Non-athletic Population Research Articles

Comparison of Primal Reflex Release Technique and Positional Release Therapy on Pain, Functional Ability and Ankle Range in patients with Plantar Fasciitis: An Experimental Study

Background: Plantar fasciitis (PF) is characterized by inflammation, fibrosis and structural deterioration of foot and there is pain over heel and plantar fascia. Plantar fasciitis pain is gradual in onset, sharp and diffusely located initially which later localizes to medial calcaneal tuberosity. Typically, pain is most severe in the morning which lessens with movement but intensifies with long-standing weight bearing. Plantar fasciitis has been experienced by 10% of the non-athletic population and most typically observed in weight-bearing activities. So, the aim was to study the effects of primal reflex release technique and positional release therapy on pain, functional ability and ankle range in patients with plantar fasciitis. Method: Total 36 patients were recruited for the study as per the selection criteria and were divided into two groups (18 in each group). Group A was treated with primal reflex release technique (PRRT) along with conventional therapy and Group B was treated with positional release therapy (PRT) along with conventional therapy for 7 consecutive days. Intergroup analysis by independent t-test showed statistically significant improvement in pain and functional ability (P value ≤ 0.001). Conclusion: Primal reflex release technique along with conventional therapy was found to be more predominant in improving pain and functional ability than positional release therapy along with conventional therapy. Also, Primal reflex release technique along with conventional therapy and positional release therapy along with conventional therapy were equally effective in improving ankle range of motion.

Acute Alpha-Glycerylphosphorylcholine Supplementation Enhances Cognitive Performance in Healthy Men.

Choline is an essential nutrient required for proper cell functioning. Due to its status as a precursor to acetylcholine, an important neurotransmitter connected to cognition and neuromuscular function, maintaining or enhancing choline levels is of interest. Supplementation with alpha-glycerylphosphorycholine (A-GPC) can maintain choline levels, but its ability to offer support towards cognition remains an area of ongoing research. Using a randomized, double-blind, placebo-controlled, crossover approach, 20 resistance-trained males (31.3 ± 11.0 years, 178.6 ± 7.3 cm, 84.6 ± 11.4 kg, 15.4 ± 5.6% body fat) consumed either a placebo (PL), 630 mg A-GPC (HD), or 315 mg (LD) A-GPC (GeniusPure®, NNB Nutrition, Nanjing, China). After resting hemodynamic assessments, participants took their assigned dose and had cognitive assessments (Stroop, N-Back, and Flanker), visual analog scales, and hemodynamics evaluated 60 min after ingestion. All participants then warmed up and completed vertical jumps and bench press throws before completing a bout of lower-body resistance exercise (6 × 10 repetitions using the Smith squat at a load of 70% 1RM). Venous blood was collected 5, 15, 30, and 60 min after completion of the squat protocol to evaluate changes in growth hormones, and follow-up visual analog scales and cognitive measurements were evaluated 30 min after completing the exercise bout. When compared to PL, changes in Stroop total score were statistically greater after HD (13.0 ± 8.2 vs. 5.2 ± 9.0, p = 0.013, d = 0.61) and LD (10.8 ± 7.7 vs. 5.2 ± 9.0, p = 0.046, d = 0.48) administration, in addition to significantly faster times to complete the Stroop test in the HD group when compared to PL (-0.12 ± 0.09 s vs. -0.05 ± 0.09 s, p = 0.021, d = 0.56). No significant differences between groups were found for the Flanker and N-Back assessments, while a tendency was observed for HD to have faster reaction times when compared to PL during the Flanker test. No group differences were realized for visual analog scales, physical performance, or growth hormone. Statistically significant changes in heart rate and blood pressure were observed in all groups, with all recorded values aligning with clinically accepted normative values. HD and LD A-GPC supplementation significantly increased cognitive performance in a group of young, healthy males as measured by changes in the Stroop Total Score and completion time of the Stroop test. These results offer unique insight into the potential for A-GPC to acutely increase cognition in a group of young, healthy males. While previous research has indicated potential for A-GPC to acutely improve cognition in clinical populations, extending these outcomes to healthy individuals can be potentially meaningful for a wide variety of populations such as athletes, race car drivers, military operators, and other non-athletic populations who desire and have a need to improve their mental performance. This study was retrospectively registered as NCT06690619 on clinicaltrials.gov.

Anthropometric-based predictive equations developed with multi-component models for estimating body composition in athletes.

Body composition can be estimated using anthropometric-based regression models, which are population-specific and should not be used interchangeably. However, the widespread availability of predictive equations in the literature makes selecting the most valid equations challenging. This systematic review compiles anthropometric-based predictive equations for estimating body mass components, focusing on those developed specifically for athletes using multicomponent models (i.e. separation of body mass into ≥ 3 components). Twenty-nine studies published between 2000 and 2024 were identified through a systematic search of international electronic databases (PubMed and Scopus). Studies using substandard procedures or developing predictive equations for non-athletic populations were excluded. A total of 40 equations were identified from the 29 studies. Of these, 36 were applicable to males and 17 to females. Twenty-six equations were developed to estimate fat mass, 10 for fat-free mass, three for appendicular lean soft tissue, and one for skeletal muscle mass. Thirteen equations were designed for mixed athletes, while others focused on specific contexts: soccer (n = 8); handball and rugby (n = 3 each); jockeys, swimming, and Gaelic football (n = 2 each); and futsal, padel, basketball, volleyball, American football, karate, and wheelchair athletes (n = 1 each). This review presented high-standards anthropometric-based predictive equations for assessing body composition in athletes and encourages the development of new equations for underrepresented sports in the current literature.

Correlation between MRI findings and functional outcomes in patients with calf muscle strain injuries: a retrospective study on 78 patients

BackgroundCalf muscle strain injuries (CMSI), also known as “tennis leg,” are frequently observed in middle-aged and physically active people, including non-professional athletes. While magnetic resonance imaging (MRI) is frequently used to assess the extent of these injuries, the relationship between MRI findings and long-term functional outcomes in non-athletic populations remains underexplored. This study aimed to investigate the correlation between MRI-detected injury severity and functional outcomes using the Achilles Tendon Rupture Score (ATRS) and the Tegner Activity Scale (TAS).MethodsA retrospective review was conducted on 78 non-athletic patients diagnosed with CMSI and were followed for an average of 25.6 ± 16.1 months. Injury severity was classified into three grades: Grade 1 (edema without architectural disruption), Grade 2 (partial muscle disruption with hematoma), and Grade 3 (complete muscle disruption or tendon detachment) based on MRI examination. The functional outcomes were assessed using the ATRS and TAS. A simple linear regression analysis was conducted to assess the impact of demographic variables and MRI findings on ATRS.ResultsThe mean ATRS at the final follow-up was 92.9 ± 10.6, with 75.6% of patients achieving an excellent outcome. Despite the excellent ATRