Browse

Context: The COVID-19 pandemic had a significant impact on the world of sports due to the imposed quarantine and the postponement of regional, national, and international sporting events, which affected physical, socioeconomic, and psychological aspects of athletes. Thus, the present study aimed to evaluate changes in the mood state profile of Brazilian Para athletes at 2 different time points during the COVID-19 pandemic, specifically during their qualification for the Tokyo Paralympic Games. Design: This study used a longitudinal study design. Methods: The study included 83 Brazilian Para athletes from 14 sports, with a mean age of 34.64 (9.27) years, who were evaluated at 2 moments (March 2020 and April 2021) during the qualification period for the “Road to Tokyo Paralympic Games.” The online survey included questions about disability, sport, and experience; the 24-item Brunel Mood Scale questionnaire; and a question about the athlete’s perception of whether or not they had a chance of qualifying for the Tokyo Paralympics in April 2021. Results: Para athletes had significantly higher vigor scores in 2021 than in 2020, with a medium effect size (z = −3.454, P < .001). In addition, Para athletes who perceived themselves as nonqualified for the Tokyo 2021 Paralympics Games had higher scores for depression (U = 409,000, z = −2397, P = .017) and tension (U = 425,000, z = −2194, P = .017) in 2021 when compared with those who perceived that they had qualified. There were no differences between men and women. Conclusions: The COVID-19 pandemic significantly negatively impacted the mood of Brazilian Para athletes, especially those who perceived themselves as nonqualified for the Tokyo Paralympic Games. Para athletes in team sports exhibited higher potential symptoms of depression compared with those in individual sports.

Context: The rehabilitation of disabled athletes is a critical area of research aimed at improving athletes’ performance and well-being. This bibliometric analysis examines scientific studies related to the rehabilitation of disabled athletes, focusing on trends, authors, publications and interdisciplinary collaborations. Objective: This study seeks to provide quantitative and qualitative insights into the trends, interdisciplinary collaborations, and significant contributions in the rehabilitation of disabled athletes. Design: Bibliometric analysis of 660 scientific publications related to the rehabilitation of disabled athletes, from 1975 to 2023. Setting: The analysis reveals that research in this field is multidisciplinary, encompassing sports, medicine, rehabilitation and education. Studies focused on disabled athletes and their rehabilitation. Intervention: Rehabilitation plays a vital role in disabled athletes’ lives, aiding in injury recovery and enhancing overall health and performance. Results: The United States leads in research output. Collaborative networks among authors are evident, indicating joint research efforts. Identification of research trends, prominent authors  Bartosz Molik and Natalia Morgulec-Adamowicz), collaborative networks and common keywords (e.g., adaptive sports, disability, rehabilitation). Keywords such as adaptive sports, disability and rehabilitation are frequently mentioned, reflecting the focus of research. Conclusions: The rehabilitation of disabled athletes is a growing field with significant contributions from researchers worldwide. Collaborative efforts and interdisciplinary approaches are essential for advancing knowledge and improving the lives of disabled athletes.

Context: Hamstring injuries are prevalent in high-intensity sports. The lesion often occurs with concomitant knee extension and hip flexion. The Nordic curl has been suggested to prevent such injury, mainly due to its eccentric hamstring activation. Objective: The objective of this study is to assess the eccentric force output and the regional biceps femoris excitation (proximal, mid, and distal) during conventional and 80° of hip flexion of Nordic curl. Methods: Thirty-nine participants (17 men: 22.6 [2.03] y, 1.71 [0.09] m, 73.6 [13.3] kg; and 22 women: 24.4 [6.02] y; 1.64 [0.08] m; 62.2 [10.5] kg) were included in the study. Hamstring strength was analyzed through a load cell and muscle activation assessed with an electromyographer in 3 muscle portions (proximal, mid, and distal). Mixed factorial analysis of variance was used to rate the differences. Results: The conventional Nordic curl showed higher muscle activation compared with the hip-flexed Nordic curl (P = .001). No differences were observed in other factorial analysis. Conclusions: The findings suggest that conventional Nordic curl induces higher biceps femoris muscle excitation across compared with 80° hip-flexed Nordic curl. No differences were noted in muscle strength. The same force output with distinct levels of muscle activation may provide a progression system to implement hamstring training for injury prevention or even for exercise routine.

