Research

Jump to: Review

9 pages, 286 KiB

Open AccessArticle

Reference Equation of a New Incremental Step Test to Assess Exercise Capacity in the Portuguese Adult Population

by Rui Vilarinho, Ana Toledo, Carla Silva, Fábio Melo, Leila Tomaz, Luana Martins, Tânia Gonçalves, Cristina Melo, Cátia Caneiras and António Mesquita Montes

J. Clin. Med. 2023, 12(1), 271; https://doi.org/10.3390/jcm12010271 - 29 Dec 2022

Cited by 1 | Viewed by 2076

Abstract

Step tests are important in community- and home-based rehabilitation programs to assess patients’ exercise capacity. A new incremental step test was developed for this purpose, but its clinical interpretability is currently limited. This study aimed to establish a reference equation for this new [...] Read more.

Step tests are important in community- and home-based rehabilitation programs to assess patients’ exercise capacity. A new incremental step test was developed for this purpose, but its clinical interpretability is currently limited. This study aimed to establish a reference equation for this new incremental step test (IST) for the Portuguese adult population. A cross-sectional study was conducted on people without disabilities. Sociodemographic (age and sex), anthropometric (weight, height, and body mass index), smoking status, and physical activity (using the brief physical activity assessment tool) data were collected. Participants performed two repetitions of the IST and the best test was used to establish the reference equation with a forward stepwise multiple regression. An analysis comparing the results from the reference equation with the actual values was conducted with the Wilcoxon test. A total of 155 adult volunteers were recruited (60.6% female, 47.8 ± 19.7 years), and the reference equation was as follows: steps in IST = 475.52 − (4.68 × age years) + (30.5 × sex), where male = 1 and female = 0, and r² = 60%. No significant differences were observed between the values performed and those obtained by the equation (p = 0.984). The established equation demonstrated that age and sex were the determinant variables for the variability of the results. Full article

(This article belongs to the Special Issue Physical Activity, Exercise Testing and Clinical Assessment in Sports Medicine)

10 pages, 572 KiB

Open AccessArticle

Associations of Circulating Irisin and Fibroblast Growth Factor-21 Levels with Measures of Energy Homeostasis in Highly Trained Adolescent Rhythmic Gymnasts

by Jaak Jürimäe, Liina Remmel, Anna-Liisa Tamm, Priit Purge, Katre Maasalu and Vallo Tillmann

J. Clin. Med. 2022, 11(24), 7450; https://doi.org/10.3390/jcm11247450 - 15 Dec 2022

Cited by 3 | Viewed by 1038

Abstract

The aim of this investigation was to determine the associations of serum irisin and fibroblast growth factor-21 (FGF-21) with the measures of energy homeostasis, training stress and other energy homeostasis hormones in highly trained adolescent rhythmic gymnasts (RG). Thirty-three RG and 20 untrained [...] Read more.

The aim of this investigation was to determine the associations of serum irisin and fibroblast growth factor-21 (FGF-21) with the measures of energy homeostasis, training stress and other energy homeostasis hormones in highly trained adolescent rhythmic gymnasts (RG). Thirty-three RG and 20 untrained controls (UC) aged 14–18 years participated in this study. Body composition, resting energy expenditure (REE), peak oxygen consumption, and different energy homeostasis hormones in serum, including irisin, FGF-21, leptin, and resistin, were measured. Irisin and FGF-21 were not significantly different (p > 0.05) between RG and UC groups. In RG, serum irisin was positively associated with REE (r = 0.40; p = 0.021) and leptin (r = 0.60; p = 0.013), while serum FGF-21 was related to body fat mass (r = 0.46; p = 0.007) and leptin (r = 0.45; p = 0.009). Irisin was related to FGF-21, independent of age, body fat, and lean masses (r = 0.36; p = 0.049) in RG. In conclusion, serum irisin concentration was associated with energy expenditure and serum FGF-21 level with energy availability measures in lean adolescent athletes, while no relationships of irisin and FGF-21 with energy status measures were observed in lean nonathletic adolescents. Full article

(This article belongs to the Special Issue Physical Activity, Exercise Testing and Clinical Assessment in Sports Medicine)

► Show Figures

Figure 1

13 pages, 889 KiB

Open AccessArticle

The Effect of Aerobic Exercise and Low-Impact Pilates Workout on the Adaptive Immune System

by László Balogh, Krisztina Szabó, József Márton Pucsok, Ilona Jámbor, Ágnes Gyetvai, Marianna Mile, Lilla Barna, Peter Szodoray, Tünde Tarr, Zoltán Csiki and Gábor Papp

J. Clin. Med. 2022, 11(22), 6814; https://doi.org/10.3390/jcm11226814 - 17 Nov 2022

Cited by 8 | Viewed by 2021

Abstract

Growing evidence indicates the pronounced effects of physical activity on immune functions, which may largely depend on the type of exercise, intensity, and duration. However, limited information is available regarding the effects of low-impact exercises, especially on the level of adaptive immune system. [...] Read more.

Growing evidence indicates the pronounced effects of physical activity on immune functions, which may largely depend on the type of exercise, intensity, and duration. However, limited information is available regarding the effects of low-impact exercises, especially on the level of adaptive immune system. Our study aimed to investigate and compare the changes in a broad spectrum of lymphocyte subtypes after 14 weeks of aerobic-type total-body-shaping workouts (TBSW) and Pilates workouts (PW) among healthy individuals. We determined the percentages of peripheral natural killer cells and different T and B lymphocyte subtypes with flow cytometry. At the end of the exercise program, significant changes in naïve and memory lymphocyte ratios were observed in TBSW group. Percentages of naïve cytotoxic T (Tc) cells elevated, frequencies of memory Tc and T-helper cell subsets decreased, and distribution of naïve and memory B cells rearranged. Proportions of activated T cells also showed significant changes. Nonetheless, percentages of anti-inflammatory interleukin (IL)-10-producing regulatory type 1 cells and immunosuppressive CD4⁺CD127^lo/−CD25^bright T regulative cells decreased not only after TBSW but also after PW. Although weekly performed aerobic workouts may have a more pronounced impact on the adaptive immune system than low-impact exercises, both still affect immune regulation in healthy individuals. Full article

(This article belongs to the Special Issue Physical Activity, Exercise Testing and Clinical Assessment in Sports Medicine)

► Show Figures

Figure 1

16 pages, 1908 KiB

Open AccessArticle

Modeling Physiological Predictors of Running Velocity for Endurance Athletes

by Szczepan Wiecha, Przemysław Seweryn Kasiak, Igor Cieśliński, Marcin Maciejczyk, Artur Mamcarz and Daniel Śliż

J. Clin. Med. 2022, 11(22), 6688; https://doi.org/10.3390/jcm11226688 - 11 Nov 2022

Cited by 4 | Viewed by 1796

Abstract

Background: Properly performed training is a matter of importance for endurance athletes (EA). It allows for achieving better results and safer participation. Recently, the development of machine learning methods has been observed in sports diagnostics. Velocity at anaerobic threshold (V_AT), [...] Read more.

Background: Properly performed training is a matter of importance for endurance athletes (EA). It allows for achieving better results and safer participation. Recently, the development of machine learning methods has been observed in sports diagnostics. Velocity at anaerobic threshold (V_AT), respiratory compensation point (V_RCP), and maximal velocity (V_max) are the variables closely corresponding to endurance performance. The primary aims of this study were to find the strongest predictors of V_AT, V_RCP, V_max, to derive and internally validate prediction models for males (1) and females (2) under TRIPOD guidelines, and to assess their machine learning accuracy. Materials and Methods: A total of 4001 EA (n_males = 3300, n_females = 671; age = 35.56 ± 8.12 years; BMI = 23.66 ± 2.58 kg·m⁻²; VO_2max = 53.20 ± 7.17 mL·min⁻¹·kg⁻¹) underwent treadmill cardiopulmonary exercise testing (CPET) and bioimpedance body composition analysis. XGBoost was used to select running performance predictors. Multivariable linear regression was applied to build prediction models. Ten-fold cross-validation was incorporated for accuracy evaluation during internal validation. Results: Oxygen uptake, blood lactate, pulmonary ventilation, and somatic parameters (BMI, age, and body fat percentage) showed the highest impact on velocity. For V_AT R² = 0.57 (1) and 0.62 (2), derivation RMSE = 0.909 (1); 0.828 (2), validation RMSE = 0.913 (1); 0.838 (2), derivation MAE = 0.708 (1); 0.657 (2), and validation MAE = 0.710 (1); 0.665 (2). For V_RCP R² = 0.62 (1) and 0.67 (2), derivation RMSE = 1.066 (1) and 0.964 (2), validation RMSE = 1.070 (1) and 0.978 (2), derivation MAE = 0.832 (1) and 0.752 (2), validation MAE = 0.060 (1) and 0.763 (2). For V_max R² = 0.57 (1) and 0.65 (2), derivation RMSE = 1.202 (1) and 1.095 (2), validation RMSE = 1.205 (1) and 1.111 (2), derivation MAE = 0.943 (1) and 0.861 (2), and validation MAE = 0.944 (1) and 0.881 (2). Conclusions: The use of machine-learning methods allows for the precise determination of predictors of both submaximal and maximal running performance. Prediction models based on selected variables are characterized by high precision and high repeatability. The results can be used to personalize training and adjust the optimal therapeutic protocol in clinical settings, with a target population of EA. Full article

(This article belongs to the Special Issue Physical Activity, Exercise Testing and Clinical Assessment in Sports Medicine)

► Show Figures

Figure 1

15 pages, 816 KiB

Open AccessArticle

Circulating Spexin Is Associated with Body Mass Index and Fat Mass but Not with Physical Activity and Psychological Parameters in Women across a Broad Body Weight Spectrum

by Maria Suhs, Andreas Stengel, Amelie Rudolph, Selina Schaper, Ellen Wölk, Peter Kobelt, Matthias Rose and Tobias Hofmann

J. Clin. Med. 2022, 11(17), 5107; https://doi.org/10.3390/jcm11175107 - 30 Aug 2022

Cited by 2 | Viewed by 1436

Abstract

Spexin (SPX) is a novel, widely expressed peptide, with anorexigenic effects demonstrated in animal models and negatively correlated with body mass index (BMI) in humans. It increases locomotor activity in rodents and is elevated in human plasma following exercise. Studies have also shown [...] Read more.

Spexin (SPX) is a novel, widely expressed peptide, with anorexigenic effects demonstrated in animal models and negatively correlated with body mass index (BMI) in humans. It increases locomotor activity in rodents and is elevated in human plasma following exercise. Studies have also shown an effect of stress and anxiety on SPX’s expression in different brain structures in animals. The relationships between plasma SPX and physical activity, body composition, and patient-reported outcomes such as perceived stress, depressiveness, anxiety, and eating behaviors are unknown and were examined in this study over a wide BMI range. A total of 219 female (n = 68 with anorexia nervosa; n = 79 with obesity; n = 72 with normal weight) inpatients were enrolled. Perceived stress (PSQ 20), anxiety (GAD 7), depressiveness (PHQ 9), and eating disorder pathology (EDI 2), as well as BMI, bioimpedance analysis, and accelerometry, were measured cross-sectionally at the beginning of treatment and correlated with plasma SPX levels (measured by ELISA) obtained at the same time. Plasma SPX levels were negatively associated with BMI (r = −0.149, p = 0.027) and body fat mass (r = −0.149, p = 0.04), but did not correlate with perceived stress, anxiety, depressiveness, eating behavior, energy expenditure, and physical activity (p > 0.05). The results replicate the negative correlation of SPX with BMI and fat mass, but do not support the hypothesis that peripheral SPX plays a role in the regulation of stress, depressiveness, anxiety, eating behavior, or physical activity. Full article

(This article belongs to the Special Issue Physical Activity, Exercise Testing and Clinical Assessment in Sports Medicine)

► Show Figures

Figure 1

10 pages, 2231 KiB

Open AccessArticle

Step Detection Accuracy and Energy Expenditure Estimation at Different Speeds by Three Accelerometers in a Controlled Environment in Overweight/Obese Subjects

by Ville Stenbäck, Juhani Leppäluoto, Rosanna Juustila, Laura Niiranen, Dominique Gagnon, Mikko Tulppo and Karl-Heinz Herzig

J. Clin. Med. 2022, 11(12), 3267; https://doi.org/10.3390/jcm11123267 - 07 Jun 2022

Cited by 1 | Viewed by 1834

Abstract

Our aim was to compare three research-grade accelerometers for their accuracy in step detection and energy expenditure (EE) estimation in a laboratory setting, at different speeds, especially in overweight/obese participants. Forty-eight overweight/obese subjects participated. Participants performed an exercise routine on a treadmill with [...] Read more.

Our aim was to compare three research-grade accelerometers for their accuracy in step detection and energy expenditure (EE) estimation in a laboratory setting, at different speeds, especially in overweight/obese participants. Forty-eight overweight/obese subjects participated. Participants performed an exercise routine on a treadmill with six different speeds (1.5, 3, 4.5, 6, 7.5, and 9 km/h) for 4 min each. The exercise was recorded on video and subjects wore three accelerometers during the exercise: Sartorio Xelometer (SX, hip), activPAL (AP, thigh), and ActiGraph GT3X (AG, hip), and energy expenditure (EE) was estimated using indirect calorimetry for comparisons. For step detection, speed-wise mean absolute percentage errors for the SX ranged between 9.73–2.26, 6.39–0.95 for the AP, and 88.69–2.63 for the AG. The activPALs step detection was the most accurate. For EE estimation, the ranges were 21.41–15.15 for the SX, 57.38–12.36 for the AP, and 59.45–28.92 for the AG. All EE estimation errors were due to underestimation. All three devices were accurate in detecting steps when speed exceeded 4 km/h and inaccurate in EE estimation regardless of speed. Our results will guide users to recognize the differences, weaknesses, and strengths of the accelerometer devices and their algorithms. Full article

(This article belongs to the Special Issue Physical Activity, Exercise Testing and Clinical Assessment in Sports Medicine)

► Show Figures

Figure 1

13 pages, 1046 KiB

Open AccessArticle

Efficacy of Core Training in Swimming Performance and Neuromuscular Parameters of Young Swimmers: A Randomised Control Trial

by Ahmad Khiyami, Shibili Nuhmani, Royes Joseph, Turki Saeed Abualait and Qassim Muaidi

J. Clin. Med. 2022, 11(11), 3198; https://doi.org/10.3390/jcm11113198 - 03 Jun 2022

Cited by 1 | Viewed by 2418

Abstract

Background: This study aimed to investigate the efficacy of core training in the swimming performance and neuromuscular properties of young swimmers. Methods: Eighteen healthy male swimmers (age: 13 ± 2 years, height: 159.6 ± 14.5 cm, weight: 48.7 ± 12.4 kg) were recruited [...] Read more.

Background: This study aimed to investigate the efficacy of core training in the swimming performance and neuromuscular properties of young swimmers. Methods: Eighteen healthy male swimmers (age: 13 ± 2 years, height: 159.6 ± 14.5 cm, weight: 48.7 ± 12.4 kg) were recruited from the Public Authority for Sports swimming pool in Dammam and randomly assigned to the experimental and control groups. The experimental group performed a six-week core-training program consisting of seven exercises (three times/week) with regular swimming training. The control group maintained its regular training. Swimming performance and neuromuscular parameters were measured pre- and post-interventions. Results: The experimental group benefitted from the intervention in terms of the 50 m swim time (−1.4 s; 95% confidence interval −2.4 to −0.5) compared with the control group. The experimental group also showed improved swimming velocity (+0.1 m.s⁻¹), stroke rate (−2.8 cycle.min⁻¹), stroke length (+0.2 m.cycle⁻¹), stroke index (+0.4 m²·s⁻¹), total strokes (−2.9 strokes), and contraction time for erector spinae (ES; −1.5 ms), latissimus dorsi (LD; −7 ms), and external obliques (EO; −1.9 ms). Maximal displacement ES (DM-ES) (+3.3 mm), LD (0.5 mm), and EO (+2.2 mm) were compared with the baseline values for the experimental group, and TC-ES (5.8 ms), LD (3.7 ms), EO (2.5 ms), DM-ES (0.2 mm), LD (−4.1 mm), and EO (−1.0 mm) were compared with the baseline values for the control group. The intergroup comparison was statistically significant (p < 0.05; DM-ES p > 0.05). Conclusion: The results indicate that a six-week core-training program with regular swimming training improved the neuromuscular properties and the 50 m freestyle swim performance of the experimental group compared with the control group. Full article

(This article belongs to the Special Issue Physical Activity, Exercise Testing and Clinical Assessment in Sports Medicine)

► Show Figures

Figure 1

13 pages, 2584 KiB

Open AccessArticle

Measurement of Lipid Peroxidation Products and Creatine Kinase in Blood Plasma and Saliva of Athletes at Rest and following Exercise

by Aleksandr N. Ovchinnikov, Antonio Paoli, Vladislav V. Seleznev and Anna V. Deryugina

J. Clin. Med. 2022, 11(11), 3098; https://doi.org/10.3390/jcm11113098 - 30 May 2022

Cited by 1 | Viewed by 2664

Abstract

This study aimed to assess the agreement between quantitative measurements of plasmatic and salivary biomarkers capable of identifying oxidative stress and muscle damage in athletes at rest and following exercise. Thirty-nine high-level athletes participating in track and field (running), swimming or rowing were [...] Read more.

This study aimed to assess the agreement between quantitative measurements of plasmatic and salivary biomarkers capable of identifying oxidative stress and muscle damage in athletes at rest and following exercise. Thirty-nine high-level athletes participating in track and field (running), swimming or rowing were recruited and assigned to one of three groups depending on the sport. Each athlete group underwent its specific exercise. Blood and saliva samples were collected before and immediately after the exercise. Diene conjugates (DC), triene conjugates (TC), Schiff bases (SB), and creatine kinase (CK) were measured. Comparisons were made using Wilcoxon signed-rank test. Correlation analysis and Bland–Altman method were applied. DC levels were elevated in plasma (p < 0.01) and saliva (p < 0.01) in response to exercise in all three groups, as were the plasmatic (p < 0.01) and salivary (p < 0.01) TC and SB concentrations. CK activity was also significantly higher at postexercise compared to pre-exercise in both plasma (p < 0.01) and saliva (p < 0.01) in all groups. Strong positive correlation between salivary and plasmatic DC (p < 0.001), TC (p < 0.001), SB (p < 0.01), and CK (p < 0.001) was observed at rest and following exercise in each athlete group. The bias calculated for DC, TC, SB, and CK using the Bland–Altman statistics was not significant at both pre-exercise and postexercise in all three groups. The line of equality was within the confidence interval of the mean difference. All of the data points lay within the respective agreement limits. Salivary concentrations of DC, TC, SB, and CK are able to reliably reflect their plasma levels. Full article

(This article belongs to the Special Issue Physical Activity, Exercise Testing and Clinical Assessment in Sports Medicine)

► Show Figures

Figure 1

15 pages, 2207 KiB

Open AccessArticle

An Intervention of 12 Weeks of Nordic Walking and Recreational Walking to Improve Cardiorespiratory Capacity and Fitness in Older Adult Women

by Nebojsa Cokorilo, Pedro Jesús Ruiz-Montero, Francisco Tomás González-Fernández and Ricardo Martín-Moya

J. Clin. Med. 2022, 11(10), 2900; https://doi.org/10.3390/jcm11102900 - 20 May 2022

Cited by 6 | Viewed by 2213

Abstract

(1) Background: The main aim of this study was to examine the effect of an intervention of 12 weeks in three groups on anthropometric measurement and heart rate (HR) variables, fitness index, and maximal oxygen consumption (VO₂max) in older women. (2) [...] Read more.

(1) Background: The main aim of this study was to examine the effect of an intervention of 12 weeks in three groups on anthropometric measurement and heart rate (HR) variables, fitness index, and maximal oxygen consumption (VO₂max) in older women. (2) Methods: In total, 166 Serbian adult women, aged 50 to 69 years old, participated in this study, comprising a control group (60 participants, μ_age = 57.8 + 6.6), Nordic-walking (NW) group (53 participants, μ_age = 57.5 + 6.8), and recreational-walking (RW) group (53 participants, μ_age = 57.8 + 6.6) in a physical fitness programme for 12 weeks. (3) Results: Anthropometric measurement variables were measured using a stadiometer and an electronic scale. The data showed differences in walking heart rate (bt/min) (p < 0.001; η² = 0.088) between control, NW, and RW groups in the pretest analysis. Moreover, there were significant differences in walking heart rate (bt/min) (η² = 0.155), heart rate at the end of the test (bt/min) (η² = 0.093), total time of fitness index test (min) (η² = 0.097), fitness index (η² = 0.130), and VO₂max (η² = 0.111) (all, p < 0.001) between control, NW, and RW groups in the posttest analysis. (4) Conclusions: NW group training resulted in slightly greater benefits than RW group training. The present study demonstrated that both groups could act as modalities to improve the functionality and quality of life of people during the ageing process, reflected mainly in HR variables; UKK test measurements, and VO₂max. It also contributes to the extant research on older women during exercise and opens interesting avenues for future research. Full article

(This article belongs to the Special Issue Physical Activity, Exercise Testing and Clinical Assessment in Sports Medicine)

► Show Figures

Figure 1

17 pages, 1343 KiB

Open AccessArticle

Cardiopulmonary Exercise Testing and Cardiac Biomarker Measurements in Young Football Players: A Pilot Study

by Alexandru-Dan Costache, Mihai Roca, Cezar Honceriu, Irina-Iuliana Costache, Maria-Magdalena Leon-Constantin, Ovidiu Mitu, Radu-Ștefan Miftode, Alexandra Maștaleru, Dan Iliescu-Halițchi, Codruța-Olimpiada Halițchi-Iliescu, Adriana Ion, Ștefania-Teodora Duca, Delia-Melania Popa, Beatrice Abălasei, Veronica Mocanu and Florin Mitu

J. Clin. Med. 2022, 11(10), 2772; https://doi.org/10.3390/jcm11102772 - 14 May 2022

Cited by 2 | Viewed by 2581

Abstract

Constant and intense physical activity causes physiological adaptive changes in the human body, but it can also become a trigger for adverse events, such as sudden cardiac arrest or sudden cardiac death. Our main objective was to assess the use of combined cardiopulmonary [...] Read more.

