Dietary insulin index and dietary insulin load in relation to non-alcoholic fatty liver disease: a cross-sectional study

OBJECTIVE

Postprandial hyperinsulinaemia plays a key role in the development of non-alcoholic fatty liver disease (NAFLD). Diet is a potential factor affecting serum insulin levels. This study aimed to examine the relations of dietary insulin index (DII) and dietary insulin load (DIL) to the risk of NAFLD.

DESIGN

This study was a cross-sectional study. DII and DIL were calculated using the dietary data obtained from the FFQ. Fatty liver index ≥ 60 and the confirmation of a gastroenterologist were required to diagnose NAFLD.

SETTING

Community-based study.

PARTICIPANTS

A total of 3158 people (46·7 % male), aged 40·57 ± 8·25 years, participated in this study in Tehran, Iran from April 2016 to December 2019.

RESULTS

The prevalence of NAFLD was 29·9 % (21·59 % in males and 33·74 % in females). In the fully adjusted model controlled for sex, age, energy intake, BMI, smoking, physical activity and education, DII was significantly associated with the increased risk of NAFLD in males (OR: 2·74, 95 % CI = 1·75, 4·31; P-trend = ≤0·001) and females (OR: 2·26, 95 % CI = 1·39, 3·69; P-trend = 0·005). A significant relationship was also detected between DIL and NAFLD in females (OR: 2·90, 95 % CI = 1·70, 4·93; P-trend ≤0·001) but not in males (OR: 1·33, 95 % CI = 0·84, 2·10; P-trend = 0·13).

CONCLUSIONS

Adherence to a diet with a high DII and DIL may be related to the increased risk of NAFLD. These results may be useful for healthcare providers to design appropriate preventive measures for people at risk of NAFLD.

Static Stretch Training versus Foam Rolling Training Effects on Range of Motion: A Systematic Review and Meta-Analysis

BACKGROUND

Long-term static stretching as well as foam rolling training can increase a joint's range of motion (ROM). However, to date, it is not clear which method is the most effective for increasing ROM.

OBJECTIVE

The purpose of this systematic review and meta-analysis was to compare the effects of static stretching and foam rolling training on ROM.

METHODS

The literature search was performed in PubMed, Scopus, and Web of Science to find the eligible studies. Eighty-five studies (72 on static stretching; and 13 on foam rolling) were found to be eligible with 204 effect sizes (ESs). For the main analyses, a random-effect meta-analysis was applied. To assess the difference between static stretching and foam rolling, subgroup analyses with a mixed-effect model were applied. Moderating variables were sex, total intervention duration, and weeks of intervention.

RESULTS

Static stretch (ES =  - 1.006; p < 0.001), as well as foam rolling training (ES =  - 0.729; p = 0.001), can increase joint ROM with a moderate magnitude compared with a control condition. However, we did not detect a significant difference between the two conditions in the subgroup analysis (p = 0.228). When the intervention duration was ≤ 4 weeks, however, a significant change in ROM was shown following static stretching (ES =  - 1.436; p < 0.001), but not following foam rolling (ES =  - 0.229; p = 0.248). Thus, a subgroup analysis indicated a significant favorable effect with static stretching for increasing ROM compared with foam rolling (p < 0.001) over a shorter term (≤ 4 weeks). Other moderator analyses showed no significant difference between static stretch and foam rolling training on ROM.

CONCLUSIONS

According to the results, both static stretching and foam rolling training can be similarly recommended to increase joint ROM, unless the training is scheduled for ≤ 4 weeks, in which case static stretching demonstrates a significant advantage. More studies are needed with a high-volume foam rolling training approach as well as foam rolling training in exclusively female participants.

Discussing Conflicting Explanatory Approaches in Flexibility Training Under Consideration of Physiology: A Narrative Review

The mechanisms underlying range of motion enhancements via flexibility training discussed in the literature show high heterogeneity in research methodology and study findings. In addition, scientific conclusions are mostly based on functional observations while studies considering the underlying physiology are less common. However, understanding the underlying mechanisms that contribute to an improved range of motion through stretching is crucial for conducting comparable studies with sound designs, optimising training routines and accurately interpreting resulting outcomes. While there seems to be no evidence to attribute acute range of motion increases as well as changes in muscle and tendon stiffness and pain perception specifically to stretching or foam rolling, the role of general warm-up effects is discussed in this paper. Additionally, the role of mechanical tension applied to greater muscle lengths for range of motion improvement will be discussed. Thus, it is suggested that physical training stressors can be seen as external stimuli that control gene expression via the targeted stimulation of transcription factors, leading to structural adaptations due to enhanced protein synthesis. Hence, the possible role of serial sarcomerogenesis in altering pain perception, reducing muscle stiffness and passive torque, or changes in the optimal joint angle for force development is considered as well as alternative interventions with a potential impact on anabolic pathways. As there are limited possibilities to directly measure serial sarcomere number, longitudinal muscle hypertrophy remains without direct evidence. The available literature does not demonstrate the necessity of only using specific flexibility training routines such as stretching to enhance acute or chronic range of motion.

Little associations exist between the three commonly used functional screening tests in collegiate athletes

Although an abundant number of studies have investigated the predictability of the commonly used functional screening tests and despite their popularity and applicability, the relationships between these tests have rarely been studied and have not been well established. This study aimed to examine the potential association between the Functional Movement Screen (FMS), Y Balance Test (YBT), and Landing Error Scoring System (LESS). Six hundred twenty-seven Iranian collegiate athletes (347 males, age = 22.63 ± 4.07, weight = 75.98 ± 13.79, height = 181.99 ± 10.15, BMI = 22.84 ± 3.16; and 280 females, age = 22.22 ± 3.37, weight = 60.63 ± 9.58, height = 166.55 ± 6.49, BMI = 21.81 ± 2.84) participated in this study. Following a 5-min warm-up, each participant underwent a standardized screening battery including the FMS, YBT, and LESS, and the scores were recorded and live coded for the statistical analysis, except for the LESS. The LESS tests were video recorded and scored by one expert examiner using an open-source 2D video analysis software (Kinovea- version 0.9.5), afterwards. The Spearman correlation was utilized as a measure for the correlation, and the Mann‒Whitney U test with a significance level of 0.05 was used to check the differences between male and female athletes. The statistical analysis was performed with RStudio 2023.03.0 using R 4.3.1. A small correlation (0.364) was observed between the FMS composite score and the YBT in male athletes. All other pairwise correlations were negligible among male and female athletes, ranging from - 0.096 to 0.294. Reducing the FMS to the component scores targeting the lower extremities did not alter the correlation to the other screening scores. The median FMS composite score in female athletes was significantly higher than that in males (p < 0.001). Negligible correlations exist between the FMS, LESS, and YBT; they do not measure the same values and therefore are irreplaceable with one another. A combination of these tests as a standardized screening battery may potentially better identify injury-predisposed athletes than the application of each test as a stand-alone screening test. Females outperformed males in the FMS test significantly, so sex must be considered a key variable in the FMS studies. Males had slightly higher LESS scores (median difference = 0.5) than females, but this difference is not clinically meaningful. Future research should continue to explore the relationships between various functional screening tests and identify the most effective combinations for comprehensive assessment in different populations and sports disciplines.

Neuromechanical Differences between Pronated and Supinated Forearm Positions during Upper-Body Wingate Tests

Arm-cycling is a versatile exercise modality with applications in both athletic enhancement and rehabilitation, yet the influence of forearm orientation remains understudied. Thus, this study aimed to investigate the impact of forearm position on upper-body arm-cycling Wingate tests. Fourteen adult males (27.3 ± 5.8 years) underwent bilateral assessments of handgrip strength in standing and seated positions, followed by pronated and supinated forward arm-cycling Wingate tests. Electromyography (EMG) was recorded from five upper-extremity muscles, including anterior deltoid, triceps brachii lateral head, biceps brachii, latissimus dorsi, and brachioradialis. Simultaneously, bilateral normal and propulsion forces were measured at the pedal-crank interface. Rate of perceived exertion (RPE), power output, and fatigue index were recorded post-test. The results showed that a pronated forearm position provided significantly (p < 0.05) higher normal and propulsion forces and triceps brachii muscle activation patterns during arm-cycling. No significant difference in RPE was observed between forearm positions (p = 0.17). A positive correlation was found between seated handgrip strength and peak power output during the Wingate test while pronated (dominant: p = 0.01, r = 0.55; non-dominant: p = 0.03, r = 0.49) and supinated (dominant: p = 0.03, r = 0.51; don-dominant: p = 0.04, r = 0.47). Fatigue changed the force and EMG profile during the Wingate test. In conclusion, this study enhances our understanding of forearm position's impact on upper-body Wingate tests. These findings have implications for optimizing training and performance strategies in individuals using arm-cycling for athletic enhancement and rehabilitation.

The Duration of Non-Local Muscle Fatigue Effects

Non-local muscle fatigue (NLMF) refers to a transient decline in the functioning of a non-exercised muscle following the fatigue of a different muscle group. Most studies examining NLMF conducted post-tests immediately after the fatiguing protocols, leaving the duration of these effects uncertain. The aim of this study was to investigate the duration of NLMF (1-, 3-, and 5-minutes). In this randomized crossover study, 17 recreationally trained participants (four females) were tested for the acute effects of unilateral knee extensor (KE) muscle fatigue on the contralateral homologous muscle strength, and activation. Each of the four sessions included testing at either 1-, 3-, or 5-minutes post-test, as well as a control condition for non-dominant KE peak force, instantaneous strength (force produced within the first 100-ms), and vastus lateralis and biceps femoris electromyography (EMG). The dominant KE fatigue intervention protocol involved two sets of 100-seconds maximal voluntary isometric contractions (MVIC) separated by 1-minute of rest. Non-dominant KE MVIC forces showed moderate and small magnitude reductions at 1-min (p < 0.0001, d = 0.72) and 3-min (p = 0.005, d = 0.30) post-test respectively. The KE MVIC instantaneous strength revealed large magnitude, significant reductions between 1-min (p = 0.021, d = 1.33), and 3-min (p = 0.041, d = 1.13) compared with the control. In addition, EMG data revealed large magnitude increases with the 1-minute versus control condition (p = 0.03, d = 1.10). In summary, impairments of the non-exercised leg were apparent up to 3-minutes post-exercise with no significant deficits at 5-minutes. Recovery duration plays a crucial role in the manifestation of NLMF.

