Health benefits of hard martial arts in adults: a systematic review

Comprehensive health assessment of retired martial arts athletes: bone density, dietary intake, physical activity, and wellbeing

Regular physical activity offers benefits like enhanced bone density, which often persists post-retirement. However, retirement can lead to weight gain and changes in quality of life due to reduced physical activity. Therefore, this study investigates the long-term effects of elite athletic experience by comparing retired Jordanian male elite athletes (ages 40-50) with non-athletes of the same age. The differences were explored in weight changes, bone density, quality of life, happiness, stress, insomnia, physical activity, and dietary intake to understand how martial arts impact these health dimensions.

Methods

A descriptive case-control study was conducted among 30 retired male elite athletes and 20 age-matched non-athletes. Bone density and body composition were measured using dual-energy X-ray absorptiometry (DEXA) scans. Additional assessments included anthropometric measurements, a 3-day dietary recall, physical activity (International Physical Activity Questionnaire), quality of life (WHOQOL), happiness (Subjective Happiness Scale), stress (Perceived Stress Scale), and insomnia (Insomnia Severity Index).

Results

Retired athletes showed significantly higher Z-scores for the left femur (neck and total) and the AP spine, with p-values <0.05. Among non-athletes, 65% had normal bone density with a Z-score ≥ -1.9 and a T-score > -1.1, 20% had abnormal bone density with a Z-score < -1.9, and 15% had osteopenia with a T-score between -1.1 and -2.4. In contrast, 100% of retired athletes had normal bone density with a Z-score ≥ -1.9 and a T-score > -1.1. Retired athletes exhibited greater weight changes than non-athletes, with a p-value <0.05; the average weight gain among retired athletes was 18.548 kg, and the mean weight gain among non-athletes was 4.3 kg. There were statistically significant mean differences in perceived stress levels between retired athletes and non-athletes with a p-value <0.05. In contrast, there were no statistically significant mean differences between the groups in quality of life, subjective happiness, and the Insomnia Severity Index.

Conclusion

The study reveals that retired elite athletes maintain better bone density but face greater weight gain and stress than their non-athlete counterparts. Both groups enjoy a high quality of life and low levels of insomnia. These findings underscore the importance of continued physical activity for health and suggest that both retired athletes and non-athletes should adopt a balanced lifestyle to manage weight and stress effectively.

Comparing The Effects of Compression Contrast Therapy and Dry Needling on Muscle Functionality, Pressure Pain Threshold, and Perfusion after Isometric Fatigue in Forearm Muscles of Combat Sports Athletes: A Single-Blind Randomized Controlled Trial

The aim of this study was to compare the acute effects of compression contrast therapy (CT) and dry needling therapy (DN) on muscle tension (MT), muscle strength (Fmax), pressure pain threshold (PPT), and perfusion (PU) following fatigue of forearm muscles (e.g., flexor carpi radialis) in combat sports athletes. A single-blind randomized controlled trial was employed. Participants first underwent muscle fatigue induction, which involved sustaining an isometric handgrip at 60% of their maximum voluntary contraction in 5-second cycles. This was followed by exposure to one of the regenerative therapies. Forty-five participants were randomly assigned to one of three groups: CT/DN (n = 15), CT/ShDN (n = 15), and ShCT/DN (n = 15). The sham condition (Sh) involved a simulated version of the technique. Measurements were taken at four time points: (i) at rest; (ii) immediately after exercise that led to a state of fatigue; (iii) 5 minutes after therapy (PostTh5min); and (iv) 24 hours after therapy (PostTh24h). Each participant was exposed to one experimental condition and one control condition, thereby undergoing evaluation in two sessions. Significant differences between groups were found in MT during the PostTh5min (p = 0.005), as well as in PU during the PostTh5min (p < 0.001) and PU during the PostTh24h (p < 0.001). All groups showed significant improvements at 5 minutes post-therapy compared to immediately post-muscle fatigue. As conclusions, CT/DN seems to be significantly better for enhancing MT and PU after 5 minutes of muscle fatigue induction. Using either CT, DN, or both combined is recommended to enhance the recovery of muscle functionality and properties, favoring recovery and potentially speeding up performance enhancement.

Effects of 12 weeks of functional training vs. Muay Thai on cardiac autonomic modulation and hemodynamic parameters in older adults: a randomized clinical trial

BACKGROUND

The elevated blood pressure (BP) and lower cardiac autonomic modulation (CAM) are associated with higher morbidity mortality risk among older adults. Although exercise is an important intervention for cardiovascular promotion, it is unclear whether combat sports training could benefit cardiovascular outcomes as much as autonomic in this population. This study compared the effects of 12 weeks of Muay Thai (MT) training against functional training (FT) on CAM and hemodynamic parameters in older adults.

METHODS

The sample consisted of 50 older adults (41 women; 66.0 ± 5.3 years old), who were equaly randomized into FT (n = 25) and MT (n = 25) intervention groups. CAM was measured by 30-min rest heart rate variability. Systolic blood pressure (SBP), diastolic blood pressure (DBP) and resting heart rate (RHR) were measured using an automatic oscillometric device. Pulse pressure (PP) and the double product (DP) were also calculated. The interventions were carried out three times a week, with 60-min length per session, during 12 consecutive weeks. The intensity of the interventions was measured using the subjective perception of exertion scale and by accelerometer. Two-factor repeated measures analysis of covariance was used for groups comparison, considering intervention group and body mass as factors. The 95% confidence interval of the difference (95%CIdif) was also calculated and the effect size was measured using partial eta squared (η2p).

