Translational sports medicine最新文献

Background: The treatment of unicompartmental knee osteoarthritis (OA) in young, active individuals with anterior cruciate ligament (ACL) insufficiency is a debatable topic. The objective, radiological, and functional results of medial unicompartmental knee arthroplasty (UKA) combined to ACL reconstruction and those of isolated UKA are compared in the present study. Methods: Twelve patients with medial OA and ACL incompetence were suitable for combined UKA and ACL reconstruction (Group A). A control group consisted of 24 patients who underwent isolated UKA within the same time frame and were matched for age, body mass index, and male/female ratio (Group B). The Oxford Knee Score (OKS), the Knee OA Outcome Score (KOOS), the WOMAC index of OA, and standard X-rays were used for clinical and radiologic evaluation. Results: The mean KOOS score, OKS, and WOMAC index improved 10 years after surgery, demonstrating a statistically significant change (p < 0.001). At follow-up, there was no significant between-groups difference concerning KOOS, OKS, or WOMAC scores (p=n.s.). One female patient in Group A underwent revision total knee arthroplasty (TKA) 3 years after the first surgery because OA in the lateral compartment had developed and the patient's discomfort persisted. There were no signs of pathologic radiolucent lines or radiographic signs of implant loosening at the most recent follow-up, which occurred at an average of 7.9 years for Group A and 9.1 years for Group B. Conclusion: Ten years after surgery, UKA combined to ACL reconstruction provides clinical and radiographic results similar to UKA without increasing the incidence of complications.

Introduction: Epidemiological studies on elite female ice hockey players are lacking but needed to tailor preventive efforts in this growing group of athletes. Therefore, the aim of this study was to describe the incidence, prevalence, and burden of health problems in elite female ice hockey players. Methods: In this prospective cohort study, we asked all Swedish Women's Hockey League (SWHL) players (N = 207) to report their health status on the OSTRC-H2 weekly throughout the 2022/2023 season (28 weeks). Reported problems were categorized as injuries (acute or overuse) or illnesses and presented as incidence per player season and mean weekly prevalence. Results: A total of 129 players (62% of all SWHL players) provided 2286 health reports with a mean weekly response rate of 67%. Mean weekly prevalence of health problems was 21% (95% confidence interval [CI]: 19-23) (injuries: 15% [95% CI: 14-17] and illnesses: 6% [95% CI: 5-8]). Injury incidence was 2.1 (95% CI: 1.8-2.4) per player season (acute: 1.2 [95% CI: 1.0-1.5] and overuse: 0.8 [95% CI: 0.7-1.1]). Illness incidence was 1.3 per player season (95% CI: 1.1-1.6). Most reported health problems were acute injuries (59.4% of reported injuries). Most common among acute injuries where to the shoulder (15%), head (13%), and knee (11%). The hip/groin was the most reported (35%) and burdensome (49% of severity score) region among overuse injuries. Reported illnesses were mostly represented by respiratory infections (75%). Conclusions: In average, one in five elite ice hockey players reported a health problem at any given time during the season. Results of this study highlight the need to develop and test primary prevention strategies for shoulder, head, and knee injuries and secondary prevention strategies for hip and groin problems.

Menstrual dysfunction (MD) in female athletes might be indicative of the syndrome of relative energy deficiency in sports (REDs), associated with, e.g., impaired bone health, an increased risk of injury, and decreased performance. In the present study, we investigated differences in objective indicators of REDs, bone mineral density (BMD), and blood-based biomarkers in female elite athletes with self-reported MD or eumenorrhoea (CON) from mixed sport disciplines. Athletes reporting < 9 menstrual bleedings within the last year were recruited in the MD group, whereas eumenorrheic athletes with no symptoms of eating disorders were recruited for CON. Of the 24 athletes included, 19 completed the examinations (9 MD; 10 CON, mean age ± SD: 24.8 ± 5.5 years). Dual-energy x-ray absorptiometry (DXA) was used to assess body composition and BMD. Fasted rested blood sampling was performed to assess blood-based biomarkers of bone and endocrine status. Two MD athletes were excluded from the analysis due to suspected polycystic ovary syndrome. Results showed that MD was associated with lower BMD Z-scores across several sites compared to CON (between-group differences ± SE); whole-body Z-score: -1.4 ± 0.5, p=0.03; lumbar spine Z-score: -1.4 ± 0.6, p=0.03; proximal femur: -1.6 ± 0.6, p=0.02). However, no between-group differences in biomarkers of bone turnover were observed. MD was associated with lower plasma concentrations of luteinizing hormone (p=0.02), prolactin (p < 0.001), and free T ₃ (p=0.01). In conclusion, the present data indicate impairment in bone health and endocrine homeostasis in female elite athletes with current MD and underline the importance of MD as a potential indicator of REDs in female elite athletes. Furthermore, these findings call for regular screening of symptoms for early identification of athletes at risk in all sport disciplines and more education of athletes, coaches, and medical staff regarding this issue.

