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Bencke J. #Sportskongres: finally back in business! BMJ Open Sport Exerc Med 2023; 9:e001529. [PMID: 36660446 PMCID: PMC9843165 DOI: 10.1136/bmjsem-2022-001529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/23/2022] [Indexed: 01/15/2023] Open
Affiliation(s)
- Jesper Bencke
- Department of Orthopaedic Surgery, Copenhagen University Hospital, Copenhagen, Denmark
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2
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Shore J, Hutchison MG, Nalder E, Reed N, Hunt A. Tele-Active Rehabilitation for adolescents with concussion: a feasibility study. BMJ Open Sport Exerc Med 2022; 8:e001277. [PMID: 35309373 PMCID: PMC8886419 DOI: 10.1136/bmjsem-2021-001277] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives Active rehabilitation involving subsymptom threshold exercise and education/support promotes recovery among adolescents with concussion, but is typically delivered in-person, which limits accessibility. This study explored the feasibility of a remotely delivered Tele-Active Rehabilitation (Tele-AR) intervention for adolescents with concussion. Methods A precase–postcase series design was used. Three adolescents (ages 14–17 years) experiencing postconcussion symptoms ≥2 weeks postinjury participated with a parent. The Tele-AR intervention was a 6-week programme supervised by a rehabilitation clinician through weekly videoconferencing appointments and included (1) aerobic exercise, (2) coordination drills and (3) comprehensive education and support. Feasibility indicators included rates of recruitment, retention, adherence, as well as adolescent and parent ratings of technology usability using an adapted Telehealth Usability Questionnaire and satisfaction using the Client Satisfaction Questionnaire-8. Prechanges to postchanges in postconcussion symptoms, illness perceptions, and occupational performance and satisfaction were also assessed. Results Rates of recruitment (n=3/4) and retention (n=3/3) achieved success criteria. Adherence was high among all participants (77%–100%), and there were no adverse events. Participant ratings of technology usability and satisfaction approached 90%. All participants reported improvements in postconcussion symptoms and illness perception. Clinically significant positive changes were also observed in occupational performance and satisfaction. Conclusions The Tele-AR intervention appears feasible in a small group of adolescents with concussion, and positive changes were observed in postconcussion symptoms, illness perception and occupational performance. Further study is warranted to evaluate the efficacy of this approach, which may enable access to care that supports recovery in adolescents with concussion.
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Affiliation(s)
- Josh Shore
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - Michael G Hutchison
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
| | - Emily Nalder
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Nick Reed
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Anne Hunt
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
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3
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Riquier O, Vuillemin A, Van Hoye A. PERSISTE: a mixed methods protocol to identify barriers and levers to a sustainable physical activity practice among patients with chronic disease after physical activity resumption programs. BMJ Open Sport Exerc Med 2022; 8:e001261. [PMID: 35070353 PMCID: PMC8744104 DOI: 10.1136/bmjsem-2021-001261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/24/2021] [Indexed: 11/04/2022] Open
Abstract
Physical activity (PA) has evidence-based benefits for physical, social and mental health, but investigation of how PA interventions for patients with chronic disease affects their PA practice up to 1 year after programmes are rare. Moreover, few studies document how the context and intervention mechanisms of PA programmes affect sustainable PA practice and its determinants. The present protocol describes a mixed methods study comparing the effectiveness and conditions for the effectiveness of two PA resumption programmes (a hospital-led and a community-based programme). Using a comparative longitudinal study, 60 patients (3-month duration) will be followed for 1 year though four data collections: before (T0) and at the end (T1) of the intervention, 6 months (T2) and 1 year (T3) after the start of the programme. The primary outcome will be PA practice in min/week and categorised as light, moderate or vigorous (using International Physical Activity Questionnaire (IPAQ)), and secondary outcomes will include sedentary time in min/week (IPAQ), quality of life evaluated though the physical and mental composite scores ('Medical Outcome Study Short Form 12'), and enjoyment using four statements rated from 1 to 5, a high score being synonymous of enjoyment (Intrinsic Motivation Inventory). Qualitative data on further determinants of PA practice and intervention mechanisms will be collected. The expected results will offer the opportunity to understand how the intervention context contributes to a more effective, sustainable PA practice. Trial registration number: NCT04954209.