RESULTS

CAM indices did not show significant changes across moments and intervention groups. In hemodynamic parameters, only in DBP was there an effect of the moment (F1,39 = 8.206; P = 0.007; η2p = 0.174, large) and interaction effect between group*moment (F1,39 = 7.950; P = 0.008; η2p = 0.169, large). Specifically, the MT group at the post-training moment showed lower DBP (P = 0.010; 95%CIdif = -13.3; -1.89) in relation to the FT group. Furthermore, the MT group showed a decrease in DBP during training (P = 0.002; 95%CIdif = -10.3; -2.6). Also, an increase in training intensity was also found over the 12 weeks in FT, with no difference between the groups.

CONCLUSION

After 12 weeks of MT practice there was a reduction in DBP compared to FT in older adults.

TRIAL REGISTRATION

NCT03919968 Registration date: 01/02/2019.

Analysis of Common Exercise Modalities in Improving Athletic Performance in Older Adults: A Narrative Review

ABSTRACT

Exercise leads to robust cardiovascular, musculoskeletal, and psychological benefits that improve quality of life and longevity for older adults, but accompanying improvements in athletic parameters are less well explored. The aim of this review is to summarize some of the most common exercise modalities, namely, Pilates, martial arts (tai chi, Japanese-style karate, hard martial arts), locomotion (brisk walking/jogging and running), Masters sports, resistance training, and high-intensity interval training, in improving athletic performance for older adults. Regular participation in these activities can have robust yet unique impacts on physical performance that prolong exercise participation. In particular, this review will explore benefits in cardiorespiratory fitness, power, strength, flexibility, and balance, thereby hopefully improving endurance, exercise adherence, and overall fall risk. A narrative literature review was performed to explore benefits, pitfalls, and recommendations for some of the most popular exercise modalities for older adults.

Hand-to-hand combat in the 21st century-INNOAGON warrior or modern gladiator?-a prospective study

Introduction

In being an important lifestyle factor, the physical activity influences people's health status, including life expectancy. Specific forms of physical activity are exercises related to hand-to-hand combat in the broadest sense, often overlapping and containing similar elements associated with combat sports (for Western culture) and martial arts (for Far Eastern culture). There are many types of forms of practising hand-to-hand combat exercises, which can be seen as opposing or in some ways complementary, e.g.: "traditional"-e.g., karate or kung fu, practised for hundreds or even thousands of years, usually adhering to moral codes of conduct, and drawing ideas from philosophy, religion vs. "modern"-e.g., American pro wrestling or mixed martial arts-MMA, suggesting a combination of various traditional forms of martial arts. In terms of shaping a healthy lifestyle with mental health elements based on the implementation of hand-to-hand combat exercises, an analysis of these fundamental insights into physical activity is warranted. This study aims to investigate the development direction of the hand-to-hand exercises in Western culture, opposing the "traditional" and "modern" forms.

Discussion

In this study, INNOAGON theory responds to the overuse of the term "science of martial arts". It is currently being used to promote extreme aggression and violence as an acceptable means of achieving success, and this model is expressively permeating other spheres of social interaction. In INNOAGON's understanding, hand-to-hand combat should be associated with the ancient thought of "doing good" (ancient Greece) or "wisdom" (Far Eastern cultures) including aesthetic and philosophical aspects. This links to numerous psychosocial benefits, self-esteem, discipline, body-mind coordination including breath control and relaxation, respect for others. The modern form of hand-to-hand combat, framed in these discussions as MMA or American pro wrestling, historically refers to the gladiatorial fights held during the Roman Games. The holding of fights in so-called "cages" refers to the arena in which Roman slave fights were held, and the athletes performing there are often referred to as modern-day "gladiators".

Conclusion

Proper education, including education in the area of physical culture, leading to the development of a society turned towards values broader than just fun or self-satisfaction should be the basis for the development of the next generations. It actually remains to decide which path of social change we will choose: in the case of INNOAGON a positive one, and in the case of modern gladiator a destructive one. Only a proper education combined with a broad programme of social role modelling, social facilitation-the foundations of which are laid by INNOAGON-including promotion on the Internet and social media can provide the right counterbalance to the pathology increasingly penetrating our lives, leading to the promotion of aggression and threats to physical and mental health.

A nationwide analysis of upper extremity injuries in martial arts

Objective

Given the rise of martial arts within the fitness and recreational industry, it is important to study trends in injury and note that practicing martial arts comes with a risk of injury, particularly to the upper extremities. By studying consumer product-related injuries to the upper extremities and addressing the current gap in the literature, future martial arts equipment can come with increased safety features, better provide information to healthcare providers treating such injuries, and improve risk mitigation through the Consumer Product Safety Commission.

Methods

The National Electronic Injury Surveillance System Database was analyzed to collect data on martial arts equipment-related injuries on the upper extremities within the last 10 years.

Results

Over the most recent span of 10 years (2013-2022), there were approximately 78,680 injuries reported to the ED. The majority of them took place in 2013 (12.8%). Men were 2.4 times more likely to get injured than women. Injuries peaked in the age group 10-19-year-olds (33%) and particularly age 12 (4.8%). The upper extremity most commonly affected was the shoulder (29.1%), and the most common diagnosis group was a fracture (29.2%). Most injuries presented to the emergency department were not hospitalized (98.7%).

Conclusions

This study highlights the occurrence of upper extremity injuries due to martial arts within the last 10 years and provides new information on the prevalence of such injuries. The results highlight that these injuries are usually non-severe and most commonly affect adolescent males; however, future research should explore performance-based recovery post-injury and long-term pain.

