Is larger eccentric utilization ratio associated with poorer rate of force development in squat jump? An exploratory study

This exploratory study examines the relationship between the eccentric utilization ratio (EUR) and the rate of force development (RFD) in squat jumps (SJ). EUR, a key metric in sports science, compares performance in countermovement jumps (CMJ) and squat jumps (SJ). The study hypothesizes that a higher EUR is associated with a poorer RFD in SJ. Basketball and soccer players, long-distance runners, alongside physical education students (209 men; age: 23.2 ± 4.95 years and 104 women; age: 22.7 ± 4.42 years) participated. The EUR was calculated from jump height, peak force and peak power. The results indicated a small to moderate but significant negative correlation between EUR based on peak force or peak power and RFD in SJ (r = -.41 and -.27), suggesting that a higher EUR might be linked to a diminished ability to rapidly develop force in SJ. Thus, a higher EUR may not indicate superior athletic performance.

The effects of taping in the management of primary dysmenorrhoea: A systematic review with meta-analysis

In this systematic review and meta-analysis, we explored the efficacy of taping as a non-pharmacological intervention for pain reduction in primary dysmenorrhoea (PD), a prevalent condition causing significant quality of life impairment. We conducted a comprehensive search across databases including PubMed, PEDro, and Web of Science to identify randomized controlled trials assessing taping's effectiveness in PD for pain relief. Our criteria focused on studies comparing taping to no intervention or alternatives, with pain outcomes primarily measured using the Visual Analogue Scale (VAS). The quality assessment utilized the PEDro scale, with scores ranging from 4 to 8, indicating a spectrum of moderate to high-quality evidence. The results indicate that both kinesiotaping (SMD = -1.22; 95 % CI: -2.15, -0.29; p = 0.01) and other tapes (SMD = -1.61, 95 % CI: -2.15, -0.65; p = 0.001) significantly reduces pain intensity in women with PD. However, the certainty of evidence was very low according to GRADE criteria. This underscores the necessity for further research to understand taping's analgesic mechanisms, its long-term effects, and its influence on related symptoms and overall quality of life. Our findings advocate for the inclusion of taping in PD management, offering a promising direction for enhancing care in affected women.

Effects of foam rolling on hamstrings stiffness in damaged and non-damaged muscle states

Introduction: The aim of this study was to examine the effects of foam rolling (FR) on hamstring muscles stiffness in both non-damaged and exercise-induced muscle damage (EIMD) states, using shear wave ultrasound elastography to measure changes in shear modulus. Methods: Fourteen healthy adults (25.5 ± 4.7 years) participated in a within-participant repeated measures design, with a 2-minute FR intervention applied on one leg and contralateral leg serving as a control. The damaging protocol encompassed maximal eccentric knee extensions performed on an isokinetic dynamometer and the Nordic hamstring exercise, consisting of 3 sets of 10 and 6 repetitions, respectively. Measurement were taken at baseline and then 1 h, 24 h and 48 h after the damaging protocol. Results: The results indicated no significant time × leg interaction for shear modulus in biceps femoris, semimembranosus, and semitendinosus muscles in both non-damaged and damaged states. Notably, there was a significant increase in biceps femoris (p = 0.001; η2 = 0.36) and semitendinosus (p < 0.001; η2 = 0.44) shear modulus after EIMD, but no significant differences were found between the FR and control leg, which was also the case for muscle soreness, range of motion, and passive resistive torque (p = 0.239-0.999 for interactions). Discussion: The absence of significant changes post-FR intervention suggests a limited role of short-duration FR in altering muscle stiffness during recovery from EIMD. These findings contribute to the understanding of FR's role in muscle recovery. Although this was not directly investigated, our results suggest a predominance of central mechanisms rather than direct mechanical modifications in muscle properties. This research highlights the necessity for additional investigations to explore how FR interventions influence muscles in different states and to elucidate the mechanisms underlying these influences.

Acute effects of static and proprioceptive neuromuscular facilitation stretching on hamstrings muscle stiffness and range of motion: a randomized cross-over study

This study aimed to compare the acute effects of static stretching (SS) and proprioceptive neuromuscular facilitation (PNF) stretching on hamstrings flexibility and shear modulus. Sixteen recreationally active young volunteers participated in a randomized cross-over study. Participants underwent an aerobic warm-up (WU), followed by either SS or PNF stretching. Range of motion (RoM) during passive straight leg raise and active knee extension, as well as shear modulus of the biceps femoris (BF) and semitendinosus (ST) muscles, were measured at baseline, post-WU, and post-stretching. Both stretching techniques significantly increased RoM, with no differences observed between SS and PNF (p < 0.001; η2 = 0.59-0.68). However, only PNF stretching resulted in a significant decrease in BF shear modulus (time×stretching type interaction: p = 0.045; η2 = 0.19), indicating reduced muscle stiffness. No changes in ST shear modulus were observed after either stretching technique. There was no significant correlation between changes in RoM and shear modulus, suggesting that the increase in RoM was predominantly due to changes in stretch tolerance rather than mechanical properties of the muscles. These findings suggest that both SS and PNF stretching can effectively improve hamstring flexibility, but PNF stretching may additionally reduce BF muscle stiffness. The study highlights the importance of considering individual muscle-specific responses to stretching techniques and provides insights into the mechanisms underpinning acute increases in RoM.

Differential Effects of Classical vs. Sports Massage on Erector Spinae and Upper Trapezius Muscle Stiffness: A Shear-Wave Elastography Study in Young Women

Classical and sports massages are commonly used interventions, but their comparative effects on muscle stiffness remain unclear. Classical massage is more general and uses light to moderate pressure, and its main purpose is relaxation. Sports massage, on the other hand, is more specialized and targets the unique needs of massaged individuals using moderate to firm pressure. This study aimed to evaluate the impacts of classical and sports massages on the stiffness of the erector spinae (ES) and upper trapezius (UT) muscles. Fifteen recreationally active young women, aged 22.9 ± 1.2 years, underwent a randomized cross-over study (with three conditions). Participants received either a five-minute classical or sports massage or a passive rest as a control on distinct days. Muscle stiffness was assessed using shear-wave elastography. The ES shear modulus displayed a significant time effect (p < 0.001; η2 = 0.515) without noticeable differences between the conditions, and the time × massage-type interactions approached statistical significance (F = 2.014; p = 0.073). There was also a large and statistically significant effect of the time on the UT (F = 11.127; p < 0.001; η2 = 0.443). We could not prove that classical and sports massages reduced muscle stiffness. The absence of significant differences might be attributed to the specific intervention parameters (massage duration of 5 min) and the small, only young women sample size. Given some tendencies towards significant effects, larger sample sizes are needed to further investigate this research question.

The Use of Shear-Wave Ultrasound Elastography in the Diagnosis and Monitoring of Musculoskeletal Injuries

Ultrasound elastography is a valuable method employed to evaluate tissue stiffness, with shear-wave elastography (SWE) recently gaining significance in various settings. This literature review aims to explore the potential of SWE as a diagnostic and monitoring tool for musculoskeletal injuries. In total, 15 studies were found and included in the review. The outcomes of these studies demonstrate the effectiveness of SWE in detecting stiffness changes in individuals diagnosed with Achilles tendinopathy, Achilles tendon rupture, rotator cuff rupture, tendinosis of the long head of the biceps tendon, injury of the supraspinatus muscle, medial tibial stress syndrome, and patellar tendinopathy. Moreover, SWE proves its efficacy in distinguishing variations in tissue stiffness before the commencement and after the completion of rehabilitation in cases of Achilles tendon rupture and patellar tendinopathy. In summary, the findings from this review suggest that SWE holds promise as a viable tool for diagnosing and monitoring specific musculoskeletal injuries. However, while the field of ultrasound elastography for assessing musculoskeletal injuries has made considerable progress, further research is imperative to corroborate these findings in the future.

Effects of 12-week full body resistance exercise on vertical jumping with and without military equipment in Slovenian Armed Forces

INTRODUCTION

Jumping ability is one of the most important physical qualities in military personnel. Previous training intervention studies have shown equivocal effects on jumping ability. In this study, we assessed the effect of a 12-week resistance exercise programme on countermovement jump (CMJ) performance with and without military equipment.

