BMC Sports Science Medicine and Rehabilitation最新文献

Background: We investigated associations of movement behaviors (moderate-vigorous physical activity, light physical activity, and stationary time) with various parameters measured during cardiopulmonary exercise testing. We applied compositional data analysis to account for the relative contributions of different movement behaviors to the overall time budget of the waking day.

Methods: We used data from 1,396 participants of the cross-sectional population-based Study of Health in Pomerania (SHIP-TREND-1), who provided valid accelerometer data worn on the hip for seven days during waking hours and participated in cardiopulmonary exercise testing on a cycle ergometer (n = 1,396 participants with a mean age of 57.1 (SD 13.2, 51% men). Linear regression models applying compositional data analysis were used to examine associations of proportions of movement behaviors (exposure) with parameters derived during cardiopulmonary exercise testing (outcome) normalized for body weight and stratified by sex. Models were adjusted for age, education, smoking, and partnership, except the %predicted VO₂peak model, where age was omitted, as it is part of the calculation of the %predicted VO₂peak. In models examining O₂pulse or HRmax, individuals using beta blockers were excluded.

Results: In males and females, more time spent in moderate-to-vigorous physical activity was associated with greater VO₂VT1, VO₂peak, and VO₂ recovery after 60 s (all p < 0.01). Greater moderate-to-vigorous physical activity was also related to higher %predicted VO₂peak and maximum heart rate in males and to higher VO₂/work in females (all p < 0.01). In both sexes, more time in stationary time was associated with less %predicted VO₂peak (p < 0.01). More light intensity physical activity was associated to higher %predicted VO₂peak in both sexes and with lower VO₂/work in women (all p < 0.01). Greater stationary time was related to less VO₂/work, VO₂VT1, and VO₂peak in males and to less VO₂ recovery after 60 s and O₂pulse in females (p values < 0.05).

Conclusion: Moderate-to-vigorous physical activity (positive) and stationary time (inverse) influence parameters derived during cardiopulmonary exercise testing irrespective of age, smoking, and living in a relationship. The sex specific effects were rather small. Hence, promoting physical activity should be encouraged to increase cardiorespiratory fitness.

Background: Limited lower-extremity flexibility has long been debated as a physical risk factor contributing to low back pain in various populations. However, its impact on younger populations, particularly elementary school-aged softball players, remains unclear. This study aimed to explore the relationship between limited lower-extremity flexibility (iliopsoas, hamstrings, and quadriceps femoris) and low back pain in elementary school-aged softball players.

Methods: This cross-sectional study included 521 elementary school-aged softball players (469 males and 52 females; mean age, 10.7 years) who participated in annual medical evaluations from 2017 to 2019. Lower-extremity flexibility was assessed once during annual medical evaluations using the Thomas test for the iliopsoas, straight-leg-raise test for the hamstrings, and heel-to-buttock-distance test for the quadriceps. Additionally, low back pain during the previous season was evaluated through self-administered questionnaires distributed to participants and collected during medical check-ups. The prevalence of low back pain and its association with lower-extremity flexibility were investigated using univariate and multivariable analyses. In multivariable analysis, age, position, body mass index, and total practice time per week were included as explanatory factors.

Results: Overall, 16.9% (88/521) of the players experienced low back pain that required rest during the previous year. After adjustment for confounding factors (age, position, body mass index, and total practice time per week) with a logistic regression model, low back pain showed a significant association with quadriceps muscle tightness (odds ratio: 3.15, 95% confidence interval: 1.51-6.56, P = .002).

Conclusion: Quadriceps femoris tightness may be a significant risk factor for low back pain in elementary school-aged softball players. These findings underscore the importance of assessing quadriceps femoris tightness to prevent low back pain in elementary school-aged softball players.

Trial registrations: Not applicable.

Introduction: Concussion is a common condition, with sources estimating between 1.2% and 6.6% of all ED presentations are related to head injury, and concussion has significant healthcare costs. In April 2023, the UK Government published guidelines for diagnosis and management of concussions in grassroots sport, recommending anyone that has sustained a suspected concussion has a same day review by an appropriate healthcare professional. It is therefore essential that emergency medicine physicians have the required knowledge and use current clinical practice guidelines in managing suspected concussions presenting to their departments. This scoping review aims to review the current literature regarding concussion knowledge, diagnosis and management amongst emergency physicians.

