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Purpose: To examine differences in resistance exercise-induced hormonal responses among young athletes according to their maturity levels. Materials and Methods: A total of 12 collegiate and 32 junior high school male athletes were enrolled. The junior high school participants were divided into pre–peak height velocity (PHV) and post-PHV groups, according to their PHV ages. The salivary testosterone, cortisol, and human growth hormone levels were analyzed before (pre), immediately after (post), and at 15 minutes after performing body weight resistance exercise. Results: The testosterone levels were higher in the collegiate than in the junior high school group (P P P P P P P Conclusion: Exercise-induced acute hormonal responses to resistance exercise may depend on individuals’ maturity levels, even in those having the same age.

This crossover trial aimed to investigate whether additional loading of unilateral Nordic hamstring exercise on a sloped platform would increase the biceps femoris long head electromyographic activity. Participants were randomly allocated to unilateral Nordic hamstring exercise under three conditions: bodyweight only (BW) or BW with an added weighted ball of 3 kg (BW + 3 kg) or 6 kg (BW + 6 kg), respectively. The biceps femoris long head electromyographic activity was significantly higher for BW + 6 kg (p p

Purpose: To evaluate the effect of the number of high-acceleration movements on muscle damage and the rating of perceived exertion (RPE) in basketball games. Methods: Twenty-one male collegiate basketball players (mean age, 20.0 [1.0] y) were included. A triaxial accelerometer was used to measure acceleration in basketball-simulated scrimmages. To detect higher physical load during the actual game, the resultant acceleration was calculated, and 3 thresholds were set: >4G, >6G, and >8G resultant accelerations. The number of the extracted movements was calculated at each acceleration threshold. Plasma creatine kinase (CK) levels (marker of muscle damage) were estimated before and 24 hours after the match, and the session-RPE load was calculated within 30 minutes after the match. Pearson product-moment correlations with 95% confidence intervals were used to determine the relationships between the number of high-acceleration movements and plasma CK and session-RPE load. Results: Significant correlations were observed between the number of high-acceleration movements >8G and CK level (r = .74; 95% confidence interval, 0.44–0.89; P 4G: r = .65; >6G: r = .69). Contrastingly, the correlation coefficient between acceleration and the session-RPE load decreased with increased acceleration threshold (>4G: r = .72; >6G: r = .52; >8G: r = .43). Conclusions: The session-RPE reflects the total amount of movement, while the high-acceleration movement reflects the momentary large impact load or intensity, and they evaluated different factors. Basketball coaching and conditioning professionals recommended combining acceleration and session-RPE when monitoring the load of athletes.

This study aimed to clarify the kinematic, kinetic characteristics associated with lateral ankle sprain.A 16-month prospective cohort study.Laboratory.A total of 179 college athletes.Joint kinematics, moment during single-leg landing tasks, and ankle laxity were measured. The attendance of each participating team, injury mechanism, existence of body contact, presence of orthosis, with or without medical diagnosis, and periods of absence were recorded.Twenty-nine participants incurred lateral ankle sprain during non-contact motion. The Cox regression analysis revealed that greater knee varus peak angle (hazard ratio: 1.16 [95% confidence interval: 1.10-1.22], p 0.001) and greater pelvic internal rotation peak angle toward the support leg were associated with lateral ankle sprain (hazard ratio: 1.08 [95% confidence interval: 1.02-1.15], p = 0.009). The cut-off values for each predictive factor were -0.17° (area under the curve = 0.89, p 0.001) and 6.63° (area under the curve = 0.74, p 0.001), respectively.A greater knee varus peak angle and pelvic internal rotation peak angle after single-leg landing are predictive factors for lateral ankle sprain.

Introduction Maintaining flexibility, often defined as range of motion (ROM), is important. Recently, self-massage using a foam roller (FR) has been used in clinical and/or sports settings to effectively and immediately improve ROM. Many studies have found significant increases in ROM following the FR intervention; however, the mechanism of the effect is unclear. We aimed to clarify this mechanism regarding the ROM effects following the FR intervention by evaluating local tissue and autonomic nervous system responses. Method The study employed a crossover design that included a comparison between non-intervention (CON trial: left leg) and intervention (FR trial: right leg) groups. Fourteen volunteers participated. Nine outcomes (passive maximum ankle ROM [ROM with a specified and non-specified passive strength], tissue hardness, skin temperature, water contents, circumference, blood flow velocity, pressure pain threshold, autonomic nervous system, and heart rate) were investigated before (PRE) and 0 min (POST0), 20 min (POST20), 40 min (POST40), and 60 min (POST60) post intervention. Results Skin temperature, impedance, and circumference changed significantly following the intervention, and increased ROM with non-specified strength was observed. Discussion Although we found that the FR intervention influenced skin temperature, impedance, circumference, and ROM, adaptability to the intervention may differ depending on an individual's characteristics. Females and/or individuals with a high body water content could obtain greater positive ROM effects than males and/or individuals with a low body water content. Conclusion These findings suggest that the FR intervention may be an effective method to improve ROM, with alterations of skin temperature, impedance, and circumference.