METHODS

Ninety-six members of the Slovenian Armed Forces (age range 20-47 years) were allocated to the intervention (n=65) and the control (n=32) group. The intervention group performed 2 sessions of full body resistance exercise per week for 12 weeks, while the control group continued with their regular training routine. Before and after the intervention, CMJ assessment using force plates was conducted with and without military equipment.

RESULTS

CMJ testing with and without equipment both exhibited high to excellent relative and absolute reliability. The intervention elicited statistically significant (p=0.011-0.026; η2=0.05-0.06), but small improvements in CMJ height when performed without equipment (from 28.2±3.8 cm to 29.5±3.3 cm) and with equipment (from 25.3±3.7 cm to 27.1±6.1). Other variables showed even smaller or trivial changes.

CONCLUSIONS

This study suggests that CMJ with equipment could be a reliable tool to assess jumping performance specific to requirements of military work, which would increase the ecological validity of the testing. The present structured full-body training intervention showed modest improvements in jumping ability in both testing conditions.

TRIAL REGISTRATION NUMBER

NCT0341546.

Which muscles exhibit increased stiffness in people with chronic neck pain? A systematic review with meta-analysis

Introduction

Chronic neck pain (CNP) substantially impacts quality of life, posing both personal challenges and economic strains. This systematic review sought to discern muscle-specific stiffness differences between CNP patients and individuals without CNP.

Methods

We searched the PubMed, Scopus, and PEDro databases for studies using ultrasound elastography or myotonometry to compare muscle stiffness between CNP patients and asymptomatic controls. Using a meta-analysis with a random-effects model, we derived the pooled effect as standardized mean difference (SMD).

Results

Out of the six studies selected, the adjusted Newcastle-Ottawa rating scale for cross-sectional studies denoted three as moderate-quality and three as high-quality. Our findings indicate that the upper trapezius (UT) stiffness was elevated in CNP patients compared to their counterparts without CNP (SMD = 0.39, 95% CI = 0.05 to 0.74; p = 0.03; small effect size). The data for other muscles remained inconclusive.

Discussion

Given the case-control design of all reviewed studies, a direct causative link between UT stiffness and CNP is yet to be confirmed. As such, recommending a reduction in trapezius muscle stiffness as a primary rehabilitation strategy for CNP patients is still inconclusive and further research is needed.

The relationship between elastography-based muscle properties and vertical jump performance, countermovement utilization ratio, and rate of force development

This study explored the relationships between passive muscle stiffness (shear modulus) and vertical jumping performance, countermovement utilization ratio (CUR) and rate of force development (RFD) in an attempt to unravel the mechanism that may explain the association between shear modulus and performance. 32 recreationally active participants (16 males, 16 females; age: 22.4 ± 5.1 years) participated. Shear modulus was assessed for the lateral and medial gastrocnemius (GL and GM), and vastus medialis (VM) and lateralis (VL) muscles using shear wave elastography. Squat jump (SJ) and countermovement (CMJ) jump were determined, with CUR being expressed as the ratio between the two. RFD in ankle and knee extension tasks was measured using isometric dynamometers. Our results suggest that within a heterogeneous group of recreational athletes, passive muscle stiffness is not related to RFD and jump performance, but positively related to CUR. In males, shear modulus of the GL was positively related to SJ height (r = 0.55). We also found inverse moderate correlations between VL and VM shear modulus and RFD in females only (r = -0.50 to -0.51), but this relationship was possibly affected by age and body fat content. Different mechanisms may underpin the association between shear modulus and performance depending on the muscle, task and population investigated.

Influence of unilateral and bilateral knee extension fatigue protocols on inter-limb asymmetries assessed through countermovement jumps

This study explores the sensitivity of jump type (unilateral and bilateral) and output variable (mean force, propulsive impulse, and jump height) to detect the changes in inter-limb asymmetries induced by unilateral and bilateral fatigue protocols. Thirty-eight individuals performed two testing sessions that consisted of (I) nine "pre-fatigued" countermovement jumps (CMJs; three bilateral and six unilateral [three with each leg]), (II) fatigue protocol and (III) nine "post-fatigued" CMJs. The testing sessions only differed in the fatigue protocol (five sets to failure against the 15-repetition maximum load using either the unilateral or bilateral knee extension exercise). The magnitude of all CMJ-derived variables (mean force, impulse, and jump height) decreased following both unilateral (p ≤ 0.002) and bilateral fatigue protocols (p ≤ 0.018). However, only unilateral protocol accentuated inter-limb asymmetries, which was detected for all variables during the unilateral CMJ (from -4.33% to -2.04%; all p < 0.05) but not during the bilateral CMJ (from -0.64% to 0.54%; all p > 0.05). The changes in inter-limb asymmetries following the unilateral and bilateral fatigue protocols were not significantly correlated between the unilateral and bilateral CMJs (r_s ≤ 0.172). The unilateral CMJ should be recommended for the testing purposes over the bilateral CMJ due to its greater sensitivity to detect the selective effects of fatigue.

Stretching and Releasing of Iliotibial Band Complex in Patients with Iliotibial Band Syndrome: A Narrative Review

Iliotibial band syndrome (ITBS) is one of the most common overuse syndromes causing knee pain; it is especially prevalent in runners and also common in cyclists, rowers, and field athletes, with occasional cases occurring in non-athletes too. ITBS symptoms can negatively affect not only knee function, but also mental and physical aspects of health-related quality of life. Although various conservative treatment options have been investigated and discussed, there is still no consensus on a standard of care for ITBS. Moreover, the literature on the etiology and risk factors of ITBS, which could help in selecting appropriate treatment methods, is conflicting and inconclusive. The role of individual treatment modalities such as stretching and releasing techniques has not been extensively studied and remains unclear. In this article, we will critically review the available evidence for the benefits of ITB stretching and "release" methods in the treatment of ITBS. In addition to the direct evidence (clinical studies examining the effects of ITB stretching and other methods that purportedly stretch or "release" the ITB), we present several additional lines of reasoning that discuss the rationale for ITB stretching/releasing in terms of the etiology of ITBS, the mechanical properties and behavior of the ITB, and the risk factors for ITBS development. We conclude that the current literature provides some evidence for the inclusion of stretching or other "release" methods in the early rehabilitation of ITBS. Long-term interventions typically include ITB stretching; however, it remains unclear to what extent stretching within a multimodal treatment actually contributes to resolving the symptoms. At the same time, there is no direct evidence to suggest that stretching and "release" methods have any negative effects.

Incidence and Duration of Sick Leave Due to Work-Related Musculoskeletal Disorders in the Accommodation and Food Services Activities Sector in Slovenia: A Nationwide 5-Year Observational Study

OBJECTIVES

The aim of this study was to analyze Slovenian data on sick leave (SL) due to the most common work-related musculoskeletal disorders (MSDs) among workers in sector I "accommodation and food services activities" from the NACE Rev2 classification.

METHODS

We investigated both SL incidence (i.e., number of cases) and disease severity (i.e., average SL duration) by body site, gender, age and divisions within the sector. In addition, trends in SL data (difference between 2015 and 2019) were analyzed. The effect of age group, gender and division was also assessed with relative risk (RR).

RESULTS

Female gender was associated with higher risk of MSDs in young (RR = 1.91 (1.53-2.43)) and older (RR = 2.24 (1.90-2.65)) subgroups. Older age was associated with greater SL incidence and longer SL duration, regardless of gender and division within sector I. This was also reflected in relative risk calculations between older and younger groups (females: RR = 4.43; CI = 3.75-5.01; p < 0.001; males: RR = 3.71; CI = 2.89-4.77; p < 0.001). Low back disorders were the most frequent cause for SL, while lower limb disorders tended to cause the longest average SL. The SL durations were similar across divisions within the sector, while the incidence rate tended to be higher in the "accommodation" than the "food and beverage services" division.

CONCLUSIONS

Special attention needs to be paid to reducing the risk of low back disorders, which are by far the most common cause of SL, and lower limb disorders, which cause the longest SL. We recommend the implementation of countermeasures that focus on early detection and rapid treatment/recovery of MSDs in older workers.

