Cohort Of Athletes Research Articles

Correlation between myocardial work indices and main echocardiographic and cardiopulmonary exercise stress test parameters in Olympic endurance athletes.

Myocardial works indices (MWI) are new echocardiographic parameters that innovatively assess left ventricular function. Although recent studies show correlation between these indices and traditional morpho-functional echocardiographic (TTE) and cardiopulmonary test (CPET) parameters in general population and in different pathologic conditions, data on athletes remains scarce. Aim of our study is to investigate a relationship between MWI and main TTE and CPET parameters in a large cohort of endurance athletes. We enrolled 306 endurance Olympic athletes, mean age 26.3 ± 4.3 years old, 170 (55.5%) males who underwent clinical and anthropometric evaluation, TTE and CPET. Strain rate and MWI were measured and the following parameters collected: global longitudinal strain (GLS), global myocardial work index (GWI), global constructive myocardial work (GCW), Global Wasted Work (GWW) and global cardiac work efficiency (GWE). MWI showed correlation with peak systolic blood pressure at CPET (GWI, p = 0.012 and GCW, p < 0.0001) and functional TTE parameters such as EF (p = 0.016 for GWI and p = 0.017 for GCW), RV GLS% (p < 0.0001 for GWI and GCW) and LA strain (p < 0.0001 for GWI and GCW). Moreover, MWI were also correlated to echocardiographic heart remodeling parameters, such as LVEDVi (p = 0.046 for GWI) and LVEDDi (p = 0.035 for GWW and p = 0.018 for GWE). MWI correlate also with O2pulse (p = 0.005 for GWI; p = 0.010 for GCW), but not with VO2max/kg. In this study, MWI were associated with cardiac remodeling, but not with VO2 max. It should therefore not be considered as a surrogate marker of an athlete's training status.

Normalization Methods for Shoulder Strength in Baseball Athletes.

Arm injuries in baseball continue to rise. Previous studies have confirmed relationships between shoulder strength, injury risk, and performance in baseball athletes. Shoulder strength measures vary considerably within and among baseball players and are influenced heavily by anthropometric measures. Presently, the normalization of shoulder strength measures has not been tested adequately to meet necessary statistical assumptions. At least 1 shoulder strength normalization method would meet 2 statistical assumptions: the intercept assumption and correlation assumption. Cross-sectional study. Level 3. Isometric shoulder strength was tested in a cohort of uninjured baseball athletes on the dominant limb via handheld dynamometry: external rotation (ER), internal rotation (IR), and scapular plane abduction (SCAP). Five normalization methods were assessed using 2 statistical assumptions to determine the most appropriate normalization method for each shoulder strength measure: first, the regression line between a participant characteristic (body mass, height, ulnar length, and their respective combinations) and the unnormalized strength measure passes through the origin; second, normalizing shoulder strength eliminates its correlation with the participant characteristics. Statistical significance was set a priori at α < 0.05. Body mass normalization was the only normalization method that satisfied the intercept and correlation assumptions for ER, IR, and SCAP strength (P > .05). Normalizing shoulder ER, IR, and SCAP strength in uninjured baseball athletes using body mass satisfied both statistical assumptions. When clinicians seek to compare shoulder strength in baseball athletes of differing anthropometric make-up, using body mass as the denominator is the most appropriate method for normalization. The utilization of a statistically supported shoulder strength normalization method is warranted to account for anthropometric differences when comparing strength between athletes. This study adds a clinically relevant and reproducible method for normalizing isometric shoulder strength in uninjured baseball players.

Routine Retention of Metalwork After Extra-articular Dorsal Plate Fixation of Ligamentous Lisfranc Injuries in Elite Athletes Enables Early Return to Sports

Background: Operative intervention to achieve accurate anatomic reduction for unstable ligamentous Lisfranc joint injuries in athletes is recommended for good outcomes, although open reduction and internal fixation (ORIF) compared with primary arthrodesis is still debated. In addition, there is also no consensus on whether metalwork should be routinely removed or retained after Lisfranc joint ORIF. Purpose: To evaluate outcomes of retaining metalwork after ORIF for acute isolated ligamentous Lisfranc injuries in a cohort of professional elite athletes, focusing on complications such as metalwork breakage, reoperation, and expected return to sports (RTS) time. Study Design: Case series; Level of evidence, 4. Methods: A total of 32 elite athletes (mean follow-up, 40.6 months [range, 26-58 months]) with acute isolated ligamentous Lisfranc injuries treated with ORIF using the extra-articular dorsal bridge-plating technique were evaluated. Removal of metalwork was not planned routinely unless symptomatic. Descriptive data, time to RTS, player status at the last visit, and complications specific to metalwork retention were analyzed and reported. Results: All 32 athletes had a diastasis of &gt;2 mm, categorized as Nunley and Vertullo type 2 injuries. The mean time of return to their preinjury level of sports was 18.7 weeks (range, 14-25 weeks). Soccer players returned to their sport significantly earlier (17.3 weeks vs 19.9 weeks; P = .09) when compared with rugby players. Four athletes (12.5%) required removal of metalwork at a mean of 8.5 months postoperatively. Three cases were due to screws backing out and 1 case had a broken screw with pain across the plate region. There were 3 additional patients with broken screws that were left in situ, as the patients were asymptomatic and still playing competitively. Two other athletes required conversion to arthrodesis because of painful midfoot arthritis at 16 months and 35 months after fixation, respectively. Despite that, all these athletes returned to their professional career at their last review. Conclusion: Retention of metalwork after extra-articular dorsal bridge-plating ORIF for acute isolated ligamentous Lisfranc injury in elite athletes enables return to preinjury sporting level without significant mechanical complications, and selective removal of metal may be considered if symptoms arise.

Athlete’s blood: sport category specific hematological adaptations in a large cohort of Olympic athletes

Athlete’s blood: sport category specific hematological adaptations in a large cohort of Olympic athletes

Effects of Short-Term Creatine Nitrate Plus Creatinine Intake on Creatine Pharmacokinetics and Safety Biomarkers in Healthy Adults

Background: A blend of creatine nitrate and creatinine has demonstrated promising bioavailability; however, prior studies have not thoroughly examined its pharmacokinetics and safety profiles, particularly its impact on kidney stress indicators, such as serum cystatin C. Objective: This study aimed to assess the effects of varying doses of creatine nitrate-creatinine intervention on pharmacokinetics and safety in healthy humans. Methods: Ten young adults (mean age 26.1 ± 5.0 years; 5 females) volunteered for this double- blind, crossover, randomized controlled trial. The participants were randomly assigned to receive either a low-dose creatine nitrate-creatinine mixture (CN-CRN-Low; 1.5 g of creatine nitrate and 1.5 g of creatinine), a high-dose creatine nitrate-creatinine mixture (CN-CRN-High; 3 g of creatine nitrate and 3 g of creatinine), or 1.5 g of creatine nitrate (CONTROL) in both a single-dose pharmacokinetics experiment, and a 14-day safety trial. Results: Both CN-CRN-Low and CN-CRN-High interventions displayed increased volume of distribution and total clearance compared to the CONTROL intervention (P &lt; 0.05) in a single-dose pharmacokinetics experiment. Additionally, the CN-CRN-High intervention showed significantly higher creatine maximum serum concentrations compared to the other interventions (P &lt; 0.05). Serum cystatin C levels remained unchanged across all interventions (P = 0.65), with no participants experiencing abnormal cystatin C concentrations or major changes in other safety biomarkers. Conclusion: The present study demonstrates dose-specific utilization of creatine nitrate-creatinine intervention, with the mixture induced no kidney damage. Further studies are needed to explore the potential functional and performance benefits of creatine nitrate-creatinine supplementation in diverse clinical and athletic cohorts.

Exploring Food Choice Influences in Athletes and Active Populations in Ireland: A Cross-Sectional Study.

Exploring Food Choice Influences in Athletes and Active Populations in Ireland: A Cross-Sectional Study.

Mental distress is associated with injury and illness in elite Para athletes: a 44-week prospective study over 13 860 athlete days

BackgroundThe interest in elite athletes’ mental health has increased over the past decade. However, there is still a paucity in the literature concerning elite Para athletes’ mental health and its...

Cardiac Magnetic Resonance Feature-Tracking in Olympic Athletes: a myocardial deformation analysis.

Athlete's heart induces extreme cardiovascular remodelling, generating challenges for the differential diagnosis with early stages of cardiomyopathies. Advanced cardiac function analysis could be helpful, but data on healthy athletes and the impact of sports disciplines are lacking. To describe myocardial deformation by cardiac magnetic resonance (CMR) in a cohort of Olympic athletes and to evaluate possible differences based on sports disciplines and sex. A group of Olympic athletes with normal cardiovascular evaluation and a group of sedentary controls matched for age and sex underwent CMR without contrast administration. Cine-images were post-processed for volumes and function evaluation and to assess bi-ventricular myocardial deformation parameters, as left ventricular global longitudinal and circumferential strain (LV-GLS and -GCS) and right ventricular GLS, by a dedicated feature-tracking (FT) software. Athletes were divided according to ESC sports classification and sex. Three hundred Olympic athletes (13% skill, 20% power, 25% mixed, 42% endurance, 58% male) and 42 untrained controls were enrolled. No significant differences were found between LV-GLS, -GCS, and RV-GLS when comparing different sports categories, except for a slightly lower LV-GLS in the endurance group compared to the skill one (p=0.045). Athletes showed slightly lower biventricular ejection fraction (p<0.001) and LV-GCS (p<0.001) than sedentary controls, while only endurance athletes showed significant differences in LV- and RV-GLS versus the sedentary group (p=0.002 and p=0.001). Female athletes showed higher bi-ventricular GLS than males (p<0.001 for LV- and RV-GLS). Our results provided for the first time CMR-FT strain values in a large cohort of Olympic athletes free of cardiovascular abnormalities, according to type of sports. Endurance athletes showed the lowest LV-GLS values being significantly different versus skill and sedentary controls. No other significant differences in myocardial deformation parameters between sports categories were found, but only based on sex.

Dental Caries, Tooth Erosion and Nutritional Habits in a Cohort of Athletes: A Cross-Sectional Study.

this study aimed to study the association of dental caries and erosion in athletes with dietary and oral health habits. An observational cross-sectional study was conducted at the Sports Dentistry department of a university clinic. Intraoral examination included the International Caries Detection and Assessment System (ICDAS II) index and the Basic Erosive Wear Examination (BEWE). A questionnaire was completed with sociodemographic data, and dietary and oral hygiene habits. An inferential and multivariable regression analysis was performed to study the association of dental caries and erosion with confounding variables. A total of 80 athletes were included. The prevalence of dental caries and erosion was 50.0% and 40%, respectively. Significant associations were observed between self-perceived oral health and caries lesions, with "Good" (-5.01, p < 0.001) and "Very good" (-5.46, p < 0.001) perceptions linked to fewer lesions. BEWE scores revealed significant associations with meal frequency uncertainty (-12.56, p = 0.014) and uncertainty about the last dental visit (8.82, p = 0.014). Self-perceived oral health as "Good" or "Very good" was associated with lower dental erosion (p < 0.010). Other demographic and behavioral factors were not significantly associated with caries or erosion. this cohort of athletes exhibited a high prevalence of dental caries and erosion, with associated dietary and oral hygiene habits. These results highlight the need for targeted dietary counseling and oral health education for athletes, whose nutritional needs may lead to increased consumption of sugar-rich diets.

