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PURPOSE Anterior cruciate ligament (ACL) injuries are the most common in sports and have doubled in the past 20 years. This study aimed to analyze the latest trends and changes in training programs for ACL injury prevention. METHODS In this study, literature was searched using academic search sites, such as ‘PubMed’, ‘Google Scholar’, and ‘Wiley Online Library’. The literature published between 2015 and 2021 was used. RESULTS Eleven papers were selected based on the literature selection criteria. Five warm-up exercise papers and six ACL injury prevention training program papers emphasized neuromuscular training. CONCLUSIONS The ACL injury prevention program can be applied in warm-up exercises and training programs. It consists of an exercise form that includes multidimensional components such as plyometrics, muscle strength, balance, and agility. The key to the ACL injury prevention program is to reflect multidimensional components in neuromuscular training and to obtain a significant effect, and it is recommended to participate in regular training for 12-18 sessions and at least 6 months. In addition, it is suggested to utilize the ACL injury prevention program presented in this study until an individual study for ACL injury prevention by sports type is conducted.

Purpose Cancer is a disease affecting millions of people and one of the primary causes of death worldwide like cardiovascular diseases. Nonpharmacological and nonoperative methods such as proper exercise-intervention, nutrition, maintaining the activity of daily living (ADL), psychological methods can also improve the physical function, cancer progression, and health-related quality of life (HRQOL). However it is extremely important, little light shed on the impacts of exercise-intervention on cancer prevention and treatments. Therefore, the purpose of this study was to analyze the impacts of nonpharmaceutical approaches such as diverse exercise-intervention on cancer prevention and treatments with psychological and physiological health for cancer patients. Moreover, this paper wants to combine knowledge regarding the many experimental papers and systemic reviews of cancer researches and exercise intervention liter-ature. Methods A meta-analysis and systemic reviews of the impacts of an exercise intervention on cancer prevention and treatments were conducted to the PRISMA guidelines. 20 research articles were selected for final inclusion and extraction. And electronic analysis such as PubMed, Google scholar was carried for this study up to May 2020. The search keyword was ‘exercise-intervention and cancer’. Results We can suggest that physical exercise-intervention might be a suitable combination partner to exercise-related immune therapy in the prevention, delay, and treatment of cancer patients. Moreover, physical exercise-intervention directly enhances the QOL, ADL, healthy life, and even resilience of cancer patients. Conclusions Therefore, these exercise interventions can be effective at reducing cancer symptoms, and enhancing cancer treatments for diverse and many cancer patients. Reversing low muscle mass can enhance cancer therapy outcomes and mortality. Nutrition strategies also might be helpful. A Follow-up study about specific high-quality tailoring exercise-intervention program on counteracting cancer symptoms, cancer prevention and treatment, physiological and psychological health and HRQOL is urgently needed in this area.

PURPOSE Resting heart rate[RHR] is a simple, inexpensive, non-invasive, and ubiquitously collected vital sign. Further, heart rate information is now more readily accessible to the general population due to the popularity of wearable devices, capable of measuring RHR. Purpose of the current review paper are to summarize 1) literature which report associations between RHR and health outcomes, and 2) to suggest the use of RHR as a new health indicator METHODS We performed a search, including reviews and original papers, on the PubMed and Korean Information Service System (KISS) electronic databases of articles assessing the association between RHR and the risk and prognosis of diseases. For our search strategy, we used combinations of the following key terms: resting heart rate, cardiovascular disease, hypertension and cancer. RESULTS RHR’s prognostic value as a marker of general health, has received considerable attention recently. Studies have consistently shown clear associations of elevated RHR with cardiovascular disease [CVD], type 2 diabetes, and even cancer [prevalence, incidence and mortality]. Due to strong association between RHR and health outcomes, RHR may be used as a preliminary health indicator, to detect undiagnosed cardiometabolic diseases and cancer. However, it is still unclear whether elevated RHR is one of the risk markers or risk factors in diseases of our interest. Factors associated with RHR include aerobic fitness, physical activity, body mass, smoking, drinking, sleep duration, and stress. Changing these modifiable lifestyle components coincide with general health recommendations, which would improve one’s health. CONCLUSIONS RHR may reflect disease risk and changes lifestyles which may affect health outcomes. Therefore, due to the ease of measurement, lowering RHR may be a new target for better health.