The purpose of this study was to examine whether the NHE with an increased lower leg slope angle would enhance hamstring EMG activity in the final phase of the descend. The hamstring EMG activity was measured, the biceps femoris long head (BFlh) and the semitendinosus (ST). Fifteen male volunteers participated in this study. Subjects performed a prone leg curl with maximal voluntary isometric contraction to normalize the hamstring EMG activity. Subsequently, subjects performed the NHE, with the help of a certified strength and conditioning specialist, while the lower leg slope angle were randomly set at 0° (NH), 20° (N20), and 40° (N40). To compare hamstring EMG activity during the NHE variations, the knee flexion angle was set in the range from 0° to 50°, divided into five phases (0–10°, 10–20°, 20–30°, 30–40° and 40–50°), where 0° indicated that the knee was fully extended. To calculate the knee extension angular velocity, the knee flexion angle divided by time, and break point angle (BPA) was the angle at which 10°/s was exceeded. In the statistical analysis, a two-way repeated measures ANOVA was used for the hamstring EMG activity and a one-way repeated measures ANOVA was used for the BPA. The EMG activity of the BFlh and the ST in N20 and N40 was significantly higher than in NH at knee flexion angle of 0–20° (p < 0.05). For the BPA, NH (57.75° ± 13.28°), N20 (36.27° ± 9.89°) and N40 (16.26° ± 9.58°) were significantly higher in that order (p < 0.05). The results of this study revealed that the NHE with an increased lower leg slope angle shifted the BPA to the lower knee flexion angle and enhanced the hamstring EMG activity in the final phase of the descent.

Kenichiro Murata,1 Tsukasa Kumai,2 Norikazu Hirose2 1Graduate School of Sport Sciences, Waseda University, Nishi-tokyo, Japan; 2Faculty of Sport Sciences, Waseda University, Saitama, JapanCorrespondence: Norikazu HiroseFaculty of Sport Sciences, Waseda University, 2-579-15, Mikajima, Tokorozawa, Saitama 359-1192, JapanTel/Fax +81 42-451-1022Email toitsu_hirose@waseda.jpPurpose: Lateral ankle sprain (LAS) in childhood can result in lateral malleolus avulsion fractures; additionally, bone nonunion may occur. Physical maturity relates to the development of bone morphology and physical functionality. It is unknown how changes in physical functionality attributable to physical maturity affect young soccer players with abnormal lateral malleolus (ALM) morphology. Hence, the present study aimed to investigate the bone morphology of the lateral malleolus in young soccer players and to examine its relationship with physical functionality at different maturity levels.Subjects and Methods: Two hundred and ninety young soccer players aged 6– 15 years were included. The presence of ALM was assessed using ultrasonography. The subjects were allocated to three groups based on physical maturity (Pre-, Mid-, and Post-peak height velocity age [PHVA]). The prevalence of ALM and the relationship between ALM and physical maturity were examined for body composition, foot pressure distribution, foot alignment, ankle mobility, and single-leg balance.Results: The prevalence of ALM was 17.6%. For physical maturity, the post-PHVA group showed a decrease in ankle dorsiflexion and eversion and an increase in one-leg hop distance compared to the Pre-PHVA group (P < 0.05). In the ALM group, the center of pressure during heel raising was distributed laterally in the Post-PHVA (P < 0.01), and the weight-bearing dorsiflexion angle was decreased in the Mid- and Post-PHVA (P < 0.05).Conclusion: In the Post-PHVA young soccer players, decreased ankle dorsiflexion and eversion and increased one-leg hop distance were observed. The ALM group exhibited lateral loading during heel raising in the Post-PHVA group and decreased weight-bearing ankle dorsiflexion angle in the Mid- and Post-PHVA groups. The findings indicate the importance of secondary prevention of LAS and ultrasonography. Prospective studies of LAS in young athletes are required in the future.Keywords: lateral ankle sprain, ultrasonography, physical maturity, physical function, soccer

In this study, we investigated differences in electromyographic activity in the biceps femoris long head (BFl), semitendinosus, and semimembranosus muscles during 45° hip extension with different knee angles during eccentric, concentric, and isometric hip 0°, and isometric hip 45° conditions with non-external resistance and 5-kg load. Twenty-two male volunteers performed 45° hip extension with knee flexion angles of 0°, 45° and 90° with non-external resistance and 5-kg load eccentric, concentric, isometric hip 0°, and isometric hip 45° conditions. The electromyographic data obtained during each condition were normalized with the values collected during maximal voluntary isometric contraction of each muscle. A multivariate analysis of variance with repeated measures using syntax was used to compare the normalized electromyography of each muscle across different knee joint angles in each weight condition. Electromyographic activities of the BFl, semitendinosus, and semimembranosus at 45° and 90° knee flexion angles were significantly greater than at 0° in the eccentric, concentric, isometric hip 0°, and in isometric hip 45° conditions with both non-external resistance and 5-kg load (p

Context: Several studies have reported that self-massage using a foam roller (FR) increased joint range of motion (ROM) immediately. However, the mechanism of increasing ROM by the FR intervention has not been elucidated. Objective: To clarify the mechanism by investigating properties and morphological changes of muscles targeted by the FR intervention. Design: An interventional study. Setting: An athletic training laboratory. Participants: Ten male college volunteers with no injuries in their lower limbs (mean [SD]: age 23.8 [3.2] y, height 173.2 [4.9] cm, weight 69.5 [8.6] kg). Intervention: The FR intervention on the right plantar flexors for 3 minutes. Main Outcome Measures: Maximum ankle ROM, muscle hardness, and fascicle length of the gastrocnemius muscle at the neutral (0°), maximum dorsiflexion, and maximum plantar flexion positions. All measurements were conducted before (PRE) and after (POST) the FR intervention. Results: Dorsiflexion ROM increased significantly at POST (PRE: 13.6° [8.0°], POST: 16.6° [8.4°]; P Conclusions: Dorsiflexion ROM increased significantly by the FR intervention in the present study; however, muscle hardness and fascicle length did not change. FR may affect not only the muscle but also the fascia, tendon, and muscle-tendon unit. The FR protocol of the present study can be applied in clinical situations, because it was found to be effective to increase ROM.

The neuromuscular activity in the hamstring and quadriceps muscles is vital for rapid force control during athletic movements. This study aimed to investigate the recruitment properties of the corticospinal pathway of the biceps femoris long head (BFlh) and rectus femoris (RF) muscles. Thirty-two male subjects were participated in this study. Corticospinal excitability was investigated for BFlh and RF during the isometric knee flexion and extension tasks, respectively, using transcranial magnetic stimulation. A sigmoidal relationship was observed between the stimulus intensity and amplitude of motor-evoked potentials and characterized by a plateau value, maximum slope, and threshold. Compared with RF, BFlh had a significantly lower plateau value (P 0.001, d = 1.17), maximum slope (P 0.001, r = 0.79), and threshold (P = 0.003, d = 0.62). The results showed that the recruitment properties of the corticospinal pathway significantly differ between BFlh and RF. These results reveal that when a sudden large force is required during athletic movements, the RF can produce force through a rapid increase in the recruitment of motor units. The BFlh, on the other hand, requires larger or more synchronized motor commands for enabling the proper motor unit behavior to exert large forces. These differences in the neurophysiological factors between the hamstrings and quadriceps can have a substantial effect on the balance of force generation during athletic activities.

To examine the incidence and survival rates of sudden cardiac arrest that were documented during school organized sports in Japan.Retrospective cohort study.Insurance claim data of cardiac events (sudden cardiac death and sudden cardiac arrest with resultant disabilities) that occurred during Japanese high school organized sports between 2009 and 2018 were retrieved. Participation data from All Japan High School Athletic Federation and Japan High School Baseball Federation were used for incidence rate calculations. Incidence rate ratios with 95 % confidence interval were calculated to compare the risk by sports and sex. The survival rate was calculated with the proportion of resuscitated cases to total number of cardiac events in this dataset.A total of 55 cardiac events (25 survivors and 30 deceased) were identified in the dataset. The majority affected male student-athletes (92.7 %). The frequency and incidence rate of cardiac events were highest in male baseball (n = 16 [29.1 %], incidence rate: 0.91 per 100,000 athlete-years). Incidence rate ratio revealed that male basketball (2.19, 95 % confidence interval: 1.04-4.60), male baseball (2.31, 95 % confidence interval: 1.32-4.03), and first-year male baseball (4.11, 95 % confidence interval: 2.10-8.07) had significantly higher risk of cardiac events, compared to the overall incidence rate (0.38 per 100,000 athlete-years). The survival rates were 37.5 % in the first half (2009-2013) and 56.5 % in the latter half (2014-2018) of the study period.The risk of cardiac events was highest in male, baseball, first-year student-athletes. Rapid AED application by bystanders should be advocated to enhance better survival.

Koyama, T, Rikukawa, A, Nagano, Y, Sasaki, S, Ichikawa, H, and Hirose, N. Acceleration profile of high-intensity movements in basketball games. J Strength Cond Res 36(6): 1715-1719, 2022-This study aimed to elucidate movements that require greater acceleration during basketball games, their occurrence frequency, and compare acceleration components. Eighteen male collegiate basketball players (age: 19.5 ± 0.8 years) were enrolled. Triaxial accelerometer was used to measure acceleration and a synchronized video was recorded. Moments that generated resultant accelerations4, 6, and 8 G, and their coincided movements were identified. Ratios and frequencies of the extracted movements were calculated and Jonckheere-Terpstra trend test was used to examine which movement rate increased when acceleration threshold increased. In addition, the top 7 movements that generated a resultant acceleration6 G among the combination of basketball-specific movements were extracted. Their resultant, mediolateral, vertical, and anteroposterior accelerations were identified and compared using one-way analysis of variance. Cohen's d was used to calculate effect sizes. All p0.05 were considered statistically significant. The extracted frequencies were 33.6, 9.1, and 2.3 cases per minute for4 G,6 G, and8 G, respectively. As the threshold increased, the rate of deceleration, landing, and physical contact increased. The mediolateral acceleration of physical contact was significantly greater than other movements, whereas the vertical acceleration of landing and deceleration was significantly greater than other movements. Thus, acceleration component analysis was performed to classify movement types. Greater acceleration appeared frequently in movement during defense. It is suggested that many defense movements involve a reaction to the ball and opponent. There are many passive movements during defense and speed changes rapidly. If many passive movements occur when defending, larger physical load is applied, and may lead to fatigue.

Itoh, R and Hirose, N. Relationship among biological maturation, physical characteristics, and motor abilities in youth elite soccer players. J Strength Cond Res 34(2): 382-388, 2020-Studies investigating skeletal maturity and motor abilities in youth Asian elite soccer players are lacking. We aimed to investigate the cross-sectional relationship among skeletal age (SA), physical characteristics, and motor abilities in youth elite soccer players. Skeletal age is commonly used to estimate the maturity status of youth athletes using a hand-wrist radiograph. We enrolled 49 youth elite male soccer players (12.7 ± 0.2 years). Height, body mass, body fat percentage, circumference (thigh/calf), flexibility, 10-m/50-m sprint, 10-m × 5 shuttle run, the crank test, 5-step bounding, Yo-Yo intermittent recovery test level 2, and cooper run were measured. Participants were divided into early (n = 14), average (n = 22), and late (n = 13) maturation groups according to their chronological age (CA) and SA based on the following criteria: SA-CA-1 year, SA-CA = ±1 year, and SA-CA+1 year, respectively. The difference in parameters among the groups was analyzed using one-way analysis of variance and Tukey's post hoc test. Statistical significance was set at p0.05. The early and average maturation groups were taller and heavier and had a larger circumference than the late maturation group (p0.05). Conversely, the early and average groups were significantly faster in 50-m sprint (p0.05) and scored higher in 5-step bounding (p0.05) than the late group. There was no difference in other parameters among the groups. In conclusion, the difference in biological maturity influences physical and physiological development, particularly height and muscular power, in youth elite soccer players.

This study investigated the effect of high-intensity cycling re-warm up (RW) within a very short time-frame on the subsequent intermittent sprint performance. Twelve active males completed three trials in random order: control (CON); 3-min RW at 30% of maximal oxygen uptake (VO2max) (RW30); and 1-min RW at 90% of VO2max (RW90). During the experimental trials, participants performed 40-min intermittent cycling exercise followed by 15-min rest. During the rest period, participants completed CON, RW30, or RW90. After the rest period, participants performed the Cycling Intermittent-Sprint Protocol (CISP), which consisted of 10-s rest, 5-s maximal sprint, and 105-s active recovery with the cycles repeated over 10 min. The mean work during sprint for the CISP was significantly higher in both RW trials than in the CON trial (mean±standard deviation; CON: 3539±698 J; RW30: 3724±720 J; RW90: 3739±736 J; p, This study was supported by JSPS KAKENHI Grant Number 17J02878 (to TY) and internal funding from the Waseda University (to MM and NH).

Ankle sprains are the most prevalent injuries, and elevated fear avoidance beliefs after ankle sprain episodes could inhibit athletic performance and contribute to residual symptoms, such as functional and/or mechanical instability. However, it remains unclear how fear avoidance beliefs differ according to conditions of posttraumatic sequelae. The purpose of this study was to determine whether fear of movement/reinjury differed between individuals with and without functional ankle instability (FI, NFI) and healthy controls (CON) and to examine the relationship between fear and ankle joint laxity by sex. Participants (115 male athletes, 105 female athletes) completed the Identification of Functional Ankle Instability, Athlete Fear Avoidance Questionnaire (AFAQ), Tampa Scale for Kinesiophobia (TSK), and ankle joint laxity test. Total 168 athletes (79 males, 89 females) data were eligible for analysis. The results demonstrated that fear of movement/reinjury was lower in individuals in the absence of functional ankle instability although they experienced ankle sprain (FI; TSK=38.6±4.5, AFAQ=27.4±6.2, NFI; TSK=35.7±5.6, AFAQ=24.5±6.6). The fear of movement/reinjury had correlation with ankle joint laxity only in female athletes (TSK; r=0.285, p=0.013, AFAQ; r 0=0.322, p=0.045).

This study aimed to examine longitudinal age-related changes in muscle morphology and jump and sprint performances of youth athletes. The subjects of this longitudinal study were 41 youth male basketball players who were assigned to late, mid, and early groups based on differences regarding the estimated age at peak height velocity. The vastus medialis, vastus intermedius, rectus femoris, vastus lateralis, biceps brachii, and triceps brachii thicknesses were assessed using ultrasonography. The subjects’ anaerobic capacities were evaluated based on Abalakov jumps and 20-m sprint time. After 1 year, the vastus medialis and biceps brachii thicknesses increased significantly in all groups, and the rectus femoris, vastus intermedius, and vastus lateralis thicknesses increased significantly in the late and mid groups, but not in the early group. The Abalakov jumps and 20-m sprint time improved significantly in all groups. The early group’s 10-m sprint time improved significantly. Cross-sectional comparisons showed that after 1 year, the early group’s Abalakov jumps and 20-m sprint time at baseline, its Abalakov jumps, and 10-m and 20-m sprint times were significantly better than those in the mid and late groups. Hence, significant muscle growth occurred before the athletes reached the age at peak height velocity. During puberty, late maturers’ sprint times and jump performances may not catch up with those of early maturers. The speed and tempo of the morphological growth and anaerobic ability of athletes in the same age category depend on athletes’ biological maturity.

Objective. Joint torque differences between healthy and rehabilitated legs are often measured as a clinical index of recovery from muscle strain injury. Unfortunately, it should be noted that this is a questionable evaluation measure of the muscle after injury because it is a composite value including related cooperating muscles. Meanwhile, the use of ultrasound elastography for the measurement of individual muscle mechanical properties (i.e., muscle hardness) has recently expanded. The purpose of this study was to examine, using ultrasound elastography, the differences in the linear relationship between muscle contraction intensity and muscle hardness during knee extension in athletes who had recovered from grade II rectus femoris muscle strain injury through comparison of the healthy and rehabilitated legs. Methods. Six athletes participated. Rectus femoris muscle hardness, determined during isometric contraction at 10%, 20%, 30%, and 40% of maximum voluntary contraction, was evaluated using ultrasound strain elastography. Results and Conclusion. The results indicated that for the healthy legs, the strain ratios, as indicated by muscle hardness, decreased linearly (became harder) with contraction intensity, but the strain ratios for the rehabilitated legs decreased nonlinearly. These results show the danger of judging the recovery period using only the difference between healthy and rehabilitated muscle strengths and the importance of evaluating individual muscles.

Hamstring strain often occurs when an opponent unanticipatedly perturbs an athlete's movements. We examined the neuromuscular responses of hamstring and trunk muscles during unanticipated trunk perturbations in athletes with and without a history of hamstring strain injury. Male college athletes (11 with a history of a unilateral hamstring injury and 10 without prior injury) knelt while wearing a chest harness attached to a cable that was pulled backward. They were instructed to resist the force isometrically and maintain their position when the perturbations were applied. The pressure was released with or without a cue (CUE or NoCUE). We measured trunk acceleration, three-dimensional kinematic data, and surface electromyography (EMG) signals of the erector spinae, internal oblique, gluteus maximus, biceps femoris long head, and semitendinosus muscles. Maximum trunk acceleration and displacement were greater with NoCUE in both groups (p < 0.05). EMG amplitude did not differ after perturbation of any investigated muscle. The injured group demonstrated a delayed onset of the gluteus maximus and erector spinae muscles in NoCUE versus CUE stimuli (p < 0.05). Athletes with a history of hamstring strain injury exhibited a reduced neuromuscular coordination of the lumbopelvic muscles in response to unanticipated trunk movement.

Self-massage using a foam roller (foam rolling) has been used to improve joint range of motion (ROM). However, the effect of foam rolling on the morphology of a targeted muscle, tendon, and muscle-tendon unit (MTU) has not been fully clarified. This study aimed to investigate extensibility changes in the gastrocnemius muscle (GM), MTU, and the Achilles tendon (AT) in terms of maximum ankle dorsiflexion (max-DF) following a foam rolling intervention. This was an interventional study with no controls.Study participants comprised 10 male and female students (mean [standard deviation]: 22.7 [2.5] years; height, 164.2 [6.7] cm; weight, 57.9 [7.9] kg). The foam rolling intervention was performed on the right leg plantar flexor muscles for 3 min. The outcomes were max-DF with specified resistance values (ROM-SR) and non-specified resistance values (ROM-NSR) and GM, MTU, and AT extensibility. An ultrasound device was used to determine the rate of change by subtracting the value in a neutral ankle joint position (0°) from the ankle max-DF to identify GM, MTU, and AT extensibility. All outcomes were measured pre- and post-intervention.The range of ankle joint dorsiflexion increased significantly following the foam rolling intervention (Δ: ROM-SR, +4.35 [5.79]; ROM-NSR, +4.18 [4.43]), whereas GM extensibility increased 4.0 mm, although no significant difference was observed pre- and post-intervention.Foam rolling was effective in increasing ankle joint dorsiflexion ROM. Moreover, it was suggested that the GM morphology might be affected by the intervention.

Context: This study aimed to examine the differences in electromyographic (EMG) activity of the biceps femoris long head (BFlh) and semitendinosus (ST) muscles, break-point angle (BPA), and the angle at peak BFlh EMG activity between bilateral and unilateral Nordic hamstring exercise (NHE) on a sloped platform. Design: This study was designed as a case-control study. Methods: Fourteen men participated in the study. The participants initially performed maximum voluntary isometric contraction (MVIC) on the prone leg curl to normalize the peak hamstring EMG amplitude as the %MVIC. Then, participants were randomized to perform the following 3 variations of NHE: bilateral (N40) or unilateral (N40U) NHE with a platform angle of 40°, and unilateral NHE with a platform angle of 50° (N50U). The EMG activities of the BFlh and ST and the knee flexion angle during the NHE variations were recorded to calculate the EMG activity of the BFlh and ST in terms of the %MVIC, the angle at peak BFlh EMG, and BPA. Results: The BFlh %MVIC was significantly higher in N40U (P P P P Conclusions: In the late swing phase of high-speed running, BFlh showed higher EMG activity; thus, unilateral NHE may be a specific hamstring exercise for hamstring injury prevention.