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Affiliation(s)
| | - Anne Vuillemin
- LAHMESS, Université Côte d'Azur, Nice, Provence-Alpes-Côte d'Azur, France
| | - Aurélie Van Hoye
- APEMAC, Université de Lorraine, Nancy, France.,Physical Education and Sport Sciences Department, University of Limerick, Limerick, Ireland
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4
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Gabbett T, Sancho I, Dingenen B, Willy RW. When progressing training loads, what are the considerations for healthy and injured athletes? Br J Sports Med 2021; 55:947-948. [PMID: 33837004 DOI: 10.1136/bjsports-2020-103769] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2021] [Indexed: 11/04/2022]
Affiliation(s)
- Tim Gabbett
- Gabbett Performance Solutions, Brisbane, Queensland, Australia .,Centre for Health Research, University of Southern Queensland, Ipswich, Queensland, Australia
| | - Igor Sancho
- Sports and Exercise Medicine, Queen Mary University of London, London, UK.,Physiotherapy Department, University of Deusto, San Sebastian, Spain
| | - Bart Dingenen
- Reval Rehabilitation Research Centre, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
| | - Richard W Willy
- Physical Therapy and Movement Science, University of Montana Missoula, Missoula, Montana, USA
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5
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Eggerding V, Reijman M, Meuffels DE, van Es E, van Arkel E, van den Brand I, van Linge J, Zijl J, Bierma-Zeinstra SM, Koopmanschap M. ACL reconstruction for all is not cost-effective after acute ACL rupture. Br J Sports Med 2021; 56:24-28. [PMID: 33737313 PMCID: PMC8685656 DOI: 10.1136/bjsports-2020-102564] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2021] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To conduct a cost-utility analysis for two commonly used treatment strategies for patients after ACL rupture; early ACL reconstruction (index) versus rehabilitation plus an optional reconstruction in case of persistent instability (comparator). METHODS Patients aged between 18 and 65 years of age with a recent ACL rupture (<2 months) were randomised between either an early ACL reconstruction (index) or a rehabilitation plus an optional reconstruction in case of persistent instability (comparator) after 3 months of rehabilitation. A cost-utility analysis was performed to compare both treatments over a 2-year follow-up. Cost-effectiveness was calculated as incremental costs per quality-adjusted life year (QALY) gained, using two perspectives: the healthcare system perspective and societal perspective. The uncertainty for costs and health effects was assessed by means of non-parametric bootstrapping. RESULTS A total of 167 patients were included in the study, of which 85 were randomised to the early ACL reconstruction (index) group and 82 to the rehabilitation and optional reconstruction group (comparator). From the healthcare perspective it takes 48 460 € and from a societal perspective 78 179 €, to gain a QALY when performing early surgery compared with rehabilitation plus an optional reconstruction. This is unlikely to be cost-effective. CONCLUSION Routine early ACL reconstruction (index) is not considered cost-effective as compared with rehabilitation plus optional reconstruction for a standard ACL population (comparator) given the maximum willingness to pay of 20 000 €/QALY. Early recognition of the patients that have better outcome of early ACL reconstruction might make rehabilitation and optional reconstruction even more cost-effective.
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Affiliation(s)
- Vincent Eggerding
- Orthopedics, Erasmus Medical Center, Rotterdam, Zuid-Holland, The Netherlands
| | - Max Reijman
- Orthopedics, Erasmus Medical Center, Rotterdam, Zuid-Holland, The Netherlands
| | | | - Eline van Es
- Orthopedics, Erasmus Medical Center, Rotterdam, Zuid-Holland, The Netherlands
| | - Ewoud van Arkel
- Orthopedics, Medisch Centrum Haaglanden, Den Haag, Zuid-Holland, The Netherlands
| | - Igor van den Brand
- Orthopedics, Elisabeth-TweeSteden Ziekenhuis, Tilburg, Noord-Brabant, The Netherlands
| | - Joost van Linge
- Orthopedics, Reinier de Graaf Gasthuis, Delft, Zuid-Holland, The Netherlands
| | - Jacco Zijl
- Department of Orthopaedic Surgery, Sint Antonius Hospital, Nieuwegein, The Netherlands
| | - Sita Ma Bierma-Zeinstra
- Department of General Practice and Orthopedics, Erasmus Medical Center, Rotterdam, Zuid-Holland, The Netherlands
| | - Marc Koopmanschap
- Institute for Medical Technology Assessment (iMTA), Erasmus University Rotterdam, Rotterdam, Zuid-Holland, The Netherlands
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6
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Nugent FJ, Vinther A, McGregor A, Thornton JS, Wilkie K, Wilson F. The relationship between rowing-related low back pain and rowing biomechanics: a systematic review. Br J Sports Med 2021; 55:bjsports-2020-102533. [PMID: 33397675 DOI: 10.1136/bjsports-2020-102533] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Low back pain (LBP) is common in rowers. Understanding rowing biomechanics may help facilitate prevention and improve rehabilitation. OBJECTIVES To define the kinematics and muscle activity of rowers and to compare with rowers with current or LBP history. DESIGN Systematic review. DATA SOURCES EMBASE, MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Web of Science and Scopus from inception to December 2019. Grey literature was searched. STUDY ELIGIBILITY CRITERIA Experimental and non-experimental designs. METHODS Primary outcomes were kinematics and muscle activity. Modified Quality Index (QI) checklist was used. RESULTS 22 studies were included (429 participants). Modified QI score had a mean of 16.7/28 points (range: 15-21). Thirteen studies investigated kinematics and nine investigated muscle activity. Rowers without LBP ('healthy') have distinct kinematics (neutral or anterior pelvic rotation at the catch, greater hip range of motion, flatter low back spinal position at the finish) and muscle activity (trunk extensor dominant with less flexor activity). Rowers with LBP had relatively greater posterior pelvic rotation at the catch, greater hip extension at the finish and less efficient trunk muscle activity. In both groups fatigue results in increased lumbar spine flexion at the catch, which is greater on the ergometer. There is insufficient evidence to recommend one ergometer type (fixed vs dynamic) over the other to avoid LBP. Trunk asymmetries are not associated with LBP in rowers. CONCLUSION Improving clinicians' and coaches' understanding of safe and effective rowing biomechanics, particularly of the spine, pelvis and hips may be an important strategy in reducing incidence and burden of LBP.