Novel islands of GGC and GCC repeats coincide with human evolution

BACKGROUND

Because of high mutation rate, overrepresentation in genic regions, and link with various neurological, neurodegenerative, and movement disorders, GGC and GCC short tandem repeats (STRs) are prone to natural selection. Among a number of lacking data, the 3-repeats of these STRs remain widely unexplored.

RESULTS

In a genome-wide search in human, here we mapped GGC and GCC STRs of ≥3-repeats, and found novel islands of up to 45 of those STRs, populating spans of 1 to 2 kb of genomic DNA. RGPD4 and NOC4L harbored the densest (GGC)3 (probability 3.09061E-71) and (GCC)3 (probability 1.72376E-61) islands, respectively, and were human-specific. We also found prime instances of directional incremented density of STRs at specific loci in human versus other species, including the FOXK2 and SKI GGC islands. The genes containing those islands significantly diverged in expression in human versus other species, and the proteins encoded by those genes interact closely in a physical interaction network, consequence of which may be human-specific characteristics such as higher order brain functions.

CONCLUSION

We report novel islands of GGC and GCC STRs of evolutionary relevance to human. The density, and in some instances, periodicity of these islands support them as a novel genomic entity, which need to be further explored in evolutionary, mechanistic, and functional platforms.

A Hypermutable Region in the DISP2 Gene Links to Natural Selection and Late-Onset Neurocognitive Disorders in Humans

(CCG) short tandem repeats (STRs) are predominantly enriched in genic regions, mutation hotspots for C to T truncating substitutions, and involved in various neurological and neurodevelopmental disorders. However, intact blocks of this class of STRs are widely overlooked with respect to their link with natural selection. The human neuron-specific gene, DISP2 (dispatched RND transporter family member 2), contains a (CCG) repeat in its 5' untranslated region. Here, we sequenced this STR in a sample of 448 Iranian individuals, consisting of late-onset neurocognitive disorder (NCD) (N = 203) and controls (N = 245). We found that the region spanning the (CCG) repeat was highly mutated, resulting in several flanking (CCG) residues. However, an 8-repeat of the (CCG) repeat was predominantly abundant (frequency = 0.92) across the two groups. While the overall distribution of genotypes was not different between the two groups (p > 0.05), we detected four genotypes in the NCD group only (2% of the NCD genotypes, Mid-p = 0.02), consisting of extreme short alleles, 5- and 6-repeats, that were not detected in the control group. The patients harboring those genotypes received the diagnoses of probable Alzheimer's disease and vascular dementia. We also found six genotypes in the control group only (2.5% of the control genotypes, Mid-p = 0.01) that consisted of the 8-repeat and extreme long alleles, 9- and 10-repeats, of which the 10-repeat was not detected in the NCD group. The (CCG) repeat specifically expanded in primates. In conclusion, we report an indication of natural selection at a novel hypermutable region in the human genome and divergent alleles and genotypes in late-onset NhCDs and controls. These findings reinforce the hypothesis that a collection of rare alleles and genotypes in a number of genes may unambiguously contribute to the cognition impairment component of late-onset NCDs.

Chronic effects of stretching on range of motion with consideration of potential moderating variables: A systematic review with meta-analysis

BACKGROUND

It is well known that stretch training can induce prolonged increases in joint range of motion (ROM). However, to date more information is needed regarding which training variables might have greater influence on improvements in flexibility. Thus, the purpose of this meta-analysis was to investigate the effects of stretch training on ROM in healthy participants by considering potential moderating variables, such as stretching technique, intensity, duration, frequency, and muscles stretched, as well as sex-specific, age-specific, and/or trained state-specific adaptations to stretch training.

METHODS

We searched through PubMed, Scopus, Web of Science, and SportDiscus to find eligible studies and, finally, assessed the results from 77 studies and 186 effect sizes by applying a random-effect meta-analysis. Moreover, by applying a mixed-effect model, we performed the respective subgroup analyses. To find potential relationships between stretch duration or age and effect sizes, we performed a meta-regression.

RESULTS

We found a significant overall effect, indicating that stretch training can increase ROM with a moderate effect compared to the controls (effect size = -1.002; Z = -12.074; 95% confidence interval: -1.165 to -0.840; p < 0.001; I2 = 74.97). Subgroup analysis showed a significant difference between the stretching techniques (p = 0.01) indicating that proprioceptive neuromuscular facilitation and static stretching produced greater ROM than did ballistic/dynamic stretching. Moreover, there was a significant effect between the sexes (p = 0.04), indicating that females showed higher gains in ROM compared to males. However, further moderating analysis showed no significant relation or difference.

CONCLUSION

When the goal is to maximize ROM in the long term, proprioceptive neuromuscular facilitation or static stretching, rather than ballistic/dynamic stretching, should be applied. Something to consider in future research as well as sports practice is that neither volume, intensity, nor frequency of stretching were found to play a significant role in ROM yields.

Dyads of GGC and GCC form hotspot colonies that coincide with the evolution of human and other great apes

BACKGROUND

GGC and GCC short tandem repeats (STRs) are of various evolutionary, biological, and pathological implications. However, the fundamental two-repeats (dyads) of these STRs are widely unexplored.

RESULTS

On a genome-wide scale, we mapped (GGC)2 and (GCC)2 dyads in human, and found monumental colonies (distance between each dyad < 500 bp) of extraordinary density, and in some instances periodicity. The largest (GCC)2 and (GGC)2 colonies were intergenic, homogeneous, and human-specific, consisting of 219 (GCC)2 on chromosome 2 (probability < 1.545E-219) and 70 (GGC)2 on chromosome 9 (probability = 1.809E-148). We also found that several colonies were shared in other great apes, and directionally increased in density and complexity in human, such as a colony of 99 (GCC)2 on chromosome 20, that specifically expanded in great apes, and reached maximum complexity in human (probability 1.545E-220). Numerous other colonies of evolutionary relevance in human were detected in other largely overlooked regions of the genome, such as chromosome Y and pseudogenes. Several of the genes containing or nearest to those colonies were divergently expressed in human.

CONCLUSION

In conclusion, (GCC)2 and (GGC)2 form unprecedented genomic colonies that coincide with the evolution of human and other great apes. The extent of the genomic rearrangements leading to those colonies support overlooked recombination hotspots, shared across great apes. The identified colonies deserve to be studied in mechanistic, evolutionary, and functional platforms.

The Effects of Physical and Mental Fatigue on Time Perception

The perception of time holds a foundational significance regarding how we elucidate the chronological progression of events. While some studies have examined exercise effects on time perception during exercise periods, there are no studies investigating the effects of exercise fatigue on time perception after an exercise intervention. This study investigated the effects of physical and mental fatigue on time estimates over 30 s immediately post-exercise and 6 min post-test. Seventeen volunteers were subjected to three conditions: physical fatigue, mental fatigue, and control. All participants completed a familiarization session and were subjected to three 30 min experimental conditions (control, physical fatigue (cycling at 65% peak power output), and mental fatigue (Stroop task)) on separate days. Time perception, heart rate, and body temperature were recorded pre-test; at the start of the test; 5, 10, 20, 30 seconds into the interventions; post-test; and at the 6 min follow-up. Rating of perceived exertion (RPE) was recorded four times during the intervention. Physical fatigue resulted in a significant (p = 0.001) underestimation of time compared to mental fatigue and control conditions at the post-test and follow-up, with no significant differences between mental fatigue and control conditions. Heart rate, body temperature, and RPE were significantly (all p = 0.001) higher with physical fatigue compared to mental fatigue and control conditions during the intervention and post-test. This study demonstrated that cycling-induced fatigue led to time underestimation compared to mental fatigue and control conditions. It is crucial to consider that physical fatigue has the potential to lengthen an individual's perception of time estimates in sports or work environments.

A GCC repeat in RAB26 undergoes natural selection in human and harbors divergent genotypes in late-onset Alzheimer's disease

Although mainly located in genic regions and being mutation hotspots, intact blocks of CG-rich trinucleotide short tandem repeats (STRs) are largely overlooked with respect to their link with natural selection. The human RAB26 (member RAS oncogene family) directs synaptic and secretory vesicles into preautophagosomal structures, inhibition of which specifically disrupts axonal transport of degradative organelles and leads to an axonal dystrophy, resembling Alzheimer's disease (AD). Human RAB26 contains a GCC repeat in the top 1st percent in respect of length. Here we sequenced this STR in 441 Iranian individuals, consisting of late-onset neurocognitive disorder (NCD) (N = 216) and controls (N = 225). In both groups, the 12-repeat allele and the 12/12 genotype were predominantly abundant. We found excess of homozygosity for non-12 alleles in the NCD group (Mid-P exact = 0.027). Furthermore, divergent genotypes were detected that were specific to the NCD group (2.8% of genotypes) (Mid-P exact = 0.006) or controls (3.1% of genotypes) (Mid-P exact = 0.004). The patients harboring divergent genotypes received the diagnosis of AD. Based on the predominant abundance of the 12-repeat and 12/12 genotype in both groups, excess of non-12 homozygosity in the NCD group, and divergent genotypes across the NCD and control groups, we propose natural selection at this locus and link with late-onset AD. Our findings strengthen the hypothesis that a collection of rare genotypes unambiguously contribute to the pathogenesis of late-onset NCDs, such as AD.

Acute Effects of Various Stretching Techniques on Range of Motion: A Systematic Review with Meta-Analysis

Background

Although stretching can acutely increase joint range of motion (ROM), there are a variety of factors which could influence the extent of stretch-induced flexibility such as participant characteristics, stretching intensities, durations, type (technique), and muscle or joint tested.

Objective

The objective of this systematic review and meta-analysis was to investigate the acute effects of stretching on ROM including moderating variables such as muscles tested, stretch techniques, intensity, sex, and trained state.

Methods

A random-effect meta-analysis was performed from 47 eligible studies (110 effect sizes). A mixed-effect meta-analysis subgroup analysis was also performed on the moderating variables. A meta-regression was also performed between age and stretch duration. GRADE analysis was used to assess the quality of evidence obtained from this meta-analysis.

Results

The meta-analysis revealed a small ROM standard mean difference in favor of an acute bout of stretching compared to non-active control condition (ES = −0.555; Z = −8.939; CI (95%) −0.677 to −0.434; p  < 0.001; I2 = 33.32). While there were ROM increases with sit and reach (P  = 0.038), hamstrings (P  < 0.001), and triceps surae (P  = 0.002) tests, there was no change with the hip adductor test (P  = 0.403). Further subgroup analyses revealed no significant difference in stretch intensity (P  = 0.76), trained state (P  = 0.99), stretching techniques (P  = 0.72), and sex (P  = 0.89). Finally, meta-regression showed no relationship between the ROM standard mean differences to age (R2 = −0.03; P  = 0.56) and stretch duration (R 2 = 0.00; P  = 0.39), respectively. GRADE analysis indicated that we can be moderately confident in the effect estimates.

Conclusion

A single bout of stretching can be considered effective for providing acute small magnitude ROM improvements for most ROM tests, which are not significantly affected by stretch intensity, participants’ trained state, stretching techniques, and sex.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40798-023-00652-x.

The meta-analysis on joint range of motion (ROM) increases revealed a small effect size in favor of an acute bout of stretching compared to the control condition. Subgroup analysis revealed a significant increase in ROM with sit and reach, hamstrings, and triceps surae tests, but no improvement with the hip adductor tests. Whereas all moderating variables presented significant increases in ROM, further subgroup analyses revealed no significant difference in ROM gains with the stretch intensity, trained state of the participants, stretching techniques, and sex. A meta-regression showed no relationship between the effect sizes to age and stretch duration, respectively.

The Use of Elastic Resistance Bands to Reduce Dynamic Knee Valgus in Squat-Based Movements: A Narrative Review

An elastic band wrapped around the distal thighs has recently been proposed as a method for reducing dynamic knee valgus (medial movement of the knee joint in the frontal/coronal plane) while performing squats. The rationale behind this technique is that, by using an external force to pull the knees into further knee valgus, the band both exaggerates the pre-existing movement and provides additional local proprioceptive input, cueing individuals to adjust their knee alignment. If these mechanisms are true, then elastic bands might indeed reduce dynamic knee valgus, which could be promising for use in injury prevention as excessive knee valgus may be associated with a greater risk of sustaining an ACL rupture and/or other knee injuries. Due to this possibility, certain athletic populations have already adopted the use of elastic bands for training and/or rehab, despite a limited number of studies showing beneficial findings. The purpose of this narrative review is to examine current literature that has assessed lower limb muscle activity and/or lower limb kinematics performance on squat-based movements with or without an elastic band(s). Importantly, this paper will also discuss the key limitations that exist in this area, propose suggestions for future research directions, and provide recommendations for training implementations.

Level of Evidence

5.

Maximal and Submaximal Intensity Isometric Knee Extensions Induce an Underestimation of Time Estimates with Both Younger And Older Adults: A Randomized Crossover Trial

Our perception of time plays a critical role in nearly all daily activities and especially in sports. There are no studies that have investigated and compared time perception during exercise in young and older adults. Thus, this study aimed to compare the effects of exercise on time perception between younger and older adult populations. Thirty-three recreationally active participants were recruited and assigned to either the younger (university students, 9 males and 10 females) or older adults (>60 years, 8 males and 6 females). All participants completed four exercise conditions over two sessions on separate days: approximately 30-seconds of knee extensors 100%, 60% and 10% of maximum voluntary isometric contraction (MVIC), and control (no contractions). Prospective time perception was estimated (at 5-, 10-, 20-, and 30-seconds) at the beginning of each session and while performing the exercise. A main effect for condition (p < 0.001, d = 1.06) with subsequent post-hoc tests indicated participants significantly underestimated (estimated time was shorter than chronological time) time in all three exercise conditions compared to the control. There were no significant age group differences. In conclusion, exercise underestimated time estimates regardless of intensity or age. This questions the postulated intensity-dependent relationship between exercise and time perception. While older adults were expected to be less accurate in their time estimates, they may have been able to adopt alternative strategies for age-related changes in their internal clock, resulting in no significant age group differences.

The Effect of a Mental Task Versus Unilateral Physical Fatigue on Non-Local Muscle Fatigue in Recreationally Active Young Adults

Non-local muscle fatigue (NLMF) has been attributed to both physical and mental fatigue. The purpose of this study was to investigate the effects of mental exertion versus unilateral physical fatigue on NLMF. Sixteen recreationally active participants completed a physical task (2-sets of 100-s unilateral knee extension (KE) maximal voluntary isometric contractions (MVIC) with the dominant leg with 40-s recovery between sets, mental task (4-minute Stroop task), and control condition. Before and after each condition, blood lactate was collected, and contralateral 5-s KE, flexion (KF) and bilateral lateral trunk flexors MVIC (measure of trunk stability strength) was performed. Following the post-test 5-s MVICs, participants performed 12 non-dominant KE MVICs with a work-to-rest ratio of 5/10-s. Electromyography was monitored during the MVICs. Neither the 4-minute Stroop test or the unilateral KE physical fatigue intervention adversely affected the non-dominant KE forces or EMG activity with a single MVIC or 12 repetition MVICs. Although the non-dominant KF fatigue index forces and hamstrings EMG were not impaired by the interventions, there was a significant interaction (p = 0.001) small magnitude (d = 0.42) decrease in the non-dominant KF single MVIC force following the contralateral fatigue intervention, albeit with no significant change in hamstrings EMG. This MVIC deficit may be related to the significant decrease in dominant (p = 0.046, d = 2.6) and non-dominant external obliques (p = 0.048, d = 0.57) activation adversely affecting trunk stability. In conclusion, a 4-minute Stroop test or unilateral KE physical fatigue intervention did not impair non-dominant KE single or repeated 12 repetition MVIC forces or EMG activity. The small magnitude deficit in the non-dominant KF single MVIC force following the contralateral fatigue intervention are in accord with the heterogenous findings common in the literature.