Martial arts, combat sports, and mental health in adults: A systematic review

Martial arts (MA) and combat sports (CS) are physical activities that may be associated with health-related outcomes. The aim of this systematic review was to synthesize and evaluate the available evidence on the relationship between MA and CS training and mental health of adult practitioners (≥18 years). CochraneLibrary, EBSCOhost, Web-of-Science, and Scopus databases were searched up to September 2022 for measures of self-related constructs, ill-being and well-being, cognition and brain structure/function, in adult MA/CS practitioners. Seventy cross-sectional and two longitudinal studies were retained and submitted to risk of bias assessments through an adapted version of the Cochrane Collaboration's Tool. Associations between MA/CS practice and self-related constructs were inconclusive for both consistency and strength of evidence. Limited evidence of significant associations emerged for sub-domains of ill-being (i.e., externalizing and internalizing emotion regulation), and well-being. In regard to cognitive and brain structural/functional variables, evidence of positive association with MA/CS practice was consistent with respect to perceptual and inhibition abilities but limited with respect to attention and memory. Evidence on negative associations of boxing with changes of brain structure integrity due to concussions was also inconclusive. Functional imaging techniques could shed light onto brain activation mechanisms underlying complex cognitive performance. In relation to moderators, mixed results were found for activity exposure, expertise, level of competitive engagement (which often covary with the length of training) and sex and type of MA/CS. The MA/CS' multifaceted nature may produce different, sometimes conflicting outcomes on mental health. Studies on MA/CS represent a flourishing research area needing extensive improvement in theoretical and practical approaches.

Preparation and sports performance of multilayer flexible anti stabbing fabric martial arts sports composite conjugate materials

Puncture-resistant clothing plays an important role in martial arts. This article studies the preparation process of multi-layer flexible stab-resistant fabrics, analyzes the sports properties of the fabric, and explores the potential application of stab-resistant clothing in martial arts. This article uses ultra-high molecular weight polyethylene fiber as raw material, preprocesses it, including fiber cleaning, drying, lamination, and laminating them together through needle punching, then soaks the laminated fibers in resin, and the soaked fibers solidifies to form a specific flexible puncture-resistant fabric. This article prepares three types of layered fabrics, namely woven fabrics, nonwoven materials, and composite materials of nonwoven materials + woven fabrics + nonwoven materials, and analyzes the kinematic characteristics of the three layered fabrics. Experimental results show that when the number of layers is 4, the average breaking tensile forces of woven fabrics, nonwoven materials and composite materials are 3400, 4600 and 3860 respectively, and the average breaking elongations are 11.8%, 40.6% and 17.4% respectively. This shows that woven fabrics have the highest levels of air permeability and moisture permeability.

Impact of adapted taekwondo vs. multicomponent training on health status in independent older women: a randomized controlled trial

This study, called the TKD and Aging Project, aimed to analyze and compare the effects of an adapted taekwondo program concerning multicomponent training on blood pressure, morphological variables, food consumption frequency, health-related quality of life (HRQoL), physical fitness, handgrip strength, and postural balance in independent older women. A randomized controlled trial study was conducted with parallel groups for 8 weeks (24 sessions of 60 min each), employing a double-blind design and incorporating repeated measures. Twenty-eight older women initially participated in the intervention. Three participants were excluded because they did not participate in the re-assessments. Thus, 14 older women from the adapted taekwondo group (TKD; age: 62.86 ± 2.38 years) and 11 from the multicomponent training group (MCT; age: 63.18 ± 1.94 years) participated in the final analysis. A two-factor mixed analysis of variance (ANOVA) model with repeated measures was performed to measure the time × group effect. The TKD showed significant improvements in the mental health (p = 0.024; ES = 0.91) and general health (p < 0.001; ES = 0.75) dimensions of the HRQoL, as well as in the chair stand (p = 0.001; ES = 1.18), arm curl (p < 0.001; ES = 2.10), 2-min step (p < 0.001; ES = 1.73), and chair sit-and-reach (p = 0.001; ES = 0.91) tests. Additionally, it showed a significant reduction in postural balance for the eyes-closed condition in the center of the pressure area (p = 0.021; ES = 0.89), mean velocity (p = 0.004; ES = 0.79), and mediolateral velocity (p < 0.001; ES = 1.26). However, the MCT showed significant increases in the general health (p = 0.013; ES = 0.95) dimension of the HRQoL and a significant reduction (p = 0.039; ES = 0.28) in the mediolateral velocity of postural balance for the eyes-closed condition. Multiple comparisons showed that the TKD scored significantly higher in the chair stand (p = 0.017; ES = 1.79), arm curl (p = 0.003; ES = 1.77), and 2-min step (p = 0.018; ES = 0.91) tests than the MCT. Compared to multicomponent training, taekwondo improves postural balance and provides better benefits in terms of physical fitness and HRQoL for older women. Therefore, it is possible to recommend it as a safe physical activity strategy, as long as it is well-dosed, since it showed high adherence to intervention in older women.