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Affiliation(s)
- Frank James Nugent
- Physical Education and Sport Sciences Department, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
- Sport and Human Performance Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Anders Vinther
- Department of Physiotherapy and Occupational Therapy, Herlev Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Alison McGregor
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Jane S Thornton
- Western Centre for Public Health and Family Medicine, University of Western Ontario, London, Ontario, Canada
| | - Kellie Wilkie
- Bodysystem Physiotherapy, Hobart, Tasmania, Australia
| | - Fiona Wilson
- Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, Dublin, Ireland
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7
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Breda SJ, Oei EHG, Zwerver J, Visser E, Waarsing E, Krestin GP, de Vos RJ. Effectiveness of progressive tendon-loading exercise therapy in patients with patellar tendinopathy: a randomised clinical trial. Br J Sports Med 2020; 55:501-509. [PMID: 33219115 PMCID: PMC8070614 DOI: 10.1136/bjsports-2020-103403] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To compare the effectiveness of progressive tendon-loading exercises (PTLE) with eccentric exercise therapy (EET) in patients with patellar tendinopathy (PT). METHODS In a stratified, investigator-blinded, block-randomised trial, 76 patients with clinically diagnosed and ultrasound-confirmed PT were randomly assigned in a 1:1 ratio to receive either PTLE or EET. The primary end point was clinical outcome after 24 weeks following an intention-to-treat analysis, as assessed with the validated Victorian Institute of Sports Assessment for patellar tendons (VISA-P) questionnaire measuring pain, function and ability to play sports. Secondary outcomes included the return to sports rate, subjective patient satisfaction and exercise adherence. RESULTS Patients were randomised between January 2017 and July 2019. The intention-to-treat population (mean age, 24 years, SD 4); 58 (76%) male) consisted of patients with mostly chronic PT (median symptom duration 2 years). Most patients (82%) underwent prior treatment for PT but failed to recover fully. 38 patients were randomised to the PTLE group and 38 patients to the EET group. The improvement in VISA-P score was significantly better for PTLE than for EET after 24 weeks (28 vs 18 points, adjusted mean between-group difference, 9 (95% CI 1 to 16); p=0.023). There was a trend towards a higher return to sports rate in the PTLE group (43% vs 27%, p=0.13). No significant between-group difference was found for subjective patient satisfaction (81% vs 83%, p=0.54) and exercise adherence between the PTLE group and EET group after 24 weeks (40% vs 49%, p=0.33). CONCLUSIONS In patients with PT, PTLE resulted in a significantly better clinical outcome after 24 weeks than EET. PTLE are superior to EET and are therefore recommended as initial conservative treatment for PT.
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Affiliation(s)
- Stephan J Breda
- Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, Zuid-Holland, The Netherlands .,Department of Orthopaedics and Sports Medicine, Erasmus MC, Rotterdam, Zuid-Holland, The Netherlands
| | - Edwin H G Oei
- Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, Zuid-Holland, The Netherlands
| | - Johannes Zwerver
- Centre for Human Movement Sciences, University Medical Centre Groningen, Groningen, The Netherlands.,Sports Valley, High Performance Medical Centre, Gelderse Vallei Hospital, Ede, Gelderland, The Netherlands
| | - Edwin Visser
- Department of Physical Therapy, Sportgeneeskunde Rotterdam, Rotterdam, Zuid-Holland, The Netherlands
| | - Erwin Waarsing
- Department of Orthopaedics and Sports Medicine, Erasmus MC, Rotterdam, Zuid-Holland, The Netherlands
| | - Gabriel P Krestin
- Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, Zuid-Holland, The Netherlands
| | - Robert-Jan de Vos
- Department of Orthopaedics and Sports Medicine, Erasmus MC, Rotterdam, Zuid-Holland, The Netherlands
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8
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Löllgen H, Bachl N, Papadopoulou T, Shafik A, Holloway G, Vonbank K, Jones NE, Bigard X, Niederseer D, Meyer J, Muniz-Pardos B, Debruyne A, Zupet P, Steinacker JM, Wolfarth B, Bilzon JLJ, Ionescu A, Dohi M, Swart J, Badtieva V, Zelenkova I, Casasco M, Geistlinger M, Di Luigi L, Webborn N, Singleton P, Miller M, Pigozzi F, Pitsiladis YP. Recommendations for return to sport during the SARS-CoV-2 pandemic. BMJ Open Sport Exerc Med 2020; 6:e000858. [PMID: 34192007 PMCID: PMC10577793 DOI: 10.1136/bmjsem-2020-000858] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
In this viewpoint we make specific recommendations that can assist and make the return to sport/exercise as safe as possible for all those impacted - from the recreational athlete to the elite athlete. We acknowledge that there are varying rules and regulations around the world, not to mention the varying philosophies and numerous schools of thought as it relates to return to sport/exercise and we have been cognisant of this in our recommendations. Despite the varying rules and circumstances around the world, we believe it is essential to provide some helpful and consistent guidance for return to training and sport for sport and exercise physicians around the world at this most difficult time. The present viewpoint provides practical and medical recommendations on the resumption to sport process.