PURPOSE The purpose of this study was to analysis the effective short foot exercise methods and verify the effect of short foot exercise (SFE) on medial longitudinal arch (MLA) and balance in order to utilize it as foundation data for clinical fields. METHODS In this study, research papers were collected by using RISS, KISS and PubMed as a search term for SFE, foot intrinsic muscle exercise (FIME) and MLA. RESULTS A total of 30 research were gathered, and 16 papers of data were related effect of SFE, and 9 papers was related to effective exercise methods, and 5 papers was related to a comparison with other FIME. The collected data were classified into the influence of SFE on the MLA, balance, and the efficient exercise methods. CONCLUSIONS The result of this study confirmed that SFE was very effective to maintain MLA and improve foot stability, dynamic balance and gait. In addition to, imagery training and biofeedback with SFE was efficient methods, and SFE applied with weight bearing, or windlass effect, or 30° ankle dorsiflexion strengthened abductor halluces muscle effectively. Therefore, SFE will be useful for rehabilitation of pes planus patients or athletes.

Abstracts Purpose Coronavirus-19 (COVID-19) was first reported in China at the end of 2019. COVID-19 infected people increased and spreads COVID-19 rapidly across the globe. Finally, this outbreak turn into a pandemic and yields national crisis and finally to endemic. Most individual are exposed to stressful situation because of unknown duration of COVID-19. Most of all, smoking, obesity, metabolic syndromes, lowered immunity such as decreased natural killer (NK) cell, T cell activity were significantly correlated with the COVID-19 incidence. However, all this variables were concerned with exercise habit and exercise-intervention, therefore, the present study aimed to assess the relationship between COVID-19 incidence and physical activity status. Methods PubMed database was searched from December 2019 to August 2020 using predefined search terms “COVID-19”, “exercise”, and “immunity”.Based on reference search, more than 65 articles were identified whereas 50 papers (36 references) met the inclusion criteria and were well connected with COVID-19 and physical exercise with immunity. We analyzed the connections between exercise and COVID-19 with many variables, and dealtabout COVID-19 prevention and exercise-intervention programs in the main text. Results & Conclusions Smoking, obesity, metabolic syndromes, reduced respiratory muscle mass, lowered immunity such as decreased natural killer cell and T cell activity were significantly correlated with the COVID-19 infection. However, all this variables were also concerned with exercise habit and exercise-intervention. Regular physical activity have shown to be an effective prescription for obesity, many metabolic syndromes and good immunity. However, physical inactivity and chronic metabolic syndromes were associated with reduced immunity such as reduced NK cell activity, uncontrolled T cell immunity, decreased respiratory immunity and even URTIs (upper respiratory track infection) for elite athletes. Multicomponent exercise program is considered especially for the elderly people, 5 days per week, 40-60% HRR (heart rate reserve) intensity, and 150-300 minutes aerobic and resistance training (200–400 minutes/week under the quarantine period) were recommended. Moreover, all form of psychological support also to increase immunity against COVID-19. More mechanism studies are urgently needed to determine which mode and which duration exercises are best most suited, and effective for prevention and treatment of COVID-19.

PURPOSE Skeletal muscle atrophy induces overall health problems and many related diseases in older adults. In particular, sarcopenia is related to lowered quality of life, decreased physical activity, high levels of morbidity and mortality owing to chronic diseases, and even falling. Despite the many clinical studies on skeletal muscle atrophy, a little study had been about the exact mechanism of skeletal muscle atrophy at the molecular level. In 2017, A disease code (ICD-10-CM) for skeletal muscle atrophy related to sarcopenia was announced to attempt a clinical approach in the United States. According to these approaches, non-invasive clinical treatment is the most effective method for treating skeletal muscle atrophy. The purpose of this study was to analyze the molecular mechanisms of muscular exercise and related skeletal muscle atrophy factors. METHODS This systemic review focused on skeletal muscle atrophy and muscular exercise. The keywords were used on “MeSH: muscle atrophy OR skeletal muscle atrophy OR muscle OR atrophy AND physical exercise OR exercise OR exercise training” for English and Korean. This paper searched PubMED, OVIDMEDLINE, and EMBASE for literature consideration. RESULTS Skeletal muscle atrophy was related to a complex molecular network, and exercise affects IGF-1/Akt/mTOR signaling. The related skeletal muscle atrophy factors were evaluated as MurF1, MAFbx, IGF-1, and NFkB. We proposed new related factors such as ATF 4, Gadd45a, and p21; however, the results related to exercise were not shown in recent studies. CONCLUSIONS In conclusion, we identified skeletal muscle atrophy factors at the molecular level of muscle physiology, and these new factors may become an interesting field of study in clinical human trial and animal studies.

