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Bingnan W, Jiao T, Ghorbani A, Baghei S. Enhancing regenerative potential: A comprehensive review of stem cell transplantation for sports-related neuronal injuries, with a focus on spinal cord injuries and peripheral nervous system damage. Tissue Cell 2024; 88:102429. [PMID: 38833939 DOI: 10.1016/j.tice.2024.102429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 05/28/2024] [Accepted: 05/30/2024] [Indexed: 06/06/2024]
Abstract
Neuronal injuries, as one of the consequences of sports-related incidents, exert a profound influence on the athletes' future, potentially leading to complete immobility and impeding their athletic pursuits. In cases of severe damage inflicted upon the spinal cord (SC) and peripheral nervous systems (PNS), the regenerative process is notably compromised, rendering it essentially inefficient. Among the pivotal therapeutic approaches for the enhancement and prevention of secondary SC injuries (SCI), stem cell transplantation (SCT) stands out prominently. Stem cells, whether directly involved in replacement and reconstruction or indirectly through modification and secretion of crucial bioenvironmental factors, engage in the intricate process of tissue regeneration. Stem cells, through the secretion of neurotrophic factors (NTFs) (aiming to modulate the immune system), reduction of inflammation, axonal growth stimulation, and myelin formation, endeavor to facilitate the regeneration of damaged SC tissue. The fundamental challenges of this approach encompass the proper selection of suitable stem cell candidates for transplantation and the establishment of an appropriate microenvironment conducive to SC repair. In this article, an attempt has been made to explore sports-related injuries, particularly SCI, to comprehensively review innovative methods for treating SCI, and to address the existing challenges. Additionally, some of the stem cells used in neural injuries and the process of their utilization have been discussed.
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Affiliation(s)
- Wang Bingnan
- Department of P.E, Central South University, Changsha 410083, China
| | - Tong Jiao
- The High School Attached to Hunan Normal University Bocai Experimental Middle School,Changsha 410208, China.
| | - A Ghorbani
- Biotechnology Department, Islamic Azad University, Isfahan, Iran
| | - Sh Baghei
- Biotechnology Department, Islamic Azad University, Isfahan, Iran.
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Morgan RM, Wheeler TD, Poolman MA, Haugen ENJ, LeMire SD, Fitzgerald JS. Effects of Photobiomodulation on Pain and Return to Play of Injured Athletes: A Systematic Review and Meta-analysis. J Strength Cond Res 2024; 38:e310-e319. [PMID: 38781474 DOI: 10.1519/jsc.0000000000004752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
ABSTRACT Morgan, RM, Wheeler, TD, Poolman, MA, Haugen, ENJ, LeMire, SD, and Fitzgerald, JS. Effects of photobiomodulation on pain and return to play of injured athletes: A systematic review and meta-analysis. J Strength Cond Res 38(6): e310-e319, 2024-The aims of this systematic review and meta-analysis were to evaluate the effect of photobiomodulation (PBM) on musculoskeletal pain in injured athletes and to determine if the effects of PBM allowed injured athletes to return to play faster. Electronic databases (MEDLINE Complete, CINAHL, and SPORTDiscus, PubMed, Web of Science, and Embase) were systematically searched (up to and including November 7, 2023) for peer-reviewed randomized controlled trials (RCTs) meeting criteria. Six RCTs, representing 205 competitive and recreational athletes with a mean age of 24 years, were included in the analysis. There were 6 intervention groups using standard physical therapy (n = 1), placebo PBM (n = 4), and aloe gel (n = 1) lasting between 10 minutes and 8 weeks in duration. The level of significance set for the study was p < 0.05. Overall, the use of PBM indicated a positive effect on pain reduction for PBM vs. control groups, standardized mean differences = 1.03, SE = 0.22, 95% confidence intervals = [0.43-1.63], p = 0.0089, but the 2 RCTs found evaluating the effect of PBM on time to return to play after injury in athletes do not support a benefit. Allied healthcare professionals may use PBM to reduce pain, thus allowing an athlete to return to their normal biomechanical movement faster; however, limited evidence suggests that PBM does not reduce time to return to play after an injury.