Quantitative Ultrasound Examination (QUS) of the Calcaneus in Long-Term Martial Arts Training on the Example of Long-Time Practitioners of Okinawa Kobudo/Karate Shorin-Ryu

Quantitative research of bone tissue related to physical activity (PA) and sport has a preventive dimension. Increasing the parameters of bone tissue strength, especially reaching the maximum value of peak bone strength in childhood, adolescence, and early adulthood due to practicing sports can contribute to maintaining bone health throughout life. Practicing martial arts (tai chi, traditional karate, judo, and boxing) can effectively improve the quality of bone and reduce the risk of falls and fractures. The study aimed to evaluate the calcaneus bones among Okinawa Kobudo/Karate Shorin-Ryu practitioners using the quantitative ultrasound method as an indicator for assessing bone fracture risk. Forty-four adult martial arts practitioners with a mean age of 36.4 participated in this study. Quantitative ultrasound (QUS) with a portable Bone Ultrasonometer was used in this study. Speed of sound (SOS), broadband ultrasound attenuation (BUA), and the stiffness index (SI) were measured. Subjects were assigned to two groups of black and color belts, according to the advancement in Kobudo/karate practice. The measurements of the SI, BUA, SOS, T-score, and Z-score were significantly higher in subjects from the advanced, long-term practice (black belts) (p < 0.05). The long-term martial arts training in traditional karate and Kobudo significantly impacts the parameters of the calcaneus quantitative ultrasound measurements. Significantly higher bone density was observed among the black belt holders. Long-term practice subjects achieved results far beyond the norm for their age groups. Further studies using non-invasive methods of bone quantification are needed to determine the specific conditions for preventing osteoporosis through physical activity, sports, and martial arts, particularly the duration of the activity, the magnitude of loads, and other related factors.

Judo training program improves brain and muscle function and elevates the peripheral BDNF concentration among the elderly

Programmed exercise interventions modulating both physical fitness and cognitive functions have become a promising tool to support healthy aging. The aim of this experiment was to determine the effect of a 12-week judo training (JEX) on cognitive processing and muscle function among the elderly. Forty participants were divided into two groups: the JEX group and the control group (CTL). Before and after 12-week of JEX, participants performed a battery of physiological and psychological tests. The peripheral level of brain-derived neurotrophic factor (BDNF) was analyzed. A 12-week JEX intervention led to improved Stroop performance reflected by a shortening of the response time related to Stroop “naming” interference. In addition, the peripheral concentration of BDNF was significantly increased following the JEX compared with the CTL group. In response to JEX, balance and lower limb strength significantly increased. The current results suggest that JEX could have beneficial effects on cognitive functions, denoted by elevated peripheral BDNF, as well as on balance and strength abilities. A combination of positive effects with respect to movement and cognition makes JEX an ideal preventive lifestyle modification for the aging population.

The effect of karate interventions on the motor proficiency of female adolescents with developmental coordination disorder (DCD) from high and low socio-economic status

Background

There is not a general consensus on the best type of intervention to improve the motor proficiency (MP) of adolescents with developmental coordination disorder (DCD). Considering the effect of socio-economic status (SES) in relation to the MP of adolescents with DCD, it is necessary to examine this issue further. The purpose of this study was to investigate the effect of Karate-Do interventions on the MP of adolescents with DCD from high/low SES.

Methods

Participants included 16 adolescent girls (12 to 13 years old) with DCD, and their classification into high/low SES groups was done by using appropriate previously validated questionnaire. A short form of the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2), was used to assess fine motor precision, fine motor integration, manual dexterity, upper limb coordination, bilateral coordination, balance, strength, speed, agility, and overall MP level of the participants. Both high/low-SES groups completed a specifically prescribed Karate-Do intervention program for 8 consecutive weeks (3 sessions per week with each session lasting for 75 min).

Results

Results from this 8-week intervention showed that the pattern of change in manual dexterity, bilateral coordination, strength and the total MP score improved over time in both groups with varied socioeconomic backgrounds. Specifically, the high-SES group performed significantly better than their low-SES counterparts during the 8-week Karate-Do intervention (p < 0.05).

Conclusions

Following participants’ completion of the Karate-Do intervention, the existence of significant changes in the MP of adolescents’ with DCD at high/low SES confirmed our hypothesis. Compared to the low-SES group, adolescents with high SES displayed superior MP following the intervention. It seems that karate (kata) training serves as a good alternative for rehabilitation MP programs, however, an important issue concerning social infrastructure is to create a suitable exercise environment for adolescents at lower SES. Until the SES achievement gap in female adolescent MP is stable, future work is warranted to discover more practical and meaningful interventions.

The effect of expertise on postural control in elite sport ju-jitsu athletes

Background

Due to the high postural control demands of sport ju-jitsu, it is likely that long-term sport ju-jitsu training may induce sport-specific adaptations in postural control, especially in positions directly related to combat. The aim of the study was to assess the differences in postural control between elite sport ju-jitsu athletes and untrained controls in non-ecological and ecological conditions and to investigate the relative contribution of spinal and supraspinal mechanisms to postural control in expert athletes.

Methods

The study was conducted on eleven male elite ju-jitsu athletes and ten non-athletes. The data was collected with the use of a force plate under two conditions: quiet standing and ju-jitsu combat stance. Apart from the standard analysis of the spatial–temporal parameters of center of foot pressure, non-linear measures were used, namely rambling-trembling and sample entropy. The non-parametric Mann–Whitney U test was used to compare both groups.

Results

The main findings of the study showed that in quiet standing, elite ju-jitsu athletes and non-athletes had comparable postural control in both the anterior–posterior and mediolateral planes. In contrast, in the combat stance, elite athletes had lower values of postural sway and rambling component (range and rms) and higher values of sample entropy in comparison to the non-athletes (p < 0.05). No differences were found in the trembling component of sway between groups in the combat stance (p < 0.05).

Conclusions

Smaller postural sway and its rambling component in sport ju-jitsu athletes may indicate the more precise control of center of foot pressure and improved ability in estimating its position. The sample entropy results confirmed that the displacement of center of foot pressure for sport ju-jitsu athletes was more irregular, which demonstrates greater automatization in postural control. The results also confirm the importance of ecological validity in investigating postural adaptations associated with sports expertise.

Effects of Olympic Combat Sports on Health-Related Quality of Life in Middle-Aged and Older People: A Systematic Review

Olympic combat sports are unconventional physical activity strategies to train middle-aged and older people with and without health problems. This systematic review aimed to assess the available body of published peer-reviewed articles related to the effects of Olympic combat sports interventions (boxing, fencing, judo, karate, taekwondo, wrestling) on health-related quality of life in adults aged 45 and older. The search was carried out in five generic databases until July 2021 and the protocol was registered in PROSPERO (code: CRD42021244161). The PRISMA guidelines were followed and the Downs and Black checklist was used to assessed the methodological quality of the studies. After reviewing 1,151 records, only seven studies met the inclusion criteria, adding 212 participants (43.4% female) with a mean age of 63.7 years. Six studies (two with middle-aged participants and four with older people) provided data to calculate the effect size (ES) in the Olympic combat sports groups (No research that used taekwondo or wrestling as an intervention modality was found). Three studies reported beneficial changes with a small ES for the total score (d < 0.40) of the health-related quality of life. Two studies reported a beneficial change with a small ES (d = 0.49) and strong ES (d = 4.45) for physical health. One study reported improvements with a small ES for emotional (d = 0.23) and functional (d = 0.26) well-being. In conclusion, interventions based on Olympic combat sports produce beneficial effects with a small and moderate ES on health-related quality of life in male and female aged 45 and older who are healthy participants, participants with Parkinson's disease, and participants with breast cancer. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/, PROSPERO: CRD42021244161.

Effectiveness of Olympic Combat Sports on Balance, Fall Risk or Falls in Older Adults: A Systematic Review

Simple Summary

The regular practice of physical activity has achieved greater diffusion in recent years as a strategy for fall prevention and improving or maintaining the general health status of older adults, which contributes to an active and healthy lifestyle. The strategies to promote active and healthy aging need to be reassessed due to the COVID-19 pandemic to promote the safe practice of physical activity among older adults, considering, among other measures, practicing social distancing or training at home. Such a scenario could provide the opportunity to promote physical activity that requires a limited number of participants in reduced spaces for its practice, such as Olympic combat sports. In this review, an overview of the effects of Olympic combat sports on balance, fall risk, or falls in older adults is presented. From 1496 records, eight studies were included, involving 322 older adults (64% female; mean age = 71.1 years). The available evidence does not allow a definitive recommendation for or against Olympic combat sports interventions as an effective strategy to improve balance and reduce the fall risk or falls in older adults. Therefore, more high-quality studies are required to draw definitive conclusions.

Abstract

This systematic review and meta-analysis aimed to assess the available body of published peer-reviewed articles related to the effects of Olympic combat sports (OCS), compared with active/passive controls, on balance, fall risk, or falls in older adults. The TESTEX and GRADE scales assessed the methodological quality and certainty of the evidence. The protocol was registered in PROSPERO (code: CRD42020204034). From 1496 records, eight studies were included, involving 322 older adults (64% female; mean age = 71.1 years). The TESTEX scale revealed all studies with a score ≥ 60% (moderate-high quality). The GRADE scale indicated all studies with at least some concerns, up to a high risk of bias (i.e., was rated very low). Meta-analyses were planned, although the reduced number of studies precluded its incorporation in the final manuscript. Only two from six studies that assessed balance found improvements after OCS compared to controls. No differences were found between OCS vs. control groups for fall risk or falls. The available evidence does not allow a definitive recommendation for or against OCS interventions as an effective strategy to improve balance and reduce the fall risk or falls in older adults. Therefore, more high-quality studies are required to draw definitive conclusions.

Corrigendum: Sport Karate and the Pursuit of Wellness: A Participant Observation Study of a Dojo in Scotland

[This corrects the article DOI: 10.3389/fsoc.2020.587024.].

Effects of Olympic Combat Sports on Older Adults' Health Status: A Systematic Review

The aim of this systematic review was to analyse the studies centered on the effects of Olympic combat sports (OCS [i.e., boxing, fencing, judo, karate, taekwondo, wrestling]) on older adults’ physical-functional, physiological, and psychoemotional health status. The review comprised randomised-controlled trials with OCS interventions, including older adults (≥60 years), and measures of physical-functional, physiological, and/or psychoemotional health. The studies were searched through SCOPUS, PubMed/MEDLINE, Web of Science, PsycINFO, and EBSCO databases until 5 January 2021. The PRISMA-P and TESTEX scales were used to assess the quality of the selected studies. The protocol was registered in PROSPERO (code: CRD42020204034). Twelve OCS intervention studies were found (scored ≥ 60% for methodological quality), comprising 392 females and 343 males (mean age: 69.6 years), participating in boxing, judo, karate, and taekwondo. The qualitative analysis revealed that compared to controls, OCS training improved muscle strength, cardiorespiratory capacity, agility, balance, movement, attention, memory, mental health, anxiety, and stress tolerance. Meta-analysis was available only for the chair stand test, and an improvement was noted after OCS training compared to control. In conclusion, OCS interventions improves older adults’ physical-functional, physiological, and psychoemotional health. Our systematic review confirms that OCS training has high adherence (greater than 80%) in older adults.

