Journal of Sports Medicine and Physical Fitness最新文献

Background: Weight-lifting among the pediatric population has surged during the last two decades motivated by the new evidence-based positive health effects. The increasing popularity of this activity has increased the number of emergency department (ED) presentations. Therefore, we sought to analyze the epidemiology of weightlifting-associated upper (UE) and lower extremity (LE) injuries in the pediatric population.

Methods: The National Electronic Injury Surveillance System (NEISS) was queried for the years 2003 to 2022. All UE and LE injuries presenting to the ED directly stemming from weightlifting activity were selected after careful narrative inclusion and exclusion.

Results: Weight-lifting injuries increased significantly from 2003 to 2022 in UE from 3527 to 5540 and in LE from 750 to 1853; there was a prominent dip during the COVID-19 pandemic years, from 4126 to 3479, and from 1789 to 1625, respectively (P<0.001). Numbers also increased in sports centers from 0.6% of injuries to 3.7% in UE and from 0.4% to 3.2% in LE (P<0.001), while decreasing in schools from 2.6% to 1.5% in UE and from 2.2% to 0.6% in LE (P<0.001). The majority of the pediatric population sustaining weight-lifting injuries were males, 85.1% in UE, and 77.5% in LE. Strains and sprains were the most common injuries, representing 46.4% of UE injuries and 40.6% in LE. The knee was the most commonly injured body part in LE accounting for 38% of total injuries and the shoulder in UE accounting for 33.4% of total injuries.

Conclusions: Our study found that UE and LE weight-lifting injuries among children and adolescents have increased in the past two decades. Injuries increased mostly in unsupervised settings like sports centers while decreasing in regulated milieus. They predominantly affected males and involved sprains, strains, and knee or shoulder injuries. This underlines the need for more research establishing guidelines for weight-lifting activities for children.

Introduction: Alzheimer's Disease (AD) is a form of dementia defined as a degenerative neurological condition associated with cognitive and functional decline above the natural and irreversible structural changes in body tissues caused by ageing. AD is the most common form of cognitive impairment in the population over 65 years old, also associated with poor functional mobility (FM) and balance, which can lead to falls in elderly populations.

Evidence acquisition: This systematic review, conducted according to the PRISMA and PROSPERO guidelines, assesses the effectiveness of various physical exercise interventions in improving functional mobility, balance and reducing the risk of falls in patients with Alzheimer's older than 65 years. A search has been conducted in PubMed, PEDro and Cochrane Library databases to identify relevant Randomized Controlled Trial studies. Only studies published in English focusing on Exercise, Exercise Intervention, Alzheimer's, Alzheimer's Disease, Functional Mobility, Mobility, Risk of Falling, Balance, Over 65, and combinations were included. The Cochrane RoB2 tool was used to assess the quality of the identified RCTs. Seven out of 5432 studies were included in the analysis.

Evidence synthesis: A moderate level of evidence suggests that interventions involving strength exercises, FM and balance are effective in improving mobility and balance in older Alzheimer's patients. Limited evidence indicates that this type of activity could also reduce the risk of falls.

Conclusions: Further recommendations concerning exercises, including walking activities, and suggestions for future studies on more comprehensive AD cohorts were discussed.

Background: There are many sport-specific factors in daily sport/competition environment that may negatively affect athletes and cause athletic shame or guilt linked with mental health problems. The aim of the present study was to establish psychometric data for the Turkish version of the Athletic Perceptions of Performance Scale (APPS-Tr) and evaluate correlates of athletic shame and guilt among adult Turkish professional athletes.

Methods: This cross-sectional online survey study utilized standardized scales to assess athletic shame and guilt, performance concerns, athlete-specific stress, depression, and anxiety. The survey was distributed to 960 Turkish professional athletes. A subset of participants (N.=45) provided APPS-Tr test-retest data at 30 days.

Results: A total of 426 athletes participated. Confirmatory factor analysis validated the APPS-Tr, test-retest data confirmed its temporal stability, and the reliability values were within an acceptable range. Younger athletes (compared to older counterparts) reported higher athletic guilt scores (P<0.01), while athletes with less sport experience (compared to more sporting experienced counterparts) reported higher athletic shame scores (P=0.04). Athletes who had experienced recent adverse life events were more likely to endorse athletic shame and guilt and performance concerns (P=0.01, P=0.01, P<0.01, respectively). Athletic shame was more strongly associated with athlete-specific stress, depression, and anxiety than athletic guilt (r>0.30 versus r<0.30).

Conclusions: Findings provide cross-cultural validation of the APPS assessing athletic shame and guilt among adult elite athletes. Consistent with other studies, athletic shame was more strongly associated with mental health problems than athletic guilt. Results suggest that athletes experiencing athletic shame and performance concerns may benefit from supportive coaching and/or mental health support.

Background: Reduced cognitive ability may affect sports performance and increase injury risk. Current cognitive function screening tools in athletes include stationary procedures that may lack external validity, whole-body movements, and time constraints. We aimed to study the reliability and the between- and within-session variations of newly developed cognitive-motor tests.

Methods: Twelve physically active participants participated in two experimental sessions. In each session, they completed a test battery to assess sport-relevant cognitive-motor domains (reaction time, processing speed, divided attention, visual memory, peripheral vision) using a specific training system, including devices with a LED matrix and proximity sensor. Each test comprised three blocks of 25 trials or 4 blocks of 20 trials. Test-retest reliability was assessed using two-way mixed-effects intraclass correlation coefficient. Within- and between-session changes were assessed using repeated measures ANOVA and paired t-tests.