The prevalence and severity of sick-leaves due to musculoskeletal disorders among workers in water supply; sewerage, waste management and remediation activities

The aim of this study was to analyse the nationwide data on sick leaves (SL) due to work-related musculoskeletal disorders among Slovenian workers in section E "water supply; sewerage, waste management and remediation activities" from NACE Rev2 classification. We report both, SL frequency (ie, number of cases) and SL severity (ie, average SL duration), stratified by body region, gender, age and divisions within the section. In addition, trends in SL data (year 2015-2019 difference) were analyzed. Throughout the analysed years, ∼9,000 workers were employed in the section, with male to female ratio at ∼ 4:1. The major findings are as follows: (i) low back disorders were by far the most prevalent, however, the mean SL duration was the highest for lower limb disorders; (ii) older age was associated with increased SL frequency and duration, irrespective of gender; (iii) male gender was consistently associated with larger SL duration, while the data on SL frequency is inconclusive, as older females had more frequent SL than older males; (iv) the effect of division was relatively minor and the comparisons are limited due to large discrepancies regarding the number of workers across divisions; (v) a slight increasing trend for both SL frequency and duration was observed from 2015 to 2019. In conclusion, particular attention in terms of early diagnosis and treatment of musculoskeletal disorders should be given to male workers and older workers in general in section E.

Comparison of Vertical and Horizontal Reactive Strength Index Variants and Association With Change of Direction Performance

ABSTRACT

Šarabon, N, Kozinc, Ž, and Bishop, C. A comparison of vertical and horizontal reactive strength index variants and association with change of direction performance. J Strength Cond Res 37(1): 84-90, 2023-This study sought to investigate the interrelationship between different vertical and horizontal variants of reactive strength index (RSI) and change of direction (CoD) performance. Thirty-one male volleyball players (age: 22.4 ± 3.9 years) performed bilateral drop jumps (DJs), bilateral and unilateral countermovement jumps (CMJs), and triple hops for distance. The RSI was calculated as the ratio of jump height and contact time (DJ), jump height and time to takeoff (CMJ), flight time or hop distance and contact time (triple hop), and 505 CoD test. Reactive strength index obtained from DJ and CMJ tasks exhibited excellent trial-to-trial reliability (intraclass correlation coefficient [ICC] = 0.91-0.94), whereas triple hop-based RSI had only moderate reliability (ICC = 0.67-0.74). The relationships among different RSI variants were moderate to high (i.e., DJ to CMJ: r = 0.57-0.69, p ≤ 0.004; DJ to triple hop: r = 0.54-0.66, p ≤ 0.021; and CMJ to triple hop: r = 0.42-0.63, p ≤ 0.037). For the triple hop, the associations between RSI based on hop flight time and RSI based on hop distance were high for hop 1-2 (r = 0.77-0.83; p < 0.001) and very high for hop 2-3 (r = 0.91-0.92; p < 0.001). All RSI variants were in small to moderate negative correlation with 505 test performance (r = -0.38 to -0.45; p ≤ 0.042). The agreement in interlimb asymmetry direction between RSI from unilateral CMJ and triple hop RSI variables was slight to moderate (kappa coefficient = 0.06-0.36). In conclusion, although interrelationships between RSI variants were moderate to high, the direction of interlimb asymmetry was inconsistent, highlighting the notion of movement variability in limb dominance.

The Effects of Isometric Fatigue on Trunk Muscle Stiffness: Implications for Shear-Wave Elastography Measurements

Muscle stiffness has been implicated as a possible factor in low back pain risk. There are few studies on the effects of isometric fatigue on the shear modulus of trunk muscles. This study aimed to investigate the effects of trunk isometric fatigue on the passive and active (during low and high-level contractions) shear moduli of the erector spinae (ES) and superficial and deep multifidus (MF) muscles. We assessed passive and active shear modulus using shear-wave elastography in healthy young participants (n = 22; 11 males, 11 females), before and after an isometric trunk extension fatigue protocol. Maximal voluntary force decreased from 771.2 ± 249.8 N before fatigue to 707.3 ± 204.1 N after fatigue (-8.64%; p = 0.003). Passive shear modulus was significantly decreased after fatigue in the MF muscle (p = 0.006-0.022; Cohen's d = 0.40-46), but not the ES muscle (p = 0.867). Active shear modulus during low-level contraction was not affected by fatigue (p = 0.697-0.701), while it was decreased during high-level contraction for both muscles (p = 0.011; d = 0.29-0.34). Sex-specific analysis indicated the decrease in ES shear modulus was significant in males (p = 0.015; d = 0.31), but not in females (p = 0.140). Conversely, the shear modulus in superficial MF had a statistically significant decrease in females (p = 0.002; d = 0.74) but not in males (p = 0.368). These results have important implications for further investigations of the mechanistic interaction between physical workloads, sex, muscle stiffness (and other variables affecting trunk stability and neuromuscular control), and the development/persistence of low back pain.

Acute Effects of Beetroot Juice Supplementation on Isometric Muscle Strength, Rate of Torque Development and Isometric Endurance in Young Adult Men and Women: A Randomized, Double-Blind, Controlled Cross-Over Pilot Study

This study was conducted to investigate the effect of concentrated beetroot juice on isometric strength and knee extensor muscle endurance in healthy adults. We conducted a randomized cross-over, double-blind experiment in which participants (18 healthy, physically active adults, 9 men, 9 women) consumed either concentrated beetroot juice (140 mL) or low-nitrate control supplement 2.5 h before the measurement. Isometric maximum strength (peak torque), explosive strength (isometric rate of torque development), and strength endurance at 50% of peak torque were measured on an isometric dynamometer. The results showed that concentrated beetroot juice had no effect on the maximum voluntary isometric strength and rate of torque development of the knee extensors. The only exception was the maximum rate of torque development, for which a positive influence was demonstrated only in men. As for the endurance of the knee extensors, the supplement had a positive effect in men (endurance time increased from 86.4 ± 46.1 s to 103.4 ± 53.7 s; p = 0.022), but not in women. The absence of effect on maximal voluntary strength is consistent with previous research. One the other hand, improvements in endurance and rate of torque development in men only point to an important aspect of a previously under-researched area of sex-specific responses to nitrate supplementation.

The chronic effects of eccentric exercise interventions in different populations: an umbrella review

The effectiveness of eccentric exercise interventions (EEI) has been extensively explored in different populations. The aim of our umbrella review was to combine all systematic reviews about the chronic efficiency of EEI and to summarize the literature on the chronic effects of different types of eccentric exercise protocols, with or without extra loads and devices (e.g., Flywheel device), compared to other therapeutic interventions, exercise interventions, or no intervention. We screened four major electronic scientific databases (PubMed, Scopus, Web of Science, and PEDro), using one combined string for all included databases (eccentric exercise OR flywheel OR isoinertial exercise OR eccentric training). Included reviews needed to be based on any human population, that executed EEI in comparison with any other type of intervention. The methodological quality of the included reviews was assessed using AMSTAR 2 tool. Considering the inclusion criteria, we included 35 reviews. EEI were found suitable for chronic or long-term pain reduction in patient populations. EEI largely improved muscle performance (muscle strength, and muscle power), muscle architecture (e.g., pennation angle, fascicle length, cross-sectional area, muscle thickness, and muscle mass), decreased risk of injury, incidence, and severity of the injury, and increased range of motion of the joints There is less evidence about the effects of EEI in older adult populations, compared to athletes and younger populations, however, eccentric exercise seems promising for these populations as well.

Using Shear-Wave Elastography to Assess Exercise-Induced Muscle Damage: A Review

Shear-wave elastography is a method that is increasingly used to assess muscle stiffness in clinical practice and human health research. Recently, shear-wave elastography has been suggested and used to assess exercise-induced muscle damage. This review aimed to summarize the current knowledge of the utility of shear-wave elastography for assessment of muscle damage. In general, the literature supports the shear-wave elastography as a promising method for assessment of muscle damage. Increases in shear modulus are reported immediately and up to several days after eccentric exercise, while studies using shear-wave elastography during and after endurance events are showing mixed results. Moreover, it seems that shear modulus increases are related to the decline in voluntary strength loss. We recommend that shear modulus is measured at multiple muscles within a muscle group and preferably at longer muscle lengths. While further studies are needed to confirm this, the disruption of calcium homeostasis seems to be the primary candidate for the underlying mechanism explaining the increases in shear modulus observed after eccentric exercise. It remains to be investigated how well the changes in shear modulus correlate with directly assessed amount of muscle damage (biopsy).