Quality of life in Brazilian martial arts and combat sports practitioners

Study aim: Martial arts and combat sports have been an alternative for individuals seeking the health benefits of physical activity and exercise, but little is known about its practitioners’ quality of life. Therefore, this study aimed to investigate the quality of life of practitioners of five of the most common modalities in Brazil.

Material and methods: A total of 922 young men, competitive and recreational practitioners of Brazilian jiu-jitsu, judo, karate, kung-fu, and taekwondo, answered the Brazilian version of the WHOQOL-BREF questionnaire.

Results: The results for each domain – physical, psychological, social, and environmental – are, respectively, as follow (mean ± standard deviation): Brazilian jiu-jitsu: 74 ± 11, 75 ± 12, 77 ± 17, 67 ± 14; judo: 74 ± 13, 75 ± 12, 77 ± 15, 64 ± 12; karate: 76 ± 13, 75 ± 12, 78 ± 15, 64 ± 13; kung-fu: 77 ± 13, 75 ± 13, 74 ± 17, 65 ± 13; taekwondo: 76 ± 12, 76 ± 11, 78 ± 16, 64 ± 13; total: 75 ± 13, 75 ± 12, 77 ± 16, 65 ± 13. There was no difference between modalities and no interaction between modalities and experience level. All groups and the total sample presented higher values than the normative national data in the physical and psychological domains. This was also the case for the judo, karate, and taekwondo groups, as well as the total sample in the social domain, and for the Brazilian jiu-jitsu and the whole sample in the environmental domain. Additionally, in the whole sample competitors scored higher than recreational practitioners in the psychological domain.

Conclusion: These findings reveal that the practice of these modalities is associated with higher quality of life than the normative values. Longitudinal studies are warranted for a better understanding of this association.

Perception of Self-Efficacy and Health-Related Behavior in Context of Taekwon-Do Sport Camps

Background: The aim of this paper is to expand the knowledge on the subject matter of the relations between behavior that is geared towards health and the feeling of effectiveness in the context of martial arts tourism in the form of Taekwon-do training summer camps. Method: The research encompassed 58 people (32 men and 26 women) who train Taekwon-do (ITF) (aged: 26.36 ± 8.97; scope: 18–45 years of age). The measurement of the feeling of effectiveness and healthy behavior was conducted by means of standardized tools, including the General Self-Efficacy Scale. Results: The analyzed fighters who participated in the research in the majority of the sports meetings declared a higher level of the feeling of effectiveness (p < 0.001). Through cluster analysis emerged two groups, with a significant difference between self-efficacy (mean value of 20.05 points in contrast to 33.93 points in the second group). The group with higher psychological indices values attended a higher amount of summer camps during their practice history (at least two camps attended in the second cluster). Conclusion: Sports tourism connected with martial arts, as exemplified by training groups (professionally organized training camps) of Taekwon-do (ITF), is connected with the increased feeling of personal effectiveness, while also serving the enhancement of psycho-physical health, well-being, and the development of social skills.

Karate as a supporting therapy of secondary prevention in breast cancer: a pilot study

BACKGROUND

Breast cancer is a major health burden for women and the most common female cancer. Regarding secondary prevention, it is important to evaluate new approaches of supportive care. Recently, exercise interventions derived from martial arts have been applied in breast cancer patients. The aim of this pilot study was to describe the feasibility of a health-related karate intervention in breast cancer patients.

METHODS

In this pilot study, health-related karate was offered to 20-60 years old women after primary cancer treatment. Participants were recruited in an oncological outpatient center. Feasibility of the intervention was described by eligibility, uptake, adherence, class attendance, adverse events, and continuation after the study.

RESULTS

The uptake rate was 46.5% out of 88% eligible patients. Class attendance of the 15 participating women (median age 52 years) was 84%. Adherence during intervention was 93% and 12 women (80%) continued the karate training after the study. No adverse events were reported.

CONCLUSIONS

Health-related karate exercises are feasible in breast cancer patients after finished primary cancer treatment. High eligibility, uptake and adherence allow the initiation of exercise classes.

Measuring Sports' Perceived Benefits and Aggression-Related Risks: Karate vs. Football

Little is known about people's perceived benefits and risks of sports, despite their role in shaping people's intentions to engage in them. Here, we developed and tested a scale to measure perceived physical, emotional, cognitive, and social benefits as well as aggression-related risks of karate and football. Additionally, we compared these perceptions within and between these two sports, as well as among undergraduates with current/former participation in different types of physical activity (viz., martial artists, team sports players, participants in other types of physical activity, and non-participants). After a literature review, we created a 5-factor scale with 20 items administered to 184 undergraduates, along with questions about physical activity participation. After removing five items, confirmatory factor analyses supported the factor structure of the scale. Factor loadings and reliability indices were acceptable, though less than desirable results were found concerning the average variance extracted of all benefits dimensions and the reliability of the social benefits dimension. Analyses of variance showed that: (a) physical benefits were seen as the salient outcomes of karate and football, though martial artists perceived karate's physical, emotional, and social benefits to the same extent; (b) in comparison to football, karate was perceived to bring more emotional and cognitive benefits and to entail less aggressiveness risks; (c) karate and football perceptions varied as a function of participant's involvement in physical activity. This study presents a promising instrument to gather information on people's perceptions about karate and football, which can be used to foster people's engagement in them.