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Affiliation(s)
- Richard M Morgan
- Department of Physical Therapy, University of North Dakota, Grand Forks, North Dakota
| | - Tyler D Wheeler
- Department of Athletic Training, Training HAUS, Eagan, Minnesota
| | - Mark A Poolman
- Department of Sports Medicine, University of North Dakota, Grand Forks, North Dakota
| | - Erin N J Haugen
- Department of Clinical and Sport Psychology, Assessment and Therapy Associates of Grand Forks, PLLC, Grand Forks, North Dakota
| | - Steven D LeMire
- Department of Educational Foundations and Research, University of North Dakota, Grand Forks, North Dakota; and
| | - John S Fitzgerald
- Department of Education, Health and Behavior Studies, University of North Dakota, Grand Forks, North Dakota
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Medeiros DM, Lima-E-Silva FXD, Aimi M, Vaz MA, Baroni BM. Do athletes with hamstring strain injury have shorter muscle fascicles in the injured limb? J Bodyw Mov Ther 2024; 38:269-273. [PMID: 38763569 DOI: 10.1016/j.jbmt.2024.01.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 12/01/2023] [Accepted: 01/25/2024] [Indexed: 05/21/2024]
Abstract
INTRODUCTION Previous studies have suggested that a reduced length of the biceps femoris long head (BFlh) fascicles may increase the risk of hamstring strain injury (HSI). However, it remains unclear whether the BFlh fascicles of the injured limb are shorter than those of the contralateral limb in athletes with an acute HSI. OBJECTIVE To investigate the between-limb asymmetry of BFlh fascicle length in amateur athletes with an acute HSI. METHODS Male amateur athletes were evaluated using ultrasound scans within five days following an HSI. The BFlh fascicle length was estimated using a validated equation. RESULTS Eighteen injured athletes participated in this study. There was no significant difference (p = 0.27) in the length of BFlh fascicles between the injured limb (9.53 ± 2.55 cm; 95%CI 8.26 to 10.80 cm) and the uninjured limb (10.54 ± 2.87 cm; 95%CI 9.11 to 11.97 cm). Individual analysis revealed high heterogeneity, with between-limb asymmetries (percentage difference of the injured limb compared to the uninjured limb) ranging from -42% to 25%. Nine out of the 18 athletes had a fascicle length that was more than 10% shorter in the injured limb compared to the uninjured limb, five athletes had a difference of less than 10%, and four athletes had a fascicle length that was more than 10% longer in the injured limb compared to the uninjured limb. CONCLUSION The architecture characteristics of injured and uninjured muscles is not consistent among athletes with HSI. Therefore, rehabilitation programs focused on fascicle lengthening should be evaluated on a case-by-case basis.
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Affiliation(s)
| | | | - Mateus Aimi
- Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Scaturro D, de Sire A, Vitagliani F, Lo Nardo D, Tomasello S, Ammendolia A, Letizia Mauro G. Effectiveness of cryo plus ultrasound therapy versus diathermy in combination with high-intensity laser therapy for pain relief in footballers with muscle injuries: A prospective study. J Back Musculoskelet Rehabil 2024; 37:771-780. [PMID: 38160343 DOI: 10.3233/bmr-230265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
BACKGROUND Muscle injuries are common traumatic events in the clinical practice of the rehabilitation field. There is still a gap in the scientific literature on the effectiveness of physical agent modalities in the management of muscle injuries in athletes. OBJECTIVE The aim of this study was to assess the effectiveness of cryo plus ultrasound therapy com-pared to diathermy in combination with high-intensity laser therapy (HILT) for pain relief in professional footballers with muscle injuries. METHODS A case-control study was conducted on 31 professional footballers with a muscle injury of the lower limbs. Of these, 17 patients, assigned to a Group A (AG), were treated with HILT and cryoultrasound therapy; the remaining 14 patients, assigned to a Group B (BG), underwent HILT and diathermy. We assessed the extent of the pain, the size of the muscle injury, frequency of recurrence and number of days to recovery, at the time of recruitment, at the end of the rehabilitation and 3 months after the injury. RESULTS Group A athletes had a greater benefit on pain (4.65 ± 0.61 vs 3.24 ± 0.63; p< 0.05) and muscle injury recurrence. The return to play in the athletes of group A took place 4.73 days earlier. CONCLUSION HILT and cryo plus ultrasound therapy, in combination with therapeutic exercise, rep-resent a valid strategy in the treatment of muscle injuries in professional footballers.
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Affiliation(s)
- Dalila Scaturro
- Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo, Italy
| | - Alessandro de Sire
- Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
- Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Fabio Vitagliani
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Davide Lo Nardo
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Sofia Tomasello
- Faculty of Medicine and Surgery, University of Palermo, Palermo, Italy
| | - Antonio Ammendolia
- Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
- Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Giulia Letizia Mauro
- Department of Surgical, Oncological and Stomatological Disciplines, University of Palermo, Palermo, Italy
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Poursalehian M, Lotfi M, Zafarmandi S, Arabzadeh Bahri R, Halabchi F. Hamstring Injury Treatments and Management in Athletes: A Systematic Review of the Current Literature. JBJS Rev 2023; 11:01874474-202311000-00007. [PMID: 37983561 DOI: 10.2106/jbjs.rvw.23.00161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