Materials and methods: This scoping review was conducted using the six-step process laid out by Arksey and O'Malley and included 17 papers from January 2012 to February 2023, identified by searching 5 online databases (MEDLINE, Embase, Web of Science, Scopus and Google Scholar) in February 2023 alongside a hand search of references. Search terms relevant to concussion, emergency medicine and medical education were used.

Results: 14 of the 17 papers originated from North America, all studies utilised either an online survey or chart review methodology. 3 papers included an educational intervention. 12 studies looked at all grades of EMPs. 14 of the studies highlighted knowledge gaps amongst EMPs, the 3 that did not specifically mention this were the 3 interventional studies.

Conclusion: EMPs have large knowledge gaps regarding concussion and limited adherence to current guidelines. Efforts should be made at improving these results amongst EMPs. Further research is needed to find the most beneficial and cost-effective approach to improving concussion knowledge of concussion diagnosis and management in EDs, particularly within the UK.

Background: This study compared the accuracy of three generalized approaches for estimating proximity to failure during the Smith machine bench press: (i) the relationship between relative load (%1RM) and maximum repetitions performed to failure (%1RM-RTF), (ii) the relationship between maximum repetitions to failure and fastest set velocity (RTF-velocity), and (iii) the relationship between repetitions left in reserve (RIR) and lifting velocity (RIR-velocity).

Methods: Nineteen physically active men (22.9 ± 2.7 years old) with at least two years of resistance training experience participated. Their 1-repetition maximum (1RM = 86.8 ± 16.7 kg) was determined during the first session. In the second session, participants performed single sets to failure at 60% and 80% 1RM, with proximity to failure (2RIR and 4RIR) estimated using each approach.

Results: The RIR-velocity relationship was the only approach that did not significantly deviate from the intended RIR (errors = -0.4 to 0.6 repetitions). In contrast, both the %1RM-RTF and RTF-velocity relationships overestimated the intended RIR at 60%1RM for both 2RIR (2.9 and 5.8 repetitions, respectively) and 4RIR (2.8 and 5.7 repetitions, respectively), while no significant differences were observed at 80%1RM (errors = -0.6 to 0.9 repetitions). The RIR-velocity relationship generally demonstrated the lowest absolute errors compared to the actual RIR (1.3 ± 0.7 repetitions), with greater differences compared to the other two approaches at lighter loads and closer proximities to failure.

Conclusions: In the absence of individual relationships, the general RIR-velocity relationship should be used by coaches to control the proximity to failure of their athletes during the bench press exercise.

Background: Heart rate variability (HRV) is a key marker of autonomic nervous system function and has been proposed as a tool for monitoring training adaptations. However, its relationship with performance beyond aerobic capacity remains unclear in football players. This study aimed to examine the associations between resting HRV and aerobic capacity, agility, neuromuscular coordination, sleep quality, and body awareness.

Methods: Twenty-five male football players (mean age 20 ± 3 years) underwent HRV assessment via the Polar H10 system. Performance tests included the 20 m Shuttle Test (VO2max), Illinois Agility Test, Hexagon Test (neuromuscular coordination), and Vertical Jump Tests (muscular strength). Sleep quality and body awareness were assessed using the Pittsburgh Sleep Quality Index and Body Awareness Questionnaire.

Results: HRV Score was positively correlated with VO2max (r = 0.4, p = 0.04), while LF/HF ratio showed a negative correlation with shuttle test distance (rs=-0.52, p = 0.007). Mean RR correlated with neuromuscular coordination (r = 0.56, p = 0.004), sleep quality (r = 0.45, p = 0.024), and body awareness (rs = 0.46, p = 0.019). No significant correlations were found with muscular strength.

Conclusions: Resting HRV is associated with key performance indicators in football players, supporting its potential use in monitoring physiological readiness and training adaptations. Future research should establish reference values and evaluate HRV-based interventions for performance enhancement.

Objective: To systematically evaluate the effectiveness of respiratory training interventions in the rehabilitation of patients with rib fractures through a meta-analysis, aiming to provide robust evidence for clinical practice.