Sport Karate and the Pursuit of Wellness: A Participant Observation Study of a dojo in Scotland

Health problems in society are numerous, not least stress and stress-related illness. Physical activities, including martial arts, are increasingly viewed as a means of managing such risks to health. While there are forms of karate that have a philosophical and meditative character that is related to spiritual wellness, karate as a competitive sport is less likely to be thought of in this light. The purpose of this paper is to present through a participant observation study the representations that karateka of the dojo, make of sportive karate as a resource to achieve wellness. Drawing on an eight months' immersion in the dojo, we identify five themes that express these karateka's views of sport karate and wellness, the importance of fitness, beauty in punches and kicks, how to embrace fear, the aggressive attitude as a posture in life, and the superiority given by control. The findings lead us to reflect on the need for further research to see if they are repeated in other martial arts, and if many more groups find wellness as a primary motivation for their participation.

Effectiveness of martial arts exercise on anthropometric and body composition parameters of overweight and obese subjects: a systematic review and meta-analysis

BACKGROUND

Obesity is considered a top public health concern, and its prevalence is growing every day. Thus, interventions to address this problem should be encouraged and further studied. In this regard, the aim of this review was to summarize the evidence of martial arts interventions to evaluate their effectiveness on the anthropometric and body composition parameters of overweight and obese subjects.

METHODS

A systematic literature search was conducted on January 26, 2020 using the PubMed, Medline, Lilacs, Cochrane, and Scielo databases. Reference lists of eligible articles and relevant reviews have also been examined. All randomized clinical trials on martial arts that evaluated the anthropometric and body composition parameters of overweight and obese subjects were included, and a narrative synthesis of eligible studies was conducted in accordance with PRISMA guidelines. The Downs & Black checklist was used to assess the quality of the studies. This review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (identifier CRD42018086116).

RESULTS

A total of 82 articles were identified from the initial search strategy. A further 2 articles were identified from the review of relevant bibliographies. Six studies encompassing 258 participants who were overweight or obese were included. Four studies reported Tai Chi practice, one study reported Kung Fu exercise, and another study reported martial arts exercise. The examined meta-analyses did not reveal significant benefits from martial arts practice over control groups after the experiment period for body mass index (- 1.34 kg/m2; 95% CI: - 2.72, 0.05), waist circumference (1.41 cm; 95% CI: - 0.72, 3.54) and percentage of body fat (- 0.75%; 95% CI: - 5.58, 4.08).

CONCLUSION

The scarcity, heterogeneity, short intervention time, small sample size, and significant methodological limitations of the available studies do not allow to conclude whether martial arts are effective in the anthropometric and body composition parameters of overweight and obese individuals. This study highlights the need for more research to assess the benefits of martial arts for overweight and obese individuals.

Kinematic traits of an elite paralympic karateka: a case report

Karate is a martial art that includes striking, kicking and punching techniques, and requires high levels of functional skills. Karate counts millions of practitioners worldwide and it is also spreading in Paralympic competitions: there is a need for accurate categories definition for disabled athletes. The aim of the current study was to present kinematic data of an elite Paralympic karateka, in comparison with able-bodied athletes, to promote a better classification within the discipline, based on objective evaluations of physical impairments. A male black belt Paralympic karateka (age: 36 years; body weight: 75.5 kg; height: 173 cm) with lower limbs impairments was evaluated. He performed a standardized sequence of movements (kata) from Shotokan karate. Joints and center-of-mass kinematics were collected with an optoelectronic motion capture system and compared with those obtained in two groups of able-bodied (Masters and Practitioners) athletes from a previous study. The sequence performed by the karateka lasted longer than in both able-bodied groups. Center of mass velocity and acceleration lowered in comparison with Masters. Knees range of movement and peak angular velocity were similar to Practitioners but lower than Masters. We concluded that physical impairments negatively affected the function of lower limbs in the Paralympic athlete, as fundamental skills in karate elite performance (dynamic balance control and joint angular velocity) were lower.

Influence of Judo Experience on Neuroelectric Activity During a Selective Attention Task

OBJECTIVE

We compared the cognitive performance and neuroelectric responses during a selective attentional task in judo athletes with different levels of expertise.

METHODS

Judo black and white belt athletes performed both general and specific fitness tests while simultaneously completing a Stroop color-word test recorded by 64 electroencephalogram channels.

RESULTS

Cognitive behavioral performance and event-related spectral perturbation (ERSP) present no differences between groups. However, the topographic analysis found different neural source patterns in each group. Judo black belts compared to judo white belts presented a greater peak amplitude of P300 in the middle frontal gyrus and of N200 in the cuneus, but slower latency of P300 in the precuneus.

CONCLUSION

Despite no difference in cognitive behavioral performance, judo expertise causes a difference in the allocation of attentional and conflict detection neural resources.

Characteristics of the gut microbiota in professional martial arts athletes: A comparison between different competition levels

Recent evidence suggests that athletes have microbial features distinct from those of sedentary individuals. However, the characteristics of the gut microbiota in athletes competing at different levels have not been assessed. The aim of this study was to investigate whether the gut microbiome is significantly different between higher-level and lower-level athletes. Faecal microbiota communities were analysed with hypervariable tag sequencing of the V3–V4 region of the 16S rRNA gene among 28 professional martial arts athletes, including 12 higher-level and 16 lower-level athletes. The gut microbial richness and diversity (the Shannon diversity index (p = 0.019) and Simpson diversity index (p = 0.001)) were significantly higher in the higher-level athletes than in the lower-level athletes. Moreover, the genera Parabacteroides, Phascolarctobacterium, Oscillibacter and Bilophila were enriched in the higher-level athletes, whereas Megasphaera was abundant in the lower-level athletes. Interestingly, the abundance of the genus Parabacteroides was positively correlated with the amount of time participants exercised during an average week. Further analysis of the functional prediction revealed that histidine metabolism and carbohydrate metabolism pathways were markedly over-represented in the gut microbiota of the higher-level athletes. Collectively, this study provides the first insight into the gut microbiota characteristics of professional martial arts athletes. The higher-level athletes had increased diversity and higher metabolic capacity of the gut microbiome for it may positively influence athletic performance.