Corticospinal excitability and reflex modulation in a contralateral non-stretched muscle following unilateral stretching

PURPOSE

Muscle stretching effect on the range of motion (ROM) and force deficit in non-stretched muscle, and the underlying mechanisms, is an ongoing issue. This study aimed to investigate crossover stretching effects and mechanisms on the plantar flexor muscles.

METHODS

Fourteen recreationally active females (n = 5) and males (n = 9) performed six sets of 45-s static stretching (SS) (15-s recovery) to the point of discomfort of the dominant leg (DL) plantar flexors or control (345-s rest). Participants were tested for a single 5-s pre- and post-test maximal voluntary isometric contraction (MVIC) with each plantar flexor muscle and were tested for DL and non-DL ROM. They were tested pre- and post-test (immediate, 10-s, 30-s) for the Hoffman (H)-reflex and motor-evoked potentials (MEP) from transcranial magnetic stimulation in the contralateral, non-stretched muscle.

RESULTS

Both the DL and non-DL-MVIC force had large magnitude, significant (↓10.87%, p = 0.027, pƞ2 = 0.4) and non-significant (↓9.53%, p = 0.15, pƞ2 = 0.19) decreases respectively with SS. The SS also significantly improved the DL (6.5%, p < 0.001) and non-DL (5.35%, p = 0.002) ROM. The non-DL MEP/MMax and HMax/MMax ratio did not change significantly.

CONCLUSION

Prolonged static stretching improved the stretched muscle's ROM. However, the stretched limb's force was negatively affected following the stretching protocol. The ROM improvement and large magnitude force impairment (statistically non-significant) were transferred to the contralateral muscles. The lack of significant changes in spinal and corticospinal excitability confirms that the afferent excitability of the spinal motoneurons and corticospinal excitability may not play a substantial role in non-local muscle's ROM or force output responses.

Temporal perception is distorted by submaximal and maximal isometric contractions of the knee extensors in young healthy males and females

Introduction

The estimate of time (temporal perception) is important for activities of daily living, sports and even survival, however time perception research needs greater scrutiny. Time estimation can influence movement decisions and determine whether the individual is successful at their goal, The objectives of this study were to examine participants perception of time at 5-, 10-, 20-, and 30-s intervals to determine possible distortions of time estimates caused by varying intensity isometric contractions, and sex differences.

Methods

In this repeated measures study, 19 participants (10 females, 9 males) endured two sessions, which consisted of a cognitive task of estimating time intervals while performing an isometric knee extension at maximal, submaximal (60%), and distraction (10%) intensities and a non-active control. In addition to time estimates; heart rate (HR), tympanic temperatures and electromyography during the intervention contractions were monitored. Maximal contractions induced significantly greater time underestimations at 5-s (4.43 ± 0.93, p = 0.004), 20-s (18.59 ± 2.61-s, p = 0.03), and 30-s (27.41 ± 4.07-s, p = 0.004) than control. Submaximal contractions contributed to time underestimation at 30-s (27.38 ± 3.17-s, p = 0.001). Females demonstrated a greater underestimation of 5-s during the interventions than males (p = 0.02) with 60% submaximal (-0.64-s ± 0.26) and distraction (-0.53-s ± 0.22) conditions. For the other 10-, 20-, 30-s intervals, there was no significant time perception sex differences. The control condition exhibited lower HR (75.3 ± 11.6) than the maximal (92.5 ± 13.9), 60% submaximal (92.2 ± 14.4) or distraction (90.5 ± 14.7) conditions. Tympanic temperatures were not influenced by the contraction intensities.

Discussion

There was greater integrated knee extensor electromyographic activity during the maximal contractions to suggest greater neuromuscular activation that may influence time perception. However, there was no consistent effect of changes in HR or temperature on time estimates. This work adds to the growing literature of time perception during exercise to state that time is significantly underestimated when performing moderate to vigorous intensity exercise.

