Sports Health-A Multidisciplinary Approach最新文献

Background: Estimating repetitions in reserve (RIR) has been established as a valid and practical method for monitoring set configuration concerning proximity to failure in resistance training. However, factors such as sex and exercise equipment could interfere with the estimation process. Therefore, this study aimed to determine the influence of sex (female vs male) and exercise equipment (free-weight vs Smith machine) on the RIR estimation at different relative loads during the bench press exercise.

Hypothesis: Men would be more accurate than women in the RIR estimation, and participants would better perceive their actual effort at the Smith machine compared with the free-weight bench press exercise.

Study design: Repeated measures design.

Level of evidence: Level 3.

Methods: In a counterbalanced order, recreationally trained participants (12 female, 14 male) performed 2 identical sessions with the free-weight bench press exercise in 1 week and 2 identical sessions with the Smith machine bench press exercise in another week (first session for familiarization and second session for validity analysis). In each session, participants performed single sets of repetitions to failure against 3 relative loads (65%, 75%, and 85% of the 1-repetition maximum [1RM]).

Results: Results revealed a significant interaction between RIR and sex at 65% 1RM (P < 0.01; women: -1.2 [-1.7 to -0.6] repetitions; men: -0.1 [-0.6 to 0.3] repetitions), and between RIR and exercise equipment at 65% 1RM (P < 0.01; free-weight: -1.1 [-1.5 to -0.6] repetitions; Smith machine: -0.2 [-0.6 to 0.2] repetitions), but not at 75% and 85% 1RM.

Conclusions: RIR estimation is a valid method for monitoring set configuration. However, this method tends to underestimate RIR at 65%1RM with female athletes and in the free-weight exercise for both sexes.

Clinical relevance: Strength and conditioning coaches should help their athletes understand effort awareness in the aforementioned context.

Background: Rates of emergency action plan (EAP) implementation and compliance with EAP guidelines vary in United States secondary schools. There are limited data on emergency preparedness in schools without athletic trainers (ATs).

Hypothesis: Rural and high poverty schools have poor emergency preparedness for high school athletic events due to financial barriers and lack of ATs.

Study design: Cross-sectional study.

Level of evidence: Level 5.

Methods: A web-based questionnaire was emailed by each State High School Athletics Association to ATs, athletic directors, and coaches of recipient schools to assess emergency preparedness.

Results: A total of 686 responses were received (response rate ~3.5%). Schools with an AT on staff were more likely to have an EAP (P < 0.01). Schools with a higher enrollment were more likely to have an EAP (P < 0.01), an AT on staff (P < 0.01), require additional training for coaches (P < 0.01), and have an automated external defibrillator (AED) onsite for all events (P < 0.01). Urban (odds ratio [OR], 3.514; 95% CI [2.242, 5.507]; P < 0.01) and suburban (OR, 4.950; 95% CI [3.287, 7.454]; P < 0.01) districts were more likely than rural districts to have an AT on staff. High poverty districts were less likely to have an AED (OR, 0.660; 95% CI [0.452, 0.964]; P = 0.03) or EAP (OR, 0.511; 95% CI [0.306, 0.853]; P < 0.01) at athletic venues.

Conclusion: Lower enrollment, high poverty, and rural schools are less prepared for athletic emergencies than their higher enrollment, low poverty, and suburban counterparts as these schools are generally less likely to have an AT on staff, AEDs, and EAPs and less likely to provide additional training to coaches and other staff.

Clinical relevance: This study assesses athletic emergency preparedness-a critical component of ensuring athlete safety and recovery after injury.

Background: Aerobic exercise alters gut microbiome composition, yet the impact of gentle physiotherapy on gut microbiome and its relation to muscle strengthening and physical function remains unexplored.

Hypothesis: Physiotherapy exercises modulate gut microbiome composition and changes in gut microbes are linked to improvements in muscle strength or function.

Study design: Secondary data analysis of samples from a randomized controlled trial.

Level of evidence: Level 2b.

Methods: Data from a 6-week randomized controlled trial of physiotherapy for knee pain were analyzed. Gut microbiota profiling utilized 16S sequencing. We compared intervention and control (usual care) groups using microbial diversity metrics. Amplicon sequence variants (ASVs) that changed after the program were identified with ALDEX2, and correlations between these ASVs and measures of physical function, muscle strength, and interleukin-6 (IL-6) were explored.

Results: No diversity changes were observed between standard care (n = 43) and physiotherapy (n = 34). Physiotherapy led to significant increases in Alistipes, Bacteroides, Clostridium sensu stricto 1, and Faecalibacterium ASVs. Of these, Clostridium sensu stricto 1 and Faecalibacterium were associated with postintervention muscle strength. Increase in Faecalibacterium was correlated with a decrease in IL-6 in the physiotherapy group.

Conclusion: Physiotherapy had modest effects on gut microbiome composition affecting 4 taxa. Increases in muscle strength were correlated with increases in 2 taxa including Faecalibacterium. Faecalibacterium was also linked to reduced inflammation. Improved walking speed was linked to an increase in Alistipes with no differences found for strength or squatting ability.

Clinical relevance: Improved gut microbiome composition is linked to better overall health outcomes, including enhanced immune function, reduced inflammation, and improved metabolic health. This is particularly relevant for patients with osteoarthritis, who are known to have a high prevalence of cardiometabolic comorbidities. Integrating physiotherapy protocols that positively influence the gut microbiome can thus enhance overall patient outcomes.

Background: Maximal sprinting speed (MSS) overexposure is associated with increased risk of injury. This study aimed to describe changes in sprint performance-related factors and hamstring strain injury (HSI) risk factors after a high-volume sprinting session in soccer players.

