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Chen ZY, Wang MH, Ye Z. Effect of electroacupuncture combined with rehabilitation techniques on shoulder function in patients with rotator cuff injuries. World J Clin Cases 2024; 12:4582-4589. [PMID: 39070812 PMCID: PMC11235512 DOI: 10.12998/wjcc.v12.i21.4582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 05/27/2024] [Accepted: 06/11/2024] [Indexed: 06/30/2024] Open
Abstract
BACKGROUND The rotator cuff is located below the acromion and deltoid muscles and comprises multiple tendons that wrap around the humeral head, maintaining shoulder joint stability. AIM To explore the effect of electroacupuncture combined with rehabilitation techniques on shoulder function in patients with rotator cuff injuries. METHODS We selected 97 patients with rotator cuff injuries treated in the People's Hospital of Yuhuan from February 2020 to May 2023. Patients were grouped using the envelope method. RESULTS After treatment, the study group's treatment effective rate was 94.90% (46/49 patients), significantly higher than that in the control group (79.17%, 38/48 cases; P < 0.05). Before treatment, there was no difference in Constant Murley Score (CMS) scores, shoulder mobility, or 36-Item Short Form Health Survey (SF-36) scale scores (P > 0.05). Compared with those before treatment, the CMS scores (including pain, daily living ability, shoulder mobility, and muscle strength), all aspects of shoulder mobility (forward flexion, posterior extension, external rotation, internal rotation), and SF-36 scale scores (including physiological, psychological, emotional, physical, vitality, and health status) were higher in both groups after treatment and significantly higher in the study group (P < 0.05). There was no difference in the occurrence of complications between the two treatment groups (P > 0.05). CONCLUSION Electroacupuncture combined with rehabilitation techniques has a good treatment effect on patients with rotator cuff injuries, helps accelerate the recovery of shoulder function, improves the quality of life, and is highly safe.
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Affiliation(s)
- Zhi-Ying Chen
- Department of Rehabilitation, The People's Hospital of Yuhuan, Yuhuan 317600, Zhejiang Province, China
| | - Meng-Hua Wang
- Department of Rehabilitation, The People's Hospital of Yuhuan, Yuhuan 317600, Zhejiang Province, China
| | - Zhong Ye
- Department of Rehabilitation Medicine, Yuhuan Hospital of Traditional Chinese Medicine, Yuhuan 317600, Zhejiang Province, China
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Wang Q, Huang Q, Ying X, Zhou Y, Duan S. Exploring the regulatory role of tsRNAs in the TNF signaling pathway: Implications for cancer and non-cancer diseases. PROGRESS IN BIOPHYSICS AND MOLECULAR BIOLOGY 2024; 191:1-10. [PMID: 38971324 DOI: 10.1016/j.pbiomolbio.2024.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 05/31/2024] [Accepted: 07/03/2024] [Indexed: 07/08/2024]
Abstract
Transfer RNA-derived small RNAs (tsRNAs), a recently identified subclass of small non-coding RNAs (sncRNAs), emerge through the cleavage of mature transfer RNA (tRNA) or tRNA precursors mediated by specific enzymes. The tumor necrosis factor (TNF) protein, a signaling molecule produced by activated macrophages, plays a pivotal role in systemic inflammation. Its multifaceted functions include the capacity to eliminate or hinder tumor cells, enhance the phagocytic capabilities of neutrophils, confer resistance against infections, induce fever, and prompt the production of acute phase proteins. Notably, four TNF-related tsRNAs have been conclusively linked to distinct diseases. Examples include 5'tiRNA-Gly in skeletal muscle injury, tsRNA-21109 in systemic lupus erythematosus (SLE), tRF-Leu-AAG-001 in endometriosis (EMs), and tsRNA-04002 in intervertebral disk degeneration (IDD). These tsRNAs exhibit the ability to suppress the expression of TNF-α. Additionally, KEGG analysis has identified seven tsRNAs potentially involved in modulating the TNF pathway, exerting their influence across a spectrum of non-cancerous diseases. Noteworthy instances include aberrant tiRNA-Ser-TGA-001 and tRF-Val-AAC-034 in intrauterine growth restriction (IUGR), irregular tRF-Ala-AGC-052 and tRF-Ala-TGC-027 in obesity, and deviant tiRNA-His-GTG-001, tRF-Ser-GCT-113, and tRF-Gln-TTG-035 in irritable bowel syndrome with diarrhea (IBS-D). This comprehensive review explores the biological functions and mechanisms of tsRNAs associated with the TNF signaling pathway in both cancer and other diseases, offering novel insights for future translational medical research.
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Affiliation(s)
- Qurui Wang
- Key Laboratory of Novel Targets and Drug Study for Neural Repair of Zhejiang Province, School of Medicine, Hangzhou City University, Hangzhou, Zhejiang, China.
| | - Qinyuan Huang
- Key Laboratory of Novel Targets and Drug Study for Neural Repair of Zhejiang Province, School of Medicine, Hangzhou City University, Hangzhou, Zhejiang, China.
| | - Xiaowei Ying
- Key Laboratory of Novel Targets and Drug Study for Neural Repair of Zhejiang Province, School of Medicine, Hangzhou City University, Hangzhou, Zhejiang, China.
| | - Yang Zhou
- Key Laboratory of Novel Targets and Drug Study for Neural Repair of Zhejiang Province, School of Medicine, Hangzhou City University, Hangzhou, Zhejiang, China.
| | - Shiwei Duan
- Key Laboratory of Novel Targets and Drug Study for Neural Repair of Zhejiang Province, School of Medicine, Hangzhou City University, Hangzhou, Zhejiang, China; Department of Clinical Medicine, School of Medicine, Hangzhou City University, Hangzhou, Zhejiang, China.
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Yao H, Qian J, Bian XT, Guo L, Tang KL, Tao X. miR-27b-3p reduces muscle fibrosis during chronic skeletal muscle injury by targeting TGF-βR1/Smad pathway. J Orthop Surg Res 2024; 19:329. [PMID: 38825706 PMCID: PMC11145862 DOI: 10.1186/s13018-024-04733-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 04/13/2024] [Indexed: 06/04/2024] Open
Abstract
BACKGROUND Fibrosis is a significant pathological feature of chronic skeletal muscle injury, profoundly affecting muscle regeneration. Fibro-adipogenic progenitors (FAPs) have the ability to differentiate into myofibroblasts, acting as a primary source of extracellular matrix (ECM). the process by which FAPs differentiate into myofibroblasts during chronic skeletal muscle injury remains inadequately explored. METHOD mouse model with sciatic nerve denervated was constructed and miRNA expression profiles between the mouse model and uninjured mouse were analyzed. qRT/PCR and immunofluorescence elucidated the effect of miR-27b-3p on fibrosis in vivo and in vitro. Dual-luciferase reporter identified the target gene of miR-27b-3p, and finally knocked down or overexpressed the target gene and phosphorylation inhibition of Smad verified the influence of downstream molecules on the abundance of miR-27b-3p and fibrogenic differentiation of FAPs. RESULT FAPs derived from a mouse model with sciatic nerves denervated exhibited a progressively worsening fibrotic phenotype over time. Introducing agomiR-27b-3p effectively suppressed fibrosis both in vitro and in vivo. MiR-27b-3p targeted Transforming Growth Factor Beta Receptor 1 (TGF-βR1) and the abundance of miR-27b-3p was negatively regulated by TGF-βR1/Smad. CONCLUSION miR-27b-3p targeting the TGF-βR1/Smad pathway is a novel mechanism for regulating fibrogenic differentiation of FAPs. Increasing abundance of miR-27b-3p, suppressing expression of TGF-βR1 and inhibiting phosphorylation of smad3 presented potential strategies for treating fibrosis in chronic skeletal muscle injury.
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Affiliation(s)
- Hang Yao
- Center of sports, Southwest Hospital, Army Medical University, Gaotanyan Str. 30, Chongqing city, 400038, People's Republic of China
| | - Jin Qian
- Center of sports, Southwest Hospital, Army Medical University, Gaotanyan Str. 30, Chongqing city, 400038, People's Republic of China
| | - Xu-Ting Bian
- Center of sports, Southwest Hospital, Army Medical University, Gaotanyan Str. 30, Chongqing city, 400038, People's Republic of China
| | - Lin Guo
- Center of sports, Southwest Hospital, Army Medical University, Gaotanyan Str. 30, Chongqing city, 400038, People's Republic of China.
| | - Kang-Lai Tang
- Center of sports, Southwest Hospital, Army Medical University, Gaotanyan Str. 30, Chongqing city, 400038, People's Republic of China.
| | - Xu Tao
- Center of sports, Southwest Hospital, Army Medical University, Gaotanyan Str. 30, Chongqing city, 400038, People's Republic of China.
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Raum G, Kenyon C, Bowers R. Platelet-Poor versus Platelet-Rich Plasma for the Treatment of Muscle Injuries. Curr Sports Med Rep 2024; 23:222-228. [PMID: 38838685 DOI: 10.1249/jsr.0000000000001173] [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: 06/07/2024]
Abstract
ABSTRACT Muscle injury in sport results in significant lost time and potential for reinjury for athletes. Autologous blood product, namely, platelet-rich plasma (PRP), has been investigated for possible augmentation of the treatment timeline with prevention of reinjury; however, conflicting results have been identified. A growing body of basic science and clinical literature is forming that supports the use of platelet-poor plasma (PPP) for muscle injury. The purpose of this study was to provide a background of the basic science of PRP versus PPP for muscle injury and to identify and review the clinical evidence for both autologous blood products, including the author's clinical experience utilizing the blood products. At the tissue level, PRP causes myoblast proliferation while PPP has led to myoblast induction, potentially identifying improved native muscle healing. Conflicting studies have been identified for the use of PRP for muscle injury. A growing body of positive results for PPP was identified, but high-quality comparative studies are needed.
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Affiliation(s)
- George Raum
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh Medical Center, Pittsburgh, PA
| | | | - Robert Bowers
- Department of Orthopedics, Department of Physical Medicine and Rehabilitation, Emory University, Atlanta, GA
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Nakata K, Ishikawa M, Kamei N, Miyaki S, Adachi N, Inoue K, Kawabata S. Skeletal muscle injury treatment using the Silk Elastin® injection in a rat model. Regen Ther 2024; 26:180-187. [PMID: 38948131 PMCID: PMC11214263 DOI: 10.1016/j.reth.2024.05.012] [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: 01/01/2024] [Revised: 05/04/2024] [Accepted: 05/19/2024] [Indexed: 07/02/2024] Open
Abstract
Background Skeletal muscle injury (SMI) is often treated conservatively, although it can lead to scar tissue formation, which impedes muscle function and increases muscle re-injury risk. However, effective interventions for SMIs are yet to be established. Hypothesis The administration of Silk Elastin® (SE), a novel artificial protein, to the SMI site can suppress scar formation and promote tissue repair. Study design A controlled laboratory study. Methods In vitro: Fibroblast migration ability was assessed using a scratch assay. SE solution was added to the culture medium, and the fibroblast migration ability was compared across different concentrations. In vivo: An SMI model was established with Sprague-Dawley rats, which were assigned to three groups based on the material injected to the SMI site: SE gel (SE group; n = 8), atelocollagen gel (Atelo group; n = 8), and phosphate buffer saline (PBS group; n = 8). Histological evaluations were performed at weeks 1 and 4 following the SMI induction. In the 1-week model, we detected the expression of transforming growth factor (TGF)-β1 in the stroma using immunohistological evaluation and real-time polymerase chain reaction analysis. In the 4-week model, we measured tibialis anterior muscle strength upon peroneal nerve stimulation as a functional assessment. Results In vitro: The fibroblast migration ability was suppressed by SE added at a concentration of 10⁴ μg/mL in the culture medium. In vivo: In the 1-week model, the SE group exhibited significantly lower TGFβ -1 expression than the PBS group. In the 4-week model, the SE group had a significantly larger regenerated muscle fiber diameter and smaller scar formation area ratio than the other two groups. Moreover, the SE group was superior to the other two groups in terms of regenerative muscle strength. Conclusion Injection of SE gel to the SMI site may inhibit tissue scarring by reducing excessive fibroblast migration, thereby enhancing tissue repair. Clinical relevance The findings of this study may contribute to the development of an early intervention method for SMIs.
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Affiliation(s)
- Kyohei Nakata
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University Hospital, Japan
| | - Masakazu Ishikawa
- Department of Orthopaedic Surgery, Faculty of Medicine, Kagawa University Hospital, Japan
| | - Naosuke Kamei
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University Hospital, Japan
| | - Shigeru Miyaki
- Medical Center for Translational and Clinical Research, Hiroshima University Hospital, Japan
| | - Nobuo Adachi
- Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University Hospital, Japan
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Afonso J, Reurink G, Clemente FM, Ramirez-Campillo R, Pizzari T, Andrade R. Revisiting the hamstring injury prevention and rehabilitation literature: filling the gaps! Br J Sports Med 2024; 58:243-244. [PMID: 38071509 DOI: 10.1136/bjsports-2023-106878] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2023] [Indexed: 03/10/2024]
Affiliation(s)
- José Afonso
- Centre of Research, Education, Innovation, and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, Porto, Portugal
| | - Guus Reurink
- Department of Orthopaedic Surgery and Sports Medicine, Amsterdam Medical Center, University of Amsterdam, Amsterdam, The Netherlands
- The Sport Physician Group, Department of Sports Medicine, OLVG, Amsterdam, The Netherlands
| | - Filipe Manuel Clemente
- Escola Superior Desporto e Lazer, Instituto Politécnico de Viana do Castelo, Viana do Castelo, Portugal
- Gdańsk University of Physical Education and Sport, Gdańsk, Poland
| | - Rodrigo Ramirez-Campillo
- Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, Chile
| | - Tania Pizzari
- La Trobe University La Trobe Sport and Exercise Medicine Research Centre, Melbourne, Victoria, Australia
| | - Renato Andrade
- Porto Biomechanics Laboratory (LABIOMEP), Porto, Portugal
- Clínica Espregueira - FIFA Medical Centre of Excellence, Porto, Portugal
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Herring SA, Kibler WB, Putukian M, Boyajian-O'Neill LA, Chang CJ, Franks RR, Hutchinson M, Indelicato PA, O'Connor FG, Powell A, Roach R, Safran M, Statuta SM, Sutton K. Initial Assessment and Management of Select Musculoskeletal Injuries: A Team Physician Consensus Statement. Med Sci Sports Exerc 2024; 56:385-401. [PMID: 37847756 DOI: 10.1249/mss.0000000000003324] [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: 10/19/2023]
Abstract
ABSTRACT Musculoskeletal injuries occur frequently in sport during practice, training, and competition. Injury assessment and management are common responsibilities for the team physician. Initial Assessment and Management of Musculoskeletal Injury-A Team Physician Consensus Statement is title 23 in a series of annual consensus documents written for the practicing team physician. This statement was developed by the Team Physician Consensus Conference, an annual project-based alliance of six major professional associations. The goal of this document is to help the team physician improve the care and treatment of the athlete by understanding the initial assessment and management of selected musculoskeletal injuries.