Limited literature has investigated epidemiology of sports-related fatalities during high school organizes sports in Japan. Therefore, the purposes of this study are to determine the frequency and incidence rate of sports-related fatalities in Japanese high schools by cause and sports, and to examine the type of on-site first responder. Insurance claim data of sports-related fatalities in Japanese high schools reported to Japan Sports Council Injury and Accident Mutual Aid Benefit System between 2009 and 2018 were retrieved as the primary data source. All fatalities were classified into direct or indirect type by the reported etiology and further categorized into cardiac-related, head and neck injury, exertional heat stroke (EHS), or other. Frequency and incidence rate were calculated by cause of death and sports, and incidence rates were expressed per 100,000 athlete-years (AY) with 95% confidence interval (CI). Information regarding first responder to the incident was also retrieved and examined by frequency. A total of 63 sports-related fatalities were analyzed. The overall incidence rate was 0.45 (95%CI = 0.25–0.65) per 100,000AY. The incidence rates of direct and indirect fatalities declined from 0.36 and 0.50 per 100,000AY to 0.28 and 0.00 per 100,000AY, respectively. The leading cause of deaths was cardiac-related (n = 30/63, 47.6%), followed by head and neck injury (n = 15/63, 23.8%) and EHS (n = 14/63, 22.2%). The number of fatalities was highest in male baseball (n = 12/63, 19.0%) and the incidence rate was highest in male judo (4.79 per 100,000 AY, 95%CI: 0.68–8.15). Coach was the most frequently reported first responder onsite (n = 52/63, 82.5%). Medically trained personnel were involved in onsite care in two cases (3.2%). In conclusion, the occurrence of sports-related fatalities has declined over time from 2009 to 2018. To deliver appropriate medical care onsite for better survival, employment of medically trained personnel should be promoted in high school sports setting in Japan.

In this study, we aimed to clarify the characteristics of neuromuscular function, kinetics, and kinematics of the lower extremity during sprinting in track and field athletes with a history of strain injury. Ten male college sprinters with a history of unilateral hamstring injury performed maximum effort sprint on an athletic track. The electromyographic (EMG) activity of the long head of the biceps femoris (BFlh) and gluteus maximus (Gmax) muscles and three-dimensional kinematic data were recorded. Bilateral comparisons were performed for the EMG activities, pelvic anterior tilt angle, hip and knee joint angles and torques, and the musculotendon length of BFlh. The activity of BFlh in the previously injured limb was significantly lower than that in the uninjured limb during the late-swing phase of sprinting (

Background: Throwing injuries of the shoulder and elbow are common among youth baseball players. Hypothesis: A prevention program will reduce the incidence of throwing injuries of the shoulder and elbow by 50% among youth baseball players. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: The authors block randomized 16 youth baseball teams consisting of 237 players aged 9 to 11 years into an intervention group (8 teams, 117 players) and a control group (8 teams, 120 players). The intervention program consisted of 5 stretching, 2 dynamic mobility, and 2 balance training exercises performed during warm-up. Both groups were followed up for 12 months, during which the incidence of shoulder and elbow injuries was recorded. In addition, ball speed during pitching as a performance-related factor and variables of physical function (passive range of motion of the elbow, shoulder and hip, dynamic balance, and thoracic kyphosis angle) were assessed during the pre- and postintervention periods. Results: The incidence of shoulder and elbow injuries in the intervention group (1.7 per 1000 athlete-exposures) was significantly lower than that in the control group (3.1 per 1000 athlete-exposures) (hazard ratio, 1.940; 95% CI, 1.175-3.205; P = .010). The factors related to pitching performance, as assessed by ball speed, tended to increase in the intervention group as compared with the control group ( P = .010). The program also improved shoulder horizontal adduction deficits on the dominant side, hip internal rotation on the nondominant side, and the thoracic kyphosis angle. Conclusion: A prevention program decreases throwing injuries of the shoulder and elbow and enhances the parameter of pitching performance in youth baseball players.

Objective To assess the discriminability as well as the reliability, and internal consistency of the Identification of Functional Ankle Instability questionnaire translated into Japanese (IdFAI-J). Design Cross-sectional study. Setting Collegiate athletic training/sports medicine clinic. Participants Twenty bilingual and sixty-five collegiate athletes including participants with and without functional instability (FI). Main outcome measures The sensitivity, specificity, test retest reliability, and internal consistency of IdFAI-J. Results The optimal cutoff score between the FI and non-FI participants was >10, with an area under the curve of 0.92. We calculated high sensitivity (0.94) and specificity (0.77) at the cutoff point. For the test-retest reliability, the intraclass correlation coefficient value of the IdFAI-J was 0.96; the standard error of measurement and minimal detectable change value was 1.69 and 3.60, respectively. Cronbach's α was 0.87; there was no improvement when a particular item was deleted from the scale. Conclusions The IdFAI-J has excellent discriminability, test-retest reliability, and internal consistency. Hence, the IdFAI-J significantly contribute to clinical practice and future research related to ankle instability in Japan.