Introduction: Playing football (American soccer) at the elite level places extremely high demands on the spine. The choice of treatment for lumbar spinal canal stenosis combined with spondylolysis and anterolisthesis is challenging for surgeons, physicians, and clinicians. Case Presentation: A 28-year-old elite football player from the leading Russian football club is the focus of this case study. Patient complained of constant low back pain radiating to the posterior surface of the right thigh and limited mobility in the lumbar spine. Diagnosis: The patient was diagnosed with degenerative stenosis of the spinal canal at the L5 to S1 level, L4 to L5 disc herniation, spondylolysis, and anterolisthesis of L5 vertebra. Management and Outcomes: Two-stage surgery of combined lumbar spine pathology was performed in May 2021. The first stage of surgical treatment included the spinal and foraminal canals decompression at the L4 to L5 and L5 to S1 levels, as well as posterior fusion with rigid pedicle screws. The second stage involved the subsequent replacement of the rigid to dynamic semirigid rods as signs of the bone defect healing appeared. The athlete returned to team training 6 months after the first stage of surgery and was able to play football at the elite level without restrictions 1 year after the first stage and just 30 days following the second stage of surgical treatment. The athlete continues his career as of the last manuscript’s revision. Conclusions: This method holds potential as an effective approach in the treatment of combined lumbar spine pathology among elite athletes.

Context: The rate of force development (RFD), defined as the ability to rapidly generate muscle force, is commonly tested using an electromechanical dynamometer in isometric mode. However, these devices are expensive and not readily available. Therefore, this study aims to evaluate the interrater reliability of a fixed handheld dynamometer to measure the knee extensors’ RFD and provide reference values using the proposed method. Design: This study used a cross-sectional study design. Methods: Using a fixed handheld dynamometer (microFET2) and a 3-dimensional-printed adapter, we evaluated the knee extensor muscles  in participants seated at the edge of a treatment bed. Each participant performed a standardized warm-up, followed by 3 maximal isometric knee extension trials. The outcome measures were peak force and early and late phase RFD (0–100 and 0–200 ms, respectively). The study consisted of 3 sessions: Visit one comprised of an initial session (session 1A) followed by a second session (session 1B) after 30 minutes for intrasession reliability; and visit two, conducted on week later, comprised the third session (session 2) for intersession reliability. Results: Fifty-one participants were enrolled in the study. The in-session intraclass correlation coefficient for the early phase RFD was .87 (95% CI, .74–.92) and .91 to .92 (95% CI, .87–.94) for the late phase. The between-session intraclass correlation coefficient for the early phase RFD was .83 to .86 (95% CI, .74–.91) and .87 to .90 (95% CI, .80–.94) for the late phase. Finally, the peak force’s intraclass correlation coefficient was .95 (95% CI, .92–.97) for the in-session and .91 to .92 (95% CI, .86–.95) for the between-session reliability. Conclusions: Our approach provides a reliable, cost-effective, and quick method to evaluate the knee extensor muscles’ RFD and peak force.