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Herring SA, Kibler WB, Putukian M, Boyajian-O'Neill LA, Chang CJ, Franks RR, Hutchinson M, Indelicato PA, O'Connor FG, Powell A, Roach R, Safran M, Statuta SM, Sutton K. Initial Assessment and Management of Select Musculoskeletal Injuries: A Team Physician Consensus Statement. Curr Sports Med Rep 2024; 23:86-104. [PMID: 38437494 DOI: 10.1249/jsr.0000000000001151] [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: 03/06/2024]
Abstract
ABSTRACT Musculoskeletal injuries occur frequently in sport during practice, training, and competition. Injury assessment and management are common responsibilities for the team physician. Initial Assessment and Management of Musculoskeletal Injury-A Team Physician Consensus Statement is title 23 in a series of annual consensus documents written for the practicing team physician. This statement was developed by the Team Physician Consensus Conference, an annual project-based alliance of six major professional associations. The goal of this document is to help the team physician improve the care and treatment of the athlete by understanding the initial assessment and management of selected musculoskeletal injuries.
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Yang X, Liang J, Shu Y, Wei L, Wen C, Luo H, Ma L, Qin T, Wang B, Zeng S, Liu Y, Zhou C. Asperosaponin VI facilitates the regeneration of skeletal muscle injury by suppressing GSK-3β-mediated cell apoptosis. J Cell Biochem 2024; 125:115-126. [PMID: 38079224 DOI: 10.1002/jcb.30510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 10/26/2023] [Accepted: 11/26/2023] [Indexed: 01/16/2024]
Abstract
Asperosaponin VI (ASA VI) is a bioactive triterpenoid saponin extracted from Diptychus roots, of Diptyl, and has previously shown protective functions in rheumatoid arthritis and sepsis. This study investigates the effects and molecular mechanisms of ASA VI on skeletal muscle regeneration in a cardiotoxin (CTX)-induced skeletal muscle injury mouse model. Mice were subjected to CTX-induced injury in the tibialis anterior and C2C12 myotubes were treated with CTX. Muscle fiber histology was analyzed at 7 and 14 days postinjury. Apoptosis and autophagy-related protein expression were evaluated t s by Western blot, and muscle regeneration markers were quantified by quantitative polymerase chain reaction. Docking studies, cell viability assessments, and glycogen synthase kinase-3β (GSK-3β) activation analyses were performed to elucidate the mechanism. ASA VI was observed to improve muscle interstitial fibrosis, remodeling, and performance in CTX-treated mice, thereby increased skeletal muscle size, weight, and locomotion. Furthermore, ASA VI modulated the expression of apoptosis and autophagy-related proteins through GSK-3β inhibition and activated the transcription of regeneration genes. Our results suggest that ASA VI mitigates skeletal muscle injury by modulating apoptosis and autophagy via GSK-3β signaling and promotes regeneration, thus presenting a probable therapeutic agent for skeletal muscle injury.
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Affiliation(s)
- Xinru Yang
- Department of Pharmacology, Guangdong Provincial Key Laboratory of Shock and Microcirculation, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, China
| | - Jian Liang
- Department of Pediatrics, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Yue Shu
- Department of Pharmacology, Guangdong Provincial Key Laboratory of Shock and Microcirculation, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, China
| | - Linlin Wei
- Department of Pharmacology, Guangdong Provincial Key Laboratory of Shock and Microcirculation, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, China
| | - Cailing Wen
- Department of Pharmacology, Guangdong Provincial Key Laboratory of Shock and Microcirculation, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, China
| | - Hui Luo
- Department of Pharmacology, Guangdong Provincial Key Laboratory of Shock and Microcirculation, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, China
| | - Liqing Ma
- Department of Pharmacology, Guangdong Provincial Key Laboratory of Shock and Microcirculation, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, China
| | - Tian Qin
- Department of Pharmacology, Guangdong Provincial Key Laboratory of Shock and Microcirculation, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, China
| | - Bin Wang
- Department of Cardiovascular Ultrasound, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China
| | - Siyu Zeng
- Department of Pharmacy, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Ying Liu
- Department of Pharmacology, School of Pharmacy, Macau University of Science and Technology, Taipa, Macao, China
- Department of Pharmacology, School of Pharmacy, Guangzhou Xinhua University, Guangzhou, China
| | - Chun Zhou
- Department of Pharmacology, Guangdong Provincial Key Laboratory of Shock and Microcirculation, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, China
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Dutra YM, Lopes JPF, Murias JM, Zagatto AM. Within- and between-day reliability and repeatability of neuromuscular function assessment in females and males. J Appl Physiol (1985) 2023; 135:1372-1383. [PMID: 37916269 DOI: 10.1152/japplphysiol.00539.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 10/31/2023] [Accepted: 10/31/2023] [Indexed: 11/03/2023] Open
Abstract
The study evaluated the reliability and repeatability of the force and surface electromyography activity (EMG) outcomes obtained through voluntary and electrically evoked contractions of knee extensors in females (n = 18) and males (n = 20) and compared these data between sexes. Maximal isometric voluntary contractions (iMVCs) of knee extensors associated with electrical stimulation of the femoral nerve were performed over 4 days (48-h interval), with the first day involving familiarization procedures, the second involving three trials (1-h interval), and the third and fourth involving just one trial. The intraclass correlation coefficient (ICC), coefficient of variation (CV), and repeatability of outcomes from within- and between-day trials were determined for each sex. Females presented lower maximal voluntary force during iMVC (iMVCForce) and associated vastus lateralis EMG activity (root mean square, RMSVL), force evoked by potentiated doublet high-frequency (Db100Force) and single stimuli (Qtw), and M-wave amplitude than males (P ≤ 0.01, partial eta squared ≥0.94). Voluntary activation (VA) and RMSVL/M-wave amplitude did not differ between sexes. iMVCForce, VA, Db100Force, Qtw, and M-wave amplitude were the most reliable outcomes in within-day trials, with similar results between sexes (ICC > 0.62; CV < 6.4%; repeatability: 12.2%-22.6%). When investigating between-day trials, the iMVCForce, VA, Db100Force, and Qtw were the most reliable (ICC > 0.66; CV < 7.5%; repeatability: 13.2%-33.45%) with similar results between sexes. In conclusion, females presented lower iMVCForce and evoked response than males. Although reliability and repeatability statistics vary between trials, data (e.g., from EMG or force signal), and sexes, most of the outcomes obtained through this technique are reliable in females and males.NEW & NOTEWORTHY Although reliability and repeatability of knee extensors vary according to the type of neuromuscular function outcome (e.g., from force or EMG responses), the trial intervals (i.e., hours or days), and the sex of the participant, most force and EMG outcomes obtained through these neuromuscular assessment protocols present ICC > 0.75, very good CV (<10%), and repeatability <25% in within- and between-day trials in both sexes.
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Affiliation(s)
- Yago Medeiros Dutra
- Department of Physical Education, Laboratory of Physiology and Sport Performance (LAFIDE), School of Sciences, São Paulo State University (UNESP), Bauru, Brazil
| | - João Pedro Fialho Lopes
- Department of Physical Education, Laboratory of Physiology and Sport Performance (LAFIDE), School of Sciences, São Paulo State University (UNESP), Bauru, Brazil
| | - Juan M Murias
- College of Health and Life Sciences, Hamad Bin Khalifa University, Doha, Qatar
| | - Alessandro Moura Zagatto
- Department of Physical Education, Laboratory of Physiology and Sport Performance (LAFIDE), School of Sciences, São Paulo State University (UNESP), Bauru, Brazil
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Su Q, Li J, Huang J, Cai Q, Xue C, Huang C, Chen L, Li J, Li D, Ge H, Cheng B. Histological characteristics of exercise-induced skeletal muscle remodelling. J Cell Mol Med 2023; 27:3217-3234. [PMID: 37517049 PMCID: PMC10623533 DOI: 10.1111/jcmm.17879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 07/09/2023] [Accepted: 07/19/2023] [Indexed: 08/01/2023] Open
Abstract
This study aims to analyse the pathological features of skeletal muscle injury repair by using rats to model responses to different exercise intensities. Eighty-four rats were randomly divided into five groups for treadmill exercise. The short-term control, low-intensity, medium-intensity and high-intensity groups underwent gastrocnemius muscle sampling after 6, 8 and 12 weeks of exercise. The long-term high-intensity group underwent optical coherence tomography angiography and sampling after 18 weeks of exercise. RNA sequencing was performed on the muscle samples, followed by the corresponding histological staining. Differentially expressed genes were generally elevated at 6 weeks in the early exercise stage, followed by a decreasing trend. Meanwhile, the study demonstrated a negative correlation between time and the gene modules involved in vascular regulation. The modules associated with muscle remodelling were positively correlated with exercise intensity. Although the expression of many genes associated with common angiogenesis was downregulated at 8, 12 and 18 weeks, we found that muscle tissue microvessels were still increased, which may be closely associated with elevated sFRP2 and YAP1. During muscle injury-remodelling, angiogenesis is characterized by significant exercise time and exercise intensity dependence. We find significant differences in the spatial distribution of angiogenesis during muscle injury-remodelling, which be helpful for the future achievement of spatially targeted treatments for exercise-induced muscle injuries.
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Affiliation(s)
- Qihang Su
- Department of Sports Medicine, Tongji Hospital, School of MedicineTongji UniversityShanghaiChina
- Department of Orthopedics, Shanghai Tenth People's Hospital, School of MedicineTongji UniversityShanghaiChina
| | - Jie Li
- Department of OrthopedicsZhabei Central Hospital of Jing'an DistrictShanghaiChina
| | - Jingbiao Huang
- Department of Sports Medicine, Tongji Hospital, School of MedicineTongji UniversityShanghaiChina
| | - Qiuchen Cai
- Department of Sports Medicine, Tongji Hospital, School of MedicineTongji UniversityShanghaiChina
| | - Chao Xue
- Department of Sports Medicine, Tongji Hospital, School of MedicineTongji UniversityShanghaiChina
| | - Chenglong Huang
- Department of Sports Medicine, Tongji Hospital, School of MedicineTongji UniversityShanghaiChina
| | - Liyang Chen
- Department of Sports Medicine, Tongji Hospital, School of MedicineTongji UniversityShanghaiChina
| | - Jun Li
- Department of Sports Medicine, Tongji Hospital, School of MedicineTongji UniversityShanghaiChina
| | - Dandan Li
- Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Ultrasound Research and Education Institute, Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, School of MedicineTongji UniversityShanghaiChina
- Department of Environmental and Public Health Sciences, College of MedicineUniversity of CincinnatiCincinnatiOhioUSA
| | - Hengan Ge
- Department of Sports Medicine, Tongji Hospital, School of MedicineTongji UniversityShanghaiChina
| | - Biao Cheng
- Department of Sports Medicine, Tongji Hospital, School of MedicineTongji UniversityShanghaiChina
- Department of Orthopedics, Shanghai Tenth People's Hospital, School of MedicineTongji UniversityShanghaiChina
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12
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Edouard P, Reurink G, Mackey AL, Lieber RL, Pizzari T, Järvinen TAH, Gronwald T, Hollander K. Traumatic muscle injury. Nat Rev Dis Primers 2023; 9:56. [PMID: 37857686 DOI: 10.1038/s41572-023-00469-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/22/2023] [Indexed: 10/21/2023]
Abstract
Traumatic muscle injury represents a collection of skeletal muscle pathologies caused by trauma to the muscle tissue and is defined as damage to the muscle tissue that can result in a functional deficit. Traumatic muscle injury can affect people across the lifespan and can result from high stresses and strains to skeletal muscle tissue, often due to muscle activation while the muscle is lengthening, resulting in indirect and non-contact muscle injuries (strains or ruptures), or from external impact, resulting in direct muscle injuries (contusion or laceration). At a microscopic level, muscle fibres can repair focal damage but must be completely regenerated after full myofibre necrosis. The diagnosis of muscle injury is based on patient history and physical examination. Imaging may be indicated to eliminate differential diagnoses. The management of muscle injury has changed within the past 5 years from initial rest, immobilization and (over)protection to early activation and progressive loading using an active approach. One challenge of muscle injury management is that numerous medical treatment options, such as medications and injections, are often used or proposed to try to accelerate muscle recovery despite very limited efficacy evidence. Another challenge is the prevention of muscle injury owing to the multifactorial and complex nature of this injury.
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Affiliation(s)
- Pascal Edouard
- Université Jean Monnet, Lyon 1, Université Savoie Mont-Blanc, Inter-university Laboratory of Human Movement Biology, Saint-Etienne, France.
- Department of Clinical and Exercise Physiology, Sports Medicine Unit, University Hospital of Saint-Etienne, Faculty of Medicine, Saint-Etienne, France.
| | - Gustaaf Reurink
- Department of Orthopedic Surgery and Sports Medicine, Academic Medical Center, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, Netherlands
- Academic Center for Evidence-based Sports Medicine (ACES), Academic Medical Center, Amsterdam, Netherlands
- The Sports Physicians Group, Onze Lieve Vrouwe Gasthuis, Amsterdam, Netherlands
| | - Abigail L Mackey
- Institute of Sports Medicine Copenhagen, Department of Orthopaedic Surgery M, Bispebjerg Hospital, Copenhagen, Denmark
- Center for Healthy Aging, Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Richard L Lieber
- Shirley Ryan AbilityLab, Chicago, IL, USA
- Departments of Physical Medicine and Rehabilitation and Biomedical Engineering, Northwestern University, Chicago, IL, USA
- Hines VA Medical Center, Maywood, IL, USA
| | - Tania Pizzari
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Tero A H Järvinen
- Tampere University and Tampere University Hospital, Tampere, Finland
| | - Thomas Gronwald
- Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Hamburg, Germany
| | - Karsten Hollander
- Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Hamburg, Germany
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Covey CJ, Knobloch AC, Kim AR. Hip Pain in an Athlete. Curr Sports Med Rep 2023; 22:313-319. [PMID: 37678350 DOI: 10.1249/jsr.0000000000001098] [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: 09/09/2023]
Abstract
ABSTRACT Hip pain is a common complaint in sports, and narrowing the differential diagnosis can be difficult. Many etiologies are secondary to overuse and respond well to nonsurgical treatment. The increased use of point-of-care ultrasound has helped provide timely and accurate diagnoses and some guided treatments. The hip is in close proximity to the abdomen and pelvis, and clinicians should be familiar with nonmusculoskeletal pain generators. This article is a comprehensive review of hip pain etiologies in athletes.