Patterns of left ventricular remodeling according to the type of sport in a cohort of elite athletes assessed by speckle tracking echocardiography

Abstract Background Athletic training is associated with hemodynamic demands leading to physiological cardiac changes referred to as athlete’s heart. Whilst some studies support the hypothesis with predicted eccentric left ventricular hypertrophy (LVH) from endurance training, data confirming concentric-type effects of resistance training are inconsistent. Also, whether specific geometric adaptations are associated with specific changes of LV myocardial performance is undefined. Purpose To assess patterns of LV remodeling in relation to the type of sport, using speckle tracking echocardiography (STE) in a cohort of elite athletes (EA). Methods 132 EA (23±5 years) referred for resting echocardiography during annual check-up were prospectively enrolled.They were involved in competitive sports for &amp;gt;10 hours/week for over 3 years and had no history of cardiac/non-cardiac disease or sudden cardiac death. A control group of 15 healthy volunteers (25±3 years), either sedentary or engaged in &amp;lt;6 h of non-competitive training/week, was enrolled. An echocardiogram was performed in all subjects. Global myocardial work (MW) indices - work index (GWI), constructive work (GCW), work efficiency (GWE) and wasted work (GWW)- were calculated using a software able to construct a noninvasive LV pressure-strain loop based on STE-derived global longitudinal strain (GLS) and LV pressure from systolic cuff pressure. Analysis was performed by an experienced investigator blinded to the sport history of each subject. Results Four subgroups of EA were defined according to the sports disciplines: power (n=27), endurance (n=30), mixed (n=62) and skill (n=13). Mean values of LV volumes, wall thickness and mass were significantly higher in EA compared with controls. Normal LV geometry was present in &amp;gt;50% of EA in each group and &amp;gt;70% of power and skill EA. LVH was more prevalent in endurance (23.3%) and mixed (19.4%) as compared to skill (7.7%) and power (7.4%) EA. Eccentric hypertrophy was found only in endurance and mixed EA (&amp;lt;15% each group). Including age, BSA, gender, sport discipline, duration and intensity of training in binary logistic regression to predict LVH, increasing age was the only significant predictor (p=0.01). Conventional and advanced parameters of LV systolic and diastolic function were within normal range in all subjects. The one-way ANOVA revealed no significant differences between groups of EA and controls regarding mean values of GLS, LV ejection fraction and MW indices. However, among EA, endurance EA exhibited the highest values of GCW(2075±228 mmHg%), GWI(1767±222 mmHg%) and GWE(95.5±1.7%) and lowest GWW(76±35 mmHg%) with statistic significance for GWW(p=0.03) and marginally for GWE(p=0.05). Conclusion In our study, the type of sport was not related to the presence of LVH. The most significant LV remodeling was observed in EA, as expected, associated with a resting myocardial work profile characterized by highest values of GWI, GCW and GWE and lowest GWW. MW parameters and the type of sport

Athletic shapeshifting of the right ventricle: 3D echocardiography-derived global and regional shape analysis in elite athletes

