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Context: We designed this study to investigate the effects of 2 myofascial release techniques, Instrument-Assisted Soft Tissue Mobilization (IASTM) and Foam Roller (FR), on pain, joint range of motion, and muscle strength in athletes suffering from iliotibial band (ITB) tightness. Design: A total of 39 male soccer players were enrolled in this randomized controlled trial, aged between 18 and 23 years who were divided into 3 groups: Only Exercise, IASTM, and FR. Methods: All participants performed daily strengthening and stretching exercises, while 1 group added IASTM, and the other added FR to the exercise program. We evaluated ITB tightness with the Ober test and an inclinometer, pressure pain threshold, using an algometer, and we evaluated muscle strength with the Cybex Norm Isokinetic device. Results: We found that all 3 groups exhibited an increase in the Ober inclination angle after the interventions (P =.001), but the increase was greater for participants in the IASTM and FR groups, compared with exercise alone. Additionally, both the IASTM and FR groups displayed an increased pressure pain threshold (P =.001), whereas there was no change in the control group. Moreover, while all 3 groups experienced an increase in hip muscle strength (P =.001), the IASTM and FR groups exhibited a greater increase compared with exercise alone (P =.001). Conclusions: Based on these findings, exercise improves pain, range of motion, and muscle strength in athletes with ITB tightness, and IASTM, and FR techniques enhanced exercise effects but did not differ from one another. While our study demonstrated that both IASTM and FR techniques significantly enhance the benefits of exercise for athletes with ITB tightness, further research could delve into the long-term effects of these interventions. [ABSTRACT FROM AUTHOR]

Context: To stabilize the humeral head within the glenoid fossa during arm elevation, the rotator cuff muscles may contribute through internal and external rotation. The main purpose of the current study was to compare the acromiohumeral distance between athletes with primary subacromial impingement syndrome who received progressive resistance exercises consisting of either shoulder internal or external rotation. Design: A randomized and controlled clinical study. Methods: Thirty athletes with primary subacromial impingement syndrome were enrolled and randomly divided into 2 experimental groups. The progressive resistance exercise protocol in experimental group I comprised shoulder internal rotation, while in experimental group II consisted of shoulder external rotation. The experimental groups worked out 3 days a week for 6 weeks. The experimental groups were compared with the control group consisting of 15 healthy athletes. The acromiohumeral distance was measured before and after the intervention using an ultrasound machine under the passive and active across no arm elevation and 45°of arm elevation. Results: The acromiohumeral distance significantly increased in both experimental groups under the passive and active arm positions following the intervention (P <.001), with no significant differences detected between the experimental groups (P >.665). The paired comparisons of the acromiohumeral distance discrepancy indicated a significant difference between the control group and each experimental group under the active and passive arm positions (P <.001), while no significant difference was observed between the experimental groups (P >.999). Conclusions: The present study revealed, for the first time, that both progressive resistance exercise protocols involving either the shoulder internal or the external rotation increased the acromiohumeral distance in individuals with primary subacromial impingement syndrome and improved associated pain and disabilities. [ABSTRACT FROM AUTHOR]

Background: Local high-frequency percussive (HFP) massage has recently found widespread application in physical therapy. Although HFP massage reportedly improves range of motion (ROM), the mechanism underlying its action has not yet been proven. This study aimed to clarify whether a 5-minute percussive massage regimen affects muscular or connective tissues, such as the deep fascia and deep intermuscular fascia and the change in joint ROM. Method: The study sample was calculated using G*Power analysis program, and this study enrolled 15 healthy men who underwent 5-minute HFP massage to the medial gastrocnemius muscle. Shear-wave elastography was used to measure tissue stiffness in the deep fascia, muscle, and deep intermuscular fascia through shear-wave velocity as well as the ROM of the volunteers' ankle joint dorsiflexion before and after the HFP massage. A value of P < .05 was used to declare statistical significance, and post hoc was used to calculate the effect size using G*Power. Results: Shear-wave velocity revealed a significant change in the deep fascia (P = .003; shear-wave velocity: -0.7 m/s) and significant increase in ROM of ankle dorsiflexion (P = .002; increase in ROM: 3.0°) after 5 minutes of HFP massage. However, the muscle and deep intermuscular fascia did not exhibit any significant changes. Conclusions: HFP massage for 5 minutes modified the stiffness of the deep fascia and concurrently improved the ankle joint-dorsiflexion ROM. This method can be used as an intervention to decrease stiffness of the deep fascia and increase the ROM efficiently. [ABSTRACT FROM AUTHOR]

Individuals with intellectual disabilities often face unique challenges in physical capabilities, making traditional training methods less effective for their specific needs. This study aimed to investigate the effect of combining balance, plyometric, and strength (CBPS) training with sprint training on physical performance in male athletes with intellectual disabilities. Twenty-seven participants were randomly assigned to either a CBPS group or a control group that only maintained their regular sprint training. Participants underwent pre- and posttraining tests, including measures of balance, jumping, agility, and sprinting ability. The results showed that the CBPS group demonstrated significant improvements (p <.05) in one-leg stance, crossover-hop jump, squat jump, countermovement jump, and 10- and 30-m sprint at posttraining compared with pretraining. CBPS training combined with sprinting significantly improves physical performance in male athletes with intellectual disabilities, suggesting implications for tailored training programs to enhance their physical fitness and overall health. [ABSTRACT FROM AUTHOR]

Introduction: Unlike the most common training approaches for bodybuilding, powerlifting programs are generally based on maximum and submaximal loads, putting enormous stresses on the lumbar spine. The flexion relaxation phenomenon evaluation is a clinical tool used for low back pain (LBP) assessment. This study aimed to evaluate the role of the flexion relaxation phenomenon in the analysis of LBP in the powerlifters. Methods: Healthy professional powerlifters participated in the study. In fact, we divided the participants into a LBP-low-risk group and a LBP-high-risk group, based on a prior history of LBP. Outcome measures included flexion relaxation ratio (FRR) and trough surface electromyography collected during trunk maximum voluntary flexion; furthermore, during a bench press lifting, we measured the height of the arched back (ARCH), using a camera and the Kinovea video editing software, to consider a potential correlation with the risk of LBP. Results: We included a group of 18 male (aged 24–39 y) powerlifters of 93 kg category. We measured a nonsignificant mean difference of ARCH between low-risk LBP group and high-risk LBP subjects. Curiously, maximum voluntary flexions were both above the threshold of 3.2 μV; therefore, with an absence of appropriate myoelectric silence, on the contrary, the FRR ratios were higher than 9.5, considering the presence of the phenomenon, exclusively for the low-risk group. The lumbar arched back measurement data did not report any association with the LBP risk, regarding the maximum voluntary flexion value, and even more than the FRR there is a relationship with the presence or the absence of LBP risk. Conclusions: FRR could be considered as a useful parameter for studying the risk of LBP in powerlifting. The FRR index not only refers to the possible myoelectric silence of the lumbar muscles in trunk maximum forward flexion but also takes into account the energy value delivered by the lumbar muscles during the flexion. Furthermore, we can indicate that the size of the powerlifter ARCH may not be a determining factor in the occurrence of LBP. [ABSTRACT FROM AUTHOR]

Context: The persistence and the recurrence of posterior medial knee pain (PKP) after anterior cruciate ligament reconstruction (ACLR) using hamstring tendon graft are often overlooked during rehabilitation. Design: Cross-sectional observational study. Methods: The study aimed (1) to evaluate the prevalence of these types of PKP before 4 months post-ACLR, (2) to measure their consequences on the knee flexors strength, and (3) to evaluate the role of the type of ACLR. From a cohort of patients operated on with hamstring tendon procedures, the persistent and the recurrent PKP were sought at 4 months post-ACLR. The evolution of isokinetic muscle strength recovery in PKP subjects was compared with those of nonpainful subjects. The functional deficit was measured at 6/7 months post-ACLR by a hop test. Results: Three hundred seventeen subjects (25.8 [6.0] y) were included. At 4 months post-ACLR, 2 populations were identified based on the recurrent onset of PKP (PKP+, n = 40) or the absence of knee pain (PKP−, n = 277). The prevalence of PKP was 8.3%. At the fourth month post-ACLR, the PKP+ group had a higher flexor strength deficit compared with the PKP− group (limb symmetry index at 60°/s: 67.2% [12.4%] vs 84.3% [12.6%]; P <.05). At 6/7 months, the loss of strength persisted (limb symmetry index at 60°/s: 82.3% [13.4%] vs 87.7% [12.8%]; P <.05). The hop test deficit was comparable, and no difference was shown according to the type of graft. Conclusions: Persistent and recurrent PKP during the rehabilitation period were not uncommon and were associated with a worsening of flexors strength loss on the ACLR side. [ABSTRACT FROM AUTHOR]