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Affiliation(s)
- Carlton J Covey
- Uniformed Services University, Family and Sports Medicine, Travis AFB, CA
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Boyd NL, von Pfeil D, James DR, Kent M, Fearnside S, White JD. Rupture of the gastrocnemius muscle at its distal musculotendinous junction: conservative treatment and outcomes in 11 dogs. N Z Vet J 2023; 71:275-281. [PMID: 37309587 DOI: 10.1080/00480169.2023.2224753] [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: 02/18/2023] [Accepted: 05/28/2023] [Indexed: 06/14/2023]
Abstract
CASE HISTORY Medical records from three veterinary referral centres and a university veterinary teaching hospital in Australia and the USA were reviewed to identify dogs with a diagnosis of distal gastrocnemius musculotendinous junction rupture (DGMJR) that were treated without surgery between 2007 and 2020. CLINICAL AND IMAGING FINDINGS All dogs (n = 11) presented with unilateral, pelvic limb lameness and bruising, swelling or pain on palpation at the distal musculotendinous junction. The diagnosis was confirmed with ultrasound or MRI in six dogs; radiographs were used to excluded stifle and tarsus pathology in four dogs; and five dogs were diagnosed on physical examination findings. TREATMENT AND OUTCOME All dogs were managed conservatively, either with complete confinement alone (n = 10; median 9 weeks), external coaptation alone (n = 1), or a combination of both (n = 4). Sporting dogs (n = 7) were completely confined (median 22 weeks) for longer periods than companion dogs (n = 3; median 5 weeks).A good to excellent outcome was achieved for all cases in this cohort. The seven sporting dogs achieved an excellent outcome; returning to their previous level of sport, with complete resolution of lameness and recovery of a normal tibiotarsal stance. The four companion dogs achieved a good outcome; returning to their previous level of activity but with persistently increased tibiotarsal standing angle compared to the contralateral limb. CLINICAL RELEVANCE Conservative treatment represents a viable treatment option for dogs with a rupture of the gastrocnemius muscle at its distal musculotendinous junction.
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Affiliation(s)
- N L Boyd
- Sports Medicine and Rehabilitation, Small Animal Specialist Hospital, Sydney, Australia
| | - D von Pfeil
- Small Animal Surgery, Bessy's Kleintierklinik, Zurich, Switzerland
- Small Animal Surgery Locum, PLLC, Dallas, TX, USA
| | - D R James
- Small Animal Surgery, Small Animal Specialist Hospital, Sydney, Australia
| | - M Kent
- Neurology Service, Small Animal Medicine & Surgery, Veterinary Teaching Hospital, University of Georgia, Athens, GA, USA
| | - S Fearnside
- Small Animal Surgery, Small Animal Specialist Hospital, Sydney, Australia
| | - J D White
- Small Animal Internal Medicine, Small Animal Specialist Hospital, Sydney, Australia
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15
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Nyhus Hagum C, Tønnessen E, Hisdal J, Shalfawi SAI. The effect of progressive and individualised sport-specific training on the prevalence of injury in football and handball student athletes: a randomised controlled trial. Front Sports Act Living 2023; 5:1106404. [PMID: 37346384 PMCID: PMC10279870 DOI: 10.3389/fspor.2023.1106404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 05/22/2023] [Indexed: 06/23/2023] Open
Abstract
Objective To evaluate the effectiveness of communication and coordination combined with designing a progressive and individualised sport-specific training program for reducing injury prevalence in youth female and male football and handball players transitioning to a sports academy high school. An additional aim was to investigate the characteristics of the reported injuries. Methods Forty-two Norwegian athletes were randomised into an intervention or control group. Mean age, height, weight and BMI was 15.5 ± 0.5 years, 178.6 cm ± 6.3 cm, 71.3 ± 9.8 kg, 22.3 ± 2.7 BMI for the intervention group (IG) (n = 23), and 15.4 ± 0.5 years, 175.6 cm ± 6.6 cm, 67.1 ± 9.8 kg, 21.7 ± 2.4 BMI for the control group (CG) (n = 19). During the summer holiday, the intervention group received weekly progressive, individualised sport-specific training programs and weekly follow-up telephone calls from the researchers. All athletes completed a baseline questionnaire and a physical test battery. Training data and injuries were recorded prospectively for 22 weeks using the Oslo Sports Trauma Research Center Questionnaire on Health Problems (OSTRC-H2). A two-way chi-square (χ2) test of independence was conducted to examine the relationship between groups and injury. Results Average weekly prevalence of all injuries was 11% (95% CI: 8%-14%) in IG and 19% (95% CI: 13%-26%) in CG. Average weekly prevalence of substantial injuries was 7% (95% CI: 3%-10%) in IG and 10% (95% CI: 6%-13%) in CG. The between-group difference in injuries was significant: χ2 (1, N = 375) = 4.865, p = .031, φ = .114, with 1.8 times higher injury risk in CG vs. IG during the first 12 weeks after enrolment. Conclusions For student athletes transitioning to a sports academy high school, progressive individualised, sport-specific training programs reduced the prevalence of all-complaint injuries following enrolment. Clubs and schools should prioritise time and resources to implement similar interventions in periods where student athletes have less supervision, such as the summer holidays, to facilitate an optimal transition to a sports academy high school.
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Affiliation(s)
- Cathrine Nyhus Hagum
- Department of Education and Sports Science, University of Stavanger, Stavanger, Norway
| | - Espen Tønnessen
- Faculty of Health Sciences, Kristiania University College, Oslo, Norway
| | - Jonny Hisdal
- Department of Vascular Surgery, Oslo University Hospital, Oslo, Norway
| | - Shaher A. I. Shalfawi
- Department of Education and Sports Science, University of Stavanger, Stavanger, Norway
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16
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de Queiroz JHM, Frota JP, Dos Reis FA, de Oliveira RR. Development and Predictive Validation of the Brazilian Adductor Performance Test for Estimating the Chance of Hip Adductor Injuries in Elite Soccer Athletes. Int J Sports Physiol Perform 2023; 18:653-659. [PMID: 37080542 DOI: 10.1123/ijspp.2022-0306] [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: 08/05/2022] [Revised: 02/24/2023] [Accepted: 03/10/2023] [Indexed: 04/22/2023]
Abstract
PURPOSE To develop and validate the Brazilian Adductor Performance Test (BAPT) for predicting hip adductor muscle injuries in elite soccer athletes. METHODS A total of 108 soccer athletes were assessed, followed up for 3 months, and evaluated for a history of adductor injury 6 months before BAPT evaluation. The Shapiro-Wilk test was used as the normality test. The Mann-Whitney U test was used to compare BAPT scores between injured and uninjured athletes. Binary logistic regression was performed to identify the athletes' chances of injury based on their BAPT scores. A receiver operating characteristic curve was used to determine the cutoff point for the number of repetitions in the BAPT and Spearman bivariate correlation and identify factors potentially related to the test score. Furthermore, the intraclass correlation coefficient was used to determine interexaminer agreement. The level of significance was set at 95%. RESULTS The BAPT scores for hip adductor injury history did not differ significantly (P = .08). A significant deficit was identified in the BAPT scores of the injured athletes at the 3-month follow-up (P = .001). The cutoff point identified was 33 repetitions. Low BAPT scores increased the chance of injury by 20% (odds ratio, 1.20%; P = .001). The interexaminer agreement was .96 (P = .001). CONCLUSION BAPT can be used to identify athletes most likely to sustain hip adductor muscle injuries, indirectly reducing the rate of this injury in soccer clubs.
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Affiliation(s)
- Jeffeson Hildo Medeiros de Queiroz
- Tendon Research Group, Master Program in Physical Therapy and Functioning-Department of Physical Therapy, Federal University of Ceará, Fortaleza, CE,Brazil
| | | | | | - Rodrigo Ribeiro de Oliveira
- Tendon Research Group, Master Program in Physical Therapy and Functioning-Department of Physical Therapy, Federal University of Ceará, Fortaleza, CE,Brazil
- Ceará Sporting Club, Fortaleza, CE,Brazil
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17
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Kay AD, Baxter BA, Hill MW, Blazevich AJ. Effects of Eccentric Resistance Training on Lower-Limb Passive Joint Range of Motion: A Systematic Review and Meta-analysis. Med Sci Sports Exerc 2023; 55:710-721. [PMID: 36730587 DOI: 10.1249/mss.0000000000003085] [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: 02/04/2023]
Abstract
INTRODUCTION Substantial increases in joint range of motion (ROM) have been reported after eccentric resistance training; however, between-study variability and sample size issues complicate the interpretation of the magnitude of effect. METHODS PubMed, Medline, and SPORTDiscus databases were searched for studies examining the effects of eccentric training on lower-limb passive joint ROM in healthy human participants. Meta-analysis used an inverse-variance random-effects model to calculate the pooled standardized difference (Hedge's g ) with 95% confidence intervals. RESULTS Meta-analysis of 22 ROM outcomes (17 studies, 376 participants) revealed a large increase in lower-limb passive joint ROM ( g = 0.86 (95% confidence intervals, 0.65-1.08)). Subgroup analyses revealed a moderate increase after 4-5 wk ( g = 0.63 (0.27-0.98)), large increase after 6-8 wk ( g = 0.98 (0.73-1.24)), and moderate increase after 9-14 wk ( g = 0.75 (0.03, 1.46)) of training. Large increases were found in dorsiflexion ( g = 1.12 (0.78-1.47)) and knee extension ( g = 0.82 (0.48-1.17)), but a small increase in knee flexion was observed ( g = 0.41 (0.05-0.77)). A large increase was found after isokinetic ( g = 1.07 (0.59-1.54)) and moderate increase after isotonic ( g = 0.77 (0.56-0.99)) training. CONCLUSIONS These findings demonstrate the potential of eccentric training as an effective flexibility training intervention and provide evidence for "best practice" guidelines. The larger effect after isokinetic training despite <50% training sessions being performed is suggestive of a more effective exercise mode, although further research is needed to determine the influence of contraction intensity and to confirm the efficacy of eccentric training in clinical populations.
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Affiliation(s)
- Anthony D Kay
- Centre for Physical Activity and Life Sciences, Faculty of Art, Science and Technology, University of Northampton, Northamptonshire, UNITED KINGDOM
| | - Brett A Baxter
- Centre for Physical Activity and Life Sciences, Faculty of Art, Science and Technology, University of Northampton, Northamptonshire, UNITED KINGDOM
| | - Mathew W Hill
- Centre for Sport, Exercise and Life Sciences, School of Life Sciences, Coventry University, Warwickshire, UNITED KINGDOM
| | - Anthony J Blazevich
- Centre for Human Performance (CHP), School of Medical and Health Sciences, Edith Cowan University, Joondalup, AUSTRALIA
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18
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Liaghat B, Pedersen JR, Husted RS, Pedersen LL, Thorborg K, Juhl CB. Diagnosis, prevention and treatment of common shoulder injuries in sport: grading the evidence - a statement paper commissioned by the Danish Society of Sports Physical Therapy (DSSF). Br J Sports Med 2023; 57:408-416. [PMID: 36261251 PMCID: PMC10086287 DOI: 10.1136/bjsports-2022-105674] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2022] [Indexed: 12/09/2022]
Abstract
This statement paper summarises and appraises the evidence on diagnosis, prevention, and treatment of common shoulder injuries in sports. We systematically searched Medline and Embase. The Grading of Recommendations Assessment, Development and Evaluation tool was applied to evaluate the overall quality of evidence.For diagnosis, we included 19 clinical tests from mixed populations. Tests for anterior instability, biceps-labrum complex injuries and full subscapularis rupture had high diagnostic accuracy (low to moderate quality of evidence).For prevention, the Oslo Sports Trauma Research Center, the Shoulder Control, the FIFA 11+ shoulder injury prevention programmes, and a baseball-specific programme (range of motion, stretching, dynamic stability and strengthening exercises) showed moderate to large effect size in reducing the risk of shoulder injury compared with no intervention (very low to moderate quality of evidence).For treatment, a rehabilitation programme including stretching, ice packs, electrotherapy and compression, and strengthening exercises showed a large effect size in reducing pain and disability compared with no intervention in athletes with subacromial impingement syndrome (very low to moderate quality of evidence). For the treatment of supraspinatus tendinopathy, hyperthermia treatment (heating the skin to 38°C-40°C) resulted in large effect size in reducing pain and disability compared with ultrasound or pendular swinging and stretching exercises (moderate quality of evidence). Strengthening exercise alone or in combination with stretching exercises promoted a large effect in reducing shoulder pain (cohort studies, no comparators) (very low quality of evidence). The quality of evidence for most estimates was low to moderate, indicating that future high-quality research may alter our recommendations for clinical practice.