Abstract Intense physical activity poses marked hemodynamic strain on the right ventricle (RV), as during exercise, RV is subjected to a proportionally higher pressure and volume overload than its left counterpart. While the morphological changes of the left ventricle can be characterized using pre-defined reference shapes (cone and sphere), the complex structure of the RV cannot be captured similarly. Therefore, the exercise-induced changes in the RV's global and regional shape have not been directly investigated. Our aim was to develop a 3D echocardiography (3DE)-based method to quantify the global and regional shape metrics of the RV in a large cohort of elite athletes. Elite athletes (n=138) and healthy, sedentary volunteers (n=104) were enrolled and underwent 3DE to measure RV volumes and ejection fraction (EF). 3D RV endocardial mesh models were reconstructed at end-diastole and end-systole to quantify regional curvature indices along 5 clinically relevant parts of the RV (apex, septum, free-wall, outflow tract, and inflow tract). Zero curvature depicts a flat surface, whereas a more positive or negative curvature represents a more convex or concave surface, respectively. Regarding the RV’s global shape, hemi-conicity and hemi-sphericity indices were introduced (Figure 1). First, the longitudinal height of the 3D RV mesh was defined. To calculate hemi-sphericity index, a hemisphere (with a radius that is half the height of the RV mesh) was created. Then, the volume of this hemisphere and the volume of the RV mesh were compared (a higher volume ratio depicts a more spherical shape). To calculate hemi-conicity index, a half-cone (whose height equals the RV’s height and volume equals the RV mesh’s volume) was defined. Then, the angle at the top of the half-cone was evaluated (a more acute angle describes a more conical shape). As expected, athletes had higher RV end-diastolic (EDV; 165±36 vs. 146±44 ml, p&amp;lt;0.001) and end-systolic volumes (ESV; 75±22 vs. 65±23, p&amp;lt;0.005), whereas RV EF did not differ in the two groups. Regional curvature analysis showed that in athletes, the septum of the RV was significantly flatter (-0.4±9 vs. 6.7±7.7, p&amp;lt;0.001), along with the RV free-wall curvature index that also depicted a significantly flatter shape (57.9±8.3 vs. 61.2±7.7, p&amp;lt;0.001) compared to controls. The global shape assessment revealed that the RV of the athlete’s heart had a more conical shape, as the hemi-sphericity volume ratio was significantly lower (0.79±0.17 vs. 1.19±0.40, p&amp;lt;0.001), and the hemi-conicity angle exhibited a more acute angle (63.8± 5.7 vs. 74.1±9.1, p&amp;lt;0.001) both pointing towards a conical remodeling. The assessment of 3D echocardiography-derived regional and global shape metrics revealed a different, more conical geometry in the athletes’ RV. Our novel method may enable a more precise quantification of the RV's unique, exercise-induced geometrical remodeling. Figure 1

Quantifying Muscle Volume Deficits Among 38 Lower Extremity Muscles in Collegiate Football Athletes After Anterior Cruciate Ligament Reconstruction

Background: Quadriceps dysfunction is ubiquitous after anterior cruciate ligament (ACL) reconstruction (ACLR). Addressing quadriceps dysfunction is crucial to improve function, reduce the reinjury risk, and maintain long-term knee health. While deficits specific to the quadriceps are well documented, less is known about the effect of an ACL injury on other lower extremity muscle groups. Purpose/Hypothesis: The purpose of this exploratory analysis was to quantify and rank lower extremity muscle volume deficits using magnetic resonance imaging in collegiate football athletes after ACLR. It was hypothesized that the quadriceps muscles would present with the greatest deficits and that compensatory hypertrophy of muscles at adjacent joints such as the hip and ankle would be observed. Study Design: Cross-sectional study; Level of evidence, 3. Methods: This study is a secondary analysis from an ongoing multicenter prospective cohort study involving Division I collegiate football athletes. Athletes who underwent primary unilateral ACLR (1 [3%] allograft, 2 [7%] quadriceps tendon autograft, 22 [73%] bone–patellar tendon–bone autograft, 5 [17%] hamstring tendon autograft) and magnetic resonance imaging were included. Muscle volumes (mL·kg–1·m–1) were quantified bilaterally from 38 lower extremity muscles using machine learning technology. Paired-samples t tests were performed between limbs for each muscle, which were then ranked and visualized in a forest plot based on standardized mean differences (surgical – nonsurgical limb). Results: A total of 30 athletes (mean time from surgery, 27.9 ± 19.0 months) were included. The largest muscle volume deficits in the surgical limb were seen in the 3 uniarticular quadriceps muscles, followed by the biarticular triceps surae muscles. The rectus femoris and soleus did not show significant differences between limbs. Conversely, the fibularis muscle group had a greater muscle volume in the surgical limb compared with the nonsurgical limb. Most other muscle groups did not present significant differences between limbs. Conclusion: Persistent quadriceps atrophy in a cohort of high-level athletes over 2 years after ACLR was highlighted in this study. Deficits in the gastrocnemius muscles, but not in the soleus, were also identified. This comprehensive approach examining various lower extremity muscles revealed latent muscle volume deficits present after ACLR.