Dynamics of cognitive performance at rest and after exhaustive exercise in top-three world-ranked mixed martial arts athletes: a series of case studies

Cognitive performance plays a key role in sports performance, especially in combat sports such as mixed martial arts (MMA). Studies with active and sedentary individuals showed either no change or decreased cognitive performance during or immediately after exercise. However, it is possible that elite MMA athletes would present preserved/improved cognitive performance after exhaustive exercise. In this series of cases studies, we tested this hypothesis by submitting three elite MMA athletes from the Bellator MMA® and UFC® to a cognitive assessment before, immediately after and 15 min after exhaustive exercise. A modified computerized version of the Stroop Test was used to test cognitive inhibition performance, from which reaction time (RT) and accuracy were obtained. The athletes performed an incremental exercise on a cycle simulator until volitional exhaustion. Immediately after exercise RT improved consistently in all three athletes (-6.5%; -8.0%; -15.0%), while accuracy presented a small increase (2.6%), decreases (-3.8%) or no change. Fifteen minutes after exercise, RT remained improved in two athletes (-9.1% and -15.5) or slightly increased (0.4%), while accuracy presented small increase in all athletes (0.5%; 1.3%; 2.1%) compared to pre-exercise. This result indicates that elite MMA athletes may present improved cognitive performance immediately after exhaustive exercise, which suggests that cognitive-motor training for MMA should be considered when planning a training program.

Effects of a Judo Training on Functional Fitness, Anthropometric, and Psychological Variables in Old Novice Practitioners

This study aimed to investigate the effects of a 4-month judo training (1 hr session, biweekly) on physical and mental health of older adults (69.7 ± 4.2 years). Participants (N = 30) were assigned to a judo novice practitioners group (n = 16) or a control group (n = 14), which did not receive any training. Before and after the program, they underwent anthropometric (body mass index and waist and hip circumferences); functional fitness (upper and lower body flexibility and strength, coordination); and psychological assessments (perceived physical and mental health, body image, and fear of falling). The judo group showed reductions of waist circumference (Δ = -1%, d = 0.2) and improvements for lower and upper body flexibility (Δ = +69%, d = 0.4 and Δ = +126%, d = 0.5, respectively) and strength (Δ = +12%, d = 0.6 and Δ = +31%, d = 1.6, respectively). The control group showed a decline in lower body strength (Δ = -12%, d = 0.8). Psychological variables did not reveal statistically significant effects. Judo seems beneficial for improving anthropometric and functional fitness variables, relevant aspects of successful aging.

Action Observation With Dual Task for Improving Cognitive Abilities in Parkinson's Disease: A Pilot Study

Action observation therapy (AOT) has been recently proposed as a new rehabilitation approach for treatment of motor deficits in Parkinson's disease. To date, this approach has never been used to deal with cognitive deficits (e.g., deficits in working memory, attention), which are impairments that are increasingly recognized in Parkinsonian patients. Typically, patients affected by these dysfunctions have difficulty filtering out irrelevant information and tend to lose track of the task goal. In this paper, we propose that AOT may also be used to improve cognitive abilities of Parkinsonian patients if it is used within a dual task framework. We articulate our hypothesis by pivoting on recent findings and on preliminary results that were obtained through a pilot study that was designed to test the efficacy of a long-term rehabilitation program that, for the first time, uses AOT within a dual task framework for treating cognitive deficits in patients with Parkinson's disease. Ten Parkinson's disease patients underwent a 45-min treatment that consisted in watching a video of an actor performing a daily-life activity and then executing it while performing distractive tasks (AOT with dual task). The treatment was repeated three times per week for a total of 4 weeks. Patients' cognitive/motor features were evaluated through standard tests four times: 1 month before treatment, the first and the last day of treatment and 1 month after treatment. The results show that this approach may provide relevant improvements in cognitive aspects related to working memory (verbal and visuospatial memory) and attention. We discuss these results by pivoting on literature on action observation and recent literature demonstrating that the dual task method can be used to stimulate cognition and concentration. In particular, we propose that using AOT together with a dual task may train the brain systems supporting executive functions through two mechanisms: (i) stimulation of goal setting within the mirror neuron system through action observation and (ii) working memory and persistent goal maintenance through dual task stimuli.

The Effect of Judo Training on Set-Shifting in School Children

Improving executive functions (EFs) is desirable as they are considered to be critical for academic attainment and mental wellness in children. The aim of this study was to explore the effect of Judo training on the set-shifting function using a spatial task-switching paradigm. Protocol  1 compared the set-shifting ability of Judo players with age-matched healthy individuals. Protocol  2 compared the difference in EFs between children who underwent Judo training (intervention) and age-matched controls. EFs were assessed by a spatial task-switching test. Error rates and response times were analysed using two-way repeated-measures ANOVA. Protocol 1. The group effect on error rates was significant. The trial type × group effect was significant in the Judo group. Error rates in the Judo group were lower in the switch trials than the control group (p = 0.001). No significant group difference was seen in the repeat trials (p = 0.764). Protocol 2. The time × trial type × group effect was significant. Post hoc analysis showed significantly lower error rates by the intervention group on switch trials compared to the control group (p = 0.006). Regular Judo training may potentially be an option for improving EFs in schoolchildren or in populations with executive dysfunction.