BACKGROUND The field of sports medicine presents a varied landscape of research on hamstring injuries in athletes, characterized by inconclusive and sometimes conflicting findings on effective treatment and rehabilitation strategies. This discordance prompted the current systematic investigation. METHODS Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed for conducting the systematic review. Multiple international bibliometric databases (Scopus, PubMed, Web of Science, and Embase) were searched to identify studies evaluating any treatment option for the management of hamstring injuries in athletes. Eligible studies were appraised for quality using Joanna Briggs Institute and Risk of Bias 2 tools. RESULTS A total of 30 studies with 1,195 participants were included. Of the reviewed studies, treatments varied from aggressive rehabilitation, platelet-rich plasma (PRP) injections, manual techniques, various exercise protocols to modalities like high-power laser and nonsteroidal anti-inflammatory drugs. Evidence suggested benefits from treatments like extensive muscle lengthening during eccentric actions, progressive agility, and trunk stabilization. PRP injections produced mixed results regarding return to sport and reinjury rates. Stretching exercises, sometimes combined with cryotherapy, showed benefits. CONCLUSION Treatments for hamstring injuries exhibit varied efficacy. Although rest, ice, compression, and elevation remains essential for acute management, rehabilitation focusing on muscle strengthening and flexibility is crucial. The potential benefits of PRP injections, especially for chronic cases, require more conclusive research. A comprehensive approach, combining evidence-based practices and patient-centric factors, is vital for effective management and recovery. LEVEL OF EVIDENCE Level IV. See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Mohammad Poursalehian
- Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Sports and Exercise Medicine, Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohadeseh Lotfi
- Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Sports and Exercise Medicine, Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sahar Zafarmandi
- Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Sports and Exercise Medicine, Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Razman Arabzadeh Bahri
- Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Sports and Exercise Medicine, Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzin Halabchi
- Sports and Exercise Medicine, Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
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Robaina BDQ, Medeiros DM, Roberti LDS, Franke RDA, Baroni BM. The Single Leg Bridge Test does not replace handheld dynamometer hamstring tests in a clinical setting. Phys Ther Sport 2023; 63:126-131. [PMID: 37573852 DOI: 10.1016/j.ptsp.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 08/03/2023] [Accepted: 08/03/2023] [Indexed: 08/15/2023]
Abstract
OBJECTIVE To examine the correlation of Single Leg Bridge Test (SLBT) scores with maximum isometric strength values obtained in handheld dynamometer (HHD) hamstring tests performed in a clinical setting. DESIGN Cross-sectional study. SETTING Physical therapy clinic. PARTICIPANTS Fifty healthy and physically active men. MAIN OUTCOME MEASURES Correlation between SLBT scores and force values found in three HHD hamstring tests: test 'A', volunteer in prone with hip in neutral position and the knee flexed at ∼90°; test 'B', volunteer in supine with hip and knee flexed at ∼90°; and test 'C', volunteer in the same position used to perform the SLBT. RESULTS The volunteers' SLBT score was 27.55 ± 7.81 repetitions. The SLBT scores were poorly associated with mean (r = 0.246) and peak (r = 0.321) results provided by HHD test 'A'. There were no significant correlations between the SLBT scores and mean or peak values obtained in tests 'B' and 'C' (p > 0.05). Similarly, the SLBT between-limb asymmetry was not associated with asymmetries found in HHD hamstring tests (p > 0.05). CONCLUSIONS HHD hamstring tests should not be replaced by the SLBT. We recommend for clinicians to applying such tests in a complementary way to assess the hamstring's functional status.
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Jankaew A, Chen JC, Chamnongkich S, Lin CF. Therapeutic Exercises and Modalities in Athletes With Acute Hamstring Injuries: A Systematic Review and Meta-analysis. Sports Health 2023; 15:497-511. [PMID: 35996322 PMCID: PMC10293564 DOI: 10.1177/19417381221118085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
CONTEXT Hamstring strain is a common injury to the lower limbs. Early intervention in the acute phase aids with restoring hamstring function and prevents secondary related injury. OBJECTIVE To systematically review and summarize the effectiveness of exercise-based interventions combined with physical modalities currently used in athletes with acute hamstring injuries. DATA SOURCES Five databases (EMBASE, Medline, Cochrane Library, SPORTDiscus, and Web of Science) were searched from inception to July 2021. STUDY SELECTION A total of 4569 studies were screened. Nine randomized controlled trials (RCTs) on the effect of therapeutic exercise programs with and without physical agents in athletes with acute hamstring injuries were identified for meta-analysis. STUDY DESIGN Systematic review and meta-analysis. LEVEL OF EVIDENCE Level 1. DATA EXTRACTION The studies were screened, and the evidence was rated using the PEDro scale. Nine RCTs with PEDro scores ranging between 3 and 9 were included and extracted pain intensity, time to return to play (TTRTP), and reinjury rate in the study. RESULTS Loading exercises during extensive lengthening were shown to facilitate TTRTP at P < 0.0001 but did not prevent recurrence (P = 0.17), whereas strengthening with trunk stabilization and agility exercise did not reduce the duration of injury recurrence (P = 0.16), but significantly reduced the reinjury rate (P < 0.007) at a 12-month follow-up. The results of the stretching programs and solely physical modalities could not be pooled in the statistical analysis. CONCLUSION The meta-analysis indicated that a loading program helps athletes to return to sports on a timely basis. Although strengthening with trunk stabilization and agility exercise cannot significantly reduce recovery time, the program can prevent reinjury. The clinical effects of stretching programs and pure physical modality interventions could not be concluded in this study due to limited evidence. PROSPERO REGISTRATION CRD42020183035.