Hypothesis: A high-volume sprinting session can induce acute changes in several sprint performance-related factors (sprint time and mechanical properties) and HSI risk factors (posterior chain muscle strength, hamstring range of motion, and dynamic lumbo-pelvic control [LPC], measured as changes in anterior pelvic tilt [APT] during maximal speed sprinting).

Study design: Prospective observational case series.

Level of evidence: Level 4.

Methods: Fifteen active male amateur soccer players participated. Changes in sprint performance-related factors and HSI risk factors were examined for 72 hours after high-volume MSS efforts (H-VMSSE) using a soccer-contextualized multifactorial approach. Muscle damage proxy markers (hamstring perceived soreness and creatine kinase) were also examined.

Results: H-VMSSE induced decrements in sprint performance-related factors. Significant reductions in theoretical maximal horizontal velocity (P < 0.01; effect size [ES], -0.71) and performance (P = 0.02; ES, -0.59) were observed for 48 and 72 hours after H-VMSSE. Small but significant reductions in posterior chain muscle force-generating capacity were detected for 48 and 72 hours after H-VMSSE for the nondominant (P < 0.03; ES, -0.60) and dominant (P < 0.04; ES, -0.40) leg. Finally, players exhibited persistent small, albeit nonsignificant (P = 0.06; ES, 0.53), decreases in dynamic LPC (APT increases) for 72 hours after H-VMSSE.

Conclusion: H-VMSSE induced declines in both sprint performance-related factors and HSI risk factors. Sprinting can alter a player's anatomic structure by increasing APT during the maximum speed phase of the sprint.

Clinical relevance: A soccer-contextualized multifactorial approach might allow for the regulation of MSS dosage depending on individual HSI risk factor status, thereby serving as a tailored "vaccine" for sprinting needs.

Context: Despite increased youth and adolescent participation in fast-pitch softball and the reporting of upper extremity injuries, there remains a relative paucity of research examining shoulder and elbow injuries in high school and collegiate softball athletes.

Objective: To evaluate the reported incidence, setting, and positional factors associated with shoulder and elbow injuries in high school and collegiate fast-pitch softball players.

Data sources: PubMed, Ovid, Medline, EMBASE, Scopus, Cochrane Central, and Clinicaltrials.gov.

Study selection: English-language articles reporting the incidence of shoulder and/or elbow injuries occurring in high school or collegiate fast-pitch softball players were included. Biomechanical studies, review articles, abstract only texts, previous systematic reviews, and meta-analyses were excluded.

Study design: Systematic review.

Level of evidence: Level 4.

Data extraction: Two reviewers independently evaluated studies. Data related to the reported incidence of shoulder and elbow injuries, injury setting, position, and rate of return to play after injury were recorded.

Results: A total of 22 studies were identified. In high school athletes, shoulder injury rates ranged from 0.88 to 1.14 per 10,000 athletic exposures (AE), with elbow injury rates ranging from 0.41 to 0.71 per 10,000 AE. In collegiate athletes, reported injury rates ranged from 3.76 to 5.93 per 10,000 AE for shoulder and 1.5 to 3.39 per 10,000 AE for elbow injuries. Shoulder and elbow injuries were reported more commonly during competition in high school athletes, and with greater frequency in the practice setting in collegiate athletes. No association between injury incidence and position was appreciated at either the high school or collegiate level. Most (81%-96%) athletes were able to return to sport within 3 weeks of injury.

Conclusion: The incidence of shoulder and elbow injuries was greater in collegiate softball athletes than in high school athletes.

Background: Rates of shoulder and elbow pathology are well documented among competitive baseball players in the United States; however, little is known about the prevalence of these pathologies in the Dominican Republic (DR).

Purpose: To report the epidemiology of shoulder and elbow pathology among participants at a Major League Baseball scouting event in Santo Domingo, DR.

Study design: Retrospective descriptive study.

Level of evidence: 3.

Methods: All pitchers and position players who attended the 2021 scouting event were reviewed. Those with complete medical history, physical examination, imaging series, and radiology reports were included. All participants underwent shoulder and elbow radiography, while pitchers also underwent magnetic resonance imaging (MRI). All pathologic findings on imaging studies were recorded and compared among position players and pitchers.

Results: Seventy-five participants (average age, 17.9 years) were reviewed (42 position players, 33 pitchers); 72% and 32% had ≥1 abnormal finding on elbow and shoulder radiographs, respectively. Position players had significantly higher numbers of elbow radiographic findings compared with pitchers (81% vs 57.6%, P = 0.03) but similar numbers on shoulder radiograph (28.6% vs 33.3%, P = 0.66). Position players had high numbers of acromioclavicular separation (14.3%) and little leaguer's shoulder (14.3%) on shoulder radiograph, with olecranon osteophytes (23.8%) and medial epicondyle nonunions (11.9%) prevalent on elbow radiograph. Pitchers had high numbers of rotator cuff pathology (93.9%), labral tears (75.8%), and Bennett lesions (51.5%). On elbow imaging, pitchers had high numbers of ulnar collateral ligament (UCL) abnormalities (81.8%), olecranon osteophytes (69.7%), osteochondral lesions (18.2%), and medial epicondyle nonunions (12.1%). Two pitchers had complete UCL disruption (6.1%), while 8 had partial tears (24.2%).

Conclusion: Dominican baseball prospects had high numbers of asymptomatic shoulder and elbow pathology on imaging studies. Knowledge of the prevalence of these pathologies can guide injury prevention programs in Dominican youth baseball.