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Affiliation(s)
- Behnam Liaghat
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Centre for Evidence-Based Orthopaedics (CEBO), Department of Orthopaedic Surgery, Zealand University Hospital, Køge, Denmark
| | - Julie Rønne Pedersen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Rasmus Skov Husted
- Physical Medicine & Rehabilitation Research - Copenhagen (PMR-C), Department of Orthopedic Surgery and Physical Therapy, Copenhagen University Hospital, Hvidovre, Denmark
- Department of Clinical Research, Copenhagen University Hospital, Hvidovre, Denmark
- Center for General Practice, Aalborg University, Aalborg, Denmark
- Clinical Orthopedic Research Hvidovre (CORH), Department of Orthopedic Surgery, Copenhagen University Hospital Amager-Hvidovre, Hvidovre, Denmark
- The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Denmark
| | - Lisbeth Lund Pedersen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Danish Society of Sports Physical Therapy, Odense, Denmark
| | - Kristian Thorborg
- Physical Medicine & Rehabilitation Research - Copenhagen (PMR-C), Department of Orthopedic Surgery and Physical Therapy, Copenhagen University Hospital, Hvidovre, Denmark
- Department of Orthopaedic Surgery, Sports Orthopedic Research Center - Copenhagen (SORC-C), Amager-Hvidovre Hospital, Faculty of Health Sciences, Copenhagen University, Copenhagen, Denmark
| | - Carsten B Juhl
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Department of Physiotherapy and Occupational Therapy, Copenhagen University Hospital, Herlev and Gentofte, Denmark
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Nieto-Acevedo R, Romero-Moraleda B, Montalvo-Pérez A, Valdés-Álvarez A, García-Sánchez C, Mon-López D. Should We Use the Men Load-Velocity Profile for Women in Deadlift and Hip Thrust? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4888. [PMID: 36981796 PMCID: PMC10048953 DOI: 10.3390/ijerph20064888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/01/2023] [Accepted: 03/02/2023] [Indexed: 06/18/2023]
Abstract
Injuries are common in team sports and can impact both team and individual performance. In particular, hamstring strain injuries are some of the most common injuries. Furthermore, hamstring injury ratios, in number of injuries and total absence days, have doubled in the last 21 seasons in professional soccer. Weakness in hip extensor strength has been identified as a risk factor in elite-level sprinters. In addition, strength imbalances of the hamstring muscle group seem to be a common cause of hamstring strain injuries. In this regard, velocity-based training has been proposed to analyze deficits in the force-velocity profile. Previous studies have shown differences between men and women, since there are biomechanical and neuromuscular differences in the lower limbs between sexes. Therefore, the aim of this study was to compare the load-velocity profile between males and females during two of the most important hip extension exercises: the hip thrust and the deadlift. Sixteen men and sixteen women were measured in an incremental loading test following standard procedures for the hip thrust and deadlift exercises. Pearson's correlation (r) was used to measure the strength of the correlation between movement velocity and load (%1RM). The differences in the load-velocity relationship between the men and the women were assessed using a 2 (sex) × 15 (load) repeated-measures ANOVA. The main findings revealed that: (I) the load-velocity relationship was always strong and linear in both exercises (R2 range: 0.88-0.94), (II) men showed higher velocities for light loads (30-50%1RM; effect size: 0.9-0.96) than women for the deadlift, but no significant differences were found for the hip thrust. Based on the results of this study, the load-velocity equations seem to be sex-specific. Therefore, we suggest that using sex-specific equations to analyze deficits in the force-velocity profile would be more effective to control intensity in the deadlift exercise.
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Affiliation(s)
- Raúl Nieto-Acevedo
- Deporte y Entrenamiento Research Group, Departamento de Deportes, Facultad de Ciencias de la Actividad Física y del Deporte (INEF), Universidad Politécnica de Madrid, C. de Martín Fierro 7, 28040 Madrid, Spain
| | - Blanca Romero-Moraleda
- Department of Physical Education, Sport and Human Movement, Universidad Autónoma de Madrid, 28049 Madrid, Spain
| | | | - Agustín Valdés-Álvarez
- LFE Research Group, Department of Health and Human Performance, Faculty of Physical Activity and Sport Science (INEF), Universidad Politécnica de Madrid (UPM), 28040 Madrid, Spain
| | - Carlos García-Sánchez
- Deporte y Entrenamiento Research Group, Departamento de Deportes, Facultad de Ciencias de la Actividad Física y del Deporte (INEF), Universidad Politécnica de Madrid, C. de Martín Fierro 7, 28040 Madrid, Spain
| | - Daniel Mon-López
- Deporte y Entrenamiento Research Group, Departamento de Deportes, Facultad de Ciencias de la Actividad Física y del Deporte (INEF), Universidad Politécnica de Madrid, C. de Martín Fierro 7, 28040 Madrid, Spain
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Bakeri H, Hasikin K, Abd Razak NA, Mohd Razman R, Khamis AA, Annuha M‘A, Tajuddin A, Reza D. Silicone Elastomeric-Based Materials of Soft Pneumatic Actuator for Lower-Limb Rehabilitation: Finite Element Modelling and Prototype Experimental Validation. APPLIED SCIENCES 2023; 13:2977. [DOI: 10.3390/app13052977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
This study describes the basic design, material selection, fabrication, and evaluation of soft pneumatic actuators (SPA) for lower-limb rehabilitation compression therapy. SPAs can be a promising technology in proactive pressure delivery, with a wide range of dosages for treating venous-related diseases. However, the most effective design and material selection of SPAs for dynamic pressure delivery have not been fully explored. Therefore, a SPA chamber with two elastomeric layers was developed for this study, with single-side inflation. The 3D deformation profiles of the SPA chamber using three different elastomeric rubbers were analyzed using the finite element method (FEM). The best SPA-compliant behavior was displayed by food-grade silicone A10 Shore with a maximum deformation value of 25.34 mm. Next, the SPA chamber was fabricated using A10 Shore silicone and experimentally validated. During the simulation in FEM, the air pressure was applied on the inner wall of the chamber (i.e., the affected area). This is to ensure the applied pressure was evenly distributed in the inner wall while the outer wall of the chamber remained undeformed for all compression levels. During the inflation process, pressure will be applied to the SPA chamber, causing exerted pressure on the skin which is then measured for comparison. The simulation and experimental results show an excellent agreement of pressure transmission on the skin for the pressure range of 0–120 mmHg, as depicted in the Bland–Altman plots. The findings exhibited promising results in the development of the SPA chamber using low-cost and biocompatible food-grade silicone.
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Affiliation(s)
- Hanisah Bakeri
- Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur 50603, Malaysia
- Medical Revolution Sdn. Bhd, 10 Boulevard, Petaling Jaya 47400, Malaysia
| | - Khairunnisa Hasikin
- Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur 50603, Malaysia
- Center of Intelligent Systems for Emerging Technology (CISET), Faculty of Engineering, Universiti Malaya, Kuala Lumpur 50603, Malaysia
| | - Nasrul Anuar Abd Razak
- Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur 50603, Malaysia
| | - Rizal Mohd Razman
- Faculty of Sports and Exercise Science, Universiti Malaya, Kuala Lumpur 50603, Malaysia
| | - Abd Alghani Khamis
- Department of Mechanical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur 50603, Malaysia
| | - Muhammad ‘Ammar Annuha
- Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur 50603, Malaysia
| | - Abbad Tajuddin
- Medical Revolution Sdn. Bhd, 10 Boulevard, Petaling Jaya 47400, Malaysia
| | - Darween Reza
- My Conceptual Robotics Sdn. Bhd (MyCRO), Kompleks Diamond, Bandar Baru Bangi 43650, Malaysia
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21
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Sekereš M. Electromyostimulation in sport. SLOVAK JOURNAL OF SPORT SCIENCE 2023. [DOI: 10.24040/sjss.2022.8.2.12-26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Electromyostimulation (EMS) is a widely used therapeutic tool of low-frequency electrotherapy in several areas of rehabilitation, with gradual use increasingly in sports as well. The main goal of our article is to approach the use of EMS in sports based on available studies. EMS can be called as a training method used to obtain muscle activation through externally applied electric currents to the muscles to achieve a functional increase in sports performance by training fast motor units. Even if, based on the available study database, there are no clear conclusions regarding the effectiveness and application of EMS in the sense of sports, we can say that EMS represents one of the means by which we can influence muscle functionality, not only in terms of rehabilitation, but also as a possible way of increasing sports performance.
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22
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Hua W. RESEARCH ON SPORTS INJURY PREVENTION AND REGIONAL SPORTS FITNESS. REV BRAS MED ESPORTE 2023. [DOI: 10.1590/1517-8692202329012022_0216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Introduction Many athletes suffer sports injuries during exercise and are susceptible to sequelae due to a variety of post-injury complications that occur in the process of sports activities. Preventing these injuries in physical training, impacts positively on the athletes’ physique. Objective Study the sports habit and regional physical fitness, exploring the prevention strategies in the main sports injuries. Methods This paper elaborates targeted questionnaires (n=568) including proportion of gender, fitness, exercise frequency, duration and intensity of current regional fitness, as well as athletes’ motivations in a Chinese city. Results Current urban residents’ enthusiasm for fitness is high, however due to lack of conditions, athletes tend to choose some sports with lower complexity (circuits, 65.06%; running, 48.84%; walking, 40.46%). Most of the injuries caused by these types of sports are skin abrasions. The severity of these injuries is not high. Conclusion Providing effective exercise guidance to its practitioners can improve their sports cognition, build a foundation for the professional sports system, and provide relevant knowledge about emergency treatments. Level of evidence II; Therapeutic studies - investigation of treatment results.
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Affiliation(s)
- Wang Hua
- Suzhou University of Science and Technology, China
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23
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Green B, McClelland JA, Semciw AI, Schache AG, McCall A, Pizzari T. The Assessment, Management and Prevention of Calf Muscle Strain Injuries: A Qualitative Study of the Practices and Perspectives of 20 Expert Sports Clinicians. SPORTS MEDICINE - OPEN 2022; 8:10. [PMID: 35032233 PMCID: PMC8761182 DOI: 10.1186/s40798-021-00364-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 09/22/2021] [Indexed: 11/19/2022]
Abstract
Background Despite calf muscle strain injuries (CMSI) being problematic in many sports, there is a dearth of research to guide clinicians dealing with these injuries. The aim of this study was to evaluate the current practices and perspectives of a select group of international experts regarding the assessment, management and prevention of CMSI using in-depth semi-structured interviews. Results Twenty expert clinicians working in elite sport and/or clinician-researchers specialising in the field completed interviews. A number of key points emerged from the interviews. Characteristics of CMSI were considered unique compared to other muscle strains. Rigor in the clinical approach clarifies the diagnosis, whereas ongoing monitoring of calf capacity and responses to loading exposure provides the most accurate estimate of prognosis. Athlete intrinsic characteristics, injury factors and sport demands shaped rehabilitation across six management phases, which were guided by key principles to optimise performance at return to play (RTP) while avoiding subsequent injury or recurrence. To prevent CMSI, periodic monitoring is common, but practices vary and data are collected to inform load-management and exercise selection rather than predict future CMSI. A universal injury prevention program for CMSI may not exist. Instead, individualised strategies should reflect athlete intrinsic characteristics and sport demands. Conclusions Information provided by experts enabled a recommended approach to clinically evaluate CMSI to be outlined, highlighting the injury characteristics considered most important for diagnosis and prognosis. Principles for optimal management after CMSI were also identified, which involved a systematic approach to rehabilitation and the RTP decision. Although CMSI were reportedly difficult to prevent, on- and off-field strategies were implemented by experts to mitigate risk, particularly in susceptible athletes. Supplementary Information The online version contains supplementary material available at 10.1186/s40798-021-00364-0.
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Liu J, Liao Z, Wang J, Xiang H, Zhu X, Che X, Tang Y, Xie J, Mao C, Zhao H, Xiong Y. Research on skeletal muscle impact injury using a new rat model from a bioimpact machine. Front Bioeng Biotechnol 2022; 10:1055668. [PMID: 36452210 PMCID: PMC9701740 DOI: 10.3389/fbioe.2022.1055668] [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: 09/28/2022] [Accepted: 10/28/2022] [Indexed: 08/26/2023] Open
Abstract
Introduction: Skeletal muscle impact injury occurs frequently during sports, falls, and road traffic accidents. From the reported studies on skeletal muscle injury, it is difficult to determine the injury parameters. Therefore, we developed a new model of gastrocnemius impact injury in rats with a bioimpact machine, with which the experimental operation could be conducted in feasibility from the recorded parameters. Through this novel model, we study the skeletal muscle impact injury mechanisms by combining temporal and spatial variation. Methods: The gastrocnemius of anesthetized rats was injured by a small pneumatic-driven bioimpact machine; the moving speed and impact force were determined, and the whole impact process was captured by a high-speed camera. We observed the general condition of rats and measured the changes in injured calf circumference, evaluating calf injuries using MRI, gait analysis system, and pathology at different times after the injury. Results: The gastrocnemius was injured at an impact speed of 6.63 m/s ± 0.25 m/s and a peak force of 1,556.80 N ± 110.79 N. The gait analysis system showed that the footprint area of the RH limb decreased significantly on the first day and then increased. The calf circumference of the injured limb increased rapidly on the first day post-injury and then decreased in the next few days. MRI showed edema of subcutaneous and gastrocnemius on the first day, and the area of edema decreased over the following days. HE staining showed edema of cells, extensive hyperemia of blood vessels, and infiltration of inflammatory cells on the first day. Cell edema was alleviated day by day, but inflammatory cell infiltration was the most on the third day. TEM showed that the sarcoplasmic reticulum was dilated on the first day, the mitochondrial vacuolation was obvious on the second day, and the glycogen deposition was prominent on the fifth day. Conclusion: In our experiment, we developed a new and effective experimental animal model that was feasible to operate; the injured area of the gastrocnemius began to show "map-like" changes in the light microscope on the third day. Meanwhile, the gastrocnemius showed a trend of "edema-mitochondrial vacuolation-inflammatory cell aggregation" after impact injury.