Barriers and enablers to measuring resting metabolic rate in the high-performance sporting system: A qualitative exploratory study

ABSTRACT Measurements of resting metabolic rate (RMR) may be undertaken for dietary planning purposes or to assess for low energy availability (LEA). This study investigated barriers and enablers to measuring RMR in real-world, high-performance sport environments. Twelve interviews were conducted with technicians (n = 6 dietitians, n = 6 physiologists) employed across six National Institute Networks, two National Sporting Organisations and one professional sporting code. RMR was predominantly measured to screen for LEA with measurements only occurring in a few instances for dietary planning purposes. Data was thematically analysed with six main themes identified. Barriers included lack of confidence in measuring RMR, burden of measurement on athlete and technician, confusion over measurement responsibility, and scepticism in RMR measurements as an indicator of LEA. Subthemes that contributed to scepticism included: the RMR thresholds used to indicate LEA, unanswered research questions, and measurement errors introduced by athlete presentation, testing equipment and/or environment. Enablers to use of RMR measurements included perceived value of RMR measurements as a ‘piece of the puzzle’ when assessing for LEA and its use as a longitudinal measure. Best practice guidelines for RMR measurements in athletic cohorts must consider these barriers and enablers as they highlight unique characteristics of athletes and their environment.

Prevention of Traveler's Diarrhea while Crossing the Amazon Rainforest by Bike with a Supplement Based on Lacticaseibacillus Rhamnosus LR04 (DSM 16605) + Streptococcus Thermophilus FP4 (DSM 18616) + Bifidobacterium Brevis BR03 (DSM 16604): a Phase Two, Randomized, Placebo-controlled, Double-blind, Cross-over Pilot Study

Traveler's diarrhea is a common gastrointestinal illness experienced by individuals traveling to countries with inadequate sanitation and hygiene standards. In this Phase Two, Randomized, Placebo-controlled, Double-blind, Cross-over Pilot Study, we aimed to explore whether a probiotic containing Lacticaseibacillus rhamnosus LR04 (DSM 16605) + Streptococcus thermophilus FP4 (DSM 18616) + Bifidobacterium breve BR03 (DSM 16604) could prevent traveler’s diarrhea and improve quality of life over three months of follow-up in a cohort of athletes biking though the Amazon rainforest. In this pilot study including 3 cyclists randomly assigned to one of the two experimental groups (one probiotic, one placebo). The three participants were men aged 47, 63, 64 years. During the follow-up period, we observed one episode of diarrhea in the probiotic group and one in placebo (p=1.00). However, the number of days with diarrhea was only two in the active group and seven in the placebo group (p=0.33). No episodes of severe diarrhea were observed during the follow-up. At the end of the study, the active group showed a higher quality of life, but no statistically significant. In conclusion, our study suggests that the supplementation with Lacticaseibacillus rhamnosus LR04 (DSM 16605) + Streptococcus thermophilus FP4 (DSM 18616) + Bifidobacterium breve BR03 (DSM 16604) may help prevent traveler’s diarrhea in extreme conditions such as to biking through the Amazon rainforest. However, future larger studies involving a more general population are needed to confirm our findings.

Influence of Persistently Elevated LDL Values on Carotid Intima Media Thickness in Elite Athletes.