Hirose, N and Tsuruike, M. Differences in the electromyographic activity of the hamstring, gluteus maximus, and erector spinae muscles in a variety of kinetic changes. J Strength Cond Res 32(12): 3366-3372, 2018-This study aimed to clarify the differences in the electromyographic (EMG) activity of the semitendinosus (ST), semimembranosus (SM), biceps femoris long head (BFl), gluteus maximus (GM), and erector spinae (ES) muscles during leg curl and bridge exercises across different knee angles and isometric contraction outputs. Sixteen male volunteers participated in this study. The EMG of all targeted muscles was measured at 20 and 40% of the maximal voluntary isometric contraction (MVIC) in the leg curl and during bilateral and unilateral bridge exercises. The knee flexion angle was randomly set at 30, 60, 90, and 120° during each of the exercises. The obtained data were normalized by the MVIC of the corresponding muscle, and each of the normalized values was compared with that of the ST. The EMG activity of the ST was significantly greater at 120° of knee flexion than that of 30 and 60° of knee flexion during leg curl regardless of intensity (p < 0.05), in contrast with that of the SM and BFl. However, bridge exercises diminished this inverse relationship. The ES activity changed similarly to that of the hamstrings, and no difference was observed in the activity of the GM regardless of different knee angles during bridge exercise(s). The strength and conditioning professionals should alter the knee joint angle and load during bridge and leg curl exercises according to which hamstring muscle they want to strengthen because ST, SM, and BFl EMG activity varies depending on the intensity and knee angles during these exercises.

Background The Kerlan-Jobe Orthopaedic Clinic (KJOC) score has been used to describe various parameters of throwing shoulder and elbow function for the return to play after a long period of rehabilitation, such as after ulnar collateral ligament reconstruction. No study has yet to identify how scapular dyskinesis (SD) in baseball players affects the KJOC score. This study investigated the relationship of the KJOC score to SD evaluated in collegiate baseball players with and without upper extremity injury. Materials and methods The study participants were 30 male collegiate baseball players (13 pitchers) belonging to the National Collegiate Athletic Association D-I conference. Participants were assessed with the KJOC instrument in the beginning (PRE) and end (POST) of the season. The SD test was conducted (PRE) in shoulder flexion to identify SD Results The mean value of KJOC score was significantly less in POST than that of PRE for the pitchers with SD (89.3 and 60.5, respectively; P = .001), whereas no difference was found in the KJOC score between PRE and POST for the pitchers without SD. For the position players, no difference in the mean value of KJOC score was found between PRE and POST, regardless of SD. Conclusion The results of this study provide evidence that collegiate baseball pitchers with mild SD may have lower KJOC scores, particularly setup or relief pitchers.

The semitendinosus (ST) muscle is primarily used during Nordic hamstring exercise (NHE), which is often prescribed for preventing hamstring injury, though the biceps femoris long head (BFlh) muscle that is more susceptible to injuries. Thus, this study aimed to identify the modulation of BFlh muscle activity with different knee flexion angles during NHE using an inclined platform. Fourteen male athletes performed NHE and maintained their position at maximum inclination (NH). Subjects also performed isometric NHE using a platform inclined to 50° (ICL) and 40° (ICH), and the knee flexion angle was controlled to 50° and 30°. The electromyography (EMG) activity of the BFlh, ST, semimembranosus, gluteus maximus, elector spinae, and rectus abdominus muscles was determined during each exercise. The EMG of the ST was higher than that of the BFlh during NHE and the highest of all muscles in all exercises (p < 0.05). Moreover, the activity of the BFlh tended to be higher than that of the ST for ICH than for ICL, regardless of the knee joint angle. The activity of the BFlh becomes equivalent to that of the ST during NHE at a knee flexion angle of less than 50°. These results indicate that performing NHE at a shallow knee flexion angle will enhance the activity of the BFlh muscle.

This study aimed to investigate the influence of the task type on the relative electromyography (EMG) activity of biceps femoris long head (BFlh) to semitendinosus (ST) muscles, and of proximal to distal regions during isometric leg-curl (LC) and hip-extension (HE). Twenty male volunteers performed isometric LC with the knee flexed to 30° (LC30) and 90° (LC90), as well as isometric HE with the knee extended (HE0) and flexed to 90° (HE90), at 40% and 100% maximal voluntary contraction (MVIC). Hip position was neutral in all conditions. EMG activity was recorded from the proximal and distal region of the BFlh and ST muscles. BFlh/ST was calculated from the raw root-mean-square (RMS) amplitudes. The RMS of 40% MVIC was normalized using MVIC data and the proximal/distal (P/D) ratio of normalized EMG (NEMG) was calculated. The BFlh/ST ratio was higher in HE0 than in LC90 during MVIC and 40% MVIC (p

BACKGROUND: Little is known about the activity of the abdominal internal oblique (IO) and lumbar multifidus (LM) muscles relative to kinetic chain exercises performed in a standing position. HYPOTHESIS/PURPOSE: The purpose of this study was to identify the activity of the IO and the LM muscles during weight‐bearing exercises. The authors hypothesized that IO and LM muscle activity would vary with lower body positions during the kinetic chain exercises. METHODS: Nineteen healthy, young, active subjects volunteered to participate. The electromyographic (EMG) activity (via surface EMG) of the abdominal external oblique (EO), IO, and LM muscles on both sides and the rectus femoris and semitendinosus muscles on the dominant side was determined during rhythmical lower body twisting exercise with three lower body positions: straight leg (SL), athletic position (AP), dynamic knee extension (DE) at two exercise speeds: 150 and 90 beats per min. These were reported as % maximum voluntary contraction. Mean EO, IO, and LM muscle activities were also compared with those of common core stability exercises. RESULTS: IO EMG activity was significantly greater in SL than that of AP (p