Potential Effects of Dynamic Stretching on Injury Incidence of Athletes: A Narrative Review of Risk Factors

The use of dynamic stretching as a replacement for static stretching in the warm-up is widespread based on the reports of static stretching-induced performance impairments. While acute and chronic static stretching has been reported to reduce musculotendinous injuries, especially with explosive and change of direction actions, the influence of dynamic stretching on injury incidence lacks a similar volume of literature for acute and chronic responses. It was the objective of this narrative review to examine the acute and training effects of dynamic stretching on injury incidence and possible moderating variables such as dynamic stretching effects on range of motion, strength, balance, proprioception, muscle morphology, and psycho-physiological responses. One study demonstrated no significant difference regarding injury incidence when comparing a dynamic stretching-only group versus a combined dynamic stretching plus static stretching group. The only other study examined functional dynamic stretching training with injured dancers and reported improved ankle joint stability. However, several studies have shown that dynamic activity with some dynamic stretching exercises within a warm-up consistently demonstrates positive effects on injury incidence. Regarding moderating variables, while there is evidence that an acute bout of dynamic stretching can enhance range of motion, the acute and training effects of dynamic stretching on strength, balance, proprioception, and musculotendinous stiffness/compliance are less clear. The acute effects of dynamic stretching on thixotropic effects and psycho-physiological responses could be beneficial for injury reduction. However, the overall conflicting studies and a lack of substantial literature compared with SS effects points to a need for more extensive studies in this area.

Are Acute Effects of Foam-Rolling Attributed to Dynamic Warm Up Effects? A Comparative Study

Over the last decade, acute increases in range of motion (ROM) in response to foam rolling (FR) have been frequently reported. Compared to stretching, FR-induced ROM increases were not typically accompanied by a performance (e.g., force, power, endurance) deficit. Consequently, the inclusion of FR in warm-up routines was frequently recommended, especially since literature pointed out non-local ROM increases after FR. However, to attribute ROM increases to FR it must be ensured that such adaptations do not occur as a result of simple warm-up effects, as significant increases in ROM can also be assumed as a result of active warm-up routines. To answer this research question, 20 participants were recruited using a cross-over design. They performed 4x45 seconds hamstrings rolling under two conditions; FR, and sham rolling (SR) using a roller board to imitate the foam rolling movement without the pressure of the foam rolling. They were also tested in a control condition. Effects on ROM were tested under passive, active dynamic as well as ballistic conditions. Moreover, to examine non-local effects the knee to wall test (KtW) was used. Results showed that both interventions provided significant, moderate to large magnitude increases in passive hamstrings ROM and KtW respectively, compared to the control condition (p = 0.007-0.041, d = 0.62-0.77 and p = 0.002-0.006, d = 0.79-0.88, respectively). However, the ROM increases were not significantly different between the FR and the SR condition (p = 0.801, d = 0.156 and p = 0.933, d = 0.09, respectively). No significant changes could be obtained under the active dynamic (p = 0.65) while there was a significant decrease in the ballistic testing condition with a time effect (p < 0.001). Thus, it can be assumed that potential acute increases in ROM cannot be exclusively attributed to FR. It is therefore speculated that warm up effects could be responsible independent of FR or imitating the rolling movement, which indicates there is no additive effect of FR or SR to the dynamic or ballistic range of motion.

Two weeks of arm cycling sprint interval training enhances spinal excitability to the biceps brachii

The present study aimed to investigate whether a 2-week arm cycling sprint interval training (SIT) program modulated corticospinal pathway excitability in healthy, neurologically intact participants. We employed a pre-post study design with two groups: 1) an experimental SIT group and 2) a non-exercising control group. Transcranial magnetic stimulation (TMS) of the motor cortex and transmastoid electrical stimulation (TMES) of corticospinal axons were used at baseline and post-training to provide indices of corticospinal and spinal excitability, respectively. Stimulus-response curves (SRCs) recorded from the biceps brachii were elicited for each stimulation type during two submaximal arm cycling conditions ((25 watts (W) and 30% peak power output (PPO)). All stimulations were delivered during the mid-elbow flexion phase of cycling. Compared to baseline, performance on the time-to-exhaustion (TTE) test at post-testing was improved for members of the SIT group but was not altered for controls, suggesting that SIT improved exercise performance. There were no changes in the area under the curve (AUC) for TMS-elicited SRCs for either group. However, the AUC for TMES-elicited cervicomedullary motor evoked potential SRCs were significantly larger at post-testing in the SIT group only (25W: p=0.012, d=0.870; 30% PPO: p=0.016, d=0.825). This data shows that overall corticospinal excitability is unchanged following SIT, while spinal excitability is enhanced. While the precise mechanisms underlying these findings during arm cycling at post-SIT are unknown, it is suggested that the enhanced spinal excitability may represent a neural adaptation to training.

Adipocytokines in obstructive sleep apnea: A systematic review and meta-analysis

BACKGROUND AND AIM

Adipocytokines play an important role in obstructive sleep apnea (OSA) by mediating inflammatory responses. Previous studies have reported that OSA is related to a change in the serum levels of adipocytokines; however, the results are still controversial. This meta-analysis aimed to assess the relationship between OSA and circulating level of adipocytokines in adults and children.

METHODS

A comprehensive search was conducted in databases of Medline/PubMed and Scopus for pertinent articles published since their inception to July 2022. Weighted mean differences (WMDs) and 95% confidence intervals (CIs) were used to assess the strength of the relationship between the concentrations of adipocytokines with OSA.

RESULTS

In the overall analysis, contrary to IL-10, which showed a significant reduction, IL-1β, IL-4, IL-8, IL-17, and IFN- gamma showed higher levels in OSA patients in comparison with control groups (p <0.05). For adults, IL-1β, IL-8, IL-17, IL-18, vaspin, visfatin, and chemerin were linked to a greater serum levels in patients with OSA, while, IL-5 and IL-10 were detected significantly lower in adults with OSA in comparison with healthy adults (p <0.05). In children with OSA, the serum levels of IL-4, IL-8, IL-12, IL-17, IL-23, and IFN-gamma were significantly higher than healthy children (p <0.05).