Aim: We aimed to analyze sex differences in time-limited ultramarathon participation, while also identifying trends in participation, age, and performance across different formats of events, from 1990 to 2020. Method: This is an exploratory study, using data obtained from the official event web pages. We downloaded information regarding the year of the event, athletes' year of birth, sex, race event, ranking, and mean running speed (km/h). The sex gap in participation was presented through equiplots. Regression models were fitted to analyze trends in participation, age, and performance, considering a 95% confidence interval. Results: A similar pattern of increase in participation and age was shown for athletes of both sexes until 2019. The sex gap remained, displaying different patterns across race events. A general trend of slower mean running speeds was shown. The random-effects analysis showed that sex and age played significant roles in the performance trajectory across the years, in each race event. Conclusions: Apart from the 8-day race among females, there was a decline in the performance across all race durations. Despite the trend of performance decline, future studies need to address the relevance of this decline in both theoretical and practical terms.

The study quantified total and high-intensity jump counts and assessed neuromuscular performance through countermovement jump (CMJ) force and velocity metrics by position. Twelve Division I female athletes (19.6 ± 1.3 years; 182.7 ± 6.5 cm) were included in the 16-week study using wearable microsensors to monitor daily jump loads. CMJ tests were conducted twice weekly using dual force plates to measure force and velocity metrics. There were significant main effects of position (p ≤ 0.001) for jump and force plate metrics. Middle blockers accumulated significantly more jump counts of 38.1 cm or higher (jumps 38+; 65.4 ± 39.2 counts) and jump counts of 50.8 cm or higher (jumps 50+; 39.5 ± 32.7 counts) compared to outside hitters (jumps 38+; 39.4 ± 25.9 counts and jumps 50+; 15.0 ± 15.6 counts) and opposite hitters (jumps 38+; 47.9 ± 24.1 counts and jumps 50+; 29.7 ± 18.1 counts), while setters had the fewest high-intensity jump counts (jumps 38+; 19.0 ± 16.6 counts and jumps 50+; 0.4 ± 0.8 counts). Middle blockers had the highest CMJ height (36.1 ± 6.4 cm), deepest CMJ depth (-41.7 ± 6.4 cm) and peak (2.75 ± 0.22 m/s) and average (1.49 ± 0.08 m/s) propulsion velocities (2.75 ± 0.22 m/s). Meanwhile, setters had significantly greater braking RFD (7839 ± 2617 N), average (1698 ± 223 N) and peak braking force (2061 ± 248 N), and average (1446 ± 88 N) and peak propulsion force (1994 ± 213 N), compared to all other positions. Opposite and outside hitters' data fell between setters and middle blockers. Regardless of position, neuromuscular performance fluctuates during the season and there are noticeable positional differences in jump loads and force and velocity metrics.

Background: Urine specific gravity (USG) is a commonly used assessment method to estimate the prevalence of hypohydration, typically based on a common threshold of ≥ 1.020. Some research has shown that USG can vary based on body size and composition, but the evidence to date is limited. This review examined whether an association between fat-free mass (FFM), a component of body composition, and USG could be detected among published articles that have reported these variables in athletes and physically active individuals. Methods: By searching Google Scholar, the authors identified a large number of published articles (n = 161) reporting anthropometrics and USG. Only articles reporting data on adult samples of athletes or physically active individuals were included. Given differences in body composition and FFM between men and women, articles that did not report data separately for each sex were excluded. Spearman's rank correlation coefficient (ρ) was used to assess the association between variables. Results: In men, FFM showed a significant, weak-sized positive association with USG (ρ = 0.36, p < 0.001). Among women, FFM showed a significant, moderate-sized positive association with USG (ρ = 0.57, p=0.006). When results were combined independent of sex, the association between FFM and USG remained significant (ρ = 0.38, p  < 0.001). Conclusion: Athletes with larger amounts of FFM are more likely to have elevated USG. Protein and muscle metabolites such as creatinine, urea, and uric acid likely play some role in the observed relationships. If USG continues to be utilized in sport settings, more research is needed to determine if development of FFM-specific USG thresholds may be more appropriate for determining hydration status.

Protracted return to sport (RTS) following COVID-19 is common due to long-term cardiopulmonary symptoms and persistent fatigue. In athletes, low exercise tolerance may result in emotional distress. The aim of this study is to assess the symptom severity, the management thereof and the impact on quality of life (QOL) as endurance athletes return to their preillness level of sports participation. A cross-sectional survey-based mixed methods study of long-distance athletes was performed. Quantitative data included sport and disease characteristics, fatigue score and management of persistent symptoms. A total of 295 survey responses were included. The mean age was 45.1 (10.2) years and 54.7% were male. Barriers to exercise included tachycardia (72%), fatigue (72%), dyspnoea (58%) and inability to exercise at high intensities (75%). High physical and mental fatigue scores were found, the former significantly predicting return to sport. Qualitative data were collected through open-ended questions exploring challenges faced when returning to sport post-COVID-19 convalescence and the impact on their QOL. Biopsychosocial well-being constituted three themes: Physical, Psychological and Social. Categories with high code frequencies included persistent cardiopulmonary symptoms, physical fatigue, emotional distress and social disengagement. Mixing the methods revealed that the athletes' QOL deteriorated due to protracted RTS after COVID-19. A multidisciplinary approach to management may be required by endurance athletes.