Resistance Exercise for Improving Running Economy and Running Biomechanics and Decreasing Running-Related Injury Risk: A Narrative Review

It is well-accepted that at least a certain amount of resistance exercise (RE) is recommended for most endurance athletes. In this review, we aim to summarize the evidence regarding the effects of RE on running economy, running biomechanics, and running-related injury risk in endurance runners. The evidence robustly shows that lower limb RE is effective for improving running economy and performance, with a combination of strength and plyometric training being recommended to improve RE. Isometric training is also emerging as a possible alternative to implement during periods of high overall training load. Lower limb RE may change some aspects of joint kinematics during running; however, the evidence regarding the effects on kinetics is limited. Lower limb RE may help reduce running-related injury risk, but further evidence is needed.

Differences in Force-Velocity Profiles During Countermovement Jump and Flywheel Squats and Associations With a Different Change of Direction Tests in Elite Karatekas

The force-velocity (F-v) relationship has been proposed as a biomechanical characteristic to comprehensively evaluate neuromuscular capabilities within different tasks such as vertical jumping, sprinting and bench pressing. F-v relationship during flywheel (FW) squats was already validated, however, it was never compared to F-v profile of vertical jumps or associated with change of direction (CoD) performance. The aims of our study were (1) to compare F-v profiles measured during counter movement jumps (CMJs) and FW squats, (2) to determine correlations of F-v mechanical capacities with different CoD tests, (3) to investigate the portion of explained variance in CoD tests with the F-v outcome measures. A cross-sectional study was conducted on 39 elite karatekas. They performed CMJs and FW squats using progressive loads to calculate F-v profile outcome variables and different CoD tests (CoD at 90°, CoD at 180°, t-test, short karate specific test (KST) and long KST). Our results showed significantly higher values in all F-v outcome variables (F₀—theoretical maximal force, V₀—maximal unloaded velocity, P_max—maximal power output, F-v_slope—the slope of F-v relationship) calculated from CMJs compared to FW squats (all p < 0.01). Significant positive moderate correlations between the tasks were found for F₀ and P_max (r = 0.323–0.378, p = 0.018–0.045). In comparison to F-v outcome variables obtained in FW squats, higher correlations were found between F-v outcome variables calculated from CMJs and CoD tests. The only significant correlation in F-v outcome variables calculated from FW squats was found between P_max and short KST time. For all CoD tests, only one F-v predictor was included; more specifically—CMJ-F₀ for CoD 90°, CoD 180° and t-test, and FW-P_max for short KST performance. To conclude, our results showed that F-v relationship between CMJs and FW squats differed significantly and cannot be used interchangeably for F-v profiling. Moreover, we confirmed that high force and power production is important for the successful performance of general and karate specific CoD tasks.

The effects of eccentric exercise on passive hamstring muscle stiffness: Comparison of shear-wave elastography and passive knee torque outcomes

The aim of our study was to assess eccentric-exercise-induced changes in passive knee joint torque, passive knee joint stiffness and shear modulus at of the hamstring muscles. We hypothesized that eccentric exercise would elicit an increase in all outcomes. Fourteen healthy volunteers (age = 25.5±4.7 years) performed eccentric exercise protocol. Before and after 0h, 1h, 24h and 48h, we measured the shear modulus of hamstring muscles using shear-wave elastography and passive knee joint stiffness on isokinetic dynamometer. After eccentric exercise, the shear modulus of biceps femoris increased after 0h (22.4 ± 34.1 %; p = 0.021) and for semitendinosus after 0h (14.5 ± 4.9 %), 1h (16.2 ± 6.5 %) and 24h (16.6 ± 8.3 %) (p = 0.005-0.015). There were no changes for semimembranosus and no changes in passive knee joint moment measures. There were also no correlations between the two methods. Eccentric exercise increased shear modulus of hamstring muscles, while passive joint torque was not affected. This suggests that shear-wave elastography could be more sensitive than torque measures to intra-muscular changes induced by eccentric exercise.

Relationship between hip abductor strength, rate of torque development scaling factor and medio-lateral stability in older adults

BACKGROUND

Recently, the rate of torque development scaling factor (RTD-SF) has been proposed as a useful tool that could contribute to a more comprehensive insight into muscular capacity. While lower RTD-SF is associated with ageing and certain neuromuscular diseases, it remains unknown whether this novel measure is associated with the postural control in the older adults.

RESEARCH QUESTION

Are hip abductor muscle strength, RTD and RTD-SF associated with responses to external postural perturbations in medio-lateral direction in older adults?

METHODS

Twenty healthy older adults (14 females, 6 males) were assessed for hip abductor muscle strength, RTD and RTD-SF, using a custom-built dynamometer. Perturbations were applied at waist level (4 perturbation intensities, 15 repetitions each) using a wire-pull paradigm, with centre-of-pressure (CoP) being recorded with force plates. For each condition (i.e. perturbation intensity), medio-lateral displacement and velocity of the CoP were computed. For both parameters, within-individual variation (representing consistency of the responses), expressed by the standard deviation (SD) of CoP parameters was also considered. Pearson correlation coefficients were computed between parameters of hip muscle capacity and CoP responses and SD values of CoP responses.

RESULTS

RTD-SF was moderately positively related to the consistency of the responses of both CoP displacement and velocity (r = 0.53-0.56; p = 0.011-0.016) at the lowest level of the perturbation magnitude (15 N). No other statistically significant relationships were found (all r < 0.35).

SIGNIFICANCE

RTD-SF could play a role in preserving postural balance in older adults when low-intensity perturbations are applied. RTD-SF is a novel outcome measure that could represent an important alternative clinical tool to traditional strength assessments. It could represent a supplementary tool to assess the risk of falls, however, several limitations and ambiguities need to be resolved by future research before it can be utilized in practice.

Associations between lower limb eccentric muscle capability and change of direction speed in basketball and tennis players

Background

The ability to perform a quick and rapid change of direction (CoD) is an important determinant of success in a variety of sports. Previous studies have already highlighted that eccentric strength is a dominant predictor of CoD. However, these studies evaluated eccentric strength through a limited number of outcome measures and used small sample sizes.

Methods

A total of 196 athletes participated in the study. The aim of our study was to investigate: (1) the correlation between eccentric outcome measures derived from different tests (Nordic hamstring exercise (NHE), countermovement jump (CMJ) and flywheel (FW) squats), (2) the association between eccentric outcome measures and CoD 90°, CoD 180°; and (3) proportion of explained variance in CoD performance.

Results

Very large associations (r = 0.783, p < 0.001) were observed between peak torque during NHE (NHE_PT) and force impulse during the eccentric phase of CMJ (CMJ_FI). Small to moderate correlations were calculated between peak eccentric force in flywheel squats and peak eccentric force in CMJ (r = 0.220-035, p < 0002). All eccentric CMJ outcome measures and NHE_PT were reported as moderate negative associations with both CoD tests. Eccentric measures explained 25.1% of the variance in CoD 90° (CMJ_PF, NHE_PT, F_0.125 -peak eccentric force during FW squats with 0.125 kg m² load), while the same outcome measures explained 37.4% of the variance for CoD 180°.

Conclusion

Our results suggest that different measures of eccentric strength specifically contribute to CoD performance. Therefore, for successful CoD performance, different aspects of eccentric strength training should be considered in testing and training (maximal eccentric strength, eccentric-concentric actions with fast execution).