Carotid IMT is a recognized marker for early atherosclerotic changes and a predictor of future CV events. Previous studies showed 11% increased risk of myocardial infarction with each 0.1mm incremental increase of carotid IMT. In general population, LDL cholesterol levels are positively correlated with carotid IMT in both cross-sectional and longitudinal studies while its role in elite athletes remains understudied. This study aimed to investigate the correlation between persistent lipid profile alterations and early markers of atherosclerosis, specifically carotid IMT, in a cohort of elite athletes. We included 302 athletes serially evaluated for a prolonged time period. Anthropometric data, blood tests for lipid profiles, and carotid IMT measurements were collected. Dyslipidemia was defined as LDL ≥ 116mg/dL, and persistent elevation when LDL values remained above the threshold limits in at least three pre-participation screenings. Categorical variables were expressed as frequencies and percentages and were compared using Fisher's exact test or Chi-square test, as appropriate. 91 athletes (30.1%) had persistently elevated LDL levels. Dyslipidemic athletes were older (30.7 ± 5.7 vs. 29.1 ± 4.1 years, p = 0.008), had higher BMI (p = 0.032), and a higher prevalence of obesity (5.5% vs. 0.5%, p = 0.004) compared to those with normal lipid profiles. Additionally, they had higher total cholesterol (p < 0.0001) and triglycerides (p < 0.0001) but similar HDL levels (p = 0.213). Globally, athletes with altered LDL profiles over long-time period showed higher IMT (0.60 ± 0.10mm vs. 0.57 ± 0.07mm, p = 0.014). In particular, longer exposure to elevated LDL was significantly associated with increased IMT (0.61 ± 0.12mm vs. 0.57 ± 0.06mm, p = 0.035). Our study highlights the association between persistently elevated LDL-C and increased carotid IMT in elite athletes, with longer exposure time correlating with more pronounced carotid changes. These findings underscore the importance of regular monitoring of blood lipid profiles and carotid IMT measurements as a non-invasive, cost-effective method to prevent atherosclerotic vascular disease.

Association analysis of the dopaminergic receptor 2 gene Tag1B rs1079597 and personality traits among a cohort of professional athletes

Association analysis of the dopaminergic receptor 2 gene Tag1B rs1079597 and personality traits among a cohort of professional athletes

RETORNO AO ESPORTE APÓS OSTEOTOMIA DO JOELHO EM ATLETAS EM NÍVEL COMPETITIVO – SÉRIE DE CASOS

Abstract Objectives: To analyze the return to the sport and the level of sports practice in a longitudinal cohort of athletes treated with osteotomy around the knee. Methods: Active athletes who underwent osteotomy or knee surgery to treat knee osteoarthritis were included, and their data was collected retrospectively. The primary outcomes were maximum physical activity level before and after the surgery (Tegner score), time to return to maximum activities and reoperation. Results: Twenty athletes with a mean age of 33 years at the time of surgery (standard deviation 8.9 (SD)) and with a mean follow-up of 9.8 years (SD 4) were included. The mean maximum Tegner score achieved before surgery was 8.6 (SD 1.4). Nineteen patients returned to sports (95%), and 13 returned to the same prior level (65%). The median time to return to the maximum level was 13 months (mean 17.9, SD 12.4). The mean maximum postoperative Tegner score was 7.5 (SD 2.0), slightly lower than the maximum achieved before surgery (mean difference:1.1, CI:0.2-1.9, P=0.026). Conclusion: The results of this study suggest that, after osteotomies around the knee, athletes present a high rate of return to sports activities, with most returning at the same level as before the surgery. Level of Evidence IV; Case series.

Is Strength the Main Risk Factor of Overuse Shoulder Injuries? A Cohort Study of 296 Amateur Overhead Athletes.

Shoulder pain is one of the most common musculoskeletal complaints in overhead athletes. This study investigated the prevalence of the main risk factors and sex differences related to the development of shoulder pain in a cohort of amateur overhead athletes. The external rotation/internal rotation (ER/IR) isometric strength ratio <0.75% is the most prevalent risk factor associated to overuse shoulder injuries in both sexes. Cohort study. Level 3. A total of 296 (147 male and 149 female) amateur overhead athletes from handball, volleyball, and water polo participated in this cross-sectional study. Isometric strength, rotational range of motion, and scapular control were analyzed bilaterally. The measurements and motions were randomized between sides. The ER/IR isometric strength ratio deficit among the disciplines was presented in 264 and 229 out of 296 athletes in the dominant and nondominant sides, respectively. Normalized isometric strength showed significant differences for dominant (P < 0.01; ε² = 0.47) and nondominant IR (P < 0.01; ε² = 0.60). No significant differences were observed between dominant (P = 0.44; ε² = 0.05) and nondominant ER (P = -0.24; ε² = 0.07). The prevalence of glenohumeral IR deficit (GIRD) (P = 0.81) and total arc of motion differences (TAMD) (P = 0.39) was low, with no difference between sexes. Male (16.3%) and female (12.1%) athletes had low rate of obvious scapular dyskinesis in their dominant shoulders. Muscle strength was the most prevalent risk factor. The ER/IR ratio imbalance was present in both sides, without sex differences. Risk factors such as scapular dyskinesis, GIRD, and TAMD were present in low percentages, without sex differences. It is advisable to implement shoulder exercises to strengthen ER muscles to decrease differences between internal and external rotators and prevent injuries in overhead athletes.