Constant and intense physical activity causes physiological adaptive changes in the human body, but it can also become a trigger for adverse events, such as sudden cardiac arrest or sudden cardiac death. Our main objective was to assess the use of combined cardiopulmonary exercise testing (CPET) and cardiac biomarker determinants in young professional athletes. We conducted a study which involved the full examination of 19 football players, all male, aged between 18 and 20 years old. They underwent standard clinical and paraclinical evaluation, a 12-lead electrocardiogram (ECG), and transthoracic echocardiography (TTE). Afterwards, a tailored CPET was performed and peripheral venous blood samples were taken before and 3 h after the test in order to determine five biomarker levels at rest and post-effort. The measured biomarkers were cardiac troponin I (cTnI), myoglobin (Myo), the MB isoenzyme of creatine-kinase (CK-MB), the N-terminal prohormone of brain natriuretic peptide (NT-proBNP) and D-dimers. While cTnI and NT-proBNP levels were undetectable both at rest and post-effort in all subjects, the variations in Myo, CK-MB and D-dimers showed significant correlations with CPET parameters. This highlights the potential use of combined CPET and biomarker determinants to evaluate professional athletes, and encourages further research on larger study groups. Full article

(This article belongs to the Special Issue Physical Activity, Exercise Testing and Clinical Assessment in Sports Medicine)

► Show Figures

Figure 1

20 pages, 2956 KiB

Open AccessArticle

Acute Effects of Sedentary Behavior on Ankle Torque Assessed with a Custom-Made Electronic Dynamometer

by Iulia Iovanca Dragoi, Florina Georgeta Popescu, Teodor Petrita, Florin Alexa, Sorin Barac, Cosmina Ioana Bondor, Elena-Ana Pauncu, Frank L. Bowling, Neil D. Reeves and Mihai Ionac

J. Clin. Med. 2022, 11(9), 2474; https://doi.org/10.3390/jcm11092474 - 28 Apr 2022

Cited by 1 | Viewed by 1591

Abstract

Inactivity negatively influences general health, and sedentary behaviour is known to impact the musculoskeletal system. The aim of the study was to assess the impact of time spent in active and sedentary behaviour on foot muscle strength. In this observational study, we compared [...] Read more.

Inactivity negatively influences general health, and sedentary behaviour is known to impact the musculoskeletal system. The aim of the study was to assess the impact of time spent in active and sedentary behaviour on foot muscle strength. In this observational study, we compared the acute effects of one day of prolonged sitting and one day of low-to-moderate level of activity on ankle torque in one group of eight healthy participants. Peak ankle torque was measured using a portable custom-made electronic dynamometer. Three consecutive maximal voluntary isometric contractions for bilateral plantar flexor and dorsiflexor muscles were captured at different moments in time. The average peak torque significant statistically decreased at 6 h (p = 0.019) in both static and active behaviours, with a higher average peak torque in the active behaviour (p < 0.001). Age, gender, body mass index and average steps did not have any significant influence on the average value of maximal voluntary isometric contraction. The more time participants maintained either static or active behaviour, the less force was observed during ankle torque testation. The static behaviour represented by the sitting position was associated with a higher reduction in the average peak ankle torque during a maximal voluntary isometric contraction when compared to the active behaviour. Full article

(This article belongs to the Special Issue Physical Activity, Exercise Testing and Clinical Assessment in Sports Medicine)

► Show Figures

Figure 1

8 pages, 1173 KiB

Open AccessArticle

Dynamic Ultrasound Assessment of the Anterior Tibial Translation for Anterior Cruciate Ligament Tears Diagnostic

by Anca Gabriela Stoianov, Jenel Marian Pătrașcu, Bogdan Gheorghe Hogea, Bogdan Andor, Liviu Coriolan Mișcă, Sorin Florescu, Roxana Ramona Onofrei and Jenel Marian Pătrașcu, Jr.

J. Clin. Med. 2022, 11(8), 2152; https://doi.org/10.3390/jcm11082152 - 12 Apr 2022

Cited by 4 | Viewed by 2285

Abstract

The aim of our study was to investigate the accuracy of dynamic ultrasound assessment of the anterior tibial translation, in diagnosing anterior cruciate ligament tears, and to assess its test–retest reliability. Twenty-three patients (32 ± 8.42 years; 69.56% males) with a history of [...] Read more.

The aim of our study was to investigate the accuracy of dynamic ultrasound assessment of the anterior tibial translation, in diagnosing anterior cruciate ligament tears, and to assess its test–retest reliability. Twenty-three patients (32 ± 8.42 years; 69.56% males) with a history of knee trauma and knee instability participated in the study. Knee ultrasound was performed by an experienced orthopedic surgeon. The anterior tibial translation was measured in both knees and differences between the injured and uninjured knee were calculated. Side-to-side differences > 1 mm were considered a positive diagnosis of an ACL tear. The anterior tibial translation values were 3.34 ± 1.48 mm in injured knees and 0.86 ± 0.78 mm in uninjured knees. Side-to-side differences > 1 mm were found in 22 cases (95.65%). The diagnosis accuracy was 91.30% (95%CI: 71.96–98.92%) and sensitivity 95.45% (95%CI: 77.15–99.88%). The intraclass correlation coefficient showed an excellent test–retest reliability (ICC_3,1 = 0.97 for the side-to-side difference in anterior tibial translation). The study highlights the accuracy and reliability of the dynamic ultrasound assessment of the anterior tibial translation in the diagnosis of unilateral anterior cruciate ligament tears. Ultrasound assessment is an accessible imaging tool that can provide valuable information and should be used together with physical examination in suspected cases of ACL injuries. Full article

(This article belongs to the Special Issue Physical Activity, Exercise Testing and Clinical Assessment in Sports Medicine)

► Show Figures

Figure 1

15 pages, 1777 KiB

Open AccessArticle

Blood Pressure and Heart Rate Responses to an Isokinetic Testing Protocol in Professional Soccer Players

by Arturo Pérez-Gosalvez, Francisco García-Muro San José, Ofelia Carrión-Otero, Tomás Pérez-Fernández and Luis Fernández-Rosa

J. Clin. Med. 2022, 11(6), 1539; https://doi.org/10.3390/jcm11061539 - 11 Mar 2022

Cited by 2 | Viewed by 2064

Abstract

The aim of this study was to determine blood pressure (BP) and heart rate (HR) responses triggered during an isokinetic testing protocol in professional soccer players and compare cardiovascular parameters at completion of this isokinetic protocol with those during a treadmill test. Using [...] Read more.

The aim of this study was to determine blood pressure (BP) and heart rate (HR) responses triggered during an isokinetic testing protocol in professional soccer players and compare cardiovascular parameters at completion of this isokinetic protocol with those during a treadmill test. Using purposive sampling, 63 professional soccer players were recruited. Cardiovascular responses were measured noninvasively during a bilateral testing protocol of knee flexion and extension. Treadmill ergospirometry following an incremental speed protocol was performed to analyze the same cardiovascular parameters at rest and at completion of this test. There were significant differences in diastolic blood pressure (DBP) and HR according to field position. The parameters presented high homogeneity at both competitive levels. Systolic blood pressure, mean arterial pressure, HR, and rate pressure product at completion of the treadmill test were significantly higher than those at completion of the isokinetic protocol. Intermittent isokinetic testing protocol of the knee triggers normal and safe BP and HR responses in healthy professional soccer players. The HR of the defenders was higher than those of the forwards and midfielders but was independent of the competitive level. The values of cardiovascular parameters at isokinetic protocol completion were lower than those during the treadmill test. Full article

(This article belongs to the Special Issue Physical Activity, Exercise Testing and Clinical Assessment in Sports Medicine)

► Show Figures

Figure 1

10 pages, 288 KiB

Open AccessArticle

Mechanical Hyperalgesia but Not Forward Shoulder Posture Is Associated with Shoulder Pain in Volleyball Players: A Cross-Sectional Study

by Daniel Pecos-Martín, Sergio Patiño-Núñez, Jessica Quintero-Pérez, Gema Cruz-Riesco, Cintia Quevedo-Socas, Tomás Gallego-Izquierdo, Hector Beltran-Alacreu and Josué Fernández-Carnero

J. Clin. Med. 2022, 11(6), 1472; https://doi.org/10.3390/jcm11061472 - 08 Mar 2022

Cited by 1 | Viewed by 1951

Abstract

Shoulder antepulsion, altered scapular kinematics and imbalance of muscle activity are commonly associated with shoulder pain. This study aimed to observe if there is an association between the forward shoulder angle (FSA) and the pectoralis minor length index (PMI) in volleyball players with [...] Read more.

Shoulder antepulsion, altered scapular kinematics and imbalance of muscle activity are commonly associated with shoulder pain. This study aimed to observe if there is an association between the forward shoulder angle (FSA) and the pectoralis minor length index (PMI) in volleyball players with and without shoulder pain. Furthermore, this study observed if there is an association between shoulder posture and upper limb mechanical hyperalgesia in volleyball players with and without shoulder pain. Methods: a cross-sectional study was conducted in the Physiotherapy and Pain Research Center in Alcalá de Henares (Spain). A total of 56 volleyball players met the inclusion criteria and agreed to enter the study. Subjects were divided into two groups: shoulder pain group (SPG) and control group (without pain). The following measurements of the dominant sides of the players were collected: FSA, PMI, and pressure pain threshold (PPT) in serratus anterior, lower trapezius, infraspinatus, teres minor, upper trapezius, levator scapulae, pectoralis major, radial nerve, cubital nerve, and median nerve. Results: The Spearman’s Rho revealed no significant correlations were found between FSA and PMI. Moreover, Spearman’s Rho test revealed in the SPG a negative moderate correlation between FSA and Infraspinatus-PPT (Rho = −0.43; p = 0.02); FSA and levator scapulae-PPT (Rho = −0.55; p < 0.01); FSA and pectoralis major-PPT (Rho = −0.41; p = 0.02); PMI and cubital nerve-PPT (Rho = −0.44; p = 0.01). Conclusions: No association was found between the forward shoulder angle and the pectoralis minor index in volleyball players with and without shoulder pain. There is a moderate negative association between shoulder forward angle and muscle mechanical hyperalgesia in volleyball players with shoulder pain, but no such associations were found in volleyball players without shoulder pain. Treatment of the infraspinatus, levator scapulae, pectoralis major, and pectoralis minor muscles could improve shoulder pain and ulnar nerve mechanosensitivity. Full article

(This article belongs to the Special Issue Physical Activity, Exercise Testing and Clinical Assessment in Sports Medicine)

10 pages, 295 KiB

Open AccessArticle

Anatomical and Neuromuscular Factors Associated to Non-Contact Anterior Cruciate Ligament Injury

by Marc Dauty, Vincent Crenn, Bastien Louguet, Jérôme Grondin, Pierre Menu and Alban Fouasson-Chailloux

J. Clin. Med. 2022, 11(5), 1402; https://doi.org/10.3390/jcm11051402 - 03 Mar 2022

Cited by 7 | Viewed by 3524

Abstract

The majority of anterior cruciate ligament (ACL) injuries occur during non-contact mechanisms. Knowledge of the risk factors would be relevant to help prevent athletes’ injuries. We aimed to study risk factors associated with non-contact ACL injuries in a population of athletes after ACL [...] Read more.

The majority of anterior cruciate ligament (ACL) injuries occur during non-contact mechanisms. Knowledge of the risk factors would be relevant to help prevent athletes’ injuries. We aimed to study risk factors associated with non-contact ACL injuries in a population of athletes after ACL reconstruction. From a cohort of 307 athletes, two populations were compared according to the non-contact or contact mechanism of ACL injury. Gender, age and body mass index (BMI) were reported. Passive knee alignment (valgus and extension), knee laxity (KT-1000 test), and isokinetic knee strength were measured on the non-injured limb. The relationship between these factors and the non-contact sport mechanism was established with models using logistic regression analysis for the population and after selection of gender and cut-offs of age, BMI and knee laxity calculated from Receiver Operating Characteristics curve area and Youden index. Age, BMI, antero-posterior laxity, isokinetic knee strength, passive knee valgus and passive knee extension were associated with non-contact ACL injury. According to the multivariate model, a non-contact ACL injury was associated with non-modifiable factors, age (OR: 1.05; p = 0.001), passive knee extension (OR: 1.14; p = 0.001), and with one modifiable factor (Hamstring strength: OR: 0.27; p = 0.01). For women, only passive knee valgus was reported (OR: 1.27; p = 0.01). Age, passive knee extension and weak Hamstring strength were associated with a non-contact ACL injury. Hamstring strengthening could be proposed to prevent ACL injury in young male athletes or in case of knee laxity. Full article

(This article belongs to the Special Issue Physical Activity, Exercise Testing and Clinical Assessment in Sports Medicine)

9 pages, 644 KiB

Open AccessArticle

Postural Stability in Single-Leg Quiet Stance in Highly Trained Athletes: Sex and Sport Differences

by Nebojša Trajković, Darjan Smajla, Žiga Kozinc and Nejc Šarabon

J. Clin. Med. 2022, 11(4), 1009; https://doi.org/10.3390/jcm11041009 - 15 Feb 2022

Cited by 9 | Viewed by 1970

Abstract

This study aimed to determine if there is a difference in postural stability in highly trained adolescents and young adult athletes regarding sex and sport. The participants were young athletes (n = 464) from seven different sports. We considered the center of [...] Read more.

This study aimed to determine if there is a difference in postural stability in highly trained adolescents and young adult athletes regarding sex and sport. The participants were young athletes (n = 464) from seven different sports. We considered the center of pressure (CoP) velocity (total, anterior–posterior (AP) and medial–lateral (ML)), CoP amplitude (AP and ML), and CoP frequency (AP and ML), as assessed by single-leg quiet stance test. Significant interactions were found between sex and sport for all CoP variables (p < 0.02). Additionally, a significant main effect of sport was also found in all CoP variables (p = 0.01). Regarding sex, significant effects were found for all CoP amplitude variables (p = 0.01), as well as for CoP velocity variables, except for CoP ML (p = 0.06). Moreover, there was no sex effect for CoP frequency AP (p = 0.18). The results of the current study confirm the claim that the criteria for optimal postural strategies for elite athletes likely depend on a given sport. Full article

(This article belongs to the Special Issue Physical Activity, Exercise Testing and Clinical Assessment in Sports Medicine)

► Show Figures

Figure 1

20 pages, 696 KiB

Open AccessArticle

Blood Biomarkers Variations across the Pre-Season and Interactions with Training Load: A Study in Professional Soccer Players

by Filipe Manuel Clemente, Francisco Tomás González-Fernández, Halil Ibrahim Ceylan, Rui Silva, Saeid Younesi, Yung-Sheng Chen, Georgian Badicu, Paweł Wolański and Eugenia Murawska-Ciałowicz

J. Clin. Med. 2021, 10(23), 5576; https://doi.org/10.3390/jcm10235576 - 27 Nov 2021

Cited by 7 | Viewed by 2747

Abstract

Background: Pre-season training in soccer can induce changes in biological markers in the circulation. However, relationships between chosen hematological and biochemical blood parameters and training load have not been measured. Objective: Analyze the blood measures changes and their relationships with training loads changes [...] Read more.

Background: Pre-season training in soccer can induce changes in biological markers in the circulation. However, relationships between chosen hematological and biochemical blood parameters and training load have not been measured. Objective: Analyze the blood measures changes and their relationships with training loads changes after pre-season training. Methodology: Twenty-five professional soccer players were assessed by training load measures (derived from rate of perceived exertion- known as RPE) during the pre-season period. Additionally, blood samples were collected for hematological and biochemical analyses. Results: For hematological parameters, significant increases were found for platelets (PLT) (dif: 6.42; p = 0.006; d = −0.36), while significant decreases were found for absolute neutrophils count (ANC) (dif: −3.98; p = 0.006; d = 0.11), and absolute monocytes count (AMC) (dif: −16.98; p = 0.001; d = 0.78) after the pre-season period. For biochemical parameters, there were significant increases in creatinine (dif: 5.15; p = 0.001; d = −0.46), alkaline phosphatase (ALP) (dif: 12.55; p = 0.001; d = −0.84), C-reactive protein (CRP) (dif: 15.15; p = 0.001; d = −0.67), cortisol (dif: 2.85; p = 0.001; d = −0.28), and testosterone (dif: 5.38; p = 0.001; d = −0.52), whereas there were significant decreases in calcium (dif: −1.31; p = 0.007; d =0.49) and calcium corrected (dif: −2.18; p = 0.015; d = 0.82) after the pre-season period. Moreover, the Hooper Index (dif: 13.22; p = 0.01; d = 0.78), and all derived RPE measures increased after pre-season period. Moderate-to-very large positive and negative correlations (r range: 0.50–0.73) were found between the training load and hematological measures percentage of changes. Moderate-to-large positive and negative correlations (r range: 0.50–0.60) were found between training load and biochemical measures percentage of changes. Conclusions: The results indicated heavy physical loads during the pre-season, leading to a decrease in immune functions. Given the significant relationships between blood and training load measures, monitoring hematological and biochemical measures allow coaches to minimize injury risk, overreaching, and overtraining. Full article

(This article belongs to the Special Issue Physical Activity, Exercise Testing and Clinical Assessment in Sports Medicine)

► Show Figures

Figure 1

10 pages, 1113 KiB

Open AccessArticle

Effects of Acute Psychological and Physiological Stress on Rock Climbers

by Pamela Villavicencio, Cristina Bravo, Antoni Ibarz and Silvia Solé

J. Clin. Med. 2021, 10(21), 5013; https://doi.org/10.3390/jcm10215013 - 28 Oct 2021

Cited by 2 | Viewed by 1842

Abstract

Background: The aim of this study was to assess the effects that psychological and physiological stressors have on indoor rock climbers, as well as to identify sex differences. Methods: 14 intermediate rock climbers participated in the study, 10 males and 4 females. Mean [...] Read more.

Background: The aim of this study was to assess the effects that psychological and physiological stressors have on indoor rock climbers, as well as to identify sex differences. Methods: 14 intermediate rock climbers participated in the study, 10 males and 4 females. Mean age was 31 ± 8 years for males and 21 ± 2 years for females. Day 1 consisted of test familiarization and baseline measurements. Day 2 included two test conditions, startle and fatigue, separated by 20 min. In the startle condition, participants had to lead climb a route, and a loud audio stimulus was presented near the top of the climb. In the fatigue condition, participants were required to climb as fast as they could until muscular failure. The competitive state anxiety inventory second review (CSAI-2R) questionnaire was used to assess somatic anxiety, cognitive anxiety, and self-confidence. The four-square step test (FSST) was used to assess motor control, and cortisol levels were acquired via passive drool (PD). Results: Cortisol concentrations were highest in the pre-startle condition (1.72 μg/dL ± 0.66), and values decreased post-startle (1.67 μg/dL ± 0.74) and post-fatigue (1.42 μg/dL ± 0.72). However, cortisol concentrations increased post-startle in females (1.57 μg/dL ± 0.96). Somatic anxiety in males was significantly higher post-startle (16.36 ± 5.54) than pre-startle (14.23 ± 5.09). Females had significantly higher somatic anxiety post-startle (18.00 ± 8.76), and they had lower self-confidence levels (30.00 ± 5.89) than males. Conclusions: There are differences in the way that males and females prepare and respond to stressful situations. Furthermore, time of day may have had a significant impact on cortisol concentrations. Full article

(This article belongs to the Special Issue Physical Activity, Exercise Testing and Clinical Assessment in Sports Medicine)

► Show Figures

Figure 1

13 pages, 1914 KiB

Open AccessArticle

The Effect of Submaximal Exercise Followed by Short-Term Cold-Water Immersion on the Inflammatory State in Healthy Recreational Athletes: A Cross-Over Study

by Marta Pawłowska, Celestyna Mila-Kierzenkowska, Tomasz Boraczyński, Michał Boraczyński, Karolina Szewczyk-Golec, Paweł Sutkowy, Roland Wesołowski, Małgorzata Smoguła and Alina Woźniak

J. Clin. Med. 2021, 10(18), 4239; https://doi.org/10.3390/jcm10184239 - 18 Sep 2021

Cited by 5 | Viewed by 2457

Abstract

Cold-water immersion (CWI) after exercise is a method used by sportsmen to improve recovery. The aim of the study was to assess the effect of a 3 min CWI on the inflammatory state by measuring levels of interleukin 6 (IL-6), interleukin 10 (IL-10), [...] Read more.

Cold-water immersion (CWI) after exercise is a method used by sportsmen to improve recovery. The aim of the study was to assess the effect of a 3 min CWI on the inflammatory state by measuring levels of interleukin 6 (IL-6), interleukin 10 (IL-10), tumor necrosis factor α (TNF-α), and transforming growth factor β1 (TGF-β1), and activities of α1-antitrypsin (AAT) and lysosomal enzymes, including arylsulfatase (ASA), acid phosphatase (AcP), and cathepsin D (CTS D), in the blood of healthy recreational athletes. Male volunteers (n = 22, age 25 ± 4.8 yr) performed a 30 min submaximal aerobic exercise, followed by a 20 min rest at room temperature (RT-REST) or a 20 min rest at room temperature with an initial 3 min 8 °C water bath (CWI-REST). Blood samples were taken at baseline, immediately after exercise, and after 20 min of recovery. The IL-6, IL-10, and TNF-α levels and the AAT activity increased significantly immediately after exercise. The IL-6 level was significantly higher after CWI-REST than after RT-REST. No changes in the activities of the lysosomal enzymes were observed. The effect of a 3 min CWI on the level of inflammatory markers during post-exercise recovery was limited. Thus, it might be considered as a widely available method of regeneration for recreational athletes. Full article

(This article belongs to the Special Issue Physical Activity, Exercise Testing and Clinical Assessment in Sports Medicine)

► Show Figures

Graphical abstract

10 pages, 1027 KiB

Open AccessArticle

Composite Score of Readiness (CSR) as Holistic Profiling of Functional Deficits in Footballers Following ACL Reconstruction

by Łukasz Oleksy, Anna Mika, Aleksandra Królikowska, Maciej Kuchciak, Magda Stolarczyk, Renata Kielnar, Henryk Racheniuk, Jan Szczegielniak, Edyta Łuszczki and Artur Stolarczyk

J. Clin. Med. 2021, 10(16), 3570; https://doi.org/10.3390/jcm10163570 - 13 Aug 2021

Cited by 6 | Viewed by 2047

Abstract

Background: The decision to return to sport (RTS) after anterior cruciate ligament (ACL) reconstruction is difficult; thus, coaching staff require a readable, easy-to-use, and holistic indication of an athlete’s readiness to play. Purpose: To present the Composite Score of Readiness (CSR) as a [...] Read more.