The Effect of Eccentric vs. Traditional Resistance Exercise on Muscle Strength, Body Composition, and Functional Performance in Older Adults: A Systematic Review With Meta-Analysis

The effects of eccentric exercise (ECC) in older adults have received limited scientific attention, considering the ample evidence for its effectiveness in general and athletic populations. The purpose of this paper is to review the effects of ECC exercise modalities vs. traditional or concentric (CON) exercise on muscle strength, body composition and functional performance in older adults. Inclusion criteria regarding the age was >55 years. Three major scientific literature databases (PubMed, Scopus and Web of Science) were screened for trials comparing the effect of ECC and CON exercise programs, and 19 papers were included in the meta-analysis. ECC and CON training programs were typically matched by the duration of each session. The difference between ECC and CON was expressed as standardized mean difference (SMD). Regarding isometric knee strength, the pooled effect favored ECC (SMD = 0.50), but was not statistically significant (p = 0.160). ECC exercise elicited greater improvements in timed up and go test (SMD = −0.68; p = 0.004), 2-min sit-stand test (SMD = 0.53; p = 0.030) and 30-s sit-stand test (SMD = 0.81; p = 0.002), but not in 6-min walking test (SMD = 0.01; p = 0.960). The effects on body composition and muscle architecture were unclear (SMD = −1.44 to 1.95; p = 0.060–0.689). In conclusion, our literature review indicates that ECC exercise is superior to, or at least as good as CON exercise for preserving health and overall function in older adults.

The Effects of Intermittent Trunk Flexion With and Without Support on Sitting Balance in Young Adults

Prolonged trunk flexion is known to affect passive and active stabilization of the trunk. Previous studies have evaluated changes in spinal range of motion, muscle activity and reflex behavior induced by prolonged trunk flexion, whereas the effect on sitting postural control is vastly underexplored. In this study, we compared the effects of supported and unsupported intermittent trunk flexion on center of pressure (CoP) motion during sitting on an unstable seat. Participants (n = 21; 11 males, 23.2 ± 2.0 years; 10 females, age 24.3 ± 4.0) were exposed to 1-h intermittent (60-s sets with 30 s of rest) trunk flexion (80% of the maximal range of motion) and CoP root mean square distance, velocity and frequency before and after the exposure were assessed. Contrary to our hypothesis, there were no main effects of exposure (pre. vs. post flexion protocol; p = 0.128–0.709), no main effects of condition (supported vs. unsupported; p = 0.134–0.931), and no interaction between exposure and condition (p = 0.163–0.912). Our results indicate that prolonged intermittent flexion does not induce any changes in CoP motion during a seated balance task, regardless of the presence of a trunk support during prolonged intermittent flexion. This suggests a successful compensation of decreased passive stiffness by increased reflex activity.

The association between reactive strength index and reactive strength index modified with approach jump performance

Jumping performance is one of the key components of volleyball game, thus evaluating jumping ability through different biomechanical variables offers opportunity for performance optimization. The aim of this study was to assess the associations between reactive strength index (RSI), reactive strength index modified (RSI_mod) and approach jump performance in male volleyball players. Forty volleyball players performed drop jump (DJ) form 40 cm high box, bilateral and unilateral countermovement jumps (CMJ) and approach jump. RSI in DJ was calculated as the ratio between jump height and ground contact time, while the RSI in CMJ tasks (RSI_mod) was calculated as ratio between jump height and jump time. Our results indicate that the relationships among different RSI variants and approach jump in volleyball players are moderate to strong (r = 0.42–0.73), with the highest correlations being observed for RSI_mod from bilateral CMJ (r = 0.676–0.727). Those observations are in line with the principle of movement specificity, which suggests that the best performance indicator should be the task that best resembles the demands of the sport-specific movements. Further research is needed to reveal more about the potential of implementing these findings for training optimization through monitoring RSI and RSI_mod values.

Interrater and Intrarater Reliability of the EasyForce Dynamometer for Assessment of Maximal Shoulder, Knee and Hip Strength

This study aimed to determine the interrater and intrarater reliability of EasyForce dynamometer for assessing shoulder, knee, and hip muscle strength in healthy young adults. Shoulder, knee, and hip maximal isometric strength were measured using the EasyForce in healthy adults (11 women and 12 men). Three repetitions of shoulder internal rotation, abduction, knee flexion, extension, and hip abduction and adduction were performed. The tests were performed by three raters on the same day. The results showed good to high inter- and intrarater reliability (intraclass correlation coefficient range: 0.63–0.91). Moreover, the absolute reliability of the EasyForce was slightly higher than acceptable for all tests (CV > 10%) except for hip abduction on the right leg (CV = 7.2%). The EasyForce dynamometer can be considered a reliable tool for assessing shoulder internal rotation and abduction, knee extension and flexion, as well as hip abduction and adduction strength. The EasyForce dynamometer showed no differences between the raters’ measurements, which could be of great importance for professionals who want to perform the tests regardless of their strength on the values.

Bilateral Deficit in Countermovement Jump and Its Influence on Linear Sprinting, Jumping, and Change of Direction Ability in Volleyball Players

We investigated the association between bilateral deficit (BLD) in the countermovement jump (CMJ) and change of direction (CoD) performance, CoD deficit, linear sprint, and approach jumping task. The participants (47 young volleyball players; age: 20.8 ± 3.8 years) performed bilateral and single-leg CMJs, modified T-test, 505 CoD test, 25-m sprints (with 5, 10, and 15 splits), and vertical approach jumps. The CoD deficit was also calculated from the 505 test and 10 m split time. BLD was calculated from CMJ jump height, peak power, and phase-specific force impulses (FIs). Several small to moderate statistically significant correlations (r = 0.42–0.49) were found between BLD and 505 times (7 correlations), sprint times (4 correlations), CoD deficit (1 correlation), and approach jump (1 correlation). T-test performance was not correlated with BLD variables (r = −0.15–0.22). The direction of the correlations indicated that the larger BLD is associated with superior performance, with the exception of 1 correlation for 505 times for the left leg and 1 for CoD deficit for the left leg. However, these two variables showed unacceptable reliability. Our results suggest that BLD could be useful in making decisions about the amount inclusion of unilateral training for volleyball players.

Effects of age, sex and task on postural sway during quiet stance

BACKGROUND

Postural sway during quiet standing has been shown as a useful task to assess risk of falling in older adults. While the risk of falling is consistently reported to be higher in older females than males, the sex-related differences in postural sway are not consistent across the studies.

RESEARCH QUESTION

What are the effects of age and sex on postural sway during quiet standing during different stance conditions?

METHODS

We examined the effects of age (40 young and 34 older adults), sex (37 males and 37 females), and their interaction on the postural sway during different stance conditions. We compared the center of pressure (CoP) velocity, amplitude and frequency during parallel (eyes open and eyes closed) and semi-tandem (eyes open) stances.

RESULTS

Our results suggest that postural sway is similar between sexes in young participants, while older males exhibit larger postural sway than older female participants (10/21 outcomes). Older female participants exhibited lower CoP amplitude (but larger total and anterior-posterior CoP velocity) compared to young female participants. We also found that the increase in the postural sway with increasing task difficulty is more pronounced in older vs. young adults.

SIGNIFICANCE

This study shows that ageing-related changes in postural sway are sex- and task-specific. Researchers and clinicians need to be aware of these effects when comparing groups or monitoring changes in time.

Postural Control in Unipedal Quiet Stance in Young Female Gymnasts and the Effects of Training with Consideration of Transient Behavior of Postural Sway

The purpose of this study was twofold: (a) to compare postural control between a group of young female gymnasts (n = 15; age: 11.2 ± 1.9 years) and non-trained peers (n = 15; age: 10.9 ± 2.0 years), and (b) to investigate the effect of an 8-week whole body exercise intervention program on postural control in young female gymnasts. Postural control was assessed by recording center of pressure (CoP) movements during unipedal quiet stance. Velocity and amplitude of CoP movement in anterior-posterior (AP) and medial-lateral (ML) directions were considered. In addition to common trial-averaged CoP outcomes, we also considered the transient behavior of CoP movements, by calculating relative differences between the 1st and 2nd, and the 1st and 3rd 10-s intervals within the whole trial (DIF_21 and DIF_31, respectively). The gymnast group had lower total CoP velocity (Cohen's d = 0.97) and AP amplitude (Cohen's d = 0.85), compared to their non-trained peers. The gymnasts also had lower CoP AP amplitude DIF21 (Cohen's d = 0.73), with almost constant values across all intervals. After the training ML CoP velocity was reduced for 13.12% (Cohen's d = 0.60), while ML CoP amplitude increased (Cohen's d = -0.89).