Objective Heterotaxy syndrome (HS) is often associated with complex congenital heart disease (CHD). While fetal echocardiography (FE) permits accurate prenatal identification of most CHD, the high level of disease complexity in HS may pose challenges in predicting postnatal findings and outcomes. This study aimed to define the accuracy of FE in predicting postnatal anatomy, physiology, and surgical management of CHD in the setting of HS. Study Design Retrospective single-center cohort study including all patients with a prenatal diagnosis of HS from 2003 to 2018. Anatomic diagnoses from FE reports were compared with postnatal echocardiogram, catheterization, and operative reports. Prenatal predictions were compared with postnatal outcomes with a focus on ductal dependence, time to first intervention (immediate, neonatal period, 1–6 months, or older than 6 months), and surgical approach (single or biventricular). Results There were 102 pregnancies with fetal HS resulting in 21 terminations, 5 fetal losses, and 76 live births. Of the live births, 55 had significant CHD and available postnatal data for review. Among this group, survival to 1 year was 62% and was no different comparing single versus biventricular surgical approach. FE diagnostic accuracy varied by anatomic feature and was the lowest for diagnosis of venous anatomy. Determination of postnatal care was most accurate for predicting single versus biventricular surgical approach (91%), followed by ductal dependence (75%). Accuracy for predicting time to first intervention was the lowest at 69%. The most common reason for an incorrect prediction was difficulty in assessing the severity of pulmonary stenosis. Conclusion FE permits accurate predictions regarding surgical approach. Characterizing systemic and pulmonary veins is challenging, as is predicting ductal dependence and time to first intervention. These data suggest that despite the high diagnostic accuracy of CHD in HS, a circumspect approach may be reasonable with regard to predicting some anatomic details and postnatal management decisions. Key Points In HS, FE was most accurate for intracardiac anatomy. Diagnostic accuracy of venous anatomy was less reliable. Predicting surgical approach (single ventricle vs. biventricular) was highly accurate. Predicting ductal dependence and time-to-intervention were more challenging in some instances. [ABSTRACT FROM AUTHOR]

Hands-on laboratory experience that allows for manipulation of realistic and relevant materials in course curricula has been shown to improve students' learning, understanding, and critical thinking skills. The purpose of this study was to gain insight into the experiences of students who engaged in laboratory coursework using a virtual dissection (VD) table as part of an undergraduate course in anatomy and physiology of speech and hearing. Undergraduate students enrolled in an anatomy and physiology of speech and hearing course at a single university for the fall 2021 semester consented to participate. Nine students, divided into two focus groups, were encouraged to describe their experiences and perspectives about the VD table and corresponding laboratory assignments. Following verbatim transcription of the data, the authors conducted a thematic analysis. Five themes emerged from the body of data: (1) using the VD table , (2) completing the VD lab assignments , (3) preparation for laboratory sessions , (4) suggested modifications , and (5) enriched learning. Students believed using the VD table aided in a better understanding of course material than traditional methods. Moreover, they surmised that this method of learning, particularly for speech-language pathologists, may be superior to learning through models and cadavers. [ABSTRACT FROM AUTHOR]

Aim: This prospective cohort study aimed to compare the predictive accuracy of outcome (survival/death) among trauma patients using various prognostic scores. Methods: Over 3 months, 240 trauma patients in a tertiary care hospital were assessed for demographic details, trauma characteristics, vital signs, Glasgow coma scale, arterial blood gas values, and lab markers. Injury severity score (ISS), revised trauma score (RTS), trauma and injury severity score (TRISS), and acute physiology and chronic health evaluation II (APACHE II) were applied at admission, 24 hours, and 48 hours post-admission. Results: Road traffic accidents (55.83%) were the primary cause of trauma, followed by falls (33.75%) and violence (10.41%). The all-cause mortality rate was 23.33%, with 34.16% requiring ICU admission. Head injuries (65.83%) were both the most frequent injury site and cause of mortality. Conclusion: Analysis indicated that APACHE II outperformed other scores in predicting outcomes, with ISS following closely. The study concludes that trauma severity correlates with ICU admission and mortality, emphasizing APACHE II as a superior predictor, particularly for traumatic brain injuries leading to ICU admission and mortality. Clinical significance: This study contributes to the existing body of knowledge by addressing the gap in comparing prognostic abilities among scoring systems for trauma patients. The unexpected superiority of APACHE II suggests its potential as a valuable tool in predicting outcomes in this specific patient population. [ABSTRACT FROM AUTHOR]

Context: Imbalances in upper-extremity soft tissue stiffness may play a role in the development of shoulder and elbow musculoskeletal injuries in tennis players. Ultrasound shear wave elastography provides quantifiable and specific data regarding muscle stiffness. The purpose of this study was to compare tendon and muscle stiffness in healthy tennis players to nontennis players. Design: Cross-sectional study. Methods: The shear wave modulus, measured in kilopascals, was obtained for the dominant pectoralis major, pectoralis minor, and common wrist-extensor tendon using 2-dimensional shear wave elastography ultrasound imaging (GE Logiq S8, L9 linear transducer). Independent t test was run to compare age, body mass index, and the activity index score between both groups. Within-day intrarater reliability was assessed using a within-examiner intraclass correlation coefficients (ICC [3, 1]) with 95% confidence intervals. A multivariate general linear model was run to compare the mean differences between the tennis and nontennis players for each of the soft tissues. Results: Twenty-six individuals (13 tennis players and 13 nontennis players) were recruited. Within-day ICCs were very good (ICC >.78 for the pectoralis musculature) and excellent (ICC >.94 for the common wrist extensor). Common extensor tendon stiffness was significantly higher in tennis players compared to nontennis players (mean difference = 114.8 [61.8], confidence interval, −22.8 to 252.5 kPa for the dominant arm [P =.039]). Mean pectoralis major and minor stiffness differences were not significant (P >.214). Conclusions: Common wrist-extensor stiffness in healthy recreational tennis players is higher than those who do not play tennis. Therefore, clinicians may need to facilitate a greater soft tissue stiffness response with resistance training when rehabilitating recreational tennis players as compared to those not playing tennis. Additional normative data on a larger sample of recreational tennis players should be collected. [ABSTRACT FROM AUTHOR]

Context: Plantar intrinsic foot muscle strength training is difficult to master to a degree sufficient to elicit muscle hypertrophy in most individuals. It is possible that combining neuromuscular electrostimulation (NMES) and blood flow restriction (BFR) can elicit plantar intrinsic foot muscle hypertrophy regardless of the individual's technique. This study aimed to determine the effects of NMES training with BFR on acute muscle swelling in the abductor hallucis. Design: Randomized, controlled, single-blind trial design. Methods: Forty-eight participants were randomly allocated to the NMES + BFR, NMES, or Sham NMES + BFR groups. All participants received abductor hallucis NMES for 15 minutes. Participants in the NMES + BFR and Sham NMES + BFR groups received NMES with BFR. The intensity of NMES was the sensory threshold in the Sham NMES + BFR group. The cross-sectional area of the abductor hallucis was measured pretraining and posttraining using ultrasonography by a single investigator blinded to the participants' allocations. Results: After 15 minutes of training, the cross-sectional area of the abductor hallucis was significantly increased in the NMES + BFR (P<.001) and the Sham NMES + BFR (P = .004) groups. Moreover, the rate of increase was significantly higher in the NMES + BFR group than in the NMES or the Sham NMES + BFR groups (P<.001 and P = . 001, respectively). Conclusions: Since it is possible that the amount of muscle swelling immediately after training correlates with muscle hypertrophy when training is continued, the results of this study suggest that NMES training with BFR is a training method that can be expected to produce plantar intrinsic foot muscle hypertrophy. Further studies are needed to confirm the long-term effects of NMES training with BFR. [ABSTRACT FROM AUTHOR]