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Affiliation(s)
- Herbert Löllgen
- European Federation of Sports Medicine Associations (EFSMA), Lausanne, Switzerland
| | - Norbert Bachl
- European Federation of Sports Medicine Associations (EFSMA), Lausanne, Switzerland
- Institute of Sports Science, University of Vienna, Vienna, Austria
- Austrian Institute of Sports Medicine, Vienna, Austria
- International Federation of Sports Medicine (FIMS), Lausanne, Switzerland
| | - Theodora Papadopoulou
- European Federation of Sports Medicine Associations (EFSMA), Lausanne, Switzerland
- International Federation of Sports Medicine (FIMS), Lausanne, Switzerland
- British Association of Sport and Exercise Medicine, Doncaster, UK
- Defence Medical Rehabilitation Centre, Loughborough, UK
| | - Andrew Shafik
- South Tyneside NHS Foundation Trust, Sunderland, UK
- Newcastle Thunder Rugby, Newcastle, UK
| | - Graham Holloway
- British Association of Sport and Exercise Medicine, Doncaster, UK
| | - Karin Vonbank
- Department of Pneumology, Pulmonary Function Laboratory, Medicine Clinic (KIMII), University of Vienna, Vienna, Austria
| | - Nigel Edward Jones
- British Association of Sport and Exercise Medicine, Doncaster, UK
- British Cycling, Manchester, UK
- University of Liverpool, Liverpool, UK
| | - Xavier Bigard
- European Federation of Sports Medicine Associations (EFSMA), Lausanne, Switzerland
- International Federation of Sports Medicine (FIMS), Lausanne, Switzerland
- Union Cycliste Internationale (UCI), Aigle, Switzerland
| | | | | | - Borja Muniz-Pardos
- GENUD (Growth, Exercise, Nutrition and Development), University of Zaragoza, Zaragoza, Spain
| | - Andre Debruyne
- European Federation of Sports Medicine Associations (EFSMA), Lausanne, Switzerland
- International Federation of Sports Medicine (FIMS), Lausanne, Switzerland
| | - Petra Zupet
- European Federation of Sports Medicine Associations (EFSMA), Lausanne, Switzerland
- International Federation of Sports Medicine (FIMS), Lausanne, Switzerland
- Institute of Medicine and Sports, Ljubljana, Slovenia
| | - Jürgen M Steinacker
- European Federation of Sports Medicine Associations (EFSMA), Lausanne, Switzerland
- International Federation of Sports Medicine (FIMS), Lausanne, Switzerland
- Division of Sports and Rehabilitation Medicine, Ulm University Hospital, Ulm, Germany
| | - Bernd Wolfarth
- International Federation of Sports Medicine (FIMS), Lausanne, Switzerland
- Department of Sport Medicine, Humboldt University and Charité University School of Medicine, Berlin, Deutschland, Germany
| | - James Lee John Bilzon
- International Federation of Sports Medicine (FIMS), Lausanne, Switzerland
- British Association of Sport and Exercise Medicine, Doncaster, UK
- Department for Health, University of Bath, Bath, UK
| | - Anca Ionescu
- European Federation of Sports Medicine Associations (EFSMA), Lausanne, Switzerland
| | - Michiko Dohi
- International Federation of Sports Medicine (FIMS), Lausanne, Switzerland
- Sport Medical Center, Japan Institute of Sports Sciences, Tokyo, Japan
| | - Jeroen Swart
- International Federation of Sports Medicine (FIMS), Lausanne, Switzerland
- UCT Research Unit for Exercise Science and Sports Medicine, University of Cape Town (UCT), Cape Town, South Africa
| | - Victoriya Badtieva
- International Federation of Sports Medicine (FIMS), Lausanne, Switzerland
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
- Moscow Research and Practical Centre for Medical Rehabilitation, Restorative and Sports Medicine, Moscow Healthcare Department, Moscow, Russian Federation
| | - Irina Zelenkova
- GENUD (Growth, Exercise, Nutrition and Development), University of Zaragoza, Zaragoza, Spain
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
| | - Maurizio Casasco
- European Federation of Sports Medicine Associations (EFSMA), Lausanne, Switzerland
- International Federation of Sports Medicine (FIMS), Lausanne, Switzerland
- Italian Federation of Sports Medicine (FMSI), Rome, Italy
| | - Michael Geistlinger
- International Federation of Sports Medicine (FIMS), Lausanne, Switzerland
- Unit International Law, Department of Constitutional, International and European Law, University of Salzburg, Salzburg, Austria
| | - Luigi Di Luigi
- International Federation of Sports Medicine (FIMS), Lausanne, Switzerland
- Unit of Endocrinology, Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Rome, Italy
| | - Nick Webborn
- School of Sport and Service Management, Eastbourne, UK
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | | | - Mike Miller
- World Olympians Association, Lausanne, Switzerland
| | - Fabio Pigozzi
- European Federation of Sports Medicine Associations (EFSMA), Lausanne, Switzerland
- International Federation of Sports Medicine (FIMS), Lausanne, Switzerland
- University of Rome “Foro Italico”, Rome, Italy
- FIFA Medical Center of Excellence, Villa Stuart Sport Clinic, Rome, Italy
| | - Yannis P Pitsiladis
- European Federation of Sports Medicine Associations (EFSMA), Lausanne, Switzerland
- International Federation of Sports Medicine (FIMS), Lausanne, Switzerland
- Collaborating Centre of Sports Medicine, University of Brighton, Eastbourne, UK
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Richardson E, Lewis JS, Gibson J, Morgan C, Halaki M, Ginn K, Yeowell G. Role of the kinetic chain in shoulder rehabilitation: does incorporating the trunk and lower limb into shoulder exercise regimes influence shoulder muscle recruitment patterns? Systematic review of electromyography studies. BMJ Open Sport Exerc Med 2020; 6:e000683. [PMID: 32405430 PMCID: PMC7202723 DOI: 10.1136/bmjsem-2019-000683] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2020] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To investigate the influence of trunk and lower limb motion on electromyography (EMG) muscle activity and recruitment patterns around the shoulder. DESIGN Systematic review. DATA SOURCES MEDLINE, CINAHL, PEDro, AMED, PubMed, Cochrane Central Register of Controlled trials, Cochrane Database of Systematic reviews, SportsDiscuss and PROSPERO. ELIGIBILITY CRITERIA Studies investigating both multiregional kinetic chain (KC) shoulder exercises and localised non-kinetic chain (nKC) shoulder exercises in healthy subjects under the same experimental conditions were included in this review. RESULTS KC exercises produced greater EMG activation levels in 5 of 11 studies for the lower trapezius. Of the remaining studies, five found no difference between the exercise types and one favoured nKC exercises. KC exercises produced greater EMG activation levels in 5 of 11 studies for the serratus anterior. Of the remaining studies, three reported the opposite and three found no significant difference between the exercise types. nKC exercises produced greater EMG activation in infraspinatus in three of four studies. KC exercises produced the lowest trapezius muscle ratios in all studies. Studies investigating the upper trapezius, middle trapezius, supraspinatus, subscapularis, biceps brachii, latifissimus dorsi, pectoralis major, deltoid, and trapezius and serratus anterior ratios showed inconsistency. CONCLUSION This review found evidence that integrating the KC during shoulder rehabilitation may increase axioscapular muscle recruitment, produce lower trapezius muscle ratios and reduce the demands on the rotator cuff. Stepping appears preferable to squatting. PROSPERO REGISTRATION NUMBER CRD42015032557, 2015.
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Affiliation(s)
- Eleanor Richardson
- Department of Physiotherapy, BMI The Alexandra Hospital, Cheadle, UK
- Faculty of Health Psychology and Social Care, Manchester Metropolitan University, Didsbury, Manchester, UK
| | - Jeremy S Lewis
- School of Health and Social Work, University of Hertfordshire, Hatfield, Hertfordshire, UK
- Therapy Department London, Central London Community Healthcare NHS Trust, London, UK
- Department of Physical Therapy and Rehabilitation Sciences, Qatar University, Doha, Qatar
| | - Jo Gibson
- Department of Physiotherapy, Royal Liverpool and Broadgreen Hospitals NHS Trust, Liverpool, UK
- The School of Health Sciences, University of Liverpool, Liverpool, UK
| | - Chris Morgan
- High Performance Unit, Medical Department, Arsenal Football Club, London, UK
| | - Mark Halaki
- Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Karen Ginn
- Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Gillian Yeowell
- Faculty of Health Psychology and Social Care, Manchester Metropolitan University, Didsbury, Manchester, UK
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10
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Capin JJ, Snyder-Mackler L, Risberg MA, Grindem H. Keep calm and carry on testing: a substantive reanalysis and critique of 'what is the evidence for and validity of return-to-sport testing after anterior cruciate ligament reconstruction surgery? A systematic review and meta-analysis'. Br J Sports Med 2019; 53:1444-1446. [PMID: 31289039 DOI: 10.1136/bjsports-2019-100906] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2019] [Indexed: 12/13/2022]
Affiliation(s)
- Jacob John Capin
- Biomechanics and Movement Science, Physical Therapy, University of Delaware, Newark, Delaware, USA
| | - Lynn Snyder-Mackler
- Physical Therapy, Biomechanics and Movement Science, Biomedical Engineering, Delaware Rehabilitation Institute, University of Delaware, Newark, Delaware, USA
| | - May Arna Risberg
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway.,Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway
| | - Hege Grindem
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway.,Oslo Sport Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway.,Stockholm Sports Trauma Research Center, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
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11
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Morgan GE, Martin R, Williams L, Pearce O, Morris K. Objective assessment of stiffness in Achilles tendinopathy: a novel approach using the MyotonPRO. BMJ Open Sport Exerc Med 2018; 4:e000446. [PMID: 30588326 PMCID: PMC6280907 DOI: 10.1136/bmjsem-2018-000446] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2018] [Indexed: 11/03/2022] Open
Abstract
Objectives The aim of this study was to establish quantitative values for asymptomatic and symptomatic Achilles tendons. Design Cohort study with a single (cross-sectional) time point of patients diagnosed with unilateral Achilles tendinopathy and an asymptomatic group with comparative homogeneity. Methods A sample of 50 participants: 25 diagnosed with symptomatic unilateral Achilles tendinopathy (AT group) and 25 with asymptomatic Achilles tendons (control group 2). The asymptomatic side of the AT group was used as a control (control group 1). Measurements at 2 cm intervals on the tendon from its insertion at the calcaneum up to the musculotendinous junction were taken non-weight bearing (NWB) and weight bearing (WB) using the MyotonPRO. Results There was a significant (p<0.005) decrease in natural oscillation frequency (F) at points 2, 3 and 4 of the AT group (NWB condition) and points 2 and 3 for the WB condition. There was a significant (p<0.005) increase in logarithmic decrement (D) at points 2 and 3 signifying a decrease in elasticity. Dynamic stiffness (S) was significantly (p<0.005) reduced in the AT group at points 2 and 3 WB and point 3 WB. There was no significant difference in creep (C) observed between the symptomatic and asymptomatic tendons. There was a significant (p<0.005) increase in mechanical stress relaxation time (R) at point 2 NWB.There was a correlation between body weight and gender on tendon mechanics, with the symptomatic tendons. No significant differences were observed between the control group 1 and control group 2. Conclusions The MyotonPRO measured decreased stiffness over a section of the tendon corresponding clinically with Achilles tendinopathy. This may have potential in identifying risk of injury and informing rehabilitation, however further extensive research is required to generate baseline data for specific population groups monitoring variables over time. Age, gender and body mass index appear to have some bearing on the mechanical properties of the tendon but mainly in the tendinopathy group.
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Affiliation(s)
| | | | - Lisa Williams
- Orthopaedics, Cwm Taf University Health Board, Abercynon, UK
| | - Owen Pearce
- Podiatry, Cwm Taf University Health Board, Abercynon, UK
| | - Keith Morris
- Biomedical Sciences, Cardiff Metropolitan University, Cardiff, UK
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12
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Sprague AL, Smith AH, Knox P, Pohlig RT, Grävare Silbernagel K. Modifiable risk factors for patellar tendinopathy in athletes: a systematic review and meta-analysis. Br J Sports Med 2018; 52:1575-1585. [PMID: 30054341 PMCID: PMC6269217 DOI: 10.1136/bjsports-2017-099000] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2018] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To perform a systematic review and meta-analysis identifying (1) potential modifiable risk factors and (2) associated modifiable factors for patellar tendinopathy in athletes. DESIGN A systematic review and meta-analysis was conducted. Risk of bias was assessed using the Newcastle-Ottawa Scale and grouped based on study design. Meta-analytic statistics were performed for items reported by five or more studies. A strength of evidence rating is provided for items not appropriate for meta-analysis. DATA SOURCES PubMed, Web of Science, Scopus and Cinahl were searched on 14 November 2017. ELIGIBILITY CRITERIA Quantitative, original research reporting potential modifiable risk factors or associated factors, comparing athletes with patellar tendinopathy with a group without the injury. RESULTS 862 records were screened and 31 articles were included (6 prospective, 25 cross-sectional). There was a lack of strong evidence for any potential modifiable risk factor or associated factors. There was limited or conflicting evidence that decreased ankle dorsiflexion range of motion, decreased posterior thigh and quadriceps flexibility, greater volume of jump training, more volleyball sets played per week, greater countermovement jump (CMJ) height and greater activity volume are potential modifiable risk factors. Meta-analysis supported greater activity volume (Cohen's d=0.22, 95% CI 0.06 to 0.39, p=0.008), higher body weight (0.36, 0.17 to 0.55, p<0.001) and greater CMJ height (0.31, 0.07 to 0.56, p=0.01) as associated modifiable factors. CONCLUSIONS There is a lack of strong evidence for any potential modifiable risk factors or associated factors. Factors with lower levels of support may be of interest in designing prevention programmes but require further research in high-quality, prospective studies.
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Affiliation(s)
- Andrew L Sprague
- Department of Biomechanics and Movement Science, University of Delaware, Newark, Delaware, USA
| | - Angela H Smith
- Department of Physical Therapy, University of Delaware, Newark, Delaware, USA
| | - Patrick Knox
- Department of Physical Therapy, University of Delaware, Newark, Delaware, USA
| | - Ryan T Pohlig
- Biostatistic Core Facility, College of Health Sciences, University of Delaware, Newark, Delaware, USA
| | - Karin Grävare Silbernagel
- Department of Biomechanics and Movement Science, University of Delaware, Newark, Delaware, USA
- Department of Physical Therapy, University of Delaware, Newark, Delaware, USA
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13
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Hendricks S, Till K, Oliver JL, Johnston RD, Attwood MJ, Brown JC, Drake D, MacLeod S, Mellalieu SD, Jones B. Rating of perceived challenge as a measure of internal load for technical skill performance. Br J Sports Med 2018; 53:611-613. [PMID: 30448780 DOI: 10.1136/bjsports-2018-099871] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/07/2018] [Indexed: 11/03/2022]
Affiliation(s)
- Sharief Hendricks
- Division of Exercise Science and Sports Medicine, University of Cape Town, Cape Town, South Africa.,Institute for Sport, Physical Activity and Leisure, Leeds Beckett University, Leeds, UK.,Physical Activity, Lifestyle and Sport Research Centre, University of Cape Town, Cape Town, South Africa
| | - Kevin Till
- Institute for Sport, Physical Activity and Leisure, Leeds Beckett University, Leeds, UK.,Yorkshire Carnegie Rugby Union Football Club, Leeds, UK.,Leeds Rhinos Rugby League Club, Leeds, UK
| | - Jon L Oliver
- School of Sport and Heath Sciences, Cardiff Metropolitan University, Cardiff, UK.,Sports Performance Research Institute New Zealand, Auckland University of Technology, Auckland, New Zealand
| | - Rich D Johnston
- School of Exercise Science, Australian Catholic University, Brisbane, Queensland, Australia.,Norths Devils Rugby Football League, Queensland, Australia
| | - Matthew J Attwood
- School of Sport and Heath Sciences, Cardiff Metropolitan University, Cardiff, UK.,Cardiff Metropolitan University Rugby Union Football Club, Cardiff, UK
| | - James Craig Brown
- Institute for Sport and Exercise Medicine, Stellenbosch University, Stellenbosch, South Africa.,The International Olympic Committee (IOC) Research Centre, Cape Town, South Africa
| | - David Drake
- Ulster Rugby, Kingspan Stadium, Belfast, Northern Ireland
| | - Simon MacLeod
- Ulster Rugby, Kingspan Stadium, Belfast, Northern Ireland
| | - Stephen D Mellalieu
- School of Sport and Heath Sciences, Cardiff Metropolitan University, Cardiff, UK
| | - Ben Jones
- Institute for Sport, Physical Activity and Leisure, Leeds Beckett University, Leeds, UK.,Yorkshire Carnegie Rugby Union Football Club, Leeds, UK.,Leeds Rhinos Rugby League Club, Leeds, UK.,The Rugby Football League, Leeds, UK
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14
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Liporaci RF, Saad MC, Bevilaqua-Grossi D, Riberto M. Preseason intrinsic risk factors-associated odds estimate the exposure to proximal lower limb injury throughout the season among professional football players. BMJ Open Sport Exerc Med 2018; 4:e000334. [PMID: 29955374 PMCID: PMC6018857 DOI: 10.1136/bmjsem-2017-000334] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 03/27/2018] [Accepted: 03/30/2018] [Indexed: 11/25/2022] Open
Abstract
Background/aim Football players frequently face the occurrence of non-contact musculoskeletal injuries. The purpose of the study was to verify whether the evaluation of combined risk factors could produce a score system to determine the probability of injury in football players during the Brazilian football season. Methods Sixty-two male professional soccer players recruited from the first and second division soccer teams, with ages between 18 and 36 years. Functional performance evaluations were carried out at the beginning of the preseason which included strength and jumping tests, history of injuries and characteristics of athletes. Results and conclusions The results were grouped and a score/monogram was constructed.
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Affiliation(s)
- Rogério Ferreira Liporaci
- Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, Ribeirão Preto School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Marcelo Camargo Saad
- Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, Ribeirão Preto School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Débora Bevilaqua-Grossi
- Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, Ribeirão Preto School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Marcelo Riberto
- Department of Biomechanics, Medicine and Rehabilitation of the Locomotor Apparatus, Ribeirão Preto School of Medicine, University of São Paulo, São Paulo, Brazil
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15
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Buckthorpe M, Gimpel M, Wright S, Sturdy T, Stride M. Hamstring muscle injuries in elite football: translating research into practice. Br J Sports Med 2017; 52:628-629. [PMID: 29051167 DOI: 10.1136/bjsports-2017-097573] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2017] [Indexed: 11/04/2022]
Affiliation(s)
- Matthew Buckthorpe
- Education and Research Department, Isokinetic Medical Group, FIFA Medical Centre of Excellence, Bologna, Italy.,Isokinetic Medical Group, FIFA Medical Centre of Excellence, London, UK.,Southampton Football Club, Southampton, UK
| | - Mo Gimpel
- Southampton Football Club, Southampton, UK
| | | | | | - Matthew Stride
- Isokinetic Medical Group, FIFA Medical Centre of Excellence, London, UK
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16
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Suni JH, Rinne M, Tokola K, Mänttäri A, Vasankari T. Effectiveness of a standardised exercise programme for recurrent neck and low back pain: a multicentre, randomised, two-arm, parallel group trial across 34 fitness clubs in Finland. BMJ Open Sport Exerc Med 2017; 3:e000233. [PMID: 29021908 PMCID: PMC5633732 DOI: 10.1136/bmjsem-2017-000233] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2017] [Indexed: 12/16/2022] Open
Abstract
Background Neck and low back pain (LBP) are common in office workers. Exercise trials to reduce neck and LBP conducted in sport sector are lacking. We investigated the effectiveness of the standardised Fustra20Neck&Back exercise program for reducing pain and increasing fitness in office workers with recurrent non-specific neck and/or LBP. Method Volunteers were recruited through newspaper and Facebook. The design is a multi-centre randomised, two-arm, parallel group trial across 34 fitness clubs in Finland. Eligibility was determined by structured telephone interview. Instructors were specially educated professionals. Neuromuscular exercise was individually guided twice weekly for 10 weeks. Webropol survey, and objective measurements of fitness, physical activity, and sedentary behavior were conducted at baseline, and at 3 and 12 months. Mean differences between study groups (Exercise vs Control) were analysed using a general linear mixed model according to the intention-to-treat principle. Results At least moderate intensity pain (≥40 mm) in both the neck and back was detected in 44% of participants at baseline. Exercise compliance was excellent: 92% participated 15−20 times out of 20 possible. Intensity and frequency of neck pain, and strain in neck/shoulders decreased significantly in the Exercise group compared with the Control group. No differences in LBP and strain were detected. Neck/shoulder and trunk flexibility improved, as did quality of life in terms of pain and physical functioning. Conclusions The Fustra20Neck&Back exercise program was effective for reducing neck/shoulder pain and strain, but not LBP. Evidence-based exercise programs of sports clubs have potential to prevent persistent, disabling musculoskeletal problems.
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Affiliation(s)
- Jaana H Suni
- UKK Institute for Health Promotion Research, Tampere, Finland
| | - Marjo Rinne
- UKK Institute for Health Promotion Research, Tampere, Finland
| | - Kari Tokola
- UKK Institute for Health Promotion Research, Tampere, Finland
| | - Ari Mänttäri
- UKK Institute for Health Promotion Research, Tampere, Finland
| | - Tommi Vasankari
- UKK Institute for Health Promotion Research, Tampere, Finland
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17
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Padulo J, Chamari K, Ardigò LP. Walking and running on treadmill: the standard criteria for kinematics studies. Muscles Ligaments Tendons J 2014; 4:159-162. [PMID: 25332929 PMCID: PMC4187596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
In humans, walking and running represent the most studied locomotion forms. The motorized treadmill has always been a very useful scientific tool, because it allows administer a variety of speed/slope combinations, which is not always easy-to-find in nature. The purpose of this short communication is to help improve the scientific use of the treadmill and explain some simple kinematics variables together with simple ways to measure/calculate them.
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Affiliation(s)
- Johnny Padulo
- Sport Science, University e-Campus, Novedrate, Italy
- Tunisian Research Laboratory ‘Sports Performance Optimization’, National Center of Medicine and Science in Sport, Tunis, Tunisia
| | - Karim Chamari
- Tunisian Research Laboratory ‘Sports Performance Optimization’, National Center of Medicine and Science in Sport, Tunis, Tunisia
- Research and Education Centre Aspetar, Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - Luca Paolo Ardigò
- School of Exercise and Sport Science, Department of Neurological and Movement Science, University of Verona, Italy
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