CONCLUSION

The levels of inflammatory markers were found to be higher in OSA patients compared with control individuals, suggesting that adipocytokines may contribute to the pathology of OSA.

Resistance Training Induces Improvements in Range of Motion: A Systematic Review and Meta-Analysis

BACKGROUND

Although it is known that resistance training can be as effective as stretch training to increase joint range of motion, to date no comprehensive meta-analysis has investigated the effects of resistance training on range of motion with all its potential affecting variables.

OBJECTIVE

The objective of this systematic review with meta-analysis was to evaluate the effect of chronic resistance training on range of motion compared either to a control condition or stretch training or to a combination of resistance training and stretch training to stretch training, while assessing moderating variables.

DESIGN

For the main analysis, a random-effect meta-analysis was used and for the subgroup analysis a mixed-effect model was implemented. Whilst subgroup analyses included sex and participants' activity levels, meta-regression included age, frequency, and duration of resistance training.

DATA SOURCES

Following the systematic search in four databases (PubMed, Scopus, SPORTDiscus, and Web of Science) and reference lists, 55 studies were found to be eligible.

ELIGIBILITY CRITERIA

Controlled or randomized controlled trials that separately compared the training effects of resistance training exercises with either a control group, stretching group, or combined stretch and resistance training group on range of motion in healthy participants.

RESULTS

Resistance training increased range of motion (effect size [ES] = 0.73; p < 0.001) with the exception of no significant range of motion improvement with resistance training using only body mass. There were no significant differences between resistance training versus stretch training (ES = 0.08; p = 0.79) or between resistance training and stretch training versus stretch training alone (ES = - 0.001; p = 0.99). Although "trained or active people" increased range of motion (ES = 0.43; p < 0.001) "untrained and sedentary" individuals had significantly (p = 0.005) higher magnitude range of motion changes (ES = 1.042; p < 0.001). There were no detected differences between sex and contraction type. Meta-regression showed no effect of age, training duration, or frequency.

CONCLUSIONS

As resistance training with external loads can improve range of motion, stretching prior to or after resistance training may not be necessary to enhance flexibility.

Relationship between self-esteem and subjective vitality among older people in Iran

Today, aging of the population is considered one of the most fundamental challenges worldwide. One of the important factors in active aging is paying attention to psychological variables and related factors. This study was conducted aimed to determine the relationship between self-esteem and subjective vitality of the older people in Iran, Sirjan in 2020. In this descriptive-analytical study, 200 older people aged 60 years and older were selected from comprehensive health centers in Sirjan by a two-stage random sampling method. The data were collected using the validated Rosenberg Self-Esteem Scale, and validated Subjective Vitality Scale. The data were analyzed using SPSS software version 20 using descriptive and inferential statistics, including the Mann-Whitney test, Kruskal-Wallis test, Post Hoc tests, and Spearman correlation coefficient. The mean age of the older people was 65,66±3,9 years. The the mean and standard deviation of self-esteem score was 36,34±4,62 and 21,80±2,85 for subjective vitality score. There was a positive and significant correlation between self-esteem and subjective vitality R=0,58 (p˂0,001 ). Also, gender, marital status and employment status were associated with subjective vitality (p˂0,05). Therefore, planners and policymakers should consider self-esteem and subjective vitality in designing and prioritizing interventions related to improving the health of the older people.

Comparative antibacterial effects of ginger and marjoram extract versus conventional irrigants on mature Enterococcus faecalis biofilms: An in vitro study

Background

This study evaluated antibacterial effects of Ginger and Marjoram extract compared with Routine Intracanal Irrigants on Mature Enterococcus faecalis Biofilms.

Material and Methods

Sixty-six extracted human teeth, were randomly assigned to four groups 5.25% sodium hypochlorite (NaOCl), 2% chlorhexidine (CHX), chloroform extract of marjoram (Origanum majorana), and oil extract of ginger (Zingiber officinale), and two positive and negative control groups (n=11). Samples were contaminated with E. faecalis, except the negative control group. Then the root canals were irrigated with solutions above, after which dental debris was collected from each tooth separately, followed by culturing on plates containing BHI agar. The bacterial counts were finally determined with a colony counting machine.

Results

No bacterial growth was detected in the NaOCl, CHX, and negative control groups. However, some bacterial growth was observed in the ginger and marjoram groups. All four solutions successfully eliminated E. faecalis biofilms compared to the positive control group. Significant difference in the median bacterial growth between the ginger and marjoram groups and the positive control group (P<0.001) has been shown. There was no significant difference in median bacterial growth between the ginger and marjoram groups (P=0.94).

Conclusions

Chloroform extract of marjoram and oil extract of ginger were effective in eliminating 6-week-old biofilms of E. faecalis in vitro; however, their effect was not as favorable as CHX and NaOCl. These herbal extracts yielded promising results in the present study; therefore, they can be used as intracanal irrigants instead of chemical agents. Key words:Biofilm, Chlorhexidine, E. faecalis, Ginger, Marjoram, Sodium hypochlorite.