Context: To assess the reliability of a remote 2D markerless motion tracking method (Kinovea) to quantify knee and hip angles during dynamic tasks. Methods: Fourteen healthy adults performed body weight squats and lateral lunges while video recording themselves at home. Knee and hip angles were quantified in the sagittal plane for the squats and in the frontal plane for the lateral lunges. Two students each performed the video analysis procedure twice, 2 weeks apart. Intraclass correlation coefficients were used to calculate the intrarater and interrater reliability for angles at maximum depth. The intrarater and interrater agreement over the joint angle-time signals were quantified using a validation metric; an acceptable agreement threshold was set at a validation metric of 0.803 or higher. Standard error of measurement (SEM) was also calculated. Results: Reliability was good to excellent (intraclass correlation coefficients = .80-.98) for all angle comparisons at maximum depth. The agreement over the entire joint angle-time signal was acceptable for all squat variables except for the interrater hip angle comparison (validation metric = 0.797). None of the lateral lunge variables met the threshold of acceptable agreement. The mean SEM across participants for all joint angle-time signal and for maximum depth was acceptable (<5°) for all measurements (SEM = 1.2°-4.9°). Conclusions: Overall, the reliability, agreement, and SEM quantified in this study support the integration of remote methods to quantify lower-extremity kinematics into research and clinical practice. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the effects of transcranial direct-current stimulation (tDCS) applied over the primary motor cortex (M1) and cerebellum on balance control and shooting accuracy in elite ice hockey players. Methods: Twenty-one elite ice hockey players underwent anodal tDCS over the M1 (a-tDCSM1), anodal tDCS over the cerebellum (a-tDCSCB), concurrent dual-site anodal tDCS over the M1 and the cerebellum (a-tDCSM1+CB), and sham stimulation (tDCSSHAM). Before and after receiving tDCS (2 mA for 15 min), participants completed an ice hockey shooting-accuracy test, Pro-Kin balance test (includes stance test and proprioceptive assessment), and Y-balance test in randomized order. Results: For static balance performance, the ellipse area in the 2-legged stance with eyes open and the 1-legged stance with the dominant leg significantly improved following a-tDCSM1, a-tDCSCB, and concurrent dual-site a-tDCSM1+CB, compared with tDCSSHAM (all P <.05, Cohen d = 0.64–1.06). In dynamic balance performance, the average trace error of the proprioceptive assessment and the composite score of the Y-balance test with the dominant leg significantly improved following a-tDCSM1 and concurrent dual-site a-tDCSM1+CB (all P <.05, Cohen d = 0.77–1.00). For the ice hockey shooting-accuracy test, shooting-accuracy while standing on the unstable platform significantly increased following a-tDCSM1 (P =.010, Cohen d = 0.81) and a-tDCSCB (P =.010, Cohen d = 0.92) compared with tDCSSHAM. Conclusion: tDCS could potentially be a valuable tool in enhancing static and dynamic balance and shooting accuracy on unstable platforms in elite ice hockey players. [ABSTRACT FROM AUTHOR]

The aim of the present study was to investigate the effects of multicomponent training on adropin, endothelial function, insulin resistance, and sleep quality in overweight older adults. In this randomized controlled study, 40 overweight older adults were randomly divided into training and control groups. The multicomponent training program including aerobic, resistance, and balance exercise was followed for 8 weeks, 3 days a week. Study variables were measured 48 hr before and after the intervention. After 8 weeks of multicomponent training, adropin (p =.01), nitric oxide (p =.01), and maximal oxygen uptake (VO2max; p =.002) increased, and glucose (p =.001), insulin (p =.001), insulin resistance (p =.01), systolic blood pressure (p =.01), and sleep disorders (p =.01) decreased significantly. Also, Pearson's test results showed a significant inverse relationship between adropin level (p =.01 and r = −.55) and glucose (p =.01 and r = −.51) with sleep disorders. It seems that multicomponent training increases adropin and improves insulin resistance, endothelial function, and sleep quality in older adults. [ABSTRACT FROM AUTHOR]

Purpose: This study investigated the test–retest reliability and usefulness of the foot–ankle rebound-jump test (FARJT) for measuring foot–ankle reactive strength metrics in athletes. Methods: Thirty-six highly trained, healthy athletes (5 female; 21.5 [3.9] y; 1.80 [0.10] m; 72.7 [10.4] kg) performed 8 repeated bilateral vertical foot–ankle rebound jumps on 2 testing days. Testing days were 1 week apart, and these sessions were preceded by a familiarization session. Reactive strength metrics were calculated by dividing jump height (in meters) by contact time (in seconds) for the reactive strength index (RSI) and flight time (in seconds) by contact time (in seconds) for the reactive strength ratio (RSR). The mean of 4 jumps (excluding the first and last 2 jumps) on each testing session were considered for RSI and RSR reliability and usefulness analysis. Results: We found a high reliability of the FARJT for RSI (intraclass correlation coefficient [ICC] >.90 and coefficient of variation [CV] = 12%) and RSR (ICC ≥.90 and CV = 8%). Regarding their usefulness, both RSI and RSR were rated as "marginal" in detecting the smallest worthwhile change (typical error > smallest worthwhile change) and "good" in detecting a moderate change in performance. Conclusions: The results showed that a FARJT is a highly reliable test for measuring foot–ankle reactive strength in athletes and useful for quantifying changes, for example, following a training block. However, its usefulness as an accurate daily or weekly monitoring tool in practice is questionable. [ABSTRACT FROM AUTHOR]

Musculoskeletal modeling, typically implemented using marker-based systems in laboratory environments, is commonly used for noninvasive estimations of loads. Inertial measurement units (IMUs) have become an alternative for the evaluation of kinematics. However, estimates of spine joint contact forces using IMUs have yet to be thoroughly evaluated. Dynamics tasks and static postures from activities of daily living were captured on 11 healthy subjects using both systems simultaneously. Spine kinematics obtained from IMU- and marker-based systems and L4–L5 joint contact forces were compared. Lateral bending resulted in a weak agreement with significant differences between the 2 systems (P =.02, average root mean-squared error = 4.81), whereas flexion–extension and axial rotation exhibited the highest agreement with no significant differences (P <.05, average root mean-squared error = 5.51 and P <.31, average root mean-squared error = 5.08, respectively). All tasks showed excellent correlations (R2 =.76–.99) in estimated loads between systems. Differences in predicted loads at the L4–L5 were only observed during flexion–extension (1041 N vs 947 N, P =.0004) and walking with weights (814 N vs 727 N, P =.004). Different joint reaction force outcomes were obtained in 2 of the 8 tasks between systems, suggesting that IMUs can be robust tools allowing for convenient and less expensive evaluations and for longitudinal assessments inside and outside the laboratory setting. [ABSTRACT FROM AUTHOR]

Context: Contusion and soft tissue injuries are common in sports. Photobiomodultion, light and laser therapy, is an effective aid to increase healing rates and improve function after various injury mechanisms. However, it is unclear how well photobiomodulation improves function after a contusion soft tissue injury. This study aimed to determine the effects of a pulsed red and blue photobiomodulation light patch on muscle function following a human thigh contusion injury. Design: Single-blinded randomized control trial design. Methods: We enrolled 46 healthy participants. Participants completed 5 visits on consecutive days. On the first visit, participants completed a baseline isokinetic quadriceps strength testing protocol at 60°/s and 180°/s. On the second visit, participants were struck in the rectus femoris of the anterior thigh with a tennis ball from a serving machine. Immediately following, participants were treated for 30 minutes with an active or placebo photobiomodulation patch (CareWear light patch system, CareWear Corp). Following the treatment, participants completed the same isokinetic quadriceps strength testing protocol. Participants completed the treatment and isokinetic quadriceps strength test during the following daily visits. We normalized the data by calculating the percent change from baseline. We used a mixed model analysis of covariance, with sex as a covariate, to determine the difference between treatment groups throughout the acute recovery process. Results: We found the active photobiomodulation treatment significantly increased over the placebo group, quadriceps peak torque during the 180°/s test (P =.030), and average power during both the 60°/s (P =.041) and 180°/s (P ≤.001) assessments. The mean peak torque and average power of 180°/s, at day 4, exceeded the baseline levels by 8.9% and 16.8%, respectively. Conclusions: The red and blue photobiomodulation light patch improved muscle strength and power during the acute healing phase of a human thigh contusion injury model. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate the influence of mouth rinsing and ingesting unpleasant salty or bitter solutions on cycling sprint performance and knee extensor force characteristics. Eleven male and one female trained cyclists (age: 34 ± 9 years, maximal oxygen uptake 56.9 ± 3.9 ml·kg−1·min−1) completed a ramp test and familiarization followed by four experimental trials. In each trial, participants completed an all-out 30-s cycling sprint with knee extensor maximal voluntary contractions before and immediately after the sprint. In a randomized, counterbalanced, cross-over order, the four main trials were: a no solution control condition, water, salty (5.8%), or bitter (2 mM quinine) solutions that were mouth rinsed (10 s) and ingested immediately before the cycling sprint. There were no significant differences between conditions in mean power (mean ± SD, no solution: 822 ± 115 W, water: 818 ± 108 W, salt: 832 ± 111 W, bitter: 818 ± 105 W); peak power (no solution: 1,184 ± 205 W, water: 1,177 ± 207 W, salt: 1,195 ± 210 W, bitter: 1,184 ± 209 W); or fatigue index (no solution: 51.5% ± 5.7%, water: 50.8% ± 7.0%, salt: 51.1% ± 5.9%, bitter: 51.2% ± 7.1%) during the sprint. Maximal force and impulse declined postexercise; however, there were no significant differences between conditions in knee extensor force characteristics. The present data do not support the use of unpleasant salty or bitter solutions as an ergogenic aid to improve sprint exercise performance. [ABSTRACT FROM AUTHOR]