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Affiliation(s)
- Jun Liu
- Department of Orthopedics, Daping Hospital, Army Medical University, Chongqing, China
| | - Zhikang Liao
- Institute for Traffic Medicine, Daping Hospital, Army Medical University, Chongqing, China
| | - Jingkun Wang
- Department of Orthopedics, Daping Hospital, Army Medical University, Chongqing, China
| | - Hongyi Xiang
- Institute for Traffic Medicine, Daping Hospital, Army Medical University, Chongqing, China
| | - Xiyan Zhu
- Institute for Traffic Medicine, Daping Hospital, Army Medical University, Chongqing, China
| | - Xingping Che
- Institute for Traffic Medicine, Daping Hospital, Army Medical University, Chongqing, China
| | - Yuqian Tang
- Institute for Traffic Medicine, Daping Hospital, Army Medical University, Chongqing, China
| | - Jingru Xie
- Institute for Traffic Medicine, Daping Hospital, Army Medical University, Chongqing, China
| | - Chengyi Mao
- Department of Pathology, Daping Hospital, Army Medical University, Chongqing, China
| | - Hui Zhao
- Institute for Traffic Medicine, Daping Hospital, Army Medical University, Chongqing, China
| | - Yan Xiong
- Department of Orthopedics, Daping Hospital, Army Medical University, Chongqing, China
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Ping N, Li H. PROJECTION OF FATIGUE AND NEUROMUSCULAR CHANGES CAUSED BY DIFFERENT EXCISES. REV BRAS MED ESPORTE 2022. [DOI: 10.1590/1517-8692202228052022_0061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Introduction: Athletes’ muscles can be weakened by fatigue caused by excessive activity. This limitation compromises their functional capacity and professional performance. The competition's performance correlates positively with muscular quality of function. The changes analysis caused by different athletic activities in muscle contraction by noninvasive tensiomyography reflects the functional state of the muscles. Still, no experiments are adapted to verify the fatigue risk level. Objective: Verify the possible relationship between exercise and neuromuscular fatigue using noninvasive tensiomyography. Methods: 90 athletes were randomly selected in weightlifting, badminton, and athletics sports. Maximum radial displacement, contraction, delay, duration, and relaxation time indices were collected. Muscle fatigue detection was based on the empirical mode decomposition modeling method with the Rogers sensitivity fluctuation rate. All values were collected in the rectus femoris muscle before and after the exercises. They were statistically treated and compared (P<0.05). Results: All athletes showed a decline in maximum radial displacement values after exercise. It reveals that their muscles are in a considerable state of tension, especially in the track and field group (from 8.57±3.42mm to 5.43±2.14mm). However, the slightest change in delay time was observed in the weightlifting group (16.21±4.15ms initial versus 18.34±3.27ms final). Conclusion: Through tensiomyography technology, it is possible to obtain a relationship between exercise and neuromuscular fatigue, analyzing the physical activity effects in a noninvasive way. Evidence Level II; Therapeutic Studies - Investigating the result.
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Affiliation(s)
- Na Ping
- Shijiazhuang University, China
| | - Hongyu Li
- Shijiazhuang Preschool Teachers College, China
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Lucena-Anton D, Luque-Moreno C, Valencia-Medero J, Garcia-Munoz C, Moral-Munoz JA. Effectiveness of Dry Needling of Myofascial Trigger Points in the Triceps Surae Muscles: Systematic Review. Healthcare (Basel) 2022; 10:healthcare10101862. [PMID: 36292308 PMCID: PMC9602116 DOI: 10.3390/healthcare10101862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/13/2022] [Accepted: 09/20/2022] [Indexed: 11/16/2022] Open
Abstract
This study aims to analyze the effects of Dry Needling (DN) for the release of myofascial trigger points (MTrPs) in the triceps surae muscles (TSM). A systematic review was performed up to February 2022 in PubMed, PEDro, Scopus, CENTRAL, and Web of Science. Selection criteria were studies involving subjects older than 18 years presenting MTrPs in the TSM, without any concomitant acute or chronic musculoskeletal conditions; DN interventions applied to the MTrPs of the TSM; and results on pain, range of motion (ROM), muscle strength, muscle stiffness, and functional outcomes. The PEDro scale was used to assess the methodological quality of the studies, and the Risk of Bias Tool 2.0 to assess risk of bias. A total of 12 studies were included in the systematic review, involving 426 participants. These results suggest that DN of MTrPs in TSM could have a positive impact on muscle stiffness and functional outcomes. There are inconclusive findings on musculoskeletal pain, ROM, and muscle strength. Significant results were obtained in favor of the control groups on pressure pain thresholds. Despite the benefits obtained on muscle stiffness and functional performance, the evidence for the use of DN of MTrPs in the TSM remains inconclusive.
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Affiliation(s)
- David Lucena-Anton
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Cadiz, 11009 Cadiz, Spain
| | - Carlos Luque-Moreno
- Department of Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain
- Correspondence:
| | - Jesus Valencia-Medero
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Cadiz, 11009 Cadiz, Spain
| | - Cristina Garcia-Munoz
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Cadiz, 11009 Cadiz, Spain
| | - Jose A. Moral-Munoz
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Cadiz, 11009 Cadiz, Spain
- Institute of Research and Innovation in Biomedical Sciences of the Province of Cadiz (INiBICA), University of Cadiz, 11009 Cadiz, Spain
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Midseason Screening for Groin Pain, Severity, and Disability in 101 Elite American Youth Soccer Players: A Cross-Sectional Study. Clin J Sport Med 2022; 32:501-507. [PMID: 34759181 DOI: 10.1097/jsm.0000000000000987] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 10/01/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To (1) systematically screen for groin pain and type in young elite soccer players and (2) assess whether hip and groin-related severity and disability differed between players with different levels of groin pain and tenderness. DESIGN Cross-sectional observational. SETTING Elite American soccer academy at midseason. PARTICIPANTS One hundred one academy soccer players (mean age 14.3 ± 1.8 years). INTERVENTION All players underwent clinical examinations to classify groin pain by the Doha agreement taxonomy. MAIN OUTCOME MEASURES Tests for groin-related severity and disability included the Copenhagen 5-second squeeze test, Copenhagen Hip and Groin Outcome Score (HAGOS), and Hip Outcome Score (HOS). Players were stratified into 3 groups: those with groin pain, those with tenderness, and those with no groin pain or tenderness. RESULTS Twenty-two players (22%) reported groin pain. Adductor-related groin pain was the most common (n = 14), followed by iliopsoas-related (n = 3), and pubic-related (n = 2). Multiple locations were present in 3 players. Thirty-nine players (39%) did not have groin pain but were tender to palpation in 1 or more structures related to the Doha agreement taxonomy. Copenhagen 5-second squeeze test differentiated between players with and without groin pain (groin pain vs tenderness group: P = 0.011; groin pain vs no groin pain group P < 0.001). Four HAGOS subscales (pain, symptoms, sport/recreation, and quality of life) differentiated between players with and without groin pain ( P < 0.05). CONCLUSIONS One in five academy soccer players experiences groin pain with adductor-related most common during a midseason screening. Both Copenhagen 5-second squeeze test and HAGOS subscales can differentiate between players with and without groin pain.
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Glasser L, Frey M, Frias GC, Varghese B, Melendez JX, Hawes JD, Escobar J, Katt BM. Ballet Rehabilitation: A Novel Return to Sport Protocol. Cureus 2022; 14:e27896. [PMID: 36120223 PMCID: PMC9467490 DOI: 10.7759/cureus.27896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/11/2022] [Indexed: 11/05/2022] Open
Abstract
Dance injuries and re-injuries are common but can be difficult to rehabilitate because of the unique demands and motor skills required. During tissue healing, pain resolves prior to tissue maturation and re-injury often occurs if the original injury is not properly rehabilitated. The purpose of this narrative review is to analyze the existing literature addressing ballet injury, re-injury, and recovery, and to provide clinicians with timing guidelines for entering and implementing a Return to Sport (RTS) ballet rehabilitation protocol designed to prevent re-injury by progressive, sport-specific tissue loading. Thus far, a literature-based ballet-specific and body region-specific late-stage rehabilitation RTS protocol has not been established. The authors sought to address this literature gap by combining this comprehensive narrative review with our extensive clinical expertise to develop a late-stage rehabilitation RTS protocol to help guide medical clinicians treating injured ballet dancers.
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Wang Y. Prevention of Physical Risk and Rehabilitation of Muscle Injury in Sanda Competition. Occup Ther Int 2022; 2022:9486697. [PMID: 35912306 PMCID: PMC9282994 DOI: 10.1155/2022/9486697] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/19/2022] [Accepted: 05/23/2022] [Indexed: 11/17/2022] Open
Abstract
The Target. The purpose of this study is to explore the reduction of sports injury risk and verify the effective methods and means of athlete's muscle injury rehabilitation. Methods. In this study, 80 sanda athletes from a university were randomly selected as subjects, and the main parts of injury of all subjects were counted. After 12 weeks of muscle injury rehabilitation intervention, the pain, acute injury, and technical and tactical evaluation levels of subjects in the intervention group and the control group were compared. Results/Discussion. The overall performance of the 80 subjects' basic exercise ability was at a moderate level, and there was no significant difference between male and female subjects (P >0.05). After 12 weeks of rehabilitation intervention, there was no significant difference in the scores of shoulder joint flexibility, supine straight leg raising, and trunk stable support between male and female subjects in the intervention group in more than 7 sports (P >0.05). In the control group, there were significant differences in the scores of shoulder flexibility and trunk stability of male and female subjects (P < 0.05). Future research should further explore the effect of muscle injury rehabilitation on effectively reducing potential sports injuries and introduce advanced and effective medical rehabilitation methods.
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Affiliation(s)
- Yong Wang
- School of Physical Education and Health, Hangzhou Normal University, Hangzhou, Zhejiang, China 311121
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McAleer S, Macdonald B, Lee J, Zhu W, Giakoumis M, Maric T, Kelly S, Brown J, Pollock N. Time to return to full training and recurrence of rectus femoris injuries in elite track and field athletes 2010-2019; a 9-year study using the British Athletics Muscle Injury Classification. Scand J Med Sci Sports 2022; 32:1109-1118. [PMID: 35332596 DOI: 10.1111/sms.14160] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 11/25/2021] [Accepted: 03/21/2022] [Indexed: 12/01/2022]
Abstract
Rectus femoris (RF) injuries are common in sports requiring maximal acceleration and sprinting. The British Athletics Muscle Injury Classification (BAMIC) describes acute muscle injury based on the anatomical site of injury and has been associated with return to play in hamstring and calf muscle injury. The aim of this study was to describe and compare the time to return to full training (TRFT) and injury recurrence for BAMIC-classified RF injuries sustained by elite track and field (T&F) athletes over a 9-year period. All rectus femoris injuries sustained by elite T&F athletes on the British Athletics World Class Program between September 2010 and September 2019 that were investigated with an MRI within 7 days of acute onset anterior thigh pain were included. Injuries were graded from the MRI by a specialist musculoskeletal radiologist using the BAMIC, and TRFT and injury recurrence were determined by evaluation of the Electronic Medical Record. Athlete demographics and World Athletics event discipline were recorded. Specific injury details including mechanism, location of injury, and whether surgical or rehabilitation management was undertaken were recorded. There were 38 RF injuries in 27 athletes (24.7 ± 2.3 years; 10 male, 17 female). Average TRFT for rehabilitation managed cases was 20.4 ± 14.8 days. Grade 1 injuries had significantly shorter TRFT compared with grades 2 (p = 0.04) and 3 (p = 0.01). Intratendinous (c) and surgically managed RF injuries each had significantly longer TRFT compared with other injury classes (p < 0.001). Myofascial (a) injuries had reduced repeat injury rates compared with b or c classes (p = 0.048). Grade 3 injuries had an increased repeat injury rate compared with other grades (p = 0.02). There were 4 complete (4c) proximal free tendon injuries sustained during sprinting and all in female athletes. The average TRFT for RF injuries in elite T&F is similar to that previously identified in elite football and Australian Rules. Similar to previous research in hamstring and calf injury, RF injuries extending into the tendon (BAMIC class c) had delayed TRFT which may reflect the longer duration required for tendon healing and adaptation. Grade 3 injuries had in increased repeat injury rate compared with grades 1 and 2. The BAMIC diagnostic framework may provide useful information for clinicians managing rectus femoris injuries in T&F.
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Affiliation(s)
| | - Ben Macdonald
- Wolverhampton Wanderers Football Club, Wolverhampton, UK
| | | | | | | | - Tanya Maric
- Chelsea and Westminster NHS Trust, London, UK.,King's College London, London, UK
| | | | | | - Noel Pollock
- University College London, London, UK.,The Royal Ballet, London, UK.,Institute of Sport, Exercise and Health, London, UK
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Rapid Spike in Hip Adduction Strength in Early Adolescent Footballers: A Study of 125 Elite Male Players From Youth to Senior. Int J Sports Physiol Perform 2022; 17:1407-1414. [PMID: 35534012 DOI: 10.1123/ijspp.2022-0025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 03/21/2022] [Indexed: 11/18/2022]
Abstract
PURPOSE To investigate the differences in hip adductor and abductor muscle strength in elite male footballers from youth to senior level. METHODS We tested 125 players from the under-13-years (U'13) to senior squads of a Danish male professional football club in this cross-sectional design study. Hip adductor and abductor force (in newtons), torque (in newton meters), normalized torque (in newton meters per body mass), and adduction-to-abduction ratio were measured using handheld dynamometry. RESULTS Between U'13 and senior level, adductor force increased by 104%, torque by 127%, and normalized torque by 21%. Abductor force increased by 78%, torque by 126%, and normalized torque by 17%. For incremental differences between age groups, significant increases were observed between the ages of U'13 to U'14 (18%-39%) and U'14 to U'15 (19%-33%) for all strength measures (P ≤ .021). No incremental difference was observed for adductor-to-abductor ratio. CONCLUSIONS The large increases in hip adductor and abductor strength occurring between the ages of U'13 and U'15 offer insight into the strength capabilities and stress demands in these players, which may relate to injury vulnerability, and facilitate clinicians in selecting best-suited exercise interventions.
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Garcia AG, Andrade R, Afonso J, Runco JL, Maestro A, Espregueira-Mendes J. Hamstrings injuries in football. J Orthop 2022; 31:72-77. [PMID: 35464813 PMCID: PMC9026901 DOI: 10.1016/j.jor.2022.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/08/2022] [Accepted: 04/09/2022] [Indexed: 11/15/2022] Open
Abstract
Background Hamstrings injuries are a major concern in football (soccer), affecting both recreational players and professional athletes. Although being a recognized issue within the football community, its incidence has been increasing over the last years and still poses a challenge to all practitioners involved. Study objectives and rationale The goal of this narrative review is to outline hamstrings injuries epidemiology and mechanisms of injury, identify and discuss its risk factors, provide an approach to a proper early diagnosis, evaluate the efficacy of current treatment options and return to sports, and present the best strategies for hamstrings injury prevention. These guidelines will help the sports medicine staff team on how to better manage their players with or at risk of hamstrings injuries. Conclusion Despite several breakthroughs in research of hamstrings injuries, there is still heterogeneity across studies and lack of consensus in regards to classification, diagnosis, treatment and prevention. Hamstrings injuries compromise the athlete's performance with time loss due to injury, shortens their highest-level career longevity with higher risk of reinjury rates, and is a defying problem for clubs to balance financial losses due to having their players off the pitch. Further research is warranted to keep moving forward with evidence on treating and preventing hamstrings injuries to mitigate its high incidence and keep the players safe.