The reliability of wearable commercial sensors for outdoor assessment of running biomechanics: the effect of surface and running speed

The aim of this study was to investigate the reliability of running biomechanics assessment with a wearable commercial sensor (RunScribeTM). Participants performed multiple 200-m runs over sand, grass and asphalt ground at the estimated 5-km tempo, with an additional trial with 21-km tempo at the asphalt. Intra-session reliability was excellent for all variables at 5-km pace (intra-class coefficient correlation (ICC) asphalt: 0.90-0.99; macadam: 0.94-1.00; grass: 0.92-1.00), except for shock (good; ICC = 0.83), and contact time and total power output (moderate; ICC = 0.68-0.71). Coefficient of variation (CV) were mostly acceptable in all conditions, except for horizontal ground reaction force (GRF) rate in asphalt 5-km pace trial (CV = 24.5 %), power (CV = 14.3 %) and foot strike type (CV = 30.9 %) in 21-km pace trial, and horizontal GRF rate grass trial (CV = 15.7 %). Inter-session reliability was high or excellent for the majority of the outcomes (ICC≥0.85). Total power output (ICC = 0.56-0.65) and shock (ICC = 0.67-0.75) showed only moderate reliability across all conditions. Power (CV = 12.5-13.8 %), foot strike type (CV = 14.9-29.4 %) and horizontal ground reaction force rate (CV = 12.4-36.4 %) showed unacceptable CV.

Is the Shape of the Force-Time Curve Related to Performance in Countermovement Jump? A Review

Countermovement jump (CMJ) is frequently used to assess the neuromuscular capacity in athletes and track adaptations to training, typically through outcome variables such as jump height, peak/mean force, power or velocity, and rate of force development. Recently, there has been an increasing interest to analyze the shape of the force-time curve of the CMJ and its relationship to CMJ performance. This aim of the present review was to collect and analyze the available literature pertaining to this topic. One approach to analyze CMJ curve shape is to classify it as "unimodal" or "bimodal," based on the number of force peaks. The difference between athletes showing unimodal and bimodal curves is negligible in terms of jump height, while unimodal curves are associated with higher reactive strength index. Rather than the number of peaks, the most important characteristics that maximizes CMJ height seems to be the temporal alignment of peak force with the instant of the lowest center-of-mass position (i.e., when the jumper transitions from the braking to the propulsive phase). Other than bimodal/unimodal classification, the "shape factor" (the value of force impulse, divided by the area of the rectangular shape drawn around) has been emerging as another approach to assess CMJ curve shape; however, the studies exploring its relationship with performance are few and inconclusive.

The Prevalence and Severity of Sick Leave due to Low Back Disorders among Workers in Slovenia: Analysis of National Data across Gender, Age and Classification of Economic Activities

Musculoskeletal disorders are the most common work-related health problems. As low back disorders (LBD) are the most problematic, the aim of this study was to provide an in-depth analysis of the nationwide data on sick leaves due to work-related LBDs among workers in Slovenia in 2015-2019 by gender, age and various economic activities (NACE Rev 2 classification). We retrospectively analyzed the Slovene national data for sick leave (SL) rates due to the LBDs between 2015 and 2019. The analyzed SL outcomes were (i) index of temporary disability as a diagnosis-specific loss of calendar days (all calendar days except Sundays) per employee, (ii) frequency of spells as the number of SL cases per 100 employees in one year and (iii) severity as the average duration of one absence from work due to a health condition. A high prevalence of sick leaves due to LBDs in Slovenia was present among young male workers in "mining and quarrying". In the next age group (20.0-44.9 years), LBD is most frequent in "water supply; sewerage, waste management and remediation activities". Particular attention should be paid to ''agriculture, forestry and fishing'' which shows a large average sick leave duration and probably a more demanding course of LBDs.

The Association Between Force-Velocity Relationship in Countermovement Jump and Sprint With Approach Jump, Linear Acceleration and Change of Direction Ability in Volleyball Players

The force-velocity (FV) relationship allows the identification of the mechanical capabilities of musculoskeletal system to produce force, power and velocity. The aim of this study was to assess the associations of the mechanical variables derived from the FV relationship with approach jump, linear sprint and change of direction (CoD) ability in young male volleyball players. Thirty-seven participants performed countermovement jumps with incremental loads from bodyweight to 50–100 kg (depending on the individual capabilities), 25-m sprint with split times being recorded for the purpose of FV relationship calculation, two CoD tests (505 test and modified T-test) and approach jump. Results in this study show that approach jump performance seems to be influenced by maximal power output (r = 0.53) and horizontal force production (r = 0.51) in sprinting, as well as force capacity in jumping (r = 0.45). Only the FV variables obtained from sprinting alone contributed to explaining linear sprinting and CoD ability (r = 0.35–0.93). An interesting finding is that sprinting FV variables have similar and some even stronger correlation with approach jump performance than jumping FV variables, which needs to be considered for volleyball training optimization. Based on the results of this study it seems that parameters that refer to horizontal movement capacity are important for volleyball athletic performance. Further interventional studies are needed to check how to implement specific FV-profile-based training programs to improve specific mechanical capabilities that determine volleyball athletic performance and influence the specific physical performance of volleyball players.

The effects of leg preference and leg dominance on static and dynamic balance performance in highly-trained tennis players

In this study, 90 (51 males, 39 females) tennis players performed single-leg quiet stance and single-leg landing tasks. For the static standing task, center-of pressure (CoP) velocities, amplitudes, frequency and area were calculated. For the landing tasks, time to stabilization as well as dynamic postural stability index were considered. The analysis of differences between the legs was done based on two methods for a priori determination of leg preference, one based on the preference of kicking a ball and one based on the preference for single-leg jumping. An additional analysis was done based on the leg dominance (determined post hoc), based on the observed performance of the tasks. In case of the classification based on kicking a ball, there was a statistically significantly lower CoP anterior-posterior velocity and anterior-posterior amplitude in static balance task (p ≤ 0.017; 0.17 ≤ d ≤ 0.28) for the preferred leg. The CoP frequency was higher in the preferred leg for both directions (p ≤ 0.002; 0.10 ≤ d ≤ 0.22). For the landing task, CoP medial-lateral time to stabilization was statistically significantly shorter for the preferred leg (0.28 ± 0.38 s) compared to the non-preferred leg (0.47 ± 0.60 s) (p = 0.012; d = 0.38). There were no differences between the legs for the landing task. Moreover, there were no differences between the legs when we used the preference based on jumping for either of the tasks (d ≤ 0.14). The differences between legs in terms of observed dominance were larger than the differences based on the preference, which stresses the need for clear distinction of limb preference and limb dominance in research and practice. Regarding the effect of leg preference, small differences in static balance may exist between the legs (when the preference is based on kicking a ball).

Questionable Utility of the Eccentric Utilization Ratio in Relation to the Performance of Volleyball Players

The difference between squat jump (SJ) and countermovement jump (CMJ), termed eccentric utilization ratio (EUR), is frequently suggested as an outcome that can be used in athletic training design. Unlike performance in SJ and CMJ, which is associated with sports performance, the association between EUR and sports performance is almost unexplored. This study aimed to investigate whether EUR is associated with performance in approach jump, linear sprint and change of direction (CoD) tasks in volleyball players. Forty-five male volleyball players performed SJ, CMJ, 25 m linear sprint, approach jump and two CoD tasks (505 test and modified T-test). EUR was calculated based on jump height, peak power, peak force and average power. SJ and CMJ variables showed moderate to high correlation with approach jump performance (r = 0.42–0.70), small correlation with modified T-test (r = 0.33–0.40) and small to moderate correlation with sprint time (r = 0.35–0.49). EUR showed only small associations with performance variables (r = 0.31–0.34). In all linear regression models with performance outcomes as dependent variables, the CMJ height was always the only statistically significant predictor. Our results support the recent arguments that the EUR offers limited insight into the neuromuscular capabilities of athletes.