Maintaining balance involves the combination of sensory signals from the visual, vestibular, proprioceptive, and auditory systems. However, physical and biological constraints ensure that these signals are perceived slightly asynchronously. The brain only recognizes them as simultaneous when they occur within a period of time called the temporal binding window (TBW). Aging can prolong the TBW, leading to temporal uncertainty during multisensory integration. This effect might contribute to imbalance in the elderly but has not been examined with respect to vestibular inputs. Here, we compared the vestibular-related TBW in 13 younger and 12 older subjects undergoing 0.5 Hz sinusoidal rotations about the earth-vertical axis. An alternating dichotic auditory stimulus was presented at the same frequency but with the phase varied to determine the temporal range over which the two stimuli were perceived as simultaneous at least 75% of the time, defined as the TBW. The mean TBW among younger subjects was 286 ms (SEM ± 56 ms) and among older subjects was 560 ms (SEM ± 52 ms). TBW was related to vestibular sensitivity among younger but not older subjects, suggesting that a prolonged TBW could be a mechanism for imbalance in the elderly person independent of changes in peripheral vestibular function. [ABSTRACT FROM AUTHOR]

The aim of this study was to determine the effect of posture changes on vascular compliance in intracranial (brain) versus extracranial vascular beds (forearm). Eighteen young adults (nine females) performed a supine-to-seated-to-standing protocol involving 5 min of rest in each position. Continuous blood pressure, middle cerebral artery (MCA) blood velocity, and brachial artery blood velocity were recorded at each posture. Three to five consecutive steady-state cardiac cycles at each posture were analyzed by a four-element lumped parameter modified Windkessel model to calculate vascular compliance. Mean arterial pressure (MAP) increased from supine to seated (76(9) vs. 81(12) mmHg; P = 0.006) and from supine to standing (76(9) vs. 82(13) mmHg; P = 0.034). Mean blood flow was greater in the MCA relative to the forearm (forearm: 40(5) mL·min−1, MCA: 224(17) mL·min−1; main effect P < 0.001). Conversely, vascular resistance (forearm: 3.25(0.50) mmHg−1·mL·min−1, brain: 0.36(0.04) mmHg−1·mL·min−1; main effect P < 0.001) and compliance (forearm: 0.010(0.001) mL·min−1·mmHg−1, brain: 0.005(0.001) mL·min−1·mmHg−1; main effect P = 0.001) were greater in the forearm compared to the brain. Significant main effects of posture were observed with decreasing values in upright positions for mean blood flow (P = 0.001) in both vascular beds, but not for resistance (P = 0.163) or compliance (P = 0.385). There were no significant interaction effects between vascular bed and posture for mean flow (P = 0.057), resistance (P = 0.258), or compliance (P = 0.329). This study provides evidence that under steady-state conditions, posture does not affect cerebrovascular compliance. [ABSTRACT FROM AUTHOR]

Background: Modification of foods or liquids is commonly administered as part of dysphagia treatment. However, no consensus exists on the parameters for defining texture‐modified food for patients with dysphagia. Objectives: The aim of this study was to evaluate the effect of food/liquid material on swallowing physiology in patients with dysphagia and to discuss the optimal food choice for direct swallowing therapy. Materials and Methods: A total of 140 patients underwent a videofluoroscopic swallowing study using three test foods/liquids: 3 mL of mildly thick liquid (Thick liquid), jelly made of agar and polysaccharide [ABSTRACT FROM AUTHOR]

Context: Slideboards are commonly used in exercise programs, but there is limited information about how they affect muscle activities during exercise. We aim to compare the activation levels of quadriceps and hamstring muscles and hip- and knee-flexion angles during lunge and single-leg squat exercises between normal ground and slideboard in physically active individuals. Design: Cross-sectional study. Methods: Thirty healthy individuals (age: 23.83 [2.84] y, body mass index: 21.75 [1.72] kg/m2) were included in the study. Surface electromyography was used to measure vastus medialis, vastus lateralis, biceps femoris, and semitendinosus activation levels during reaching and returning phases of the forward, lateral, and back lunges and squats that were performed on the normal ground and slideboard. Exercises were performed at a slow pace (60 beats/min). Hip- and knee-flexion angles during the exercises were evaluated by using 2-dimensional motion analysis. Repeated measures of analysis of variance were used for statistical analysis. Results: Vastus medialis and vastus lateralis activation levels were greater during reaching and returning phases of the exercises on slideboard compared with normal ground (P <.05). However, semitendinosus and biceps femoris activity were greater only during the returning phase of the forward lunge (P <.001) and the returning phase of the back squat (P =.002, P =.009, respectively). Hip-to-knee flexion ratios were closer to 1 when the forward lunge (P <.001), back lunge (P =.004), and forward squat (P =.001) exercises were performed on a slideboard. Conclusion: In exercise programs that target the quadriceps and hamstring muscles, slideboards can be effectively used in exercise progressions as they can increase muscle activity. Moreover, squat and lunge exercises on slideboard with a slow pace may also be helpful for improving the balance between hip- and knee-flexion angles. [ABSTRACT FROM AUTHOR]

Purpose: To compare the effects of 6-week barbell weighted-jump-squat (WJS) training with and without eccentric load reduction on explosive performance. Methods: Twenty well-trained male athletes were randomly assigned to either an experimental group (n = 10) or a control group (n = 10). Participants completed 12 WJS training sessions (6 sets of 5 repetitions of barbell back squat at 30% of 1-repetition maximum [1RM]) twice a week over a 6-week period. While the control group used 0% eccentric loading (ie, traditional WJS), the experimental group utilized a 50% eccentric loading reduction with a mechanical braking unit (ie, eccentric load set at 15% of 1RM). Performance assessments, including countermovement jump, 20-m sprint, standing long jump, and 1RM barbell back squat, were conducted both before (pretests) and after (posttests) the intervention. Results: Both the experimental group and the control group demonstrated a significant increase in countermovement-jump height (+6.4% [4.0%] vs +4.9% [5.7%]; P <.001) and peak power output (+2.3% [2.7%] vs +1.9% [5.1%]; P =.017), faster 20-m sprint times (+9.4% [4.8%] vs +9.2% [5.5%]; P <.001), longer standing long jump (+3.1% [2.5%] vs +3.0% [3.3%]; P <.001), and higher 1RM back squat (+6.4% [4.0%] vs +4.9% [5.7%]; P <.001) from pretests to posttests. However, there was no significant condition × time interaction for any variable (all P ≥.294). Conclusions: Both WJS training methods, with and without load reduction in the eccentric phase, effectively enhance explosive performance. Nevertheless, athletes in later stages of injury rehabilitation or intense training may find reducing eccentric load a more tolerable strategy for achieving similar performance gains compared with traditional isoinertial loading. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to examine the impact of different rest periods between short sprint interval training (SSIT) trials on the physiological and performance adaptations of female volleyball players. Methods: Twenty-four trained college athletes volunteered to participate in this study and were randomly assigned to 3 SSIT groups with different work-to-rest ratios (1:2 [5-s run:10-s rest], 1:4 [5-s run:20-s rest], and 1:6 [5-s work:30-s rest]). Before and after 6-week training, physiological parameters (maximum oxygen uptake, first and second ventilatory thresholds, and peak and mean power output) and physical performance measures (ie, countermovement vertical jump, 10-m sprint, and T-test change-of-direction speed) were evaluated. Results: After the training period, all groups improved (P =.001) their sport-related performance and physiological parameters, ranging from moderate to very large effect sizes. Comparative analysis of the magnitude of training effects indicated that the 1:6 SSIT group had in a significantly greater change in countermovement vertical jump (P =.007), 10-m sprint (P =.014), peak power output (P =.019), and mean power output (P =.05) compared with 1:2 SSIT group. By contrast, the 1:2 SSIT group demonstrated significantly (P =.022) greater changes in maximum oxygen uptake than the 1:6 SSIT group. However, the change-of-direction speed and changes in first and second ventilatory thresholds were the same among the groups (P >.05). Conclusions: When performing SSIT, longer rest intervals are suitable for physical and anaerobic performance, and shorter rest periods are appropriate for enhancing the cardiorespiratory fitness of female volleyball players' performance. [ABSTRACT FROM AUTHOR]

Purpose: Maximal speed is an important physical-fitness attribute for female Australian footballers. The effects of sprint training, maximal strength, and technical training have been reported in laboratory studies. However, no study has determined the combined effect and relative contribution of these training modalities on maximal speed adaptation in situ. Therefore, the aim of this study was to determine the training factors affecting maximal speed adaptation during a preseason in subelite female Australian Rules footballers. Methods: Maximal speed during field training, predicted 1-repetition maximum (1RM) for box squat and hip thrust, and sprint biomechanics were assessed during early and late preseason (∼9 wk apart) in 15 female subelite Australian Rules Football players (age 20 [3] y). On-field training volume and intensity (total distance, high-speed running, very-high-speed running, and maximal speed) were determined using a Global Positioning System. A multivariate regression model was used to determine the factors associated with changes in maximal speed across the preseason. Results: The preseason training program had a small effect on maximal speed and large to very large effects on strength and sprint biomechanics. The multivariate regression with the greatest fit (P <.001, R2 =.939) included change in estimated 1RM box squat (β = −0.63), total distance per week (β = −0.55), and change in hip projection (β = 0.16) as factors. Multivariate regression of biomechanical factors (P =.044, R2 =.717) and maximal strength factors (P =.003, R2 =.676) were also significant. Conclusion: The development of maximal speed across a preseason is dependent on (1) total distance per week, (2) maximal strength adaptation, and (3) sprint technique adaptation in female subelite Australian rules football players. [ABSTRACT FROM AUTHOR]