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Affiliation(s)
- Amornthep Jankaew
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jih-Ching Chen
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Samatchai Chamnongkich
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Cheng-Feng Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Physical Therapy Center, National Cheng Kung University Hospital, Tainan, Taiwan
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Valente HG, Oliveira RRD, Baroni BM. How are hamstring strain injuries managed in elite men's football clubs? A survey with 62 Brazilian physical therapists. Phys Ther Sport 2023; 61:73-81. [PMID: 36940549 DOI: 10.1016/j.ptsp.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 03/02/2023] [Accepted: 03/03/2023] [Indexed: 03/06/2023]
Abstract
OBJECTIVE To describe perceptions and practices of physical therapists from elite men's football clubs on the management of athletes with hamstring strain injury (HSI). DESIGN Cross-sectional study. SETTING Online survey. PARTICIPANTS Physical therapists from clubs engaged in the two main divisions of Brazilian men's football. MAIN OUTCOME MEASURES Practices for assessment and rehabilitation of athletes with HSI. RESULTS This survey had 62 physical therapists from 35 of the 40 eligible clubs (87.5% representativeness). Despite heterogeneity on assessment practices, all respondents use imaging exams, adopt injury classification scales, and evaluate aspects related to pain, range of motion, muscle strength, and functional status of athletes with HSI. Rehabilitation programs are usually divided into 3 to 4 phases. All respondents usually apply electrophysical agents and stretching in HSI rehabilitation programs, 98.4% apply strengthening exercises (93.5% include eccentrics), 96.8% manual therapy, 95.2% exercises that mimic the functional demands of football, and 93.5% lumbopelvic stabilization exercises. Muscle strength was the most reported return to play criterion (71% of respondents). CONCLUSION The present study allowed the sports physical therapy community to become aware of the approaches usually adopted for management of athletes with HSI who play in the highest level of Brazilian men's football.
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Affiliation(s)
- Henrique Gonçalves Valente
- Graduate Program in Rehabilitation Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, RS, Brazil; Department of Science, Health and Performance, Grêmio Foot-Ball Porto Alegrense, Porto Alegre, RS, Brazil
| | | | - Bruno Manfredini Baroni
- Graduate Program in Rehabilitation Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre, RS, Brazil.
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Afonso J, Olivares-Jabalera J, Fernandes RJ, Clemente FM, Rocha-Rodrigues S, Claudino JG, Ramirez-Campillo R, Valente C, Andrade R, Espregueira-Mendes J. Effectiveness of Conservative Interventions After Acute Hamstrings Injuries in Athletes: A Living Systematic Review. Sports Med 2023; 53:615-635. [PMID: 36622557 DOI: 10.1007/s40279-022-01783-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2022] [Indexed: 01/10/2023]
Abstract
BACKGROUND Hamstrings injuries are common in sports and the reinjury risk is high. Despite the extensive literature on hamstrings injuries, the effectiveness of the different conservative (i.e., non-surgical) interventions (i.e., modalities and doses) for the rehabilitation of athletes with acute hamstrings injuries is unclear. OBJECTIVE We aimed to compare the effects of different conservative interventions in time to return to sport (TRTS) and/or time to return to full training (TRFT) and reinjury-related outcomes after acute hamstrings injuries in athletes. DATA SOURCES We searched CINAHL, Cochrane Library, EMBASE, PubMed, Scopus, SPORTDiscus, and Web of Science databases up to 1 January, 2022, complemented with manual searches, prospective citation tracking, and consultation of external experts. ELIGIBILITY CRITERIA The eligibility criteria were multi-arm studies (randomized and non-randomized) that compared conservative treatments of acute hamstrings injuries in athletes. DATA ANALYSIS We summarized the characteristics of included studies and conservative interventions and analyzed data for main outcomes (TRTS, TRFT, and rate of reinjuries). The risk of bias was judged using the Cochrane tools. Quality and completeness of reporting of therapeutic exercise programs were appraised with the i-CONTENT tool and the certainty of evidence was judged using the GRADE framework. TRTS and TRFT were analyzed using mean differences and the risk of reinjury with relative risks. RESULTS Fourteen studies (12 randomized and two non-randomized) comprising 730 athletes (mostly men with ages between 14 and 49 years) from different sports were included. Nine randomized studies were judged at high risk and three at low risk of bias, and the two non-randomized studies were judged at critical risk of bias. Seven randomized studies compared exercise-based interventions (e.g., L-protocol vs C-protocol), one randomized study compared the use of low-level laser therapy, and three randomized and two non-randomized studies compared injections of platelet-rich plasma to placebo or no injection. These low-level laser therapy and platelet-rich plasma studies complemented their interventions with an exercise program. Only three studies were judged at low overall risk of ineffectiveness (i-CONTENT). No single intervention or combination of interventions proved superior in achieving a faster TRTS/TRFT or reducing the risk of reinjury. Only eccentric lengthening exercises showed limited evidence in allowing a shorter TRFT. The platelet-rich plasma treatment did not consistently reduce the TRFT or have any effect on the risk of new hamstrings injuries. The certainty of evidence was very low for all outcomes and comparisons. CONCLUSIONS Available evidence precludes the prioritization of a particular exercise-based intervention for athletes with acute hamstrings injuries, as different exercise-based interventions showed comparable effects on TRTS/TRFT and the risk of reinjuries. Available evidence also does not support the use of platelet-rich plasma or low-level laser therapy in clinical practice. The currently available literature is limited because of the risk of bias, risk of ineffectiveness of exercise protocols (as assessed with the i-CONTENT), and the lack of comparability across existing studies. CLINICAL TRIAL REGISTRATION PROSPERO CRD42021268499 and OSF ( https://osf.io/3k4u2/ ).
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Affiliation(s)
- José Afonso
- Centre of Research, Education, Innovation, and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, R. Dr. Plácido da Costa 91, 4200-450, Porto, Portugal.
| | - Jesús Olivares-Jabalera
- Sport Research Lab, Football Science Institute, Granada, Spain
- Department of Physical and Sports Education, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | - Ricardo J Fernandes
- Centre of Research, Education, Innovation, and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, R. Dr. Plácido da Costa 91, 4200-450, Porto, Portugal
- Porto Biomechanics Laboratory (LABIOMEP), University of Porto, Porto, Portugal
| | - Filipe Manuel Clemente
- Escola Superior de Desporto e Lazer, Instituto Politécnico de Viana do Castelo, Viana do Castelo, Portugal
- Delegação da Covilhã, Instituto de Telecomunicações, Covilhã, Portugal
| | - Sílvia Rocha-Rodrigues
- Escola Superior de Desporto e Lazer, Instituto Politécnico de Viana do Castelo, Viana do Castelo, Portugal
- Tumor & Microenvironment Interactions Group, INEB-Institute of Biomedical Engineering, i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
- Research Center in Sports Performance, Recreation, Innovation and Technology (SPRINT), Melgaço, Portugal
| | - João Gustavo Claudino
- Group of Research, Innovation and Technology Applied to Sport (GSporTech), Multi-user Laboratory of the Department of Physical Education (MultiLab of the DPE), Department of Physical Education, Center for Health Sciences, Federal University of Piauí, Teresina, Piauí, Brazil
- Department of Physical Education, Center for Health Sciences, Federal University of Piauí, Teresina, Piauí, Brazil
| | - Rodrigo Ramirez-Campillo
- Exercise and Rehabilitation Sciences Laboratory, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, Chile
| | - Cristina Valente
- Clínica Espregueira - FIFA Medical Centre of Excellence, Porto, Portugal
- Dom Henrique Research Centre, Porto, Portugal
| | - Renato Andrade
- Porto Biomechanics Laboratory (LABIOMEP), University of Porto, Porto, Portugal.
- Clínica Espregueira - FIFA Medical Centre of Excellence, Porto, Portugal.
- Dom Henrique Research Centre, Porto, Portugal.
| | - João Espregueira-Mendes
- Clínica Espregueira - FIFA Medical Centre of Excellence, Porto, Portugal
- Dom Henrique Research Centre, Porto, Portugal
- School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal
- 3B's Research Group Biomaterials, Biodegradables and Biomimetics, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, University of Minho, AvePark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, Barco, 4805 017, Guimarães, Portugal
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Gasparin GB, Ribeiro-Alvares JBA, Baroni BM. Single Leg Bridge Test is Not a Valid Clinical Tool to Assess Maximum Hamstring Strength. Int J Sports Phys Ther 2022; 17:613-621. [PMID: 35693869 PMCID: PMC9159716 DOI: 10.26603/001c.34417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 01/23/2022] [Indexed: 11/18/2022] Open
Abstract
Background The single leg bridge test (SLBT) has been introduced in the sports context as a way of estimating hamstring muscle capacity for prevention and rehabilitation of hamstring strain injuries. Purpose The primary aim was to examine the association between SLBT scores with concentric and eccentric knee flexor peak torques. Secondarily, this study aimed examine the association of between-limb asymmetries provided by SLBT and isokinetic tests. Study design Cross-sectional study. Methods One hundred male soccer players (20±3 years) performed the SLBT and the knee flexion-extension isokinetic dynamometry evaluation (60°/s) billaterally during a single visit. SLBT score (i.e., number of repetitions until failure) and concentric and eccentric knee flexor peak torques (normalized per body mass) were considered for analysis. For both SLBT and isokinetic dynamometry, between-limb asymmetry was calculated as the percentage difference between the left limb and the right limb. Associations were assessed through Pearson's correlation coefficient. Results The mean SLBT score was 33.6±9.6 repetitions, concentric peak torque was 2.00±0.22 Nm/kg, and eccentric peak torque was 2.79±0.44 Nm/kg. Between-limb asymmetry was 0.4±9.6%, 1.08±8.5%, and 1.64±14.61% in SLBT, concentric, and eccentric tests, respectively. There was a poor association of SLBT score with concentric (p<0.001, r=0.275) and eccentric (p=0.002, r=0.215) peak torques. The SLBT between-limb asymmetry was poorly associated with asymmetry found in concentric peak torque asymmetry (p=0.033, r=0.213) and was not associated with eccentric peak torque asymmetry (p=0.539, r=0.062). Conclusion The SLBT should not be used as a clinical tool to assess the maximum strength of hamstring muscles. Level of Evidence Level 3.
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Castagna A, Fontani V, Rinaldi S. Radio Electric Asymmetric Conveyer Reparative Effects on Muscle Injuries: A Report of Two Cases. Cureus 2022; 14:e24904. [PMID: 35572458 PMCID: PMC9093253 DOI: 10.7759/cureus.24904] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2022] [Indexed: 12/11/2022] Open
Abstract
Cells and tissues work like batteries, positively charged by potassium ions and negatively charged by chloride ions. The difference in potential gradient generates an ionic flux, and this, in turn, generates a current that develops endogenous bioelectric fields (EBFs), which are fundamental for all cellular life processes, including reparative phenomena. In damaged tissues, the ionic flow is altered and, consequently, the production of EBFs is altered. This determines an alteration of the reparative processes. In previous studies, the reparative and regenerative treatments of radio electric asymmetric conveyer (REAC) technology have been shown to favor and accelerate the reparative processes of injured tissues, inducing the recovery of ionic flows and EBFs. The purpose of this report is to illustrate the clinical efficacy of REAC treatments for reparative tissue optimization on muscle injuries, even in those with a severity of third degree.
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Affiliation(s)
- Alessandro Castagna
- Department of Regenerative Medicine, Rinaldi Fontani Institute, Florence, ITA
| | - Vania Fontani
- Department of Regenerative Medicine, Rinaldi Fontani Institute, Florence, ITA
| | - Salvatore Rinaldi
- Department of Research, Rinaldi Fontani Foundation, Florence, ITA.,Department of Regenerative Medicine, Rinaldi Fontani Institute, Florence, ITA
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Poor Reporting of Exercise Interventions for Hamstring Strain Injury Rehabilitation: A Scoping Review of Reporting Quality and Content in Contemporary Applied Research. J Orthop Sports Phys Ther 2022; 52:130-141. [PMID: 34546816 DOI: 10.2519/jospt.2022.10641] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To review the quality of reporting and identify the content of exercise interventions prescribed for hamstring strain injury (HSI) rehabilitation in the scientific literature from 2010 to 2020. DESIGN Scoping review. LITERATURE SEARCH We searched the bibliometric databases Web of Science, CINAHL, SPORTDiscus, Scopus, Cochrane Library, MEDLINE, and Embase. STUDY SELECTION CRITERIA Original research articles (randomized controlled trials and cohort studies) published from 2010 to 2020 that described an exercise rehabilitation intervention for participants with acute HSIs were included. Injuries must have been confirmed within 7 days of occurrence via clinical assessment and/or diagnostic imaging. DATA SYNTHESIS The quality of reporting, in terms of completeness of exercise intervention description, was evaluated using the Consensus on Exercise Reporting Template (CERT), and the content of interventions was categorized into exercise types. RESULTS Fourteen studies were included; exercise intervention quality of reporting was moderate in 3 studies and low in 11 studies. Using the 19-item CERT, an average of 8.8 items (range, 4-14) were reported across all studies. Two studies reported sufficient exercise content and progression information to allow replication. Exercises categorized as hamstring flexibility, hamstring strength, running related, and non-hamstring specific were prescribed in 13, 11, 10, and 10 studies, respectively. Half of the included studies incorporated all 4 exercise types in their exercise interventions. CONCLUSION There is a wide variety of exercise interventions applied in published research that has addressed HSI rehabilitation. Researchers must improve reporting quality to support other professionals in replicating exercise interventions and help practitioners to effectively implement research in practice. J Orthop Sports Phys Ther 2022;52(3):130-141. Epub 21 Sep 2021. doi:10.2519/jospt.2022.10641.
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Reliability of a Clinical Test for Measuring Eccentric Knee Flexor Strength Using a Handheld Dynamometer. J Sport Rehabil 2022; 31:115-119. [PMID: 34030120 DOI: 10.1123/jsr.2020-0014] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 03/16/2021] [Accepted: 03/21/2021] [Indexed: 12/16/2022]
Abstract
CONTEXT Eccentric knee flexor strength assessments have a key role in both prevention and rehabilitation of hamstring strain injuries. OBJECTIVE To verify the reliability of a clinical test for measuring eccentric knee flexor strength during the Nordic hamstring exercise using a commercially available handheld dynamometer. DESIGN Reliability study. SETTING Physical Therapy Laboratory, Federal University of Health Sciences of Porto Alegre (Brazil). PARTICIPANTS Fifty male amateur athletes (soccer or rugby players; 24 [3] y). MAIN OUTCOME MEASURES Eccentric knee flexor strength. RESULTS When compared with a load cell-based device, the clinical test using a handheld dynamometer provided smaller force values (P < .05) with large effect sizes (.92-1.21), moderate intraclass correlation (.60-.62), typical error of 30 to 31 N, and coefficient of variation of 10% to 11%. Regarding the test-retest reproducibility (2 sessions separated by 1 week), the clinical test provided similar force values (P > .05) with only small effect sizes (.20-.27), moderate to good correlation (.67-.76), typical error of 23 to 24 N, and coefficient of variation of 9% to 10%. CONCLUSION The clinical test with handheld dynamometer proposed by this study can be considered an affordable and relatively reliable tool for eccentric knee flexor strength assessment in the clinical setting, but results should not be directly compared with those provided by load cell-based devices.