Background: The decision to return to sport (RTS) after anterior cruciate ligament (ACL) reconstruction is difficult; thus, coaching staff require a readable, easy-to-use, and holistic indication of an athlete’s readiness to play. Purpose: To present the Composite Score of Readiness (CSR) as a method providing a single score for RTS tests after ACL reconstruction. Methods: The study comprised 65 male football players (age 18–25 years), divided into three groups: ACL group—subjects after ACL rupture and reconstruction, Mild Injury (MI) group—subjects after mild lower limb injuries, and Control (C) group—subjects without injuries. The CSR was calculated based on three performed tests (Y-balance test, Functional Movement Screen, and Tuck Jump Assessment) and expressed as the sum of z-scores. The CSR index allows highlighting an athlete’s functional deficits across tests relative to the evaluated group. Results: The CSR indicated that relative to the group of athletes under the study, similar functional deficits were present. Comparing athletes following ACL reconstruction to both the MI and C groups, in the majority of subjects, the CSR index was below zero. The correlation between CSR and raw tests results indicated that the CSR is most strongly determined by YBT. Conclusion: The CSR is a simple way to differentiate people after serious injuries (with large functional deficits) from people without injuries or with only small deficits. Because the CSR is a single number, it allows us to more easily interpret the value of functional deficits in athletes, compared to rating those deficits based on raw tests results. Full article

(This article belongs to the Special Issue Physical Activity, Exercise Testing and Clinical Assessment in Sports Medicine)

► Show Figures

Figure 1

11 pages, 1806 KiB

Open AccessArticle

Impact of a Breathing Intervention on Engagement of Abdominal, Thoracic, and Subclavian Musculature during Exercise, a Randomized Trial

by Petr Bahenský, Václav Bunc, Renata Malátová, David Marko, Gregory J. Grosicki and Jan Schuster

J. Clin. Med. 2021, 10(16), 3514; https://doi.org/10.3390/jcm10163514 - 10 Aug 2021

Cited by 7 | Viewed by 4167

Abstract

Background: Breathing technique may influence endurance exercise performance by reducing overall breathing work and delaying respiratory muscle fatigue. We investigated whether a two-month yoga-based breathing intervention could affect breathing characteristics during exercise. Methods: Forty-six endurance runners (age = 16.6 ± 1.2 years) were [...] Read more.

Background: Breathing technique may influence endurance exercise performance by reducing overall breathing work and delaying respiratory muscle fatigue. We investigated whether a two-month yoga-based breathing intervention could affect breathing characteristics during exercise. Methods: Forty-six endurance runners (age = 16.6 ± 1.2 years) were randomized to either a breathing intervention or control group. The contribution of abdominal, thoracic, and subclavian musculature to respiration and ventilation parameters during three different intensities on a cycle ergometer was assessed pre- and post-intervention. Results: Post-intervention, abdominal, thoracic, and subclavian ventilatory contributions were altered at 2 W·kg⁻¹ (27:23:50 to 31:28:41), 3 W·kg⁻¹ (26:22:52 to 28:31:41), and 4 W·kg⁻¹ (24:24:52 to 27:30:43), whereas minimal changes were observed in the control group. More specifically, a significant (p < 0.05) increase in abdominal contribution was observed at rest and during low intensity work (i.e., 2 and 3 W·kg⁻¹), and a decrease in respiratory rate and increase of tidal volume were observed in the experimental group. Conclusions: These data highlight an increased reliance on more efficient abdominal and thoracic musculature, and less recruitment of subclavian musculature, in young endurance athletes during exercise following a two-month yoga-based breathing intervention. More efficient ventilatory muscular recruitment may benefit endurance performance by reducing energy demand and thus optimize energy requirements for mechanical work. Full article

(This article belongs to the Special Issue Physical Activity, Exercise Testing and Clinical Assessment in Sports Medicine)

► Show Figures

Figure 1

10 pages, 551 KiB

Open AccessArticle

Risk Factors for Non-Contact Lower-Limb Injury: A Retrospective Survey in Pediatric-Age Athletes

by Yanfei Guan, Shannon S. D. Bredin, Jack Taunton, Qinxian Jiang, Nana Wu, Yongfeng Li and Darren E. R. Warburton

J. Clin. Med. 2021, 10(14), 3171; https://doi.org/10.3390/jcm10143171 - 19 Jul 2021

Cited by 6 | Viewed by 2714

Abstract

Background: Risk factors for non-contact lower-limb injury in pediatric-age athletes and the effects of lateral dominance in sport (laterally vs. non-laterally dominant sports) on injury have not been investigated. Purpose: To identify risk factors for non-contact lower-limb injury in pediatric-age athletes. Methods: Parents [...] Read more.

Background: Risk factors for non-contact lower-limb injury in pediatric-age athletes and the effects of lateral dominance in sport (laterally vs. non-laterally dominant sports) on injury have not been investigated. Purpose: To identify risk factors for non-contact lower-limb injury in pediatric-age athletes. Methods: Parents and/or legal guardians of 2269 athletes aged between 6–17 years were recruited. Each participant completed an online questionnaire that contained 10 questions about the athlete’s training and non-contact lower-limb injury in the preceding 12 months. Results: The multivariate logistic regression model determined that lateral dominance in sport (adjusted OR (laterally vs. non-laterally dominant sports), 1.38; 95% CI, 1.10–1.75; p = 0.006), leg preference (adjusted OR (right vs. left-leg preference), 0.71; 95% CI, 0.53–0.95; p = 0.023), increased age (adjusted OR, 1.21; 95% CI, 1.16–1.26; p = 0.000), training intensity (adjusted OR, 1.77; 95% CI, 1.43–2.19; p = 0.000), and training frequency (adjusted OR, 1.36; 95% CI, 1.25–1.48; p = 0.000) were significantly associated with non-contact lower-limb injury in pediatric-age athletes. Length of training (p = 0.396) and sex (p = 0.310) were not associated with a non-contact lower-limb injury. Conclusions: Specializing in laterally dominant sports, left-leg preference, increase in age, training intensity, and training frequency indicated an increased risk of non-contact lower-limb injury in pediatric-age athletes. Future research should take into account exposure time and previous injury. Full article

(This article belongs to the Special Issue Physical Activity, Exercise Testing and Clinical Assessment in Sports Medicine)

► Show Figures

Figure 1

14 pages, 1617 KiB

Open AccessArticle

Effects of Whole-Body Vibration and Balance Training on Female Athletes with Chronic Ankle Instability

by Wen-Dien Chang, Shuya Chen and Yung-An Tsou

J. Clin. Med. 2021, 10(11), 2380; https://doi.org/10.3390/jcm10112380 - 28 May 2021

Cited by 16 | Viewed by 4711

Abstract

We explored the effects of 6-week whole-body vibration (WBV) and balance training programs on female athletes with chronic ankle instability (CAI). This randomized controlled study involved female athletes with dominant-leg CAI. The participants were randomly divided into three groups: WBV training (Group A), [...] Read more.

We explored the effects of 6-week whole-body vibration (WBV) and balance training programs on female athletes with chronic ankle instability (CAI). This randomized controlled study involved female athletes with dominant-leg CAI. The participants were randomly divided into three groups: WBV training (Group A), balance training (Group B), and nontraining (control group; Group C). Groups A and B performed three exercise movements (double-leg stance, one-legged stance, and tandem stance) in 6-week training programs by using a vibration platform and balance ball, respectively. The Star Excursion Balance Test (SEBT), a joint position sense test, and an isokinetic strength test were conducted. In total, 63 female athletes with dominant-leg CAI were divided into three study groups (all n = 21). All of them completed the study. We observed time-by-group interactions in the SEBT (p = 0.001) and isokinetic strength test at 30°/s of concentric contraction (CON) of ankle inversion (p = 0.04). Compared with the control group, participants of the two exercise training programs improved in dynamic balance, active repositioning, and 30°/s of CON and eccentric contraction of the ankle invertor in the SEBT, joint position sense test, and isokinetic strength test, respectively. Furthermore, the effect sizes for the assessed outcomes in Groups A and B ranged from very small to small. Female athletes who participated in 6-week training programs incorporating a vibration platform or balance ball exhibited very small or small effect sizes for CAI in the SEBT, joint position sense test, and isokinetic strength test. No differences were observed in the variables between the two exercise training programs. Full article

(This article belongs to the Special Issue Physical Activity, Exercise Testing and Clinical Assessment in Sports Medicine)

► Show Figures

Figure 1

18 pages, 419 KiB

Open AccessArticle

Accuracy and Repeatability of Spatiotemporal Gait Parameters Measured with an Inertial Measurement Unit

by Jorge Posada-Ordax, Julia Cosin-Matamoros, Marta Elena Losa-Iglesias, Ricardo Becerro-de-Bengoa-Vallejo, Laura Esteban-Gonzalo, Carlos Martin-Villa, César Calvo-Lobo and David Rodriguez-Sanz

J. Clin. Med. 2021, 10(9), 1804; https://doi.org/10.3390/jcm10091804 - 21 Apr 2021

Cited by 6 | Viewed by 1589

Abstract

In recent years, interest in finding alternatives for the evaluation of mobility has increased. Inertial measurement units (IMUs) stand out for their portability, size, and low price. The objective of this study was to examine the accuracy and repeatability of a commercially available [...] Read more.