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Affiliation(s)
- André Gismonti Garcia
- Casa de Saúde São José, Rio de Janeiro, Brazil
- Clínica Espregueira – FIFA Medical Centre of Excellence, Porto, Portugal
| | - Renato Andrade
- Clínica Espregueira – FIFA Medical Centre of Excellence, Porto, Portugal
- Dom Henrique Research Centre, Porto, Portugal
- Porto Biomechanics Laboratory (LABIOMEP), University of Porto, Porto, Portugal
| | - José Afonso
- Centre of Research, Education Innovation and Intervention in Sport (CIFI2D), Faculty of Sport, University of Porto, Portugal
| | | | - Antonio Maestro
- Instituto Asturiano de Traumatologia Real Sporting de Gijon, Gijon, Spain
- Corresponding author.
| | - 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, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Barco, Guimarães, Portugal
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Vermeulen R, Whiteley R, van der Made AD, van Dyk N, Almusa E, Geertsema C, Targett S, Farooq A, Bahr R, Tol JL, Wangensteen A. Early versus delayed lengthening exercises for acute hamstring injury in male athletes: a randomised controlled clinical trial. Br J Sports Med 2022; 56:792-800. [PMID: 35338036 PMCID: PMC9252858 DOI: 10.1136/bjsports-2020-103405] [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] [Accepted: 03/07/2022] [Indexed: 11/29/2022]
Abstract
Background To evaluate the efficacy of early versus delayed introduction of lengthening (ie, eccentric strengthening) exercises in addition to an established rehabilitation programme on return to sport duration for acute hamstring injuries in a randomised controlled superiority trial. Methods 90 male participants (age: 18–36 years, median 26 years) with an MRI-confirmed acute hamstring injury were randomised into an early lengthening (at day 1 of rehabilitation) group or a delayed lengthening (after being able to run at 70% of maximal speed) group. Both groups received an established rehabilitation programme. The primary outcome was time to return to sport (ie, time from injury to full unrestricted training and/or match play). The secondary outcome was reinjury rate within 12 months after return to sport. Other outcomes at return to sport included the Askling H-test, hamstring strength, clinical examination and readiness questions. Results The return to sport in the early lengthening group was 23 (IQR 16–35) days and 33 (IQR 23–40) days in the delayed lengthening group. For return to sport (in days), the adjusted HR for the early lengthening group compared with the delayed lengthening group was 0.95 (95% CI 0.56 to 1.60, p=0.84). There was no significant difference between groups for reinjury rates within 2 months (OR=0.94, 95% CI 0.18 to 5.0, p=0.94), from 2 to 6 months (OR=2.00, 95% CI 0.17 to 23.3, p=0.58), and 6 to 12 months (OR=0.57, 95% CI 0.05 to 6.6, p=0.66). Conclusion Accelerating the introduction of lengthening exercises in the rehabilitation of hamstring injury in male athletes did not improve the time to return to sport nor the risk of reinjury.
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Affiliation(s)
- Robin Vermeulen
- Department of Research, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar .,Academic Center for Evidence Based Sports Medicine, Amsterdam UMC Locatie AMC, Amsterdam, North Holland, The Netherlands
| | - Rod Whiteley
- Department of Physiotherapy, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Anne D van der Made
- Department of Research, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.,Academic Center for Evidence Based Sports Medicine, Amsterdam UMC Locatie AMC, Amsterdam, North Holland, The Netherlands.,Department of Orthopedic Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands.,Amsterdam Collaboration for Health and Safety in Sports (ACHSS), AMC/VUmc IOC Research Center, Amsterdam, The Netherlands
| | - Nicol van Dyk
- Department of Research, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.,Department of Physiotherapy, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.,High Performance Unit, Irish Rugby Football Union, Dublin, Ireland.,Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Emad Almusa
- Department of Radiology, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Celeste Geertsema
- Department of Sports Medicine, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Stephen Targett
- Department of Sports Medicine, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Abdulaziz Farooq
- Department of Research, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Roald Bahr
- Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo Sports Trauma Research Center, Oslo, Norway.,ASPREV, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Johannes L Tol
- Academic Center for Evidence Based Sports Medicine, Amsterdam UMC Locatie AMC, Amsterdam, North Holland, The Netherlands.,Department of Sports Medicine, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Arnlaug Wangensteen
- Department of Research, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.,Department of Physiotherapy, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.,Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo Sports Trauma Research Center, Oslo, Norway
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The Uptake of Nordic Hamstring Exercise Program for Injury Prevention in Major League Soccer and Its Barriers to Implementation in Practice. J Sport Rehabil 2022; 31:576-581. [PMID: 35272267 DOI: 10.1123/jsr.2021-0262] [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: 07/14/2021] [Revised: 12/01/2021] [Accepted: 01/04/2022] [Indexed: 11/18/2022]
Abstract
CONTEXT It is well demonstrated that Nordic hamstring (NH) program has poor compliance across European soccer clubs, but little is known about its implementation in Major League Soccer (MLS). The authors aimed to investigate MLS hamstring prevention practices and compliance with the NH program and understand the reasons for its inclusion or exclusion. DESIGN A cross-sectional electronic survey was completed by 24 of the 26 (92%) MLS top-division soccer clubs. METHODS The survey, based on the Reach, Efficacy, Adoption, Implementation, and Maintenance framework, was sent to team medical staff. Medical staff were also asked for opinions on barriers to implementation. RESULTS Eighteen clubs (75%) reported a formal hamstring injury prevention program, with eccentric exercises (94%; 95% CI [confidence interval], 74%-99%), high-speed running (94%; 95% CI, 74%-99%), and NH exercises (89%; 95% CI, 67%-97%) the most common strategies adopted. Fifteen clubs partially implemented the NH program, but only 5 (21%; 95% CI, 9%-40%) completed the full program and were classed as compliant. A total of 20 respondents reported that player perception and muscle soreness (83%; 95% CI, 64%-93%) were barriers to the implementation of the NH program. On a 5-point Likert scale, respondents "partially agreed" (4.13 [0.80]) that the NH exercise could substantially reduce injuries and would be "effective" at their own club (3.88 [0.61]). CONCLUSIONS The NH exercise was valued, but negative player perception and muscular soreness were identified as barriers to implementing the full program. Manipulation of volume and frequency should inform future "effectiveness" research to prospectively assess such modifications in the context of MLS.
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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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The Inclusion of a Complementary Running Progression Program in the Rehabilitation of Acute Hamstring Injuries: A Critically Appraised Topic. INTERNATIONAL JOURNAL OF ATHLETIC THERAPY AND TRAINING 2022. [DOI: 10.1123/ijatt.2021-0134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Introduction/Clinical Scenario: As many hamstring injuries occur when the hamstrings are in a lengthened state during the deceleration phase of running when the muscle is eccentrically contracting to slow the body down this functional aspect needs to be addressed. Thus, a rehabilitation program with a focus on progressive targeted eccentric hamstring exercises by gradually placing and exposing the muscle to eccentric force in a lengthened state supplemented with progressive running drills should be evaluated. Focused Clinical Question: Does the inclusion of a complementary running progression program for the rehabilitation of an acute hamstring injury reduce the time to safe return to sport with less hamstring reinjury occurrence for an athletic population? Summary of Key Findings: Three studies assessed the inclusion of a progressive running program with several types of running progression parameters addressed. Progressive running drills will load the hamstring in a functional manner, with a gradual increase in velocity of movement and lengthening of the muscle. Clinical Bottom Line: It appears that a complementary progressive running program within an acute hamstring rehabilitation program should be included as it caused no further harm and does not tend to increase hamstring reinjury occurrence. Strength of Recommendation: There is grade B evidence to include a complementary running progression program within an acute hamstring rehabilitation program.
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Juliano Eustaquio JM, Fontoura Borges AM, Vilela LS, Carvalho Gouveia MP, Rabelo AL, Kaleka CC, Debieux P, Barbosa Neto O. Does the Fight Profile Interfere with Orthopedic Injuries in Brazilian Jiu-Jitsu? Open Access J Sports Med 2021; 12:171-178. [PMID: 34803410 PMCID: PMC8594892 DOI: 10.2147/oajsm.s337912] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 11/03/2021] [Indexed: 01/10/2023] Open
Abstract
Purpose To evaluate the prevalence and characteristics of orthopedic injuries associated with the technical-tactical profiles of Brazilian Jiu-Jitsu (BJJ) fighters, according to the fighters’ graduation level (beginner and advanced). Patients and Methods Cross-sectional study, which included the participation of amateur and professional BJJ athletes, aged between 18 and 60 years and practitioners of the sport for at least six months. All answered a mixed self-reported morbidity questionnaire. Participants were divided into four groups, according to the technical-tactical profile in the fight (keeper and passer) and the fighter’s graduation level (beginner and advanced), and also into four subgroups, divided by joining the groups in pairs above. Descriptive and analytical statistical procedures were used, with a level of statistical significance set at 5% (p < 0.05). Results A total of 198 participants were included in the study. There was a higher prevalence of musculoskeletal injuries in advanced fighters (p<0.001), with no significant difference between the profiles of guard and passer fighters. Sprains were the most common type of injury in all studied groups and subgroups. The anatomical segments knee and shoulder, respectively, were the most affected in all groups, and both segments showed significant associations of the athletes in the advanced and guard groups. Conclusion The study showed important data for creation of specifics injury prevention protocols, through the higher prevalence of injuries in athletes of the advanced profile and in the segments of the knee and shoulder, with emphasis on the guard fighters.
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Affiliation(s)
- José Martins Juliano Eustaquio
- Exercise Science, Health and Human Performance Research Group, Graduate Program in Physical Education, Federal University of Triângulo Mineiro (UFTM - Universidade Federal do Triângulo Mineiro), Uberaba, MG, Brazil.,Department of Orthopedics and Traumatology, Mário Palmerio Hospital, University of Uberaba (UNIUBE - Universidade de Uberaba), Uberaba, MG, Brazil
| | - Alberto Martins Fontoura Borges
- Department of Orthopedics and Traumatology, Mário Palmerio Hospital, University of Uberaba (UNIUBE - Universidade de Uberaba), Uberaba, MG, Brazil
| | - Lorena Souza Vilela
- Department of Orthopedics and Traumatology, Mário Palmerio Hospital, University of Uberaba (UNIUBE - Universidade de Uberaba), Uberaba, MG, Brazil
| | - Matheus Pizarro Carvalho Gouveia
- Department of Orthopedics and Traumatology, Mário Palmerio Hospital, University of Uberaba (UNIUBE - Universidade de Uberaba), Uberaba, MG, Brazil
| | - Amanda Laruzo Rabelo
- Department of Orthopedics and Traumatology, Mário Palmerio Hospital, University of Uberaba (UNIUBE - Universidade de Uberaba), Uberaba, MG, Brazil
| | - Camila Cohen Kaleka
- Knee Surgery Group, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - Pedro Debieux
- Knee Surgery Group, Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.,Knee Surgery and Arthroscopy Group, Federal University of São Paulo (UNIFESP - Universidade Federal de São Paulo), São Paulo, SP, Brazil
| | - Octávio Barbosa Neto
- Exercise Science, Health and Human Performance Research Group, Graduate Program in Physical Education, Federal University of Triângulo Mineiro (UFTM - Universidade Federal do Triângulo Mineiro), Uberaba, MG, Brazil
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Ardern CL, Büttner F, Andrade R, Weir A, Ashe MC, Holden S, Impellizzeri FM, Delahunt E, Dijkstra HP, Mathieson S, Rathleff MS, Reurink G, Sherrington C, Stamatakis E, Vicenzino B, Whittaker JL, Wright AA, Clarke M, Moher D, Page MJ, Khan KM, Winters M. Implementing the 27 PRISMA 2020 Statement items for systematic reviews in the sport and exercise medicine, musculoskeletal rehabilitation and sports science fields: the PERSiST (implementing Prisma in Exercise, Rehabilitation, Sport medicine and SporTs science) guidance. Br J Sports Med 2021; 56:175-195. [PMID: 34625401 PMCID: PMC8862073 DOI: 10.1136/bjsports-2021-103987] [Citation(s) in RCA: 139] [Impact Index Per Article: 46.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2021] [Indexed: 02/01/2023]
Abstract
Poor reporting of medical and healthcare systematic reviews is a problem from which the sports and exercise medicine, musculoskeletal rehabilitation, and sports science fields are not immune. Transparent, accurate and comprehensive systematic review reporting helps researchers replicate methods, readers understand what was done and why, and clinicians and policy-makers implement results in practice. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement and its accompanying Explanation and Elaboration document provide general reporting examples for systematic reviews of healthcare interventions. However, implementation guidance for sport and exercise medicine, musculoskeletal rehabilitation, and sports science does not exist. The Prisma in Exercise, Rehabilitation, Sport medicine and SporTs science (PERSiST) guidance attempts to address this problem. Nineteen content experts collaborated with three methods experts to identify examples of exemplary reporting in systematic reviews in sport and exercise medicine (including physical activity), musculoskeletal rehabilitation (including physiotherapy), and sports science, for each of the PRISMA 2020 Statement items. PERSiST aims to help: (1) systematic reviewers improve the transparency and reporting of systematic reviews and (2) journal editors and peer reviewers make informed decisions about systematic review reporting quality.