Purpose: Performing back squats with elastic bands has been widely used in resistance training. Although research demonstrated greater training effects obtained from adding elastic bands to the back squat, little is known regarding the optimal elastic resistance and how it affects neuromuscular performance. This study aimed to compare the force, velocity, power, and muscle activity during back squats with different contributions of elastic resistance. Methods: Thirteen basketball players performed 3 repetitions of the back squat at 85% of 1-repetition maximum across 4 conditions: (1) total load from free weight and (2) 20%, (3) 30%, and (4) 40% of the total load from elastic band and the remaining load from free weight. The eccentric and concentric phases of the back squat were divided into upper, middle, and bottom phases. Results: In the eccentric phase, mean velocity progressively increased with increasing elastic resistance, and muscle activity of the vastus medialis and rectus femoris significantly increased with the largest elastic resistance in the upper phase (P ≤.036). In the concentric phase, mean power (P ≤.021) and rate of force development (P ≤.002) significantly increased with increasing elastic resistance. Furthermore, muscle activity of the vastus lateralis and vastus medialis significantly improved with the largest elastic resistance in the upper phases (P ≤.021). Conclusion: Velocity, power, rate of force development, and selective muscle activity increased as the elastic resistance increased in different phases during the back-squat exercise. [ABSTRACT FROM AUTHOR]

Purpose: To examine associations between exercise heart rate (HRex) during a continuous-fixed submaximal fitness test (CF-SMFT) and an intermittent-variable protocol (semistandardized kicking drill [SSD]) in Australian Football athletes, controlling for external intensities, within-session scheduling, and environmental conditions. Methods: Forty-four professional male Australian Football athletes (22.8 [8.0] y) were monitored over 10 sessions involving a 3-minute CF-SMFT (12 km·h−1) as the first activity and a SSD administered 35.7 (8.0) minutes after the CF-SMFT. Initial heart rate and HRex were collected, with external intensities measured as average velocity (in meters per minute) and average acceleration–deceleration (in meters per second squared). Environmental conditions were sampled. A penalized hierarchical linear mixed model was tuned for a Bayesian information criterion minima using a 10-fold cross-validation, with out-of-sample prediction accuracy assessed via root-mean-squared error. Results: SSD average acceleration–deceleration, initial heart rate, temperature, and ground hardness were significant moderators in the tuned model. When model covariates were held constant, a 1%-point change in SSD HRex associated with a 0.4%-point change in CF-SMFT HRex (95% CI, 0.3–0.5). The tuned model predicted CF-SMFT HRex with an average root-mean-squared error of 2.64 (0.57) over the 10-fold cross-validation, with 74% and 86% of out-of-sample predictions falling within 2.7%-points and 3.7%-points, respectively, from observed values, representing the lower and upper limits for detecting meaningful changes in HRex according to the documented typical error. Conclusions: Our findings support the use of an SSD to monitor physiological state in Australian Football athletes, despite varied scheduling within session. Model predictions of CF-SMFT HRex from SSD HRex closely aligned with observed values, considering measurement imprecision. [ABSTRACT FROM AUTHOR]

Context: Forward shoulder posture (FSP) is a risk factor for shoulder pathology. Manual therapists often use myofascial release (MFR) to elongate restricted pectoral fascia to reduce FSP and improve shoulder function; however, the effects of this treatment approach remain anecdotal. Objective: Determine the acute effects of 4-min of MFR, compared to a soft-touch control (CON), to the pectoral fascia on: 1) FSP, 2) shoulder horizontal abduction ROM (HA-ROM), and 3) muscle excitation of the trapezius (upper, middle, lower [UT, MT, LT]) and pectoralis major (PEC). Methods: Fifty-nine right-handed participants (27 ± 9 years, 30 female) with FSP, but otherwise asymptomatic shoulders participated in a randomized crossover clinical trial by attending two experimental sessions: one MFR and one CON treatment, each administered by a Registered Massage Therapist. FSP, HA-ROM, and muscle excitation during a reaching task, were measured before and after each treatment. Results: There was a significant interaction between treatment and time for FSP (p =.018, ηp =.093) with FSP decreasing from PRE MFR (128 ± 19 mm) to POST MFR (123 ± 19 mm; p <.001, ηp =.420) and PRE CON (126 ± 19 mm) to POST CON (124 ± 18 mm; p <.001, ηp =.191) interventions. There were no significant differences in HA-ROM or muscle excitation. Conclusion: Four minutes of MFR or CON to the pectoral fascia acutely reduces FSP. [ABSTRACT FROM AUTHOR]

This study compared lower extremity, trunk, and upper extremity kinematics between tee and front toss hitting in youth baseball athletes. Twenty youth baseball athletes (14.3±2.9 yrs) performed three maximal effort swings off front toss and tee. Kinematic data were collected during the preparatory and acceleration phases. Lower extremity, trunk, and upper extremity kinematics were compared between tee and front toss hitting using 1-dimensional statistical parametric mapping (SPM). There was a significant difference in trunk kinematics between tee and front toss during the preparatory phase (p=.001); the trunk rotated more toward the back side when hitting off a tee compared to front toss (p<0.001). There was also a significant difference in trunk kinematics between tee and front toss for 67% of the acceleration phase; the trunk rotated more towards the back side from 0 to 67% when hitting off the tee (p<0.001). Significant differences were found in trunk kinematics between tee and front toss hitting in youth baseball players, where the trunk is less rotated toward the pitcher in the tee than in the front toss. Coaches utilize various training modalities to enhance hitting performance; however, differences in trunk kinematics should be considered between modalities when developing fundamental hitting techiques in youth baseball athletes. [ABSTRACT FROM AUTHOR]

There are different ways to deliver external focus (EF) and internal focus (IF) instruction. Understanding each modality better will help to develop more effective interventions to reduce injury risk. To investigate the difference in landing biomechanics between participants who received EF and IF instruction and control participants. A secondary aim was to evaluate participant perceptions of focus of attention. Randomized controlled trial. Laboratory. Forty-one healthy women (EF: n = 14, 23.0 ± 2.9 years, 1.69 ± 0.07 m, 64.0 ± 6.8 kg; IF: n = 15, 22.9 ± 3.2 years, 1.66 ± 0.08 m, 66.2 ± 12.4 kg; control: n = 12, 21.1 ± 2.9 years, 1.67 ± 0.11 m, 74.3 ± 15.1 kg). Participants scoring greater than or equal to 5 on the Landing Error Scoring System were allocated into the EF, IF, or control group. Knee and hip flexion and abduction were collected pre- and postintervention during 5 drop vertical jumps. For the intervention, each group was provided separate instructions. In between the intervention jumps, participants answered, "What strategy were you focusing on when completing the previous jump-landing trials?" Postintervention minus preintervention change scores were calculated, and separate 1-way analysis of variance assessments were performed to determine differences in the dependent variables. Individuals in the EF group had a greater change in hip and knee flexion angles than individuals in the control group. There was no significant difference between the EF and IF groups for any variables. There were no significant differences in frontal plane variables. In the EF group, 71.4% aligned with the instructions given; in the IF group, 80% aligned; and in the control group, 50% aligned. External focus instruction may not produce immediate changes in movement compared with IF instruction. Hip and knee flexion were greater in the EF group than in the control group but was not better than that in the IF group. Clinicians should provide instructions to patients, but the mode of instruction may not be as critical to see positive biomechanical changes. Patients may not always focus on the instruction being given; therefore, the relationship between instruction and patient experience should be further explored. [ABSTRACT FROM AUTHOR]

Low‐load blood‐flow‐restriction resistance training (LL‐BFR‐RT) is gaining popularity, but its physiological effects remain unclear. This study aimed to compare LL‐BFR‐RT with low‐load resistance exercise (LL‐RT) and high‐load resistance exercise (HL‐RT) on metabolism, electrolytes, and ions in the lower extremities by invasive catheter measurements, which are crucial for risk assessment. Ten healthy men (27.6 ± 6.4 years) completed three trials of knee‐extensor exercises with LL‐RT (30% 1RM), LL‐BFR‐RT (30% 1RM, 50% limb occlusion pressure), and HL‐RT (75% 1RM). The exercise protocol consisted of four sets to voluntary muscle failure with 1 min of rest between sets. Blood gas analysis was collected before, during, and after each trial through intravenous catheters at the exercising leg. LL‐BFR‐RT had lower total workload (1274 ± 237 kg, mean ± SD) compared to LL‐RT (1745 ± 604 kg), and HL‐RT (1847 ± 367 kg, p < 0.01), with no difference between LL‐RT and HL‐RT. Pain perception did not differ significantly. Exercise‐induced drop in oxygen partial pressure, lactate accumulation and electrolyte shifts (with increased [K+]) occurred during under all conditions (p < 0.001). Creatine kinase and lactate dehydrogenase increased significantly 24‐ and 48‐h postexercise under all three conditions (p < 0.001). This study, using invasive catheter measurements, found no significant differences in metabolic, ionic, and electrolyte responses among LL‐BFR‐RT, LL‐RT, and HL‐RT when exercised to voluntary muscular failure. LL‐BFR‐RT reduced time to failure without specific physiological responses. [ABSTRACT FROM AUTHOR]

This study aimed to analyze the intersubject variability in the relationship between percentage of velocity loss (%VL) and percentage of repetitions performed out of maximum possible (%MNR) in postmenopausal women. Thirty-five postmenopausal active women (58 ± 3 years) performed sets leading to muscular failure, completing 10-13 repetitions, in both leg press (LP) and bench press (BP). Mean lift velocity of each repetition was expressed as a percentage of the fastest repetition, and repetitions were quantified as a percentage of the maximum number of repetitions completed in the set. Given the hierarchical structure of the data, %VL-%MNR relationships were fitted by linear mixed model regressions. A significant intersubject variability in the intercept (i.e., %MNR associated with 0%VL) was detected (p < 0.001 in both LP and BP), even when centered values of the completed repetitions were included in the models. The estimated variance in the intercept for LP (117.39; SE: 45.41) was almost double that for BP (67.47; SE: 20.27). The variability observed in the intercept entailed variability in the estimated %MNR for specific %VL values. The use of velocity loss thresholds for estimating the intensity of effort in active postmenopausal women does not overcome uncertainty of more traditional methods. [ABSTRACT FROM AUTHOR]

Introduction: Studies analyzing postures and mobility of the thoracic spine in the context of cervicogenic headache are missing. Insight in these parameters is needed since the cervical and thoracic spine are biomechanically related. Objective: To compare self-perceived optimal and habitual postures, active-assisted maximal range of motion, and repositioning error of the upper-thoracic and lower-thoracic spine between a cervicogenic headache-group and matched healthy control-group before and after a 30 min-laptop-task. Methods: A non-randomized longitudinal design was used to compare thoracic postures and mobility between 18 participants with cervicogenic headache (29–51 years) and 18 matched healthy controls (26–52 years). Outcomes were: self-perceived optimal and habitual postures, active-assisted maximal range of motion, and repositioning error of the upper-thoracic and lower-thoracic spine evaluated in sitting with a 3D-Vicon motion analysis system. Results: Habitual upper-thoracic postures in the cervicogenic headache-group were significantly (p =.04) less located toward the maximal range of motion for flexion compared to the control-group, self-perceived optimal upper-thoracic posture was significantly (p =.004) more extended in the cervicogenic headache-group compared to the control-group, and self-perceived optimal lower-thoracic posture could not be reestablished in the cervicogenic headache-group after the laptop-task (p =.009). Conclusion: Thoracic postures differ between a cervicogenic headache-group and control-group. These differences were detected by expressing the habitual thoracic posture relative to its maximal range of motion, and by analyzing the possibility of repositioning the thoracic spine after a headache provoking activity. Longitudinal studies are needed to determine the contribution of these musculoskeletal dysfunctions to the pathophysiology of cervicogenic headache. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Robotic surgery for localized prostate cancer offers a greater range of motion attributed to the EndoWrist instruments. Postoperative outcomes are linked to the quality of vesico-urethral anastomosis. Trainees frequently complain of suturing difficulty in a back-handed fashion. We aimed to analyze wrist motion using the DaVinci simulator. We hypothesized that using the thumb and index finger would allow superior surgical proficiency when compared to the middle finger. METHODS: After institutional review board approval, we recruited 42 medical students in one academic medical center. Students were randomly assigned to start with their thumb and index finger (1&2) or thumb and middle finger (1&3). Three standardized modules were used with nine metrics calculated, including: score, total time, economy of motion, efficiency score, collisions, inaccurate puncture, wound approximation, out of view, and penalty subtotal. Statistical analysis of the metrics was calculated using SPSS. RESULTS: Three metrics were found to have differences between the finger placement of 1&3compared to 1&2. The number of collisions, wound approximation, and penalty score where 1&3 were used had a lower score in each. The number of collisions was 5.7 less in the 1&3 finger placement (p=0.046). This metric was found to have statistically significant differences between finger placement where 1&3 had a lower score compared to 1&2. The wound approximation score was 0.2 points lower when using the 1&3 placement (p=0.075). Lastly, the penalty assigned was 6.5 points lower when using 1&3 (p=0.069). CONCLUSIONS: Although finger placement did not affect the overall score of the completed simulation, instrument collisions and unnecessary wound complications may lead to adverse outcomes when using 1&2 despite offering a wider range of motion. This may be due to decreased comfort in hand position. Trainees may be able to improve the effectiveness of their vesico-urethral anastomosis during robotic-assisted radical prostatectomy. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study is to evaluate whether the application of an interfascial injection with dextrose water could result in reduced pain and improved shoulder function and range of motion. Design: This is a double-blind randomized controlled trial. Thirty-five patients with chronic shoulder pain were randomly assigned to receive either an interfascial injection of 10 mL of 10% dextrose water guided by ultrasound or a sham injection of 0.5 mL of 10% dextrose water into the subcutaneous layer. All patients received education on a home program of self-massage and self-stretching. Shoulder pain, shoulder range of motion, and neck and shoulder function were measured before injection and at 4 and 12 wks after injection. Results: Both groups showed significant improvements in visual analog scale scores at 12-wk follow-up. The interfascial injection group exhibited a significant pain reduction compared with the sham group at the 12-wks follow-up. No between-group differences were observed in shoulder range of motion, pain threshold, and neck and shoulder function. Conclusions: Interfascial injection is effective in decreasing pain in patients with myofascial pain syndrome. [ABSTRACT FROM AUTHOR]

Limited research has characterized the metabolic health benefits of bodyweight interval exercise (BWE) performed outside of a laboratory setting. Metabolic responses to exercise can also be influenced by meal timing around exercise, but the interactive effects of BWE and nutrition are unknown. This study investigated the effects of BWE performed in the fasted or fed state on postprandial glycemia, post-exercise fat oxidation and appetite perceptions. Twelve females (23 ± 2 years; 22 ± 2 kg/m2) underwent two virtually-monitored trials that involved completing BWE (10 × 1 min, 1 min recovery) 5 min before (FastEX) or beginning BWE 10 min after (FedEX) a standardized breakfast. Heart rate and rating of perceived exertion (RPE) were measured during exercise and capillary glucose concentrations were measured for 2 h postprandial. Following exercise, appetite perceptions were assessed and Lumen expired carbon dioxide percentage (L%CO2) was measured as an index of fat oxidation. Heart rate (85 ± 5%) and RPE (14 ± 2) did not differ between conditions (p > 0.05). Postprandial glucose mean (6.1 ± 0.6 vs. 6.8 ± 0.8 mmol/L, p = 0.03), peak (7.4 ± 1.2 vs. 8.5 ± 1.5 mmol/L, p = 0.01), and area under the curve (AUC) (758 ± 72 vs. 973 ± 82 mmol/L × 2 h, p = 0.004) were lower in FedEX versus FastEX. Appetite perceptions were lower in FedEX versus FastEX (−87.63 ± 58.51 vs. −42.06 ± 34.96 mm, p = 0.029). Post-exercise L%CO2 was transiently decreased 30 min post-exercise in both conditions (4.03 ± 0.38 vs. 4.29 ± 0.34%, p = 0.0023), reflective of increased fat oxidation following BWE. These findings demonstrate that BWE performed in the fed compared to the fasted state lowered postprandial glycemia and appetite perceptions in females. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the immediate effect of Dynamic TapeTM (DT) on hip muscle activation and torque and on lower limb kinematics. Forty-five healthy, recreationally active women were randomly assigned to three groups: 1) submitted to the application of DT in the active form in the gluteus medius (GMed) muscle (BG; n = 15), 2) submitted to the application of DT in the placebo form in the GMed muscle (PG; n = 15), and 3) not submitted to any intervention (CG; n = 15). Participants were evaluated for GMed and gluteus maximus (GMax) muscle activation in a maximal voluntary isometric contraction, simultaneously with the assessment of the hip abductor and extensor torques, as well as during two functional tasks – single leg squat (SLS) and jump landing + maximum vertical jump (VJ) – simultaneously with a 2-D kinematic assessment of the lower limb. After DT application in BG, there was a significant decrease in the hip abductor time to peak torque (P = 0.004), hip extensor torque (P = 0.02), excursion to hip adduction (P = 0.007), and to knee flexion (P = 0.02) during the SLS, as well as in GMed activation during VJ (P < 0.05). DT was able to reduce GMed activation and modify lower limb torque and kinematics. [ABSTRACT FROM AUTHOR]