In recent years, interest in finding alternatives for the evaluation of mobility has increased. Inertial measurement units (IMUs) stand out for their portability, size, and low price. The objective of this study was to examine the accuracy and repeatability of a commercially available IMU under controlled conditions in healthy subjects. A total of 36 subjects, including 17 males and 19 females were analyzed with a Wiva Science IMU in a corridor test while walking for 10 m and in a threadmill at 1.6 km/h, 2.4 km/h, 3.2 km/h, 4 km/h, and 4.8 km/h for one minute. We found no difference when we compared the variables at 4 km/h and 4.8 km/h. However, we found greater differences and errors at 1.6 km/h, 2.4 km/h and 3.2 km/h, and the latter one (1.6 km/h) generated more error. The main conclusion is that the Wiva Science IMU is reliable at high speeds but loses reliability at low speeds. Full article

(This article belongs to the Special Issue Physical Activity, Exercise Testing and Clinical Assessment in Sports Medicine)

► Show Figures

Figure 1

8 pages, 972 KiB

Open AccessArticle

Judo Injuries Frequency in Europe’s Top-Level Competitions in the Period 2005–2020

by Wiesław Błach, Peter Smolders, Łukasz Rydzik, Georgios Bikos, Nicola Maffulli, Nikos Malliaropoulos, Władysław Jagiełło, Krzysztof Maćkała and Tadeusz Ambroży

J. Clin. Med. 2021, 10(4), 852; https://doi.org/10.3390/jcm10040852 - 19 Feb 2021

Cited by 16 | Viewed by 4334

Abstract

Background: The present study assesses the frequency of injury in Europe’s top-level judokas, during top-level competitions, and defines risk factors. Methods: The members of the EJU Medical Commission collected injury data over the period of 2005 to 2020 using the EJU Injury Registration [...] Read more.

Background: The present study assesses the frequency of injury in Europe’s top-level judokas, during top-level competitions, and defines risk factors. Methods: The members of the EJU Medical Commission collected injury data over the period of 2005 to 2020 using the EJU Injury Registration Form at Europe’s top judoka tournaments. Results: Over the 15 years of the study, 128 top-level competitions with 28,297 competitors were included; 699 injuries were registered. Of all competitors, 2.5% needed medical treatment. The knee (17.4%), shoulder (15.7%), and elbow (14.2%) were the most common anatomical locations of injury. Sprains (42.2%) were by far the most frequent injury type, followed by contusions (23.1%). Of all contestants, 0.48% suffered an injury which needed transportation to hospital. There was a statistically significant higher frequency of elbow injuries in female athletes (p < 0.01). Heavy-weight judokas suffered a remarkably low number of elbow injuries, with more knee and shoulder injuries. Light-weight judokas were more prone to elbow injuries. Conclusions: We found there was a low injury rate in top-level competitors, with a greater frequency of elbow injuries in female judokas. During the 15 years of injury collection data, an injury incidence of 2.5% was found, with a remarkable high injury rate in the women’s −52 kg category, and statistically significantly more elbow injuries in women overall. Full article

(This article belongs to the Special Issue Physical Activity, Exercise Testing and Clinical Assessment in Sports Medicine)

► Show Figures

Figure 1

Review

Jump to: Research

12 pages, 1402 KiB

Open AccessReview

Cardiopulmonary Exercise Test Parameters in Athletic Population: A Review

by Reza Mazaheri, Christian Schmied, David Niederseer and Marco Guazzi

J. Clin. Med. 2021, 10(21), 5073; https://doi.org/10.3390/jcm10215073 - 29 Oct 2021

Cited by 18 | Viewed by 6059

Abstract

Although still underutilized, cardiopulmonary exercise testing (CPET) allows the most accurate and reproducible measurement of cardiorespiratory fitness and performance in athletes. It provides functional physiologic indices which are key variables in the assessment of athletes in different disciplines. CPET is valuable in clinical [...] Read more.

Although still underutilized, cardiopulmonary exercise testing (CPET) allows the most accurate and reproducible measurement of cardiorespiratory fitness and performance in athletes. It provides functional physiologic indices which are key variables in the assessment of athletes in different disciplines. CPET is valuable in clinical and physiological investigation of individuals with loss of performance or minor symptoms that might indicate subclinical cardiovascular, pulmonary or musculoskeletal disorders. Highly trained athletes have improved CPET values, so having just normal values may hide a medical disorder. In the present review, applications of CPET in athletes with special attention on physiological parameters such as VO₂max, ventilatory thresholds, oxygen pulse, and ventilatory equivalent for oxygen and exercise economy in the assessment of athletic performance are discussed. The role of CPET in the evaluation of possible latent diseases and overtraining syndrome, as well as CPET-based exercise prescription, are outlined. Full article

(This article belongs to the Special Issue Physical Activity, Exercise Testing and Clinical Assessment in Sports Medicine)

► Show Figures

Figure 1

19 pages, 2280 KiB

Open AccessReview

by Jose Castro-Piñero, Nuria Marin-Jimenez, Jorge R. Fernandez-Santos, Fatima Martin-Acosta, Victor Segura-Jimenez, Rocio Izquierdo-Gomez, Jonatan R. Ruiz and Magdalena Cuenca-Garcia

J. Clin. Med. 2021, 10(16), 3743; https://doi.org/10.3390/jcm10163743 - 23 Aug 2021

Cited by 19 | Viewed by 5075

Abstract

We comprehensively assessed the criterion-related validity of existing field-based fitness tests used to indicate adult health (19–64 years, with no known pathologies). The medical electronic databases MEDLINE (via PubMed) and Web of Science (all databases) were screened for studies published up to July [...] Read more.

We comprehensively assessed the criterion-related validity of existing field-based fitness tests used to indicate adult health (19–64 years, with no known pathologies). The medical electronic databases MEDLINE (via PubMed) and Web of Science (all databases) were screened for studies published up to July 2020. Each original study’s methodological quality was classified as high, low and very low, according to the number of participants, the description of the study population, statistical analysis and systematic reviews which were appraised via the AMSTAR rating scale. Three evidence levels were constructed (strong, moderate and limited evidence) according to the number of studies and the consistency of the findings. We identified 101 original studies (50 of high quality) and five systematic reviews examining the criterion-related validity of field-based fitness tests in adults. Strong evidence indicated that the 20 m shuttle run, 1.5-mile, 12 min run/walk, YMCA step, 2 km walk and 6 min walk test are valid for estimating cardiorespiratory fitness; the handgrip strength test is valid for assessing hand maximal isometric strength; and the Biering–Sørensen test to evaluate the endurance strength of hip and back muscles; however, the sit-and reach test, and its different versions, and the toe-to-touch test are not valid for assessing hamstring and lower back flexibility. We found moderate evidence supporting that the 20 m square shuttle run test is a valid test for estimating cardiorespiratory fitness. Other field-based fitness tests presented limited evidence, mainly due to few studies. We developed an evidence-based proposal of the most valid field-based fitness tests in healthy adults aged 19–64 years old. Full article

(This article belongs to the Special Issue Physical Activity, Exercise Testing and Clinical Assessment in Sports Medicine)

► Show Figures

Figure 1

Journal Menu

Journal Browser

Physical Activity, Exercise Testing and Clinical Assessment in Sports Medicine

Share This Special Issue

Special Issue Editor

Special Issue Information

Keywords

Published Papers (27 papers)

Research

Review

Further Information

Guidelines

MDPI Initiatives

Follow MDPI