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Affiliation(s)
- Clare L Ardern
- Musculoskeletal & Sports Injury Epidemiology Center, Sophiahemmet University, Stockholm, Sweden .,Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia.,Department of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada
| | - Fionn Büttner
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - Renato Andrade
- Clinical Research, Clínica do Dragão, Espregueira-Mendes Sports Centre - FIFA Medical Centre of Excellence, Porto, Portugal.,Dom Henrique Research Centre, Porto, Portugal
| | - Adam Weir
- Aspetar Sports Groin Pain Centre, Aspetar Orthopaedic & Sports Medicine Hospital, Doha, Qatar.,Department of Orthopaedics and Sports Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands.,Sport Medicine and Exercise Clinic Haarlem (SBK), Haarlem, The Netherlands
| | - Maureen C Ashe
- Department of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada.,Centre for Hip Health and Mobility, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sinead Holden
- SMI, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.,Center for General Practice, Aalborg University, Aalborg, Denmark
| | - Franco M Impellizzeri
- Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Eamonn Delahunt
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
| | - H Paul Dijkstra
- Sports Medicine, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar.,Department for Continuing Education, University of Oxford, Oxford, UK
| | - Stephanie Mathieson
- Institute for Musculoskeletal Health, Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Michael Skovdal Rathleff
- SMI, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.,Center for General Practice, Aalborg University, Aalborg, Denmark
| | - Guus Reurink
- Academic Center for Evidence Based Sports Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Catherine Sherrington
- Institute for Musculoskeletal Health, Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Emmanuel Stamatakis
- Charles Perkins Centre, School of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
| | - Bill Vicenzino
- University of Queensland School of Health and Rehabilitation Sciences: Physiotherapy, The University of Queensland, Brisbane, Queensland, Australia
| | - Jackie L Whittaker
- Department of Physical Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada.,Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Alexis A Wright
- Doctor of Physical Therapy Program, Tufts University School of Medicine, Tufts University, Boston, Massachusetts, USA
| | - Mike Clarke
- School of Medicine, Dentistry and Biomedical Sciences, Centre for Public Health, Queen's University, Belfast, UK
| | - David Moher
- Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Matthew J Page
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Karim M Khan
- Department of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada.,School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada.,Canadian Institutes of Health Research-Institute of Musculoskeletal Health, Vancouver, British Columbia, Canada
| | - Marinus Winters
- Center for General Practice, Aalborg University, Aalborg, Denmark
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Schaber M, Guiser Z, Brauer L, Jackson R, Banyasz J, Miletti R, Hassen-Miller A. The Neuromuscular Effects of the Copenhagen Adductor Exercise: A Systematic Review. Int J Sports Phys Ther 2021; 16:1210-1221. [PMID: 34631242 PMCID: PMC8486394 DOI: 10.26603/001c.27975] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 07/12/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Groin strains are one of the most common time-loss injuries in athletes. The Copenhagen Adductor Exercise (CAE) eccentrically strengthens the adductors and may function to prevent adductor strains, similar to the eccentric mechanism in which the Nordic Hamstrings exercise acts to prevent hamstring strains. OBJECTIVE The purpose of this study was to systematically review the literature on the CAE and its effects on adductor muscle strength and muscle activity in athletes. STUDY DESIGN Systematic Review. METHODS A systematic search of the literature was performed in the following databases: Pubmed; Medline (EBSCO); Sportdiscus; Scopus; Web of Science; CINAHL; Proquest; Cochrane Library; Physiotherapy Evidence Database (PEDro). Inclusion criteria consisted of 1) implements CAE, 2) includes athletes of any age participating in at least one sport, 3) study type is a cohort study or randomized control trial. Studies were excluded if they were not written in English or did not measure strength as an outcome. Data were extracted on eccentric hip adductor strength (EHAD), eccentric hip abductor strength (EHAB), EHAD:EHAB ratio, and electromyography (EMG) activity of the adductor muscles. Quality assessment was performed on all included studies using Quality Assessment Tool for Quantitative Studies. RESULTS Five articles were identified for inclusion, four of which received a strong rating, and one a moderate rating on the Quality Assessment Tool for Quantitative Studies. The CAE significantly increased EHAD in four of the four studies that examined it; significantly increased EHAB and EHAD:EHAB in three of the three studies that examined them, and increased the EMG activity of the adductors in the dominant leg 108%. CONCLUSION Overall, the CAE increases EHAD, EHAB, EHAD:EHAB, and EMG activity in the hip adductors in male soccer players. The increase in strength may reduce adductor muscle injuries, although more research needs to be done in this area to identify a clear relationship between the CAE and groin injury prevention. LEVEL OF EVIDENCE 1b.
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Ishøi L, Nielsen MF, Krommes K, Husted RS, Hölmich P, Pedersen LL, Thorborg K. Femoroacetabular impingement syndrome and labral injuries: grading the evidence on diagnosis and non-operative treatment-a statement paper commissioned by the Danish Society of Sports Physical Therapy (DSSF). Br J Sports Med 2021; 55:1301-1310. [PMID: 34531185 DOI: 10.1136/bjsports-2021-104060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2021] [Indexed: 11/03/2022]
Abstract
This statement summarises and appraises the evidence on diagnostic tests and clinical information, and non-operative treatment of femoroacetabular impingement (FAI) syndrome and labral injuries. We included studies based on the highest available level of evidence as judged by study design. We evaluated the certainty of evidence using the Grading of Recommendations Assessment Development and Evaluation framework. We found 29 studies reporting 23 clinical tests and 14 different forms of clinical information, respectively. Restricted internal hip rotation in 0° hip flexion with or without pain was best to rule in FAI syndrome (low diagnostic effectiveness; low quality of evidence; interpretation of evidence: may increase post-test probability slightly), whereas no pain in Flexion Adduction Internal Rotation test or no restricted range of motion in Flexion Abduction External Rotation test compared with the unaffected side were best to rule out (very low to high diagnostic effectiveness; very low to moderate quality of evidence; interpretation of evidence: very uncertain, but may reduce post-test probability slightly). No forms of clinical information were found useful for diagnosis. For treatment of FAI syndrome, 14 randomised controlled trials were found. Prescribed physiotherapy, consisting of hip strengthening, hip joint manual therapy techniques, functional activity-specific retraining and education showed a small to medium effect size compared with a combination of passive modalities, stretching and advice (very low to low quality of evidence; interpretation of evidence: very uncertain, but may slightly improve outcomes). Prescribed physiotherapy was, however, inferior to hip arthroscopy (small effect size; moderate quality of evidence; interpretation of evidence: hip arthroscopy probably increases outcome slightly). For both domains, the overall quality of evidence ranged from very low to moderate indicating that future research on diagnosis and treatment may alter the conclusions from this review.
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Affiliation(s)
- Lasse Ishøi
- Sports Orthopaedic Research Center-Copenhagen (SORC-C), Arthroscopic Center, Department of Orthopedic Surgery, Copenhagen University Hospital, Hvidovre Hospital, Hvidovre, Denmark
| | - Mathias Fabricius Nielsen
- Sports Orthopaedic Research Center-Copenhagen (SORC-C), Arthroscopic Center, Department of Orthopedic Surgery, Copenhagen University Hospital, Hvidovre Hospital, Hvidovre, Denmark
| | - Kasper Krommes
- Sports Orthopaedic Research Center-Copenhagen (SORC-C), Arthroscopic Center, Department of Orthopedic Surgery, Copenhagen University Hospital, Hvidovre Hospital, Hvidovre, Denmark
| | - Rasmus Skov Husted
- Physical Medicine & Rehabilitation Research - Copenhagen (PMR-C), Department of Orthopedic Surgery and Physical Therapy, Copenhagen University Hospital, Hvidovre, Denmark.,Department of Clinical Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Per Hölmich
- Sports Orthopaedic Research Center-Copenhagen (SORC-C), Arthroscopic Center, Department of Orthopedic Surgery, Copenhagen University Hospital, Hvidovre Hospital, Hvidovre, Denmark
| | | | - Kristian Thorborg
- Sports Orthopaedic Research Center-Copenhagen (SORC-C), Arthroscopic Center, Department of Orthopedic Surgery, Copenhagen University Hospital, Hvidovre Hospital, Hvidovre, Denmark
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da Cruz CBL, Sousa Filho LF, Lima DA, de Gois JI, de Oliveira ED. Effect of Phonophoresis and Copaiba Oil on Oxidative Stress Biomarkers after Skeletal Muscle Injury in Rats. ULTRASOUND IN MEDICINE & BIOLOGY 2021; 47:2657-2663. [PMID: 34243989 DOI: 10.1016/j.ultrasmedbio.2021.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 04/03/2021] [Accepted: 04/11/2021] [Indexed: 06/13/2023]
Abstract
The objective of this study was to analyze the effectiveness of phonophoresis with copaiba oil gel, in comparison to therapeutic pulsed ultrasound alone or topical application of copaiba oil gel, on oxidative stress after a traumatic muscle injury. Forty male Wistar rats were divided into five groups: control, muscle injury, therapeutic pulsed ultrasound (TPU), copaiba oil gel (CO) and TPU plus CO. TPU and CO application occurred at 2, 12, 24, 48, 72 and 96 h after injury. The gastrocnemius muscle was injured by mechanical trauma. Malondialdehyde (a lipoperoxidation marker) and superoxide dismutase and catalase (antioxidant enzymes) were assessed 98 h after muscle injury. All were elevated in the muscle injury group. There was a significant difference among treatment groups favoring TPU plus CO for reducing malondialdehyde levels, but all treatments reduced superoxide dismutase and catalase activity, with no between-groups difference. In conclusion, phonophoresis-the application of TPU plus CO-was superior to TPU or CO alone for reducing lipoperoxidation. Phonophoresis, TPU alone and CO were all effective in decreasing antioxidant enzyme activity after a traumatic skeletal muscle injury.
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Affiliation(s)
| | - Luis Fernando Sousa Filho
- Department of Physiotherapy, Federal University of Sergipe, São Cristovão, Brazil; Graduate Program in Physical Education, Federal University of Sergipe, São Cristovão, Brazil
| | - Diego Alves Lima
- Department of Physiotherapy, Federal University of Sergipe, São Cristovão, Brazil
| | - Joyce Izabel de Gois
- Department of Physiotherapy, Federal University of Sergipe, São Cristovão, Brazil
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Liu D. SCIENTIFIC PHYSICAL EXERCISE TO PREVENT MUSCLE INJURY IN COMPETITIVE SPORTS. REV BRAS MED ESPORTE 2021. [DOI: 10.1590/1517-8692202127082021_0380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Introduction: Various factors cause many sports traumas in groups engaged in mass sports activities, amateur sports training, and professional sports training in China that must be called to our attention. Objective: Scientific Sports Therapy is a scientific and reasonable systemic sports training program formulated for competitive athletes based on their physical and disease characteristics. Methods: This article conducted scientific sports therapy interventions on tennis elbow patients and analyzed multiple physiological indicators such as muscle endurance before and after the intervention. Results: There are significant differences in the athletes’ muscle strength and muscle endurance data after physical exercise therapy. Conclusion: We analyzed the causes of muscle damage and adopted scientific and practical sports therapy. In this way, coaches and athletes can find effective ways to prevent and manage muscle injuries, thereby improving competitive sports training. Level of evidence II; Therapeutic studies - investigation of treatment results.
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Affiliation(s)
- Delong Liu
- Xi'an International Studies University, China
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Krommes K, Jakobsen MD, Bandholm T, Andersen LL, Zebis M, Shield A, Hölmich P, Thorborg K. Cross-sectional Study of EMG and EMG Rise During Fast and Slow Hamstring Exercises. Int J Sports Phys Ther 2021; 16:1033-1042. [PMID: 34386282 PMCID: PMC8329323 DOI: 10.26603/001c.25364] [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: 11/28/2020] [Accepted: 02/21/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Hamstring injuries remain a major burden in football while the effective prevention exercise the Nordic Hamstring is poorly adopted, despite the added positive effects on performance. Better understanding of hamstring function during Nordic Hamstring compared to other exercises may provide better insight to the physiological adaptations of different types of hamstring curls. PURPOSE This cross-sectional study therefore aimed to compare the Nordic Hamstring curl with a conventional prone Leg Curl at different loads, and novel high velocity Hamstring Catches; in terms of peak normalized electromyographical activity (nEMG) and rate of electromyographic rise (RER) of Biceps Femoris long head, and angular velocity of the knee. STUDY DESIGN Cross-sectional study. METHODS Out of 28 participants enrolled, the final sample included 23 recreationally active male participants who attended a session for determining RM (repetition maximum) to establish loading (8 and 16RM for Hamstring Catches, and 8, 16 and 24RM for Leg Curl) and to familiarize themselves with the three different exercises (Nordic Hamstring, Leg Curl and Hamstring Catch), and a testing session >4 days after during which EMG data were collected during 3 repetitions of each exercise performed in a random order. RESULTS The Nordic Hamstring evoked higher RER (1091.8 nEMG/s) than Hamstring Catches (mean difference: 421 nEMG/s, p<0.0001) and Leg Curl (mean difference: 705 nEMG/s, p<0.001), and at the earliest numerical timepoint from onset of muscle contraction (the Nordic Hamstring: 6 ms; Hamstring Catches: 36-41 ms; Leg Curl: 12-14 ms). Hamstring Catches displayed high peak angular velocity (mean: 471°/s). There was no difference in peak nEMG, irrespective of load for Leg Curl (8, 16 or 24RM) or Hamstring Catches (8- or 16RM). CONCLUSION The Nordic Hamstring displayed the highest level muscle activity and most explosive recruitment characteristics with early and high rate of electromyographic rise, compared to even high velocity exercises, thus providing a possible mechanism by which it may increase performance and reduce injuries. LEVELS OF EVIDENCE 3. WHAT IS KNOWN ABOUT THE SUBJECT Early phase force and muscle recruitment have been linked to both performance and hamstring-related inhibition and fatiguability. However, the potential for different hamstring exercises to elicit explosive recruitment is unknown. WHAT THIS STUDY ADDS TO EXISTING KNOWLEDGE Early phase recruitment was higher and faster during the Nordic Hamstring exercise compared with conventional hamstring Leg Curl exercises with different loads and a high-velocity hamstring exercise. CLINICAL RELEVANCE The surprisingly fast and explosive recruitment characteristics during the Nordic Hamstring exercise suggests the possibility that this exercise have the potential to improve the rate of force development and perhaps counter the effects of hamstring-related inhibition and fatigue.