Establishing Reference Values for Isometric Knee Extension and Flexion Strength

Single-joint isometric and isokinetic knee strength assessment plays an important role in strength and conditioning, physical therapy, and rehabilitation. The literature, however, lacks absolute reference values. We systematically reviewed the available studies that assessed isometric knee strength. Two scientific databases (PubMed and PEDro) were searched for the papers that are published from the inception of the field to the end of 2019. We included studies that involved participants of both genders and different age groups, regardless of the study design, that involved isometric knee extension and/or flexion measurement. The extracted data were converted to body-mass-normalized values. Moreover, the data were grouped according to the knee angle condition (extended, mid-range, and flexed). A meta-analysis was performed on 13,893 participants from 411 studies. In adult healthy males, the pooled 95% confidence intervals (CI) for knee extension were 1.34–2.23Nm/kg for extended knee angle, 2.92–3.45Nm/kg for mid-range knee angle, and 2.50–3.06Nm/kg for flexed knee angle, while the CIs for flexion were 0.85–1.20, 1.15–1.62, and 0.96–1.54Nm/kg, respectively. Adult females consistently showed lower strength than adult male subgroups (e.g., the CIs for knee extension were 1.01–1.50, 2.08–2.74, and 2.04–2.71Nm/kg for extended, mid-range, and flexed knee angle condition). Older adults consistently showed lower values than adults (e.g., pooled CIs for mid-range knee angle were 1.74–2.16Nm/kg (male) and 1.40–1.64Nm/kg (female) for extension, and 0.69–0.89Nm/kg (male) and 0.46–0.81Nm/kg (female) for flexion). Reliable normative for athletes could not be calculated due to limited number of studies for individual sports.

The Effect of Fatigue on Single-Leg Postural Sway and Its Transient Characteristics in Healthy Young Adults

Neuromuscular fatigue is known to impair balance ability, which is reflected in increased postural sway during quiet standing tasks. Recently, quantifying transient characteristics of postural sway has been suggested as an approach to obtain additional information regarding postural control. However, this approach is currently vastly unexplored. The purpose of this study was to investigate the effects of fatigue (induced by a repeated change of direction task) on postural sway and its transient characteristics during single-leg standing, including whole-trial estimates and indexes of transient behavior in young healthy active adults. The study involved 28 physically active students (14 females). Single-leg postural sway was recorded for 30s before and after a fatiguing protocol, which consisted of a repeated change of direction tasks. We calculated the traditional whole-trial estimates of postural sway [center-of-pressure (CoP) velocity and amplitude in anterior-posterior (AP) and medial-lateral (ML) directions] and corresponding transient behavior indexes, based on three 10-s intervals. Statistically significant sex×fatigue interaction with medium effect sizes was found for whole-trial CoP velocity in AP (p=0.028; η²=0.17) and ML directions (p=0.019; η²=0.19). Post-hoc test showed that both variables substantially decreased in female participants (p=0.041–0.045; d=0.54–0.56), but remained similar in males (p=0.194–0.294). There were small to medium statistically significant main effects of fatigue on transient index for CoP amplitude in both directions (p=0.042–0.049; η²=0.02–0.14). Notably, CoP AP amplitude increased in the first 10-s interval for males (before fatigue: 5.6±1.3mm; after fatigue: 6.3±1.6mm), while the CoP AP amplitude in the third interval remained similar after fatigue (before fatigue: 5.5±1.4mm; after fatigue: 5.1±1.2mm). In conclusion, the responses to fatigue in terms of postural sway were time interval specific, and there were certain sex-differences in responses to fatigue, which could be related to better ability to adapt balance strategies in females. Moreover, our results demonstrate that the indexes of transient behavior could perhaps detect smaller fatigue-induced changes in postural sway that are seen in whole-trial estimates.

The relationship between lower limb maximal and explosive strength and change of direction ability: Comparison of basketball and tennis players, and long-distance runners

Change-of-direction (CoD) ability is an important determinant of athletic performance. Muscle strength is among the most important determinants of CoD ability. However, previous studies investigating the relationship between CoD ability and muscle strength focused mostly on flexor and extensor muscle groups, or used multi-joint exercises, such as jumps, squats or mid-thigh pull. The purpose of the present study was to investigate the relationship between CoD ability and strength of ankle, knee, hip and trunk maximal and explosive strength. The participants (n = 327), consisting of male and female basketball players, tennis players and long-distance runners completed isometric strength assessments and CoD testing (90° and 180° turn tests). The times of both CoD tests were associated with muscle strength (peak torques and the rate of torque development variables), with correlation coefficients being mostly weak to moderate (r = 0.2–0.6). Strength variables explained 33%, 62% and 48% of the variance in the 90° turn task, and 42%, 36% and 59% of the variance in the 180° turn task, in basketball players, long-distance runners and tennis players, respectively. Hip and trunk muscle strength variables were the most prevalent in the regression models, especially hip adduction and abduction strength. Our results suggest that the strength of several lower limb muscles, in particular of the hip abductors and adductors, and trunk muscles, but also hip rotators, extensors and flexors, as well as knee and ankle flexors and extensors should be considered when aiming to improve CoD performance.

Bilateral deficit in countermovement jump and its association with change of direction performance in basketball and tennis players

The purpose of this study was to assess the association between bilateral deficit (BLD) in countermovement jump and change of direction (CoD) performance. Therefore, 165 young basketball players (60 females) and 95 young tennis players (39 females) performed two different CoD tasks (90° and 180° turns) and bilateral and unilateral countermovement jumps. BLD was calculated based on jump height, peak power and several phase-specific force impulses (FI). For male athletes, several statistically significant small to moderate associations were found between the CoD performance and BLD (r = 0.21-0.52). While the BLD in the propulsive phase FI seems to be most consistently associated with CoD performance, all associations were weak (r = 0.21-0.28 in basketball, 0.28-0.36 in tennis). Associations between BLD in total positive (braking and propulsive phase) FI and CoD performance were moderate (r = 0.45-0.52) in male tennis players. For female athletes, the associations were even smaller and almost exclusively statistically non-significant. Although indirectly, our results imply that resistance training based on unilateral exercises could be useful to improve CoD performance. It has to be stressed that further training studies are needed to directly confirm this assumption.

The difference between squat jump and countermovement jump in 770 male and female participants from different sports

Traditionally, a larger difference between countermovement (CMJ) and squat jump (SJ) was seen as beneficial, as it reflects the ability to utilize the stretch-shortening cycle. However, strong arguments have been made that this might not always be the case, as larger differences between the jumps could also suggest higher muscle-tendon slack, or poor capability to take this slack up quickly. The purpose of this study was to explore SJ and CMJ, as well as the CMJ to SJ difference (CMJSJ_Diff) in 9 groups of young athletes. In total, 712 athletes from various disciplines (mean age range: 15.7-36.3 years) and 58 physical education students (mean age: 19.6 years) participated in the study. The major finding of this study was that the groups that showed better SJ and CMJ performance did not show the larger CMJSJ_Diff. For instance, SJ and CMJ heights were highest in short-distance runners and lowest in long-distance runners, while the largest and smallest CMJSJ_Diff was shown in physical education students and speed skaters, respectively. Male athletes had a higher CMJSJ_Diff than female athletes, but the difference was very small. While a larger CMJSJ_Diff has been traditionally associated viewed as positive, our results could indicate both superior ability to utilize the stretch-shortening cycle, as well as poor ability of rapid force development and excessive muscle slack. Further studies are needed to directly investigate the associations between CMJSJ_Diff and indicators of athletic performance.

