). Conclusions: Findings emphasize the importance of early interventions targeting FMS enhancement and parental education to effectively support CO prevention strategies and promote lifelong physical activity. Full article

Background: Gender differences in dietary patterns and lifestyle behaviours may influence abdominal adiposity and cardiometabolic risk, but comprehensive analyses integrating these factors remain limited. Methods: We conducted a cross-sectional study including 1631 adults recruited from a centre specialising in nutrition and metabolic health. Food intake was assessed by 7-day food diaries and lifestyle behaviours were assessed by structured questionnaires. Z scores of a body shape index (zABSI) were calculated as a marker of abdominal adiposity. zABSI represents the standardised value of ABSI, an index specifically designed to assess abdominal adiposity independently of BMI Multivariable linear regression models, stratified by sex and adjusted for age, examined associations between dietary patterns, physical activity and zABSI. Results: Higher intake of plant-based protein was significantly associated with lower zABSI values in women (β = −0.052, p = 0.0053) but not in men (β = −0.015, p = 0.2675). Stratified analyses revealed that women in the middle tertile of plant-based protein intake showed significantly lower zABSI values than men. Combined analyses showed that women classified as physically active and high consumers of plant-based protein had the most favourable abdominal adiposity profiles (p = 0.0036). Participation in endurance and strength sports was associated with lower zABSI values in both sexes, whereas women engaged in team sports had the lowest zABSI values. No significant interaction terms between sex and lifestyle were identified; however, male sex remained an independent predictor of higher zABSI values. Conclusions: In this cross-sectional study, plant-based dietary patterns and physical activity were associated with lower abdominal adiposity, especially among women. These findings suggest the importance of gender-specific strategies to address cardiometabolic risk and emphasise the need for prospective studies to confirm these associations and clarify the underlying mechanisms. Full article

Background/Objectives: Aquagym is a form of practicing aerobic gymnastics to stay fit, which is constantly progressing in line with the dynamics of market growth and the fitness industry, bringing benefits to physical and mental health. The purpose of the study was to identify the level of popularity of this sport among people aged 20–65 years and to highlight the benefits of practicing aquagym. Methods: This quantitative research study was designed to use a structured questionnaire to collect data from 150 participants. The sample was chosen to reflect various age groups and to ensure representativeness for the general population interested in physical activity. Participants were divided by gender into two age categories, under 45 and over 45, in order to examine differences in preferences and perceptions between these age segments. For the analysis of between-group differences, we used the Chi-Square and Cramer’s V tests, and for the profile of respondents, a Two-Step Cluster Analysis was applied. Results: Regarding knowledge of the aquagym concept, there is a notable discrepancy between females and males, with significantly more women (54%) than men (18%) stating that they are familiar with this concept. Among the perceived benefits of water gymnastics, most responses indicate maintaining muscle tone (25% women and 14% men) and a fun way to stay fit (20% women and 11% men). Young people under 45 years of age tend to attach more importance to the social and entertaining aspects of aquagym. As for the improvement in quality of life by practicing water gymnastics, a large number of respondents (82%) rated this contribution with a score of 4 or 5 on a 5-point scale, meaning that the positive impact of this activity was highly appreciated. Conclusions: Aquagym lessons are perceived as both an effective form of exercise for health improvement and a means of socialization. The outcomes of the study highlight the opportunity to continuously promote and develop gymnastics in the aquatic environment as an accessible and enjoyable form of physical activity for all ages. Full article