Although a 3- to 7-min re-warm up (RW) elicits performance and physiological benefits after half-time (HT), a time-efficient and feasible RW protocol is required for the use of an RW in the athletic setting. This study aimed to investigate the effect of a 1-min RW at high-intensity on the performance and physiological responses during the Loughborough Intermittent Shuttle Test (LIST). In a randomized and counterbalanced cross-over design, 12 male amateur intermittent team sports players (soccer, basketball, handball, and lacrosse; age, 22 ± 2 years; height, 1.70 ± 0.08 m; body mass, 65.1 ± 8.3 kg; body mass index, 22.4 ± 1.9 kg m−2; VO2max, 53.5 ± 4.5 ml kg−1 min−1) performed the LIST. The LIST comprised two 45-min halves separated by a 15-min HT. Each half comprised repetitions of exercise cycles consisting of 3 × 20-m walking, 1 × 20-m maximal sprint, 3 × 20-m jogging, and 3 × 20-m running. During the HT, the participants were assigned to a control trial (CON; 15-min seated rest) or an RW trial (1-min running at 90% of the maximal oxygen uptake after a 14-min seated rest). Compared to the CON, the RW prevents reductions in sprint performance at the fourth and sixth periods of the LIST (fourth: 2.4%, p = 0.002, d = 1.68, sixth: 3.6%, p = 0.012, d = 1.74) and a decrement of gastrointestinal temperature during HT (0.5°C, p = 0.010, d = 1.41). Moreover, the RW decreased the electromyogram amplitude of maximal voluntary contraction (MVC) after HT (12%, p = 0.017, d = 1.12) without a decrease of maximal voluntary contraction force, suggesting an increased neuromuscular efficiency (9%, p = 0.048, d = 0.58). The RW also increased the mean heart rate in the initial part of the second half (4 bpm, p = 0.016, d = 0.38). In conclusion, the RW improved sprint performance, core temperature, muscle activation, and heart rate in the second half of the LIST. The findings suggest that the RW should be recommended for intermittent team sports players when longer RWs are not possible.

Proprioceptive function of the lower limbs deteriorates in patients following total hip arthroplasty. Patients show poor balance and rely more on visual information than proprioceptive information. Plantar vibration stimuli can mechanically enhance somatosensory input from the plantar cutaneous mechanoreceptors, thereby improving static balance. Plantar vibration stimuli may improve static balance in patients after total hip arthroplasty. This is the first study to investigate whether plantar vibration stimuli affects static balance during the early phase following total hip arthroplasty.In this cross-over design study, 16 female patients (aged 65.1 ± 11.0 years) received plantar vibration stimuli for 2 minutes or the sham interventions after total hip arthroplasty in a randomized order on different days. The foot centre of pressure was measured for the total path length, mediolateral path length, and anteroposterior path length directions before and immediately after the interventions in the static standing position both with eyes open and closed. Patients were instructed to minimize body sway when standing.A significant increase was observed in the centre of pressure parameters in the eyes closed condition than in the eyes open condition. The centre of pressure parameters for the eyes closed condition was significantly decreased after vibration interventions than that before intervention.This study supports the view that plantar vibration stimuli can change static balance in patients in the early phase after total hip arthroplasty temporarily by up-weighting sensory information. These stimuli may serve as a treatment option for influencing balance following total hip arthroplasty.

Previous studies suggest that marathon running induces lower extremity muscle damage. This study aimed to examine inter- and intramuscular differences in hamstring muscle damage after a marathon using transverse relaxation time (T2)-weighted magnetic resonance images (MRI). 20 healthy collegiate marathon runners (15 males) were recruited for this study. T2-MRI was performed before (PRE) and at 1 (D1), 3 (D3), and 8 days (D8) after marathon, and the T2 values of each hamstring muscle at the distal, middle, and proximal sites were calculated. Results indicated that no significant intermuscular differences in T2 changes were observed and that, regardless of muscle, the T2 values of the distal and middle sites increased significantly at D1 and D3 and recovered at D8, although those values of the proximal site remained constant. T2 significantly increased at distal and middle sites of the biceps femoris long head on D1 (p = 0.030 and p = 0.004, respectively) and D3 (p = 0.007 and p = 0.041, respectively), distal biceps femoris short head on D1 (p = 0.036), distal semitendinosus on D1 (p = 0.047) and D3 (p = 0.010), middle semitendinosus on D1 (p = 0.005), and distal and middle sites of the semimembranosus on D1 (p = 0.008 and p = 0.040, respectively) and D3 (p = 0.002 and p = 0.018, respectively). These results suggest that the distal and middle sites of the hamstring muscles are more susceptible to damage induced by running a full marathon. Conditioning that focuses on the distal and middle sites of the hamstring muscles may be more useful in improving recovery strategies after prolonged running.