Relationship between ankle strength and range of motion and postural stability during single-leg quiet stance in trained athletes

The aim of this study was to determine the relationship between strength of ankle plantar and dorsal flexors and range of motion (RoM), and body sway variables during single-leg quiet stance, in highly trained athletes. The participants for this study were young athletes from 9 disciplines (n = 655). Center of pressure (CoP) velocity, amplitude, and frequency were measured during single-leg quiet stance. Moreover, athletes were measured for passive ankle plantar flexion (PF) and dorsal flexion (DF) RoM, and for rate of torque development (RTD) in the 0–50 (RTD50) and 0–200 ms time windows (RTD200). Ankle strength and RoM could not predict CoP velocity total, anterior–posterior (AP), and medial–lateral (ML) (p > 0.05). However, PF_RTD50 and PF_RoM and PF_RoM positively influenced CoP amplitude in ML direction (p < 0.001, R² = 0.10). Moreover, CoP frequency in ML direction significantly increased with lower PF_RTD50, DF_RTD50, DF_RTD200, PF_RoM, and DF_RoM (p < 0.05). We have demonstrated that ankle strength and RoM were related to single-leg quiet stance postural balance in trained athletes. The ankle RoM showed the greatest influence on CoP variables in ML directions.

Trunk, Hip and Knee Exercise Programs for Pain Relief, Functional Performance and Muscle Strength in Patellofemoral Pain: Systematic Review and Meta-Analysis

Objective

Previous research suggests that muscle strength exercise is the most effective rehabilitation methods in patients with patellofemoral pain (PFP). This systematic review with meta-analysis compared the effects of Hip&Knee, Hip-only and Knee-only exercise programs on pain relief, muscle strength, and functional performance in patients with PFP.

Methods

Literature searches of PubMed, PEDro and CINAHL databases revealed twenty-one studies included in the final descriptive review, thirteen of which were included in the meta-analysis. Data extraction included baseline and post-intervention means and standard deviations of all eligible outcome measures both for the intervention and control groups, participants baseline demographics and intervention characteristics.

Results

The results showed that Hip&Knee and Hip-only exercise programs were comparatively effective, while the Knee-only exercise programs proved to be inferior to the above-mentioned approaches. The Hip&Knee exercise programs showed the greatest pain relief (mean difference = -1.71 (-3.11, -0.30); p = 0.02; I² = 96%) and functional improvement (standardized mean difference = 1.28 (0.45, 2.12); p = 0.003; I² = 84%), although the subgroup analysis did not show any significant difference compared to Hip-only exercise programs (p > 0.05).

Conclusion

Overall, Hip&Knee exercise programs appear to reduce pain and improve function more than other exercise programs and could be used as a primary rehabilitation approach in patients with PFP. However, the difference between the subgroups in most outcome measures suggests that Hip&Knee exercise programs are no more effective than Hip-only exercise programs.

Transient characteristics of body sway during single-leg stance in athletes with a history of ankle sprain

BACKGROUND

The role of the measurements of postural stability in the context of screening for ankle sprain risk is still equivocal. Transient characteristics of body sway have been suggested as an alternative or an improvement to traditional whole-trial analyses.

RESEARCH QUESTION

Are transient characteristics of body sway sensitive to the history of ankle sprain?.

METHODS

The assessment of 30-s single-leg body sway was performed on a group of 93 athletes from basketball, soccer, tennis and running who reported at least 1 ankle sprain in the last 12 months, while a group of 244 athletes from the same disciplines served as a control group without an ankle sprain reported for the same time period. We considered the mean center-of-pressure (CoP) velocity, CoP amplitude and CoP frequency. In addition to traditional whole-trial variables, we calculated the relative differences between the 1 st and the 2nd (DIF_21) and 1 st and 3rd (DIF_31) 10-s time intervals within the whole trial.

RESULTS

The indexes of transient characteristics of body sway (i.e., the DIF_21 and DIF_31) were in trivial or weak correlations with whole-trial variables (all r ≤ 0.29). Athletes with ankle sprain history exhibited smaller CoP ML velocity (p = 0.002) and larger CoP ML frequency (p = 0.001). In the injured group, the injured leg exhibited lower total and medial-lateral (ML) CoP velocity (p = 0.005-0.040), as well as lower CoP ML amplitude (p = 0.002) and higher CoP ML frequency (p = 0.010). The transient characteristics of body sway (DIF_21 and DIF_31) were very similar between the groups and between the injured and uninjured legs.

SIGNIFICANCE

Transient characteristics of body sway do not appear to differentiate the athletes with and without a history of ankle sprain. Further research is needed to confirm if the transient characteristics of body sway could be used for detection of risk of falls in older adults or assessment of athletic performance.

Human pressure tolerance and effects of different padding materials with implications for development of exoskeletons and similar devices

In this study, we assessed pressure tolerance in 16 healthy participants at the thigh, chest, and pelvic area, using different surfaces (1 cm², 20 cm² and different components, used in exoskeleton design), and the effects of different padding materials. Our results showed substantial variability in pressure tolerance among the participants, as well as lower pressure tolerance in females. Regarding the force applied with the exoskeleton components, male participants had higher discomfort threshold (230.3 ± 44.9 N compared to females (116.1 ± 24.6 N) in the chest area. For the applications with 20 cm² surface, the males also showed higher pain threshold at the thigh (89.3 ± 41.8 N vs. 34.6 ± 27.2 N) and the pelvis (97.6 ± 37.0 N vs. 56.1 ± 29.5 N). All padding materials increased pressure tolerance for 10-38% (p < 0.001), but little differences between materials were observed.

Reliability of Sprint Force-Velocity-Power Profiles Obtained with KiSprint System

This study aimed to assess the within- and between-session reliability of the KiSprint system for determining force-velocity-power (FVP) profiling during sprint running. Thirty (23 males, 7 females; 18.7 ± 2.6 years;) young high-level sprinters performed maximal effort sprints in two sessions separated by one week. Split times (5, 10, 20 and 30 m), which were recorded with a laser distance meter (a component of the KiSprint system), were used to determine the horizontal FVP profile using the Samozino's field-based method. This method assesses the FVP relationships through estimates of the step-averaged ground reaction forces in sagittal plane during sprint acceleration using only anthropometric and spatiotemporal (split times) data. We also calculated the maximal theoretical power, force and velocity capabilities and the slope of the FV relationship, the maximal ratio of horizontal-to-resultant force (RF), and the decrease in the RF (D_RF). Overall, the results showed moderate or good to excellent within- and between-session reliability for all variables (ICC > 0.75; CV < 10 %), with the exception of FV slope and D_RF that showed low relative reliability (ICC = 0.47-0.48 within session, 0.31-0.33 between-session) and unacceptable between-session absolute reliability values (CV = 10.9-11.1 %). Future studies are needed to optimize the protocol in order to maximize the reliability of the FVP variables, especially when practitioners are interested in the FV slope and D_RF. In summary, our results question the utility of the sprint-based FVP profiling for individualized training prescription, since the reliability of the FV slope and D RF variables is highly questionable.

Physical Abilities in Low Back Pain Patients: A Cross-Sectional Study with Exploratory Comparison of Patient Subgroups

An abundance of literature has investigated the association between low back pain (LBP) and physical ability or function. It has been shown that LBP patients display reduced range of motion, decreased balance ability, impaired proprioception, and lower strength compared to asymptomatic persons. The aim of this study was to investigate the differences between LBP patients and healthy controls in terms of several physical abilities. Based on the premised that different biomechanical and physiological causes and consequences could be related to different types of LBP, a secondary exploratory attempt of the study was to examine the differences between LBP subgroups based on the pain location (local or referred) or type of pathology (discogenic or degenerative) on the level of impairment of function and ability. Participants performed range of motion tests, trunk maximal voluntary contraction force tests, a sitting balance assessment, the timed up-and-go test, the chair rise test, and the trunk reposition error test. Compared to the control group, symptomatic patients on average showed 45.7% lower trunk extension (p < 0.001, η² = 0.33) and 27.7 % lower trunk flexion force (p < 0.001, η² = 0.37) during maximal voluntary contraction. LBP patients exhibited decreased sitting balance ability and lower scores in mobility tests (all p < 0.001). There were no differences between groups in Schober’s test and trunk repositioning error (p > 0.05). No differences were observed among the LBP subgroups. The exploratory analyses are limited by the sample size and uncertain validity of the diagnostic procedures within this study. Further studies with appropriate diagnostic procedures and perhaps a different subgrouping of the LBP patients are needed to elucidate if different types of LBP are related to altered biomechanics, physiology, and function.