Sports Health-A Multidisciplinary Approach最新文献

Background: Softball pitchers accrue high rates of injury. Research suggests certain mechanics at discrete pitch events are related with pain. Here, we examine relationships between peak throwing shoulder kinetics and trunk/pelvis kinematics and compare trunk/pelvis kinematics between pitchers who were healthy and those currently experiencing pain.

Hypothesis: (1) Peak shoulder kinetics would be positively related to greater trunk and pelvis flexion, lateral flexion, and rotation; and (2) pitchers in pain would exhibit greater trunk and pelvis flexion, lateral flexion, and rotation during the pitch than those who were pain-free.

Study design: Cross-sectional study.

Methods: A total of 42 high school pitchers (height, 1.71 ± 0.06 m; weight, 75.0 ± 15.9 kg; age, 16 ± 2 years) were separated into 2 groups based on presence or absence of pain. Peak kinetic data from 3 pitches per pitcher were averaged and used as dependent variables. Kinematic data were averaged across 3 trials, and time normalized to 101 datapoints between foot contact and follow-through of the pitch. Statistical parametric mapping regressions were used to assess the relationships between peak shoulder kinetics and waveform of trunk and pelvis kinematics.

Results: Pelvic lateral tilt significantly predicted peak throwing shoulder superior (P = 0.05) and lateral (P = 0.04) force. Pelvis rotation predicted peak superior force (P = 0.02). Waveform analyses revealed no waveform differences between healthy pitchers and those currently experiencing pain.

Conclusion: Peak shoulder kinetic variables are related with pelvic positioning during the pitch; however, trunk and pelvis kinematics do not differ according to presence of pain.

Clinical relevance: Pitchers in pain do not adopt specific trunk and pelvic alterations during the pitch, potentially concealing the effects of pain from visual identification. Coaches and clinicians need to discuss health status with pitchers versus relying on visual observations to understand pain and injury risk.

Background: Shoulder injuries are prevalent in adolescent water polo (WP) players. Study aimed to determine whether preseason shoulder characteristics (range of motion [ROM], flexibility, and strength) and core endurance can identify athletes at risk of future shoulder injuries.

Hypothesis: Shoulder characteristics, including changes in ROM (internal rotation [IR], external rotation [ER], and total), strength (IR and ER), pectoralis minor flexibility, shoulder capsule flexibility, and core endurance, would be risk factors for shoulder reinjury in athletes with previous overuse injuries compared with noninjured athletes.

Study design: Prospective cohort study.

Level of evidence: Level 3.

Methods: At baseline, 53 male youth WP players (mean age, 16.6 ± 3.5 years) were assigned to Group 1 (with previous shoulder injuries [G1, n = 26]) and Group 2 (without previous shoulder injuries [G2, n = 27]). ROM, flexibility, strength, and core muscle endurance were assessed preseason. After a 12-month follow-up, players were again divided into those who developed new shoulder injuries (G3, n = 27) and those who remained healthy (G4, n = 26).

Results: Total of 26 players (49%) had previous shoulder injuries at baseline. At baseline, decreased pectoralis minor flexibility, IR, total ROM, and core endurance were found in players with a previous shoulder injury compared with players without a previous shoulder injury (P < 0.05).

Conclusion: At baseline, a significant difference was present in proposed risk factors (shoulder and core endurance parameters) between players with and without a previous shoulder injury. Shoulder IR ROM and years of experience were significant predictors of shoulder injury. Early detection of modifiable proposed risk factors may help prevent reinjury in young athletes.

Clinical relevance: Screening at an early age can help identify and address pre-existing injuries, support youth athletes' return to sport after a shoulder injury, prevent new injuries, and improve performance.

Background: Unplanned sidestep cutting and forward single-leg jump-landing contribute to non-contact anterior cruciate ligament (ACL) injuries in netball. Neuromuscular training programs (NMTPs) have shown promising results in reducing injury risk in certain populations when compliance is high. Compliance is easier to achieve when NMTPs are effective yet require minimal time for completion.

Hypothesis: Once- and thrice-weekly intervention groups would be equally effective in reducing knee abduction and internal rotation moments during forward single-leg jump landing and unplanned sidestep cutting.

Study design: Randomized controlled trial.

Level of evidence: Level 3.

Methods: External peak knee abduction and peak knee internal rotation moments during unplanned sidestep cutting and forward single-leg jump-landing were assessed pre- and post-intervention for 17 elite-level female netballers assigned randomly to either a once-weekly or thrice-weekly group. Regular netball training continued throughout the intervention, which lasted 6 weeks (30 minutes/session). One-way analysis of covariance (α = 0.05) was utilized to compare post-intervention peak knee abduction and peak knee internal rotation moments between groups, controlling for pre-intervention knee moments during the forward single-leg jump-landing and unplanned sidestep cut. Paired t tests were used to examine within-group changes in knee moments pre- versus post-intervention.

Results: For unplanned sidestep cuts on the right leg, both groups differed significantly, with the once-weekly group displaying a decrease in peak knee internal rotation moments [F(1,14) = 5.23; P = 0.04] whereas the thrice-weekly group did not. No other significant group interactions were found.

Conclusion: A condensed NMTP with targeted exercises, performed once-weekly as part of regular training, shows potential to reduce peak knee internal rotation moments that are injurious to the ACL during unplanned sidestep cutting in adult female netballers.

Clinical relevance: A once-weekly targeted NMTP would pose minimal disruption to a high-performing athlete's training schedule and likely increase compliance to ensure the success of the NMTP.

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.

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.