Performance during the baseball pitch is dependent on the flow of mechanical energy through the kinetic chain. Little is known about energy flow during the pitching motion and it is not known whether patterns of energy flow are related to pitching performance and injury risk. Therefore, the purpose of this study was to quantify energy generation, absorption, and transfer across the shoulder and elbow during the baseball pitch and explore the associations between these energetic measures, pitch speed, and traditional measures of upper extremity joint loading. The kinematics of 40 youth baseball pitchers were measured in a controlled laboratory setting. Energy flow between the thorax, humerus, and forearm was calculated using a segmental power analysis. Regression analyses revealed that pitch speed was best predicted by arm cocking phase shoulder energy transfer to the humerus and peak elbow valgus torque was best predicted by arm acceleration-phase elbow energy transfer to the forearm. Additionally, energy transfer across the shoulder and elbow generally exhibited the strongest correlations to pitch speed and upper extremity joint loads. These data reinforce the importance of energy transfer through the kinetic chain for producing high pitch speeds and provide descriptive data for energy flow during baseball pitching not previously found in the literature. [ABSTRACT FROM AUTHOR]

This study was aimed to compare the knee kinematic parameters between dominant and non-dominant legs of adolescent female athletes during change of direction (CoD) in fatigued and unpredictable settings. Knee kinematic parameters on 49 athletes (mean± SD; age = 14.69 ± 0.14 years; mass = 49.05 ± 1.22 kg; height = 1.61 ± 0.08 m) during CoD before and after performing the Bruce protocol and also in predictable and unpredictable setting situations were collected. Kinematic data were recorded at a sampling rate of 200 Hz. The results showed that the dominant leg had significantly 18.7% more flexion (p = 0.001, η = 0.95), 7.1% less valgus (p = 0.001, η = 0.95) and 0.32% lower tibia rotation (p = 0.003, η = 0.16) compared to the non-dominant leg in predictable and pre-fatigue (p < 0.05) conditions. With unpredictable and post-fatigue conditions the dominant limb again demonstrated 17.4% (p = 0.001, η = 0.67), greater knee flexion, 6.8% (0.003,η = 0.97) lower knee valgus and 1.4% (p = 0.001, η = 0.71) less tibiarotation. In conclusion, there may be an increased risk of injury withthe non-dominant leg due to changes in kinematic parameters caused by fatigue and unpredictable CoD manoeuvres. [ABSTRACT FROM AUTHOR]

To investigate the effect of dual-task training on balance and knee proprioception in both weight-bearing and non-weight-bearing conditions in older adults with significant imbalance and high risk of falling. This pre-posttest experimental design included 83 older adults (43 males, 40 females), selected based on age criteria (65–75 years) and specific inclusion and exclusion criteria. Participants underwent dual-task training consisting of 30-minute sessions, three times per week, for four weeks (totaling 12-sessions). Measures included Berg Balance Scale and knee proprioception deficit before and after dual-task training. The study showed statistically significant effect of dual-task training on balance (p < 0.001) and knee proprioception in both weight-bearing (p < 0.001) and non-weight-bearing (p < 0.001) in older adults. Pre-and post-measurements of independent variables between male and female older adults showed no significant difference. Dual-task training improves balance and knee proprioception in both weight-bearing and non-weight-bearing conditions in older individuals, thereby enhancing stability and reducing the risk of falls. [ABSTRACT FROM AUTHOR]

Background: Affective responses are increasingly recognized as potentially effective intervention targets that may facilitate exercise and physical activity behavior change. While emerging correlational evidence suggests that more pleasant affective responses are associated with higher participation and adherence, experimental evidence remains scarce. In light of this, we conducted a preregistered, pragmatic, single-blinded, superiority randomized controlled trial with two parallel groups, with the goal of determining the impact of an individualized exercise-intensity prescription targeting pleasure on exercise frequency. Methods: Forty-seven non-regular exercisers were randomized into two groups. For both groups, the intervention consisted of three exercise sessions based on the Frequency-Intensity-Time-Type (FITT) principle. However, the experimental group also received an individualized intensity prescription based on prior assessment of preference for and tolerance of exercise intensity, as well as instructions emphasizing the promotion of pleasure as a basis for self-regulating exercise intensity. The primary outcome was gymnasium attendance over an eight-week follow-up period. Secondary outcomes were affective valence and arousal, post-exercise enjoyment, core affective exercise experiences, and anticipated and remembered affect. Results: Forty-six participants were retained for analysis (Mage = 32.00; SD = 8.62 years; 56.5% female). Compared to the control group, the experimental group exhibited 77% higher session attendance (14.35 vs. 8.13 sessions) over the eight-week follow-up period (group main effect p =.018, η2p =.120; Cohen's d ranged from 0.28 to 0.91 during follow-up). Also, the experimental group reported higher levels of pleasure during the intervention sessions (for all group main effects, p <.001, η2p from.33 to.37) and higher levels of remembered pleasure (group main effect p =.021, η2p =.116) and anticipated pleasure (group main effect p =.022, η2p =.114). No harm was detected. Conclusions: These results demonstrate the practicality and effectiveness of an intervention aimed at enhancing affective responses to exercise in improving short-term session attendance. Trial registration: ClinicalTrial.gov NCT05416593. [ABSTRACT FROM AUTHOR]

Methods of modelling the female torso during physical activity often neglect the position and movement of the breast. This novel investigation compares three female torso modelling approaches that differ in complexity (integrated breast, fixed breast, dynamic breast) to determine the effect on spinal joint moments during running and jumping. The commonly used integrated breast model distributed breast mass within the torso, the fixed breast model attached the mass of the breasts to fixed positions on the anterior of the torso, and a new dynamic breast model enabled relative motion between the breasts and anterior torso. Key findings demonstrated minimal differences in lumbar spine moments (<0.05 Nm/kg; 4%) between integrated breast and fixed breast models but greater differences, up to 0.86 Nm/kg (68%) during running and 0.89 Nm/kg (82%) during jumping, when breast motion was included. Thoracic spine moments revealed similar patterns with minimal differences (<0.05 Nm/kg; 11%) between integrated breast and fixed breast models and greater differences, up to 0.48 Nm/kg (92%) during running and 0.63 Nm/kg (66%) during jumping, with the dynamic breast model. Future female musculoskeletal models should consider including breast mass and motion to avoid mis-representing spinal loading in females during running and jumping. [ABSTRACT FROM AUTHOR]

Objective People living with chronic kidney disease (CKD) and receiving hemodialysis (HD) have impaired respiratory muscle strength and endurance. The objective of this study was to systematically review the effects of inspiratory muscle training (IMT) on respiratory muscle strength, functional capacity, lung function, quality of life, endothelial function, and oxidative stress in people living with CKD and receiving HD. Methods An electronic search was conducted from inception to June 2023. Randomized controlled trials that evaluated the effects of IMT on respiratory muscle strength, functional capacity, lung function, endothelial function, quality of life, or oxidative stress in adults living with CKD and receiving HD, compared with control, placebo IMT, or conventional physical therapy, were included. Results Eight studies were included, totaling 246 people. The meta-analysis showed that IMT increased the maximum inspiratory pressure (MIP) by 22.53 cm H2O, the maximum expiratory pressure (MEP) by 19.54 cm H2O, and the distance covered in the 6-minute walk test by 77.63 m. Changes in lung function and quality of life were not observed. It was not possible to quantitatively analyze data on endothelial function and oxidative stress. Conclusion IMT improves MIP, MEP, and functional capacity in people living with CKD and receiving HD. IMT did not demonstrate significant results for lung function and quality of life. Effects on endothelial function and oxidative capacity remain uncertain. Impact Inspiratory muscle training improves MIP, MEP, and functional capacity in people living with CKD and receiving HD, compared with conventional physical therapy or controls or placebo intervention. Increases in functional capacity in this population are extremely important because of the relationship with the survival of these people. [ABSTRACT FROM AUTHOR]