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Affiliation(s)
- Kasper Krommes
- Amager-Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark
| | | | - Thomas Bandholm
- Physical Medicine & Rehabilitation Research - Copenhagen (PMR-C), Department of Physical and Occupational Therapy, Department of Orthopaedic Surgery
| | | | - Mette Zebis
- Metropolitan University College, Copenhagen, Denmark
| | - Anthony Shield
- Queensland University of Technology, Brisbane, Australia
| | - Per Hölmich
- Amager-Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Kristian Thorborg
- Department of Orthopaedic Surgery, Sports Orthopedic Research Center - Copenhagen (SORC-C), Amager-Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark; Physical Medicine & Rehabilitation Research - Copenhagen (PMR-C), Department of Physical and Occupational Therapy, Department of Orthopaedic Surgery, Clinical Research Center, Amager-Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark
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Hamstring and Quadriceps Muscle Strength in Youth to Senior Elite Soccer: A Cross-Sectional Study Including 125 Players. Int J Sports Physiol Perform 2021; 16:1538-1544. [PMID: 33887700 DOI: 10.1123/ijspp.2020-0713] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 11/20/2020] [Accepted: 11/22/2020] [Indexed: 11/18/2022]
Abstract
PURPOSE Increasing age, high quadriceps strength, and low hamstring muscle strength are associated with hamstring strain injury in soccer. The authors investigated the age-related variation in maximal hamstring and quadriceps strength in male elite soccer players from under-13 (U-13) to the senior level. METHODS A total of 125 elite soccer players were included from a Danish professional soccer club and associated youth academy (first tier; U-13, n = 19; U-14, n = 16; U-15, n = 19; U-17, n = 24; U-19, n = 17; and senior, n = 30). Maximal voluntary isometric force was assessed for the hamstrings at 15° knee joint angle and for the quadriceps at 60° knee joint angle (0° = full extension) using an external-fixated handheld dynamometer. Hamstring-to-quadriceps strength (H:Q) ratio and hamstring and quadriceps maximal voluntary isometric force levels were compared across age groups (U-13 to senior). RESULTS Senior players showed 18% to 26% lower H:Q ratio compared with all younger age groups (P ≤ .026). Specific H:Q ratios (mean [95% confidence interval]) were as follows: senior, 0.45 (0.42-0.48); U-19, 0.61 (0.55-0.66); U-17, 0.56 (0.51-0.60); U-15, 0.59 (0.54-0.64); U-14, 0.54 (0.50-0.59); and U-13, 0.57 (0.51-0.62). Hamstring strength increased from U-13 to U-19 with a significant drop from U-19 to the senior level (P = .048), whereas quadriceps strength increased gradually from U-13 to senior level. CONCLUSION Elite senior soccer players demonstrate lower H:Q ratio compared with youth players, which is driven by lower hamstring strength at the senior level compared with the U-19 level combined with a higher quadriceps strength. This discrepancy in hamstring and quadriceps strength capacity may place senior-level players at increased risk of hamstring muscle strain injuries.
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DeLang MD, Garrison JC, Thorborg K. Screening to Detect Hip and Groin Problems in Elite Adolescent Football (Soccer) Players - Friend or Foe? Int J Sports Phys Ther 2021; 16:591-593. [PMID: 33842054 PMCID: PMC8016431 DOI: 10.26603/001c.21525] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 03/02/2021] [Indexed: 11/27/2022] Open
Abstract
Injury prevention strategies in team settings should not overlook early detection and secondary prevention. Monitoring systems may be an effective approach to detect common and troublesome injuries, such as hip and groin pain in football (soccer) players. The purpose of this International Perspective is to share our experiences with monitoring hip and groin pain in youth academy football and discuss challenges that surfaced. We consider why players may not accurately report pain, their perceptions of groin pain, and whether all groin pain is clinically meaningful. LEVEL OF EVIDENCE 5.
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Affiliation(s)
| | | | - Kristian Thorborg
- Sports Orthopedic Research Center Copenhagen (SORC-C), Department of Orthopedic Surgery, Amager-Hvidovre Hospital; Department of Clinical Medicine, University of Copenhagen
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Jakobsen JR, Krogsgaard MR. The Myotendinous Junction-A Vulnerable Companion in Sports. A Narrative Review. Front Physiol 2021; 12:635561. [PMID: 33841171 PMCID: PMC8032995 DOI: 10.3389/fphys.2021.635561] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 02/15/2021] [Indexed: 01/17/2023] Open
Abstract
The incidence of strain injuries continues to be high in many popular sports, especially hamstring strain injuries in football, despite a documented important effect of eccentric exercise to prevent strains. Studies investigating the anatomical properties of these injuries in humans are sparse. The majority of strains are seen at the interface between muscle fibers and tendon: the myotendinous junction (MTJ). It has a unique morphology with a highly folded muscle membrane filled with invaginations of collagen fibrils from the tendon, establishing an increased area of force transmission between muscle and tendon. There is a very high rate of remodeling of the muscle cells approaching the MTJ, but little is known about how the tissue adapts to exercise and which structural changes heavy eccentric exercise may introduce. This review summarizes the current knowledge about the anatomy, composition and adaptability of the MTJ, and discusses reasons why strain injuries can be prevented by eccentric exercise.
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Affiliation(s)
- Jens Rithamer Jakobsen
- Section of Sports Traumatology, M51, A Part of IOC Research Center, Bispebjerg and Frederiksberg Hospital, Copenhagen University Hospital, Copenhagen, Denmark
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Wan X, Li S, Best TM, Liu H, Li H, Yu B. Effects of flexibility and strength training on peak hamstring musculotendinous strains during sprinting. JOURNAL OF SPORT AND HEALTH SCIENCE 2021; 10:222-229. [PMID: 32795623 PMCID: PMC7987790 DOI: 10.1016/j.jshs.2020.08.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 06/13/2020] [Accepted: 07/10/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Hamstring injury is one of the most common injuries in sports involving sprinting. Hamstring flexibility and strength are often considered to be modifiable risk factors in hamstring injury. Understanding the effects of hamstring flexibility or strength training on the biomechanics of the hamstring muscles during sprinting could assist in improving prevention strategies and rehabilitation related to these injuries. The purpose of this study was to determine the effects of altering hamstring flexibility or strength on peak hamstring musculotendinous strain during sprinting. METHODS A total of 20 male college students (aged 18-24 years) participated and were randomly assigned to either a flexibility intervention group or a strength intervention group. Each participant executed exercise training 3 times a week for 8 weeks. Flexibility, sprinting, and isokinetic strength testing were performed before and after the 2 interventions. Paired t tests were performed to determine hamstring flexibility or strength intervention effects on optimal hamstring musculotendinous lengths and peak hamstring musculotendinous strains during sprinting. RESULTS Participants in the flexibility intervention group significantly increased the optimal musculotendinous lengths of the semimembranosus and biceps long head (p ≤ 0.026) and decreased peak musculotendinous strains in all 3 bi-articulate hamstring muscles (p ≤ 0.004). Participants in the strength-intervention group significantly increased the optimal musculotendinous lengths of all 3 hamstring muscles (p ≤ 0.041) and significantly decreased their peak musculotendinous strain during sprinting (p ≤ 0.017). CONCLUSION Increasing hamstring flexibility or strength through exercise training may assist in reducing the risk of hamstring injury during sprinting for recreational male athletes.
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Affiliation(s)
- Xianglin Wan
- Biomechanics Laboratory, Beijing Sport University, Beijing 100084, China
| | - Shangxiao Li
- Biomechanics Laboratory, Beijing Sport University, Beijing 100084, China
| | - Thomas M Best
- UHealth Sports Medicine Institute, University of Miami, Miami, FL 33136, USA
| | - Hui Liu
- Biomechanics Laboratory, Beijing Sport University, Beijing 100084, China
| | - Hanjun Li
- Biomechanics Laboratory, Beijing Sport University, Beijing 100084, China.
| | - Bing Yu
- Center for Human Movement Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7135, USA.
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Sconce E, Heller B, Maden-Wilkinson T, Hamilton N. Development of a Novel Nordic Hamstring Exercise Device to Measure and Modify the Knee Flexors' Torque-Length Relationship. Front Sports Act Living 2021; 3:629606. [PMID: 33718867 PMCID: PMC7943483 DOI: 10.3389/fspor.2021.629606] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 02/02/2021] [Indexed: 02/01/2023] Open
Abstract
The Nordic hamstring exercise (NHE) has been shown to reduce hamstring injury risk when employed in training programs. This study investigates a novel device to modify the NHE torque-length relationship of the knee flexors, as targeting the hamstrings at a more extended length may have benefits for hamstring strain injury prevention and rehabilitation. Eighteen recreational male participants completed three bilateral NHE repetitions at a conventional 0° flat position, a 10° incline, and a 10° decline slope on a novel device (HALHAM°). Measures of peak torque and break-torque angle explored the effect of inclination on the knee flexors' length-tension relationship. Relative thigh-to-trunk angle and angular velocity of the knee joint were used to assess influence of inclination on technique and exercise quality. Break-torque angle increased when performed at an incline (134.1 ± 8.6°) compared to both the decline (112.1 ± 8.3°, p <0.0001, g = 2.599) and standard flat NHE positions (126.0 ± 9.8°, p = 0.0002, g = 0.885). Despite this, altering inclination did not affect eccentric knee flexor peak torque (decline = 132.0 ± 63.1 Nm, flat = 149.7 ± 70.1 Nm, incline = 148.9 ± 64.9 Nm, F = 0.952, p = 0.389), angular velocity of the knee joint at break-torque angle (decline = 23.8 ± 14.4°, flat = 29.2 ± 22.6°, incline = 24.5 ± 22.6°, F = 0.880, p = 0.418) or relative thigh-to-trunk angle at break-torque angle (decline = 20.4 ± 10.4°, flat = 16.7 ± 10.8°, incline = 20.2 ± 11.2°, F = 1.597, p = 0.207). The report recommends the use of arbitrary metrics such as break-torque angle that can be replicated practically in the field by practitioners to assess proxy muscle length changes i.e., the angular range over which the torque can be produced. Inclination of the Nordic hamstring exercise leads to hamstring muscle failure at longer muscle lengths without reductions in the maximal force exuded by the muscle. Therefore, the NHE performed on an incline may be a more effective training intervention, specific to the proposed mechanism of hamstring strain injury during sprinting that occurs whilst the muscle is rapidly lengthening. Using a graded training intervention through the inclinations could aid gradual return-to-play rehabilitation.
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Affiliation(s)
- Emma Sconce
- Sports Engineering Research Group (SERG), Advanced Wellbeing Research Centre (AWRC), Sheffield Hallam University, Sheffield, United Kingdom
| | - Ben Heller
- Sports Engineering Research Group (SERG), Advanced Wellbeing Research Centre (AWRC), Sheffield Hallam University, Sheffield, United Kingdom
| | - Tom Maden-Wilkinson
- Physical Activity, Wellness and Public Health Research Group (PAWPH), Advanced Wellbeing Research Centre (AWRC), Sheffield Hallam University, Sheffield, United Kingdom
| | - Nick Hamilton
- Sports Engineering Research Group (SERG), Advanced Wellbeing Research Centre (AWRC), Sheffield Hallam University, Sheffield, United Kingdom
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De Blaiser C, Roosen P, Willems T, De Bleecker C, Vermeulen S, Danneels L, De Ridder R. The role of core stability in the development of non-contact acute lower extremity injuries in an athletic population: A prospective study. Phys Ther Sport 2020; 47:165-172. [PMID: 33302113 DOI: 10.1016/j.ptsp.2020.11.035] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 11/21/2020] [Accepted: 11/24/2020] [Indexed: 01/28/2023]
Abstract
OBJECTIVES Stability of the core is associated with lower extremity functioning. Consequently, impaired core stability might play a role in developing non-contact acute lower extremity sports injuries. The objective was to investigate components of core stability as potential risk factors for acute lower extremity injuries. DESIGN A cohort study was set up with a follow-up and injury registration period of 1.5 years. PARTICIPANTS 142 male and female physical education students were included. MAIN OUTCOME MEASURES Measures of isometric hip and core muscular strength, endurance, proprioception and neuromuscular control of the core, and postural control were taken at the start of the study. Sports-related injury occurrence was registered during follow-up. RESULTS 27 (19%) injuries of interest occurred during follow-up. After multivariate model building, a significant predictive effect was found for side-to-side hip abduction strength asymmetry (p = .007). The hazard of developing an acute lower extremity injury increased with 6.2% with a 1 unit increase in side-to-side strength imbalance, regardless of gender. CONCLUSION Hip abduction strength imbalance was determined as a risk factor for the development of non-contact, acute lower extremity injuries. Normalizing hip strength imbalances might be beneficial for injury prevention. However, further research is needed to support this claim.
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Affiliation(s)
- Cedric De Blaiser
- Department of Rehabilitation Sciences, Ghent University, 9000, Ghent, Belgium.
| | - Philip Roosen
- Department of Rehabilitation Sciences, Ghent University, 9000, Ghent, Belgium
| | - Tine Willems
- Department of Rehabilitation Sciences, Ghent University, 9000, Ghent, Belgium
| | - Camilla De Bleecker
- Department of Rehabilitation Sciences, Ghent University, 9000, Ghent, Belgium
| | - Stefan Vermeulen
- Department of Rehabilitation Sciences, Ghent University, 9000, Ghent, Belgium
| | - Lieven Danneels
- Department of Rehabilitation Sciences, Ghent University, 9000, Ghent, Belgium
| | - Roel De Ridder
- Department of Rehabilitation Sciences, Ghent University, 9000, Ghent, Belgium
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SPRINT PERFORMANCE IN FOOTBALL (SOCCER) PLAYERS WITH AND WITHOUT A PREVIOUS HAMSTRING STRAIN INJURY: AN EXPLORATIVE CROSS-SECTIONAL STUDY. Int J Sports Phys Ther 2020; 15:947-957. [PMID: 33344011 DOI: 10.26603/ijspt20200947] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background Hamstring strain injuries are common in many sports. Following a hamstring injury, deficits in peak and explosive strength may persist after return to sport potentially affecting sprint performance. Assessment of repeated-sprint ability is recognized as an important part of the return to sport evaluation after a hamstring injury.Purpose: This purpose of this exploratory cross-sectional study was to compare sprinting performance obtained during a repeated-sprint test between football players with and without a previous hamstring strain injury. Methods Forty-four fully active sub-elite football players, 11 with a previous hamstring strain injury during the preceding 12 months (cases; mean age, SD: 25.6 ± 4.4) and 33 demographically similar controls (mean age, SD: 23.2 ± 3.7), were included from six clubs. All players underwent a repeated-sprint test, consisting of six 30-meter maximal sprints with 90 seconds of recovery between sprints. Sprint performance was captured using high-speed video-recording and subsequently assessed by a blinded tester to calculate maximal sprint velocity, maximal horizontal force, maximal horizontal power, and mechanical effectiveness. Results A significant between-group difference was seen in favor of players having a previous hamstring injury over 6 sprints for maximal velocity (mean difference: 0.457 m/s, 95% CI: 0.059-0.849, p = 0.025) and mechanical effectiveness (mean difference: 0.009, 95% CI: 0.001-0.016, p = 0.020). Conclusion Repeated-sprint performance was not impaired in football players with a previous hamstring strain injury; in fact, higher mean maximal sprinting velocity and better mechanical effectiveness were found in players with compared to without a previous hamstring injury. The higher sprinting velocity, which likely increases biomechanical load on the hamstring muscles, in previously injured players may increase the risk of recurrent injuries. Level of evidence 3b.
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