Open Source, Open Science: Development of OpenLESS as the Automated Landing Error Scoring System.

The Open Landing Error Scoring System (OpenLESS) is a novel development aimed at automating the LESS for assessment of lower extremity movement quality during a jump-landing task. With increasing utilization of clinical measures to monitor outcomes and limited time during clinical visits for a lengthy analysis of functional movement, there is a pressing need to extend automation efforts. Addressing these issues, OpenLESS is an open-source tool that utilizes a freely available markerless motion capture system to automate the LESS using three-dimensional kinematics. To describe the development of OpenLESS, examine the validity against expert rater LESS scores in healthy and clinically relevant cohorts, and assess the intersession reliability collected across four time points in an athlete cohort. Observational. 92 participants (72 females and 20 males, mean age 23.3 years) from healthy, post-anterior cruciate ligament reconstruction (ACLR; median 33 months since surgery), and amateur athlete cohorts. A software package, "OpenLESS," was developed to interpret movement quality (LESS score) from kinematics captured from markerless motion capture. Validity and reliability were assessed with intraclass correlation coefficients (ICC), standard error of measure (SEM), and minimal detectable change (MDC). OpenLESS agreed well with expert rater LESS scores for healthy (ICC 2, k =0.79) and clinically relevant, post-ACLR cohorts (ICC 2, k =0.88). The automated OpenLESS system reduced scoring time, processing all 159 trials in under 15 minutes compared to the 18.5 hours (7 minutes per trial) required for manual expert rater scoring. When tested outside laboratory conditions, OpenLESS showed excellent reliability across repeated sessions (ICC 2, k >0.89), with a SEM of 0.98 errors and MDC of 2.72 errors. OpenLESS shows promise as an efficient, automated tool for clinically assessing jump-landing quality, with good validity versus experts in healthy and post-ACLR populations, and excellent field reliability, addressing the need for objective movement analysis. OpenLESS accurately detected jump-landing events (ICC>0.99) using markerless motion capture, validating its use as an alternative to laboratory-based force plate measurements.The automated scoring system showed good agreement with expert raters in healthy (ICC=0.79) and post-ACLR (ICC=0.88) populations.OpenLESS demonstrated good to excellent test-retest reliability (ICC=0.89) across multiple testing sessions, with minimal score variation, supporting its utility for longitudinal movement assessment.

Analyzing Targeted Muscle Strength: Impact on Speed, Endurance, and Performance in Female Volleyball

This study examines the influence of muscle strength on performance metrics in volleyball, addressing the need to understand how specific and non-specific strength training impacts athletic capabilities. A cohort of athletes underwent various strength tests, including squats (SQs), bench presses (BPs), and deadlifts (DLs), to assess their force and power during various forms of test. Lactate thresholds (LT1 and LT2) were also measured to evaluate aerobic and anaerobic capacities. The median speed at LT1 was 1.80 m/s, and LT2 was determined at a mean velocity of 2.56 m/s. Notably, a correlation was found between SQ performance and total points scored (p = 0.040, r = 0.285), while upper body strength was strongly correlated with performance metrics, showing significant relationships with points scored (p = 0.0001, r = 0.690) and peak power during BPs (p = 0.0001, r = 0.587). The findings suggest that targeted strength training enhances physical capabilities and improves technical and tactical performance in volleyball, highlighting the critical role of muscle strength in athlete selection and training strategies.