Context: Professional soccer players frequently experience fatigue due to the demanding nature of the sport. In this context, effective recovery strategies are essential for maintaining performance. Static stretching (SS) is commonly used in soccer, but its efficacy is debated. Vibration foam rolling (VFR) is a novel recovery technique that has not been extensively studied in soccer. Objective : This research aimed to investigate the acute effects of VFR (3 sets of 45 s of rolling and 15 s of rest between sets) and SS (3 sets of 45 s and 15 s of rest between sets) on muscle contractile properties in professional soccer players. Design : Eighteen players participated in this counterbalanced crossover study.  Settings : After a 1-week washout period between sessions, the subjects completed the 2 condition trials (VFR or SS) in counterbalanced order following a training session, which had a duration of 77 min and a total distance of 6500 m covered. Main Outcome Measures : Muscle contractile properties of the rectus femoris were assessed with tensiomyography before training (pre), immediately after training (post 1), and postrecovery intervention (post 2). Tensiomyography parameters included maximal radial muscle-belly displacement and contraction time and velocity. Data were analyzed using repeated-measures analysis of variance. Results : There were no significant differences in the training load between groups during the training sessions (P > .05). Results showed that maximal radial muscle-belly displacement (P = .004) and contractiontime (P = .007) significantly decrease from pre (before training) to post 1 (after training). No significant main effects for group were obtained for all the variables (P > .05). However, both VFR and SS interventions effectively restored maximal radialmuscle-belly displacement (P = .011) and contraction time (P = .008) from post 1 (after) to post 2 (postrecovery intervention), suggesting reduced muscular stiffness. Contraction velocity remained unchanged after both interventions (P > .05). Conclusions : Therefore, these interventions could offer valuable advantages for posttraining neuromuscular acute recovery in professional soccer players.

Context: Medial tibial stress syndrome (MTSS) is a common chronic injury of the lower-extremity in the physically active population. However, the risk factors for MTSS remain unclear. Objective: This study identified the risk factors for MTSS and established the continuum model of lower-extremity alignments, range of motion, muscular strength, and gait kinematics affecting each other and MTSS development. Evidence Acquisition: Online databases including PubMed, CINAHL, SPORTDiscus, and Web of Science were used to retrieve studies related to risk factors for MTSS. The study eligibility criteria were studies that used the MTSS definition of the Yates and White criteria, or included participants with MTSS, except for stress fracture and compartment syndrome. A total of 2099 papers were retrieved during the initial search stage. After screening, based on eligibility criteria and cross-reference, 21 papers were included in this study. Data on lower-extremity alignments, range of motion, muscular strength, and gait biomechanics were extracted as outcome variables for this meta-analysis. Publication bias was assessed using funnel plots and Egger’s regression analysis. Evidence Synthesis: Foot posture index (standardized mean difference [SMD] = 1.23; 95% CI, 0.02–2.43), intercondylar interval (SMD = 0.29; 95% CI, 0.10–0.48), inversion range of motion (SMD = 0.37; 95% CI, 0.10–0.63), eversion strength (SMD = 0.37; 95% CI, 0.10–0.65), and dynamic arch height change during walking (SMD = 1.05; 95% CI, 0.49–1.60) were significant risk factors for MTSS. Egger’s regression analysis revealed asymmetry in several variables, which indicates publication bias. The trim-and-fill method was applied to these variables. A comparison between the SMD and adjusted SMD showed that the variables had minimal impacts on the meta-analysis. Conclusions: Based on our results, health care professionals should assess the significant risk factors in patients before participation in physical activities and treat them to prevent and rehabilitate MTSS.

Clinical Scenario: Anterior cruciate ligament (ACL) injuries are a common injury experienced by athletes and often involve lengthy and invasive treatments. Given the literature that exists supporting psychosocial response to injury, it is important to understand how these factors influence the recovery process ultimately influencing readiness to return to play. Clinical Question: What is the impact of psychosocial factors on athlete readiness to return to sport participation post-ACL reconstruction (ACLR)? Summary of Key Findings: All studies found that psychosocial factors, including athletic identity, motivation, anxiety, control, and fear, impacted perceived readiness to return to play. Several studies found various levels of influence in both a positive (eg, motivation and resilience) and negative (eg, fear and anxiety) direction. Furthermore, despite presenting more psychosocial barriers than physical, these factors do not appear to influence actual physical recovery. Clinical Bottom Line: Psychosocial factors have both direct and indirect effects, positive and negative, on an athlete’s perceived readiness to return to the play. ACLR rehabilitation protocols are well developed, well established, and known to be effective; however, athletes still do not feel ready to return, and there are physical and mental risks associated with that uncertainty. Therefore, psychosocial factors are important to include and prioritize as part of the ACLR recovery process to ensure athletes are physically and psychosocially ready to return to play. Strength of Recommendation: Grade B evidence exists that psychosocial factors positively and negatively impact physical recovery and perceptions of recovery on return-to-play post-ACLR.