Methods: A comprehensive search was conducted in multiple databases (Pubmed, Embase, Web of Science, Cochrane Central, CNKI, Wanfang Data, and CSTJ) up to August 15, 2024, to identify relevant randomized controlled trials (RCTs). Eligible studies were those that compared RTIs plus conventional treatment with conventional treatment alone in patients with rib fractures. Study selection, data extraction, and risk of bias assessment were performed independently by two reviewers. Meta-analysis was conducted using R Studio software, with relative risk (RR) and standardized mean difference (SMD) as effect sizes, accompanied by 95% confidence intervals (95% CI).

Results: Nine RCTs involving 811 patients were included in the meta-analysis. Respiratory training interventions significantly reduced the incidence of atelectasis (RR = 0.23, 95% CI [0.13; 0.38]) and pulmonary infections (RR = 0.24, 95% CI [0.13; 0.44]), without significant heterogeneity between studies. Respiratory training interventions also shortened the length of hospital stay (SMD = -1.37, 95% CI [-1.57; -1.17]) and duration of chest tube drainage (SMD = -1.22, 95% CI [-1.43; -1.00]). Additionally, respiratory training interventions significantly improved arterial partial pressure of oxygen (PaO2) (SMD = 1.77, 95% CI [1.36; 2.18]) and arterial oxygen saturation (SaO2) (SMD = 1.92, 95% CI [1.49; 2.35]), and enhanced pulmonary function (SMD = 1.52, 95% CI [1.19; 1.84]). However, respiratory training interventions did not significantly affect the incidence of pleural effusions (RR = 1.09, 95% CI [0.49; 2.42]).

Conclusion: Respiratory training interventions significantly benefit patients with rib fractures by reducing atelectasis and pulmonary infections, shortening hospital stays and chest tube drainage times, and improving oxygenation and pulmonary function. Further high-quality studies are needed to confirm these findings and refine application strategies.

Objective: This study aims to investigate the impact of physical exercise on adolescent social anxiety and to elucidate the serial mediating roles of sports self-efficacy and expressive suppression within this context.

Methods: Utilizing a convenience random cluster sampling technique, this study surveyed 2500 primary and secondary school students across Sichuan, Guangdong, Shandong, Henan, and Jiangxi provinces. The survey utilized validated scales to assess physical exercise, sports self-efficacy, expressive suppression, and social anxiety among adolescents.

Results: The study revealed that: (1) Physical exercise has a significant negative correlation with social anxiety (r = -0.32, p < 0.01); (2) Sports self-efficacy significantly mediated the relationship between physical exercise and social anxiety, with an indirect effect of -0.15 (95% CI [-0.22, -0.09]); (3) Expressive suppression significantly mediated the relationship between physical exercise and social anxiety, with an indirect effect of -0.11 (95% CI [-0.17, -0.06]); (4) Sports self-efficacy and expressive suppression exerted a significant serial mediating effect on the relationship between physical exercise and social anxiety, with an indirect effect of -0.05 (95% CI [-0.08, -0.02]).

Conclusion: Physical exercise not only directly alleviates social anxiety in adolescents but also indirectly diminishes social anxiety through the enhancement of sports self-efficacy and the reduction of expressive suppression.

Background: Frailty is a syndrome as with aging in the population of type 2 diabetes mellitus (T2DM) and exercise has become an essential non-pharmacological tool especially in the pre-frail stage. Notably, the form of supervised home-based exercise program has been strongly recommended in recent years. This study aimed to verify the potential effects of the supervised home-based elastic band exercise in pre-frail older T2DM patients in China.

Methods: A total of 100 participants were included and randomly divided into intervention group (IG) (n = 50) and control group (CG) (n = 50). The CG received a routine care, while the IG received an extra home-based elastic band training under online and offline supervisions sustaining 12-weeks. The glycosylated hemoglobin (HbA1c), blood lipids, body composition, physical function, scales of Diabetes specificity quality of life scale (DSQL), Pittsburgh sleep quality index (PSQI) and short form geriatric depression scale (GDS-15) of the participants were evaluated before and after intervention.

Results: The average age of the participants were 66.01 ± 4.76 with 55% male and average BMI 24.75 ± 3.51 kg/m². The clinical characteristics of the two groups were comparable. After 12 weeks' training, muscle mass of the limbs (P < 0.05), physical function indicators including grip strength, chair stands (both P < 0.05), walking time (P < 0.01), HbA1c (P < 0.05), frailty score (P < 0.05), subjective sleep quality (P < 0.05), total DSQL scores (P < 0.01) and the depressive status (P < 0.01) improved significantly in IG when compared with CG.