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Rudisill SS, Kucharik MP, Varady NH, Martin SD. Evidence-Based Management and Factors Associated With Return to Play After Acute Hamstring Injury in Athletes: A Systematic Review. Orthop J Sports Med 2021; 9:23259671211053833. [PMID: 34888392 PMCID: PMC8649106 DOI: 10.1177/23259671211053833] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 08/10/2021] [Indexed: 01/14/2023] Open
Abstract
Background: Considering the lengthy recovery and high recurrence risk after a hamstring injury, effective rehabilitation and accurate prognosis are fundamental to timely and safe return to play (RTP) for athletes. Purpose: To analyze methods of rehabilitation for acute proximal and muscular hamstring injuries and summarize prognostic factors associated with RTP. Study Design: Systematic review; Level of evidence, 4. Methods: In August 2020, MEDLINE, CINAHL, Cochrane Central Register of Controlled Trials, and SPORTDiscus were queried for studies examining management and factors affecting RTP after acute hamstring injury. Included were randomized controlled trials, cohort studies, case-control studies, and case series appraising treatment effects on RTP, reinjury rate, strength, flexibility, hamstrings-to-quadriceps ratio, or functional assessment, as well as studies associating clinical and magnetic resonance imaging factors with RTP. Risk of bias was assessed using the Cochrane Risk-of-Bias Tool for Randomized Trials or the Methodological Index for Non-Randomized Studies (MINORS). Results: Of 1289 identified articles, 75 were included. The comparative and noncomparative studies earned MINORS scores of 18.8 ± 1.3 and 11.4 ± 3.4, respectively, and 12 of the 17 randomized controlled trials exhibited low risk of bias. Collectively, studies of muscular injury included younger patients and a greater proportion of male athletes compared with studies of proximal injury. Surgery for proximal hamstring ruptures achieved superior outcomes to nonoperative treatment, whereas physiotherapy incorporating eccentric training, progressive agility, and trunk stabilization restored function and hastened RTP after muscular injuries. Platelet-rich plasma injection for muscular injury yielded inconsistent results. The following initial clinical findings were associated with delayed RTP: greater passive knee extension of the uninjured leg, greater knee extension peak torque angle, biceps femoris injury, greater pain at injury and initial examination, “popping” sound, bruising, and pain on resisted knee flexion. Imaging factors associated with delayed RTP included magnetic resonance imaging-positive injury, longer lesion relative to patient height, greater muscle/tendon involvement, complete central tendon or myotendinous junction rupture, and greater number of muscles injured. Conclusion: Surgery enabled earlier RTP and improved strength and flexibility for proximal hamstring injuries, while muscular injuries were effectively managed nonoperatively. Rehabilitation and athlete expectations may be managed by considering several suitable prognostic factors derived from initial clinical and imaging examination.
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Affiliation(s)
- Samuel S Rudisill
- Sports Medicine Center, Department of Orthopaedic Surgery, Massachusetts General Hospital, Partners Health System, Boston, Massachusetts, USA.,Rush Medical College of Rush University, Chicago, Illinois, USA
| | - Michael P Kucharik
- Sports Medicine Center, Department of Orthopaedic Surgery, Massachusetts General Hospital, Partners Health System, Boston, Massachusetts, USA
| | - Nathan H Varady
- Sports Medicine Center, Department of Orthopaedic Surgery, Massachusetts General Hospital, Partners Health System, Boston, Massachusetts, USA.,Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, USA
| | - Scott D Martin
- Sports Medicine Center, Department of Orthopaedic Surgery, Massachusetts General Hospital, Partners Health System, Boston, Massachusetts, USA
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15
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Capaverde VDB, Oliveira GDS, de Lima-E-Silva FX, Ribeiro-Alvares JBA, Baroni BM. Do age and body size affect the eccentric knee flexor strength measured during the Nordic hamstring exercise in male soccer players? Sports Biomech 2021:1-11. [PMID: 34882067 DOI: 10.1080/14763141.2021.2003850] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 11/03/2021] [Indexed: 10/19/2022]
Abstract
The study aimed to verify how age, height, body mass and body mass index affects the eccentric knee flexor strength during the Nordic hamstring exercise (NHE) in male soccer players. Ten professional soccer clubs were included in this cross-sectional trial. Three hundred and eleven soccer players (192 from senior and 119 from under-20 teams) were assessed using a load-cell based device. Pearson's correlation tests were performed between peak force values (measured in Newtons) and age, height, body mass and body mass index. The individual-limb strength (n = 622 limbs) and the between-limb average strength (n = 322 players) presented no correlation with age (r = 0.12 for both) and height (r = 0.13; r = 0,15), and fair correlations with body mass (r = 0.37; r = 0,41) and body mass index (r = 0.40; r = 0,43). In conclusion, the male soccer players' eccentric knee flexor strength measured during the NHE execution is not affected by age or height. Body mass and body mass index play somewhat effect on strength, thus normalising absolute strength measures by body mass or body mass index can provide more accurate analysis in some contexts.