Context: Plantar fasciopathy (PF) is a common, self-limiting condition with notable economic impact and multifactorial origins. Clinical tests help clinicians to identify specific dysfunction and limitations influencing PF’s clinical course. This study aims to investigate whether body mass index (BMI) influences the performance of clinical tests and clinical presentation of individuals with PF and to determine whether BMI and clinical tests predict the clinical course of PF over a 3-month follow-up period. Design: This study is a longitudinal observational study. Participants were grouped, according to the median BMI, into low and high BMI. Setting: Healthcare centers and physiotherapy clinics. Participants: Fifty-two individuals with PF participated in this study. Main Outcome Measures: Baseline: Ankle dorsiflexion range of motion and navicular drop, heel-rise, and step-down tests were administered. Pain intensity and function were measured at baseline and at 3-month follow-up. Results: Low BMI group showed better function (mean difference = 11.8; 95% CI, 1.9 to 21.6) and lower pain intensity (mean difference = −1.5; 95% CI, −2.6 to −0.3) than the high BMI group. In the multivariable regression model, higher BMI predicted lower function (beta coefficient = −1.20; 95% CI, −2.3 to −0.3). Conclusions: In individuals with PF, BMI levels influenced PF clinical presentation. The high BMI group showed more severe pain and lower function. Higher BMI was found to be a poor prognostic factor for function in individuals with PF.

Context: Sport-related concussion management often requires referral to physical therapy (PT). Objectives: To (1) outline the role of PT in the management of sport-related concussion, (2) describe patients who underwent PT, and (3) discuss outcomes of athletes who underwent PT. Design: Retrospective cohort study. Setting: Single institution. Methods: Adolescent athletes aged 14–19 years old who sustained a sport-related concussion from November 2017 to April 2022 were evaluated. The cohort was dichotomized into 2 groups: PT versus no PT. The outcomes were days from initial PT visit to symptom resolution (SR) and return-to-play. Subgroup analyses compared recovery metrics between those initiating PT before and after 30 (1 mo) and 90 days (3 mo) of injury. A univariable and multivariable regression was used to determine predictors of recovery. Results: Of 1010 concussed athletes, 205 (20.3%) received referral for rehabilitation, and 58 (28.3%) patients received PT at the parent institution. Those who received PT had a higher number of prior concussions compared with those who did not (PT: 1.0 [1.2]; non-PT: 0.6 + 1.0; χ ² = 19.37, P = .007). A large proportion of PT recipients reported headache (n = 45, 81.0%); visual disturbances (n = 32, 65.5%); and vestibular (n = 37, 63.8%), cervical (n = 25, 43.1%), or oculomotor dysfunction (n = 25, 43.1%). Most patients received exertional therapy (n = 32, 55.1%), vestibular therapy (n = 31, 53.4%), and/or cervical therapy (n = 30, 51.7%). Those initiating PT before 1 and 3 months had significantly shorter median times to SR compared with those initiating after 1 and 3 months, respectively. Multivariable regression showed that a shorter time between injury and the initial PT visit was predictive of faster SR (β = 1.66, P = .048). Conclusions: Headache, dizziness, and visual disturbances were commonly reported symptoms by patients who received PT. Cervical, vestibular, and oculomotor deficits were common objective findings by physical therapists, and cervical, vestibular, and exertional therapy were common interventions. Delayed time to PT was independently associated with a longer time to SR.