There is growing concern over the safety of artificial turf when it comes to the incidence of player injuries. The artificial surfaces can withstand more play, are cheaper to maintain, and are more predictable. However, there is concern that this beneficial durability comes at the expense of the forgiveness of the surface, leading to more injuries. In this study, we aim to compare the incidence of in-game season-ending lower extremity injuries on natural and artificial playing surfaces in the National Football League (NFL) during the 2020, 2021, and 2022 seasons. For this study, we used publicly available data to determine and classify the specific injury, where the injury occurred, field surface type, and duration of recovery. All data were collected, and significance was determined using two-sample T-tests. Only in-game injuries were included in this study. Over the course of 2020, 2021, and 2022, there were 199 season-ending lower-extremity injuries. Of these, 79 occurred on natural turf (39.7%) and 120 on artificial turf (60.3%). Of the 891 games played in this three-year period, 396 were played on natural turf (44.4%) and 495 were played on artificial turf (55.6%). Natural turf saw an injury rate of 0.199 per game, and artificial turf saw 0.242 injuries per game. We determined that there is no significant difference in rates of season-ending lower-extremity injury between artificial and natural turf. Any perceived difference in injury rates could possibly be attributed to the increased amount of play on artificial surfaces and anecdotal evidence related to high profile cases. While there is no significant difference in incidence, surfaces should continue to be monitored and regulated for traits such as hardness, and player preferences should be considered for qualities that are not quantifiable.

Introduction: Recently, ultrasound (US) imaging has been used to estimate the cross-sectional area of skeletal muscle, but the reliability is uncertain. To improve the reliability of the US, we investigated skeletal muscle thickness measurement using an inertial measurement unit (IMU) to determine the direction of US beam incidence based on posture angle information. In addition, we examined whether the anatomical cross-sectional area (ACSA) of muscle can be estimated from the muscle thickness measured using the US with the IMU. Methods: In Experiment 1, two examiners measured the right psoas major at the fourth lumbar vertebra level in 10 university students using the US with and without an IMU. The intraclass correlation coefficient (ICC) was used to examine intra- and inter-rater variability. In Experiment 2, the two examiners measured the muscle thickness of the right psoas major in 31 male subjects using the US with an IMU. In addition, the ACSA of this muscle was measured using MRI. Pearson's correlation coefficient was used to examine the relationship between muscle thickness and ACSA, and a single regression analysis was performed. Results: Both intrarater reliability ICC (1, 2) and inter-rater reliability ICC (2, 2) were higher when US was used with IMU compared to without IMU (Experiment 1). A significant positive correlation (r = 0.84, p < 0.01) was observed between muscle thickness and ACSA (Experiment 2). The regression equation was significant at R ² = 0.71 (p < 0.01). Conclusion: Using an IMU during US measurement of the psoas major improves intra- and interexaminer reliability and can be used to estimate the ACSA of the muscle.

Jumping performance is influenced by body composition and excess fat mass impairs performance. Maintaining optimal fat mass and fat-free mass (FFM) is crucial for enhancing jump height. However, there is limited evidence on short-term weight loss programs that reduce fat mass without water restriction and their effects on muscle function and jumping performance. This study aimed to clarify the effects of a 1-week weight loss program on jumping height and muscle function of volleyball players. The weight loss group engaged in two 40 min slow-paced jogging sessions in addition to their daily training routine. Energy intake was restricted without limitations on water intake. Total body water and body composition using the deuterium dilution method, muscle strength, and jump height before and after 1 week were evaluated for those in the weight loss and control groups. Body mass was significantly reduced in the weight loss group (-2.7 ± 1.3%, p < 0.05) with a significant reduction in fat mass (-17.7 ± 10.7%, p < 0.05). Meanwhile, there were no significant changes in total body water or FFM. Muscle strength and power tests indicated no significant differences between the groups; no notable differences were observed in handgrip strength or knee extension torque. The height of a single vertical and continuous jump remained consistent pre- and postintervention in the control group. In the weight loss group, although the height of a single vertical jump exhibited a slight decline postintervention, the height of a continuous jump displayed no significant changes. The short-term weight loss program significantly reduced fat mass without compromising muscle function, which is crucial for sports performance. These findings may benefit other athletes who require fat mass reduction while maintaining muscle function and help create new programs during specific training phases.