Purpose: Whey protein ingestion is typically considered an optimal dietary strategy tomaximizemyofibrillar protein synthesis (MyoPS) after resistance exercise. Although single-source plant protein ingestion is typically less effective, at least partly, due to less favorable amino acid profiles, this could theoretically be overcome by blending plant-based proteins with complementary amino acid profiles. We compared the postexercise MyoPS response after the ingestion of a novel plant-derived protein blend with an isonitrogenous bolus of whey protein. Methods: Ten healthy, resistance-trained, young adults (male/female: 8/2; age: 26 ± 6 yr; BMI: 24 ± 3 kg·m-2) received a primed continuous infusion of L-[ring-²H5]-phenylalanine and completed a bout of bilateral leg resistance exercise before ingesting 32 g protein from whey (WHEY) or a plant protein blend (BLEND; 39.5% pea, 39.5% brown rice, 21.0% canola) in a randomized, double-blind crossover fashion. Blood and muscle samples were collected at rest, and 2 and 4 h after exercise and protein ingestion, to assess plasma amino acid concentrations, and postabsorptive and postexercise MyoPS rates. Results: Plasma essential amino acid availability over the 4 h postprandial postexercise period was ~44% higher inWHEY compared with BLEND (P = 0.04). From equivalent postabsorptive values (WHEY, 0.042 ± 0.020%·h-1; BLEND, 0.043 ± 0.015%·h-1) MyoPS rates increased after exercise and protein ingestion (time effect; P < 0.001) over a 0- to 2-h period (WHEY, 0.085 ± 0.037%·h-1; BLEND, 0.080 ± 0.037%·h-1) and 2- to 4-h period (WHEY, 0.085 ± 0.036%·h-1; BLEND, 0.086 ± 0.034%·h-1), with no differences between conditions during either period or throughout the entire (0-4 h) postprandial period (time-condition interactions; all P > 0.05). Conclusions: Ingestion of a novel plant-based protein blend stimulates postexercise MyoPS to an equivalent extent as whey protein, demonstrating the utility of plant protein blends to optimize postexercise skeletal muscle reconditioning. [ABSTRACT FROM AUTHOR]

Cranberries are rich in polyphenols, have a high antioxidant capacity, and may protect against exercise-induced free radical production. Mitochondria are known producers of free radical in skeletal muscle, and preventing overproduction of radicals may be a viable approach to improve muscle health. This study aimed to investigate the effect of a polyphenol-rich cranberry extract (CE) on muscle oxidative capacity and oxygenation metrics in healthy active adults. 17 participants (9 males and 8 females) were tested at: (i) baseline, (ii) 2 h following an acute CE dose (0.7 g/kg of body mass), and (iii) after 4 weeks of daily supplement consumption (0.3 g/kg of body mass). At each time point, muscle oxidative capacity was determined using near-infrared spectroscopy to measure the recovery kinetics of muscle oxygen consumption following a 15–20 s contraction of the vastus lateralis. Cranberry supplementation over 28 days significantly improved muscle oxidative capacity (k-constant, 2.8 ± 1.8 vs. 3.9 ± 2.2; p = 0.02). This was supported by a greater rate of oxygen depletion during a sustained cuff occlusion (−0.04 ± 0.02 vs. −0.07 ± 0.03; p = 0.02). Resting muscle oxygen consumption was not affected by cranberry consumption. Our results suggest that cranberry supplementation may play a role in improving mitochondrial health, which could lead to better muscle oxidative capacity in healthy active adult populations. [ABSTRACT FROM AUTHOR]

Patellar tendinopathy is more prevalent in males versus female athletes and commonly presents in the medial region of the tendon. Separate measures of patellar tendon strain in the medial, central, and lateral regions of the tendon, however, have not been quantified. The purpose was to investigate the differences in tendon strain between the medial, lateral, and central regions of the patellar tendon in healthy men and women. Strain in the medial and lateral regions of the patellar tendon in healthy participants (10 males, 10 females) was evaluated using ultrasound during isometric quadriceps contractions at 20%, 40%, 60%, 80%, and 100% of maximum voluntary contraction (MVIC) in 60° and 90° of knee flexion. Central strain was also measured at 60% MVIC in 90° of knee flexion. Mixed models were used to determine strain between tendon regions and sex at 60% MVIC in 90° of knee flexion. Sequential modeling was used to fit region, sex, %MVIC, and angle to predict strain. The central region had less strain compared with both medial and lateral regions. The lateral region had higher strain compared with the medial region regardless of sex. Females had higher strain compared with males, regardless of region. Knee position did not influence tendon strain. Patellar tendon strain differs by region and sex. The varying prevalence between sex and in location of patellar tendinopathy may in part be explained by the unbalanced strains. Differential assessment of regional patellar tendon strain may be of importance for understanding injury risk and recovery with exercise. [ABSTRACT FROM AUTHOR]

This study aimed to compare performance, kinematic, and physiological variables between open water and pool swimming conditions in elite triathletes and to examine the associations between conditions on these variables. Fourteen elite triathletes (10 males and 4 females [23.4 ± 3.8 years]) performed two 1500‐m swimming tests in open water and in a 25‐m pool. Swimming speed, stroke rate (SR), length (SL) and index (SI), heart rate (HR), blood lactate concentrations [La−], and end‐exercise oxygen uptake (EEV̇O2) were assessed in both conditions. Lower SL and SI and higher SR were obtained in open water compared with pool swimming (p < 0.05). Moreover, kinematic variables changed as a function of distance in both conditions (p < 0.05). No differences were found in the main physiological variables (HR, [La−], and EEV̇O2) between conditions. Respiratory exchange ratio presented lower values in open water than in pool conditions (p < 0.05), while time constant was higher in open water (p = 0.032). The fastest triathletes in open water obtained the best performance in the pool (r = 0.958; p < 0.001). All kinematic variables, HR and peak [La−] presented positive associations between conditions (r > 0.6; p < 0.05). Despite physiological invariance, triathletes and coaches should monitor specific open water training to adapt their swimming technique to the competitive environment. [ABSTRACT FROM AUTHOR]

The purposes of this study were to clarify the electromyography (EMG) of plantar flexors and to analyze the fascicle and tendon behaviors of the gastrocnemius medialis (GM) during running in the carbon-fiber plate embedded in thicker midsole racing shoes, such as the Nike ZoomX Vaporfly (VF) and traditional racing shoes (TRAD). We compared the fascicle and series elastic element behavior of the GM and EMG of the lower limb muscles during running (14 km/h, 45 s) in athletes wearing VF or TRAD. GM EMGs in the push-off phase were approximately 50% lower in athletes wearing VF than in TRAD. Although the series elastic element behavior and/or mean fascicle-shortening velocity during the entire stance phase were not significantly different between VF and TRAD, a significant difference was found in both the mean EMG and integral EMG of the GM during the push-off phase. EMG of the gastrocnemius lateralis (GL) during the first half of the push-off phase was significantly different between VF and TRAD. Present results suggest that VF facilitates running propulsion, resulting in a decrease in GM and GL EMGs at a given running velocity during the push-off phase, leading to a reduction in metabolic cost. [ABSTRACT FROM AUTHOR]

Manipulating the amount of muscle mass engaged during exercise can noninvasively inform the contribution of central cardiovascular and peripheral vascular-oxidative functions to endurance performance. To better understand the factors contributing to exercise limitation in older and younger individuals, exercise performance was assessed during single-leg and double-leg cycling. 16 older (67 ± 5 years) and 14 younger (35 ± 5 years) individuals performed a maximal exercise using single-leg and double-leg cycling. The ratio of single-leg to double-leg cycling power (RatioPower SL/DL) was compared between age groups. The association between fitness (peak oxygen consumption, peak power output, and physical activity levels) and RatioPower SL/DL was explored. The RatioPower SL/DL was greater in older compared with younger individuals (1.14 ± 0.11 vs. 1.06 ± 0.08, p =.041). The RatioPower SL/DL was correlated with peak oxygen consumption (r =.886, p <.001), peak power output relative to body mass (r =.854, p <.001), and levels of physical activity (r =.728, p =.003) in the younger but not older subgroup. Reducing the amount of muscle mass engaged during exercise improved exercise capacity to a greater extent in older versus younger population and may reflect a greater reduction in central cardiovascular function compared with peripheral vascular-oxidative function with aging. [ABSTRACT FROM AUTHOR]

Context: Physical changes following activity are well documented, but there is limited information about self-reported outcomes around competitive matches. High training volumes and poor recovery could predispose athletes to overuse injury. The purpose of this study was to identify the changes in daily athlete health measures before, during, and after the day of each match in high- and low-volume groups. Design: Prospective cohort. Methods: Fifty-five soccer athletes (age: 19.8 [1.2] y, 26 males, 29 females) provided daily measures of readiness, physical fatigue, mental stress, sleep quality, and soreness intensity match days, days 1 (D01) and 2 (D02) following matches, and standard practice days. Participants were grouped into high volume and low volume, based off the minutes played during the season. Results: Soreness increased, readiness decreased, and fatigue increased on D01 compared with match days (P <.008) in the high-volume group. Between groups, the high-volume group demonstrated higher soreness on D01 and D02, lower readiness on D01 and D02, and lower fatigue on D01, compared with the low-volume group (P <.008). Conclusions: Soccer athletes demonstrate significant changes in self-reported athlete health variables around competitive matches. These changes are similar to physical outcomes, potentially indicating that the athlete health variables may be used to track athlete recovery from competition, potentially limiting the impact of overuse injuries. [ABSTRACT FROM AUTHOR]