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Affiliation(s)
- Vinícius de Borba Capaverde
- Graduate Program in Rehabilitation Sciences, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Gabriel Dos Santos Oliveira
- Graduate Program in Rehabilitation Sciences, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | - Felipe Xavier de Lima-E-Silva
- Graduate Program in Rehabilitation Sciences, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Brazil
| | | | - Bruno Manfredini Baroni
- Graduate Program in Rehabilitation Sciences, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre, Brazil
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Photobiomodulation and Sports: Results of a Narrative Review. Life (Basel) 2021; 11:life11121339. [PMID: 34947870 PMCID: PMC8706093 DOI: 10.3390/life11121339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 11/24/2021] [Accepted: 11/30/2021] [Indexed: 11/17/2022] Open
Abstract
Benefits of photobiomodulation (PBM) have been known for several decades. More recently, PBM applied in sports offers a special chance to support the modeling of the performance and recovery. Increasingly complex physical activities and fierce competition in the world of sports generate a state of psycho-emotional and physical stress that can induce chronic fatigue syndrome, failure in physical training, predisposition to muscle damage, physical and emotional exhaustion etc., for which PBM could be an excellent solution. To evaluate and identify all risk factors and the influence of PBM on health and performance in sport and for a better understanding of its effects, we did a search for "Photobiomodulation and Sports" on PubMed, to update the PBM science applied in sports, and we retained for analysis the articles published from 2014 to date. The term "PBM" is recent, and we did not include previous studies with "low level laser therapy" or "LLLT" before 2014. In the present research, PBM has been shown to have valuable protective and ergogenic effects in 25 human studies, being the key to success for high performance and recovery, facts supported also by 22 animal studies. PBM applied creatively and targeted depending on sport and size of the level of physical effort could perfectly modulate the mitochondrial activity and thus lead to remarkable improvements in performance. PBM with no conclusive results or without effects from this review (14 studies from a total of 39 on humans) was analyzed and we found the motivations of the authors from the perspective of multiple causes related to technological limitations, participants, the protocols for physical activity, the devices, techniques and PBM parameters. In the near future, dose-response experiments on physical activity should be designed and correlated with PBM dose-response studies, so that quantification of PBM parameters to allow the energy, metabolic, immune, and neuro-endocrine modulation, perfectly coupled with the level of training. There is an urgent need to continuously improve PBM devices, delivery methods, and protocols in new ingenious future sports trials. Latest innovations and nanotechnologies applied to perform intracellular signaling analysis, while examining extracellular targets, coupled with 3D and 4D sports motion analysis and other high-tech devices, can be a challenge to learn how to maximize PBM efficiency while achieving unprecedented sports performance and thus fulfilling the dream of millions of elite athletes.
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Luo WT, Lee CJ, Tam KW, Huang TW. Effects of Low-Level Laser Therapy on Muscular Performance and Soreness Recovery in Athletes: A Meta-analysis of Randomized Controlled Trials. Sports Health 2021; 14:687-693. [PMID: 34428975 DOI: 10.1177/19417381211039766] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
CONTEXT Athletes must maintain their peak state of strength. Previous studies have investigated the effect of low-level laser therapy (LLLT) on muscular performance. A previous systematic review and meta-analysis has investigated this issue in healthy participants but not in physically active athletes. OBJECTIVE To investigate whether LLLT can improve muscular performance and soreness recovery in athletes. DATA SOURCES PubMed, EMBASE, and Cochrane Library. STUDY SELECTION Published randomized controlled trials and crossover studies till December 2020. STUDY DESIGN Systematic review and meta-analysis. LEVEL OF EVIDENCE Level 3. DATA EXTRACTION Assessment of study quality was rated using the risk of bias assessment method for randomized trials (Cochrane Handbook for Systematic Reviews of Interventions). RESULTS A total of 24 studies were included. LLLT application before exercise significantly improved lower-limb muscle strength in 24-hour, 48-hour, 96-hour, and 8-week follow-up groups. Furthermore, decreased soreness index, serum creatine kinase concentrations, interleukin-6, and thiobarbituric acid reactive substance concentrations and a trend toward the improvement of contract repetition number and VO2 kinetic outcomes were observed. CONCLUSION Although a definite therapeutic effect of LLLT is yet to be established, the current evidence supports that LLLT use improves muscular performance in physically active athletes. Additional trials with large sample sizes and robust design should be conducted before strong recommendations are made.
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Affiliation(s)
- Wun-Ting Luo
- School of Medicine, College of Medicine, Taipei Medical University, Taipei
| | - Chieh-Jui Lee
- School of Medicine, College of Medicine, Taipei Medical University, Taipei
| | - Ka-Wai Tam
- Center for Evidence-Based Health Care, Taipei Medical University-Shuang Ho Hospital, New Taipei City.,Department of Medical Research, Taipei Medical University-Shuang Ho Hospital, New Taipei City.,Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei.,Department of Surgery, Taipei Medical University-Shuang Ho Hospital, New Taipei City.,Cochrane Taiwan, Taipei Medical University, Taipei
| | - Tsai-Wei Huang
- Cochrane Taiwan, Taipei Medical University, Taipei.,Center for Nursing and Healthcare Research in Clinical Practice Application, Wan Fang Hospital, Taipei Medical University, Taipei.,School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
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