Results: Reliability ranged from moderate to excellent (ICC: 0.51-0.94). Processing speed and divided attention scores significantly improved in the second session (Δ: 5.3-7.7%, P<0.017; Δ: 12.0-13.7%, P<0.001, respectively). No changes were detected within the same experimental day, except for divided attention that improved across session 1 (1^st vs. 3^rd block: Δ=5%, P=0.014).

Conclusions: Given the results, some tests can be discarded, or the number of trials reduced due to lower reliability and long duration, resulting in a test battery that is overall shorter but reliable and accurate. Further research is warranted to evaluate the predictive ability of this protocol for injury risk identification in different sport-relevant populations.

The Italian Cardiological Guidelines (COCIS) for competitive sports eligibility aims to assist physicians in evaluating athletes with cardiovascular conditions. The primary objective is to balance the significant benefits of physical activity with the risks of sudden cardiac death (SCD) in competitive sports. Historically, the COCIS guidelines have adopted a cautious approach, influenced by Italy's regulatory framework, which mandates a medical certificate for participation in competitive sports. The 2023 COCIS guidelines introduce significant advancements that enhance the evaluation process. These revised guidelines place a strong emphasis on personalized risk stratification. This approach enables physicians in specialized centers to make eligibility decisions based on an athlete's individual risk profile. Consequently, athletes with a low-risk profile may now be eligible for all types of sports, marking a substantial shift from the 2017 guidelines, which restricted even low-risk patients to low-intensity sports. On the other hand, the 2023 COCIS guidelines further reinforced some traditional concepts of the athlete's cardiovascular evaluation that have been the basis for an appropriate interpretation of clinical findings and the reduction of SCD in competitive athletes. This review critically examines the 2023 COCIS guidelines, focusing on their advancements compared to the 2017 edition and exploring their alignment with international standards, including the European Society of Cardiology and the American College of Cardiology recommendations.

Background: Although cardiovascular screening including exercise testing (ET) is a recognized tool, especially in high cardiovascular risk individuals, recommendations for master athletes over 35 years are still limited, and its predictive ability for detecting ischemic disease may be poor.

Methods: This cross-sectional study included 857 asymptomatic master athletes (mean age 46.2±7.4 years), with regular engagement in moderate to high intensity physical exercise and at least a submaximal exercise test result reaching 85% of the predicted maximum heart rate. Only 36 athletes (4% of the total) matched the conditions to be included in the high cardiovascular risk group.

Results: When analyzing exercise test results, only 35 athletes reached an abnormal result, which represents about 4% of the total: 10 individuals due to suspected ischemia, 18 due to abnormal tension response, and 7 for arrhythmic events. No differences were found according cardiovascular risk.

Conclusions: In this large sample of asymptomatic master athletes from a Mediterranean area, the rate of abnormal ET is very low and is apparently not related with cardiovascular risk.

Background: The application of the rating of perceived exertion (RPE)-clamp model has allowed for the examination of unique physio-psychological fatigue mechanisms in humans. This study examined the time course of composite and inter-individual responses in force, electromyographic (EMG) and mechanomyographic (MMG) amplitude (AMP) and mean power frequency (MPF), and neuromuscular efficiency (NME) during a sustained, isometric handgrip hold to failure (HTF) anchored to RPE of 5 (RPE=5) on 0-10 omnibus-resistance RPE scale in females.

Methods: Twelve females performed a handgrip HTF at RPE=5 while force (N), EMG and MMG AMP and MPF, and NME (normalized force/normalized EMG AMP) were recorded on the brachioradialis of the dominant arm. Separate, polynomial regression analyses were used to determine the individual and composite relationships for the normalized force, EMG and MMG AMP and MPF, and NME versus normalized time during the HTF at RPE=5.

Results: The time to task failure for the handgrip HTF at RPE=5 was 585.3±445.6 sec. There were linear and quadratic decreases in force and neuromuscular parameters (P≤0.05) for the composite responses. However, there was inter-individual variability in the patterns of these responses.

Conclusions: To maintain a moderate perceptual intensity over time, it was necessary to voluntarily decrease force, muscle excitation, motor unit recruitment and firing rates, but there were also likely fatigue-induced, intramuscular, metabolic perturbations. However, the variability in force and neuromuscular responses suggested that these responses should be examined on a subject-by-subject basis to provide better insight into fatigue mechanisms across different conditions of RPE-clamp exercise.

Background: The aim of this study was to describe and compare the relationship between hand-crank and treadmill spiroergometry in associated parameters.

Methods: Thirty-seven healthy volunteers completed two exhausting performance diagnostics on both ergometers.

Results: The maximum HRmax, VO2peak and ventilatory thresholds were significant higher on the treadmill ergometer (P<0.001). The metabolic thresholds occurred at higher lactate values on hand-crank ergometer. Equations for calculating VO2peak from the maximum power on hand-crank and for the maximum speed on treadmill ergometer could be found via regression analysis. Severe physiological differences between upper and lower muscle groups make it difficult to compare the performance parameters on hand-crank and treadmill ergometer.

Conclusions: The estimated equations can be used to give a first impression of how performance parameters should be evaluated in this case. The results quantify the relationship between two well established ergometry methods in endurance assessment during rehabilitation. Patients with non-persistent limitations of the lower extremities can be advised to start endurance training on the hand-crank ergometer. As soon as possible the training method can be switched to the treadmill and individual results can be assessed and compared. This could lead to an improvement in training concepts for rehabilitation of patients as well as top-athletes.