Conclusion: Supervised home-based elastic band exercise could improve limb muscle mass, physical fitness, glucose and lipid control and quality of life in pre-frail older T2DM patients.

Trial registration number: ChiCTR2300070726; Registration date: 21/04/2023.

Background: Physical exercises and mindfulness are important components in the management of chronic pain, but pain may reduce exercise adherence. Virtual reality (VR) can provide cognitive inhibition of the ascending pain signal and may thus be a tool for the delivery of pain management during exercise interventions. In this study we assessed a VR-guided intervention seeking to improve physical fitness in individuals with chronic pain.

Methods: Participants in rehabilitation for chronic pain were included in a randomised controlled pilot trial with a cross-over design. In counter-balanced order participants were asked to perform, five minutes of aerobic exercise following identical instructions given through either a VR headset or television (TV) screen. The procedures were then repeated with mindfulness exercises. Heart rate (HR) was monitored throughout all four sessions and participants self-reported perceived exercise intensity, benefit, relaxation, and reward. Paired Student's t-test, Wilcoxon signed rank test and McNemar's test were performed to compare the outcome variables across sessions for individuals, as appropriate. (Clinical trial registration NCT06611566 09.09.24, retrospectively registered).

Results: Twenty-seven participants were included in the study. The mean age (SD) was 40.4 (11.3) years, and 17 (63%) were men. Mean HR, the proportion of time spent at moderate-vigorous exercise intensity levels, and all self-reported measurements were comparable between the VR vs. TV sessions. No major adverse events were reported. The physiological and perceived exercise outputs of aerobic exercises were thus similar across modes of delivery (VR vs. TV) in individuals with chronic pain.

Conclusions: This study confirms the possibilities of VR-guided interventions in the pain management of individuals with chronic pain with comparable levels of exertion to TV-guided exercise and few adverse events. The promise of VR-guided mindfulness in the rehabilitation of patients with chronic pain conditions is also confirmed.

Background: The analysis of ground reaction forces and muscle activities during walking or running can help clinicians decide on the usage of foot orthoses, particularly in individuals with pronated feet. Here, we aimed to investigate the effects of double- density foot orthoses on running kinetics and lower limb muscle activities in adults with and without pronated feet.

Methods: Forty male adults with pronated feet (PF: n = 20, age = 25.4 ± 0.3 years, body-mass-index [BMI] = 23.3 ± 1.2 kg/m²) and without pronated feet (WPF: n = 20, age = 26.4 ± 1.0 years, BMI = 24.0 ± 0.7 kg/m²) volunteered to participate in this study. The study was registered with the Iranian Registry of Clinical Trials (IRCT20220129053865N1). Ground reaction forces (F_x, F_y, F_z) and lower limb muscle activities (e.g., m. gastrocnemius) were recorded using surface electromyography (EMGs) during running at a constant speed of 3.2 m/s over an 18-m walkway with an embedded force plate. EMGs were normalized to maximum voluntary isometric contractions.

Results: Test-retest reliability for running speed data was excellent for PF and WPF groups and for the entire study cohort with intraclass correlation coefficients > 0.95. The 2-way ANOVA revealed lower peak F_z (p = 0.011; d = 1.226), lower time-to-peak for F_x (p = 0.023, d = 1.068), F_y (p = 0.025, d = 1.056), and F_z (p = 0.045, d = 0.931) during running with foot orthoses in PF individuals. During the loading phase, PF and WPF exhibited lower gastrocnemius (WPF: p = 0.005, d = 1.608; PF: p = 0.001, d = 2.430 ) and vastus medialis (WPF: p < 0.001, d = 2.532; PF: p < 0.001, d = 2.503) activity when running with foot orthoses.

Conclusions: Although double- density foot orthoses resulted in some beneficial biomechanical effects such as lower muscle activation (e.g., m. vastus medialis) in individuals with PF, foot orthoses constructions need further modifications to achieve even better running mechanics to enhance performance and lower limbinjury occurrence.

Trial registration: IRCT20220129053865N1 (Registration date 19/08/2024).