PURPOSE Frailty is a condition of weakness that includes an enhanced hazards of drawback and disability in elderly people. It is featured by reduced physical fitness, and also recognized as reduced psycho·physiological and immunological functions. Therefore, we need to develop more efficient methods to detect frailty and also needs to prevent and treat frailty. METHODS PubMed database was searched from January to April 2019 using predefined search terms “elderly and frailty”, “elderly and exercise”. Based on reference search, 89 articles were identified whereas 40 papers (22 references) met the inclusion criteria and were well connected with frailty and exercise. We analyzed the connections between exercise and frailty with many variables, and dealt with frailty-prevention exercise programs in the main text. RESULTS & CONCLUSIONS With aging, decreased skeletal muscle power, malnutrition, feeling of loneliness, fall, and osteoporosis were identified with an important factors to frailty. Among these, osteoporosis and related frailty fractures are a serious health problem in the elderly frailty. Osteoporosis is the most prevalent and major bone disorder, which is featured by progressive bone weakening and an increased risk of frailty fractures especially in the frail elderly. And also, physiotherapy can play a vital role in the management and intervention following frailty fractures. Osteoanabolic exercise (aerobic, resistance, and combined) also recommended to prevent, management and treatment of bone mineral density of osteoporotic females and frail elderly. More studies are urgently needed to determine which mode and duration exercises were best suited and effective for frail elderly.

PURPOSE Benign prostatic hyperplasia (BPH) is a very common urological disease in older men, and it typically leads to lower urinary tract symptoms (LUTS). The exact cause of BPH is not known. Physical activity is increasingly recognized as an important modifiable lifestyle factor and several studies have demonstrated an inverse relationship of exercise with development of BPH/LUTS. In this review paper, the evidence for the impact of exercise on the occurrence and development of BPH/LUTS in the context of the other known risk factors for BPH will be discussed. METHODS A systematic search on PubMed and RISS was performed to obtain previous studies examining the relationship between exercise and BPH/LUTS. RESULTS Studies have demonstrated that physical activity/exercise ranging from light housework to sports are inversely associated with the development of BPH/LUTS. Several mechanisms for this association have been proposed, including sympathetic tone, hormonal changes, inflammation, and autophagy. There are some points to be implemented regarding the inverse relationship between exercise and development of BPH: Prevention is likely to be more effective than treatment of BPH/LUTS through exercise, and it is more effective to exercise at a young age than at an old age. The effects of exercise on preventing BPH/LUTS are dosage-dependent, such as exercise intensity and volume. CONCLUSIONS It is concluded that there is a protective role for exercise in reducing the risk of developing BPH/LUTS. However, it is still necessary to obtain the precise mechanisms for the relationship between exercise and BPH/LUTS in the future.

PURPOSE This study was to identify trends in dementia research based on physical activity using keyword network analysis. METHODS 2025 keywords were extracted using Python, from 957 papers cited in PubMed over a 6-year span from 2013 to February 2018. Research trends were classified into introduction period (2013-2014), diffusion period (2015-2016), and settlement period (2017-2018) to confirm the temporal change. To identify research trends, frequency analysis, connection centrality analysis, and rate of change analysis were conducted using Excel program and NetMiner 4.3 software program. RESULTS The results are as follows: First, the most frequently mentioned keywords dementia research based on physical activity were exercise (145), cognition (108), and aging (88). Second, when we look at the words associated with the top 3 keywords classified by the central value of connection, ‘exercise’ is connected to ‘depression’, perception is ‘prevention’, and aging is ‘gait’. Third, in the diffusion period (2015-2016) based on the introduction period (2013-2014), keywords such as ‘stress’, ‘neurodegenerative disease’, ‘obesity’, and ‘memory’ were increased, and ‘walking’, and ‘odds ratio’ keywords were tend to decreased Moreover, the settlement period (2017-2018), ‘nursing home’ and ‘elderly’ keywords were increased and ‘huntington’ keyword was decreased. CONCLUSIONS The results of this study can be used to establish a direction for future dementia research based on physical activity.

PURPOSE Amyotrophic lateral sclerosis (ALS) is a devastating, incurable disease with five year mortality of higher than 95% mainly due to respiratory failure. Our goal was to investigate existing literature with attempts to improve ALS symptoms and mortality. METHODS A systemic search in PUBMED was performed to identify research papers and selected articles published in peer-reviewed journals. RESULTS This review outlined the two major sources of reactive oxygen species (ROS) that plays an important role on respiratory muscle weakness in ALS, which are mitochondria and NADPH oxidase. Previous animal studies have demonstrated that blocking sources of ROS enhanced respiratory muscle function and increased life span. We further discussed multiple therapeutic approaches to slow down the disease progression of ALS patients, including diaphragm pacing and intermittent hypoxia training. These previous approaches have suggested that exercise training might have beneficial impacts on the ALS patients. Regardless, exercise training, in the past years, has not been recommended due to its potential effect on accelerating disease progression. The impacts of training may benefit or harm the individuals depending on the training intensity and type of exercise (i.e. aerobic vs. resistance training). CONCLUSIONS Our systemic review suggests that excess ROS plays an important role in the pathogenesis of ALS, and exercise training might delay disease progression and symptoms. However, training effect of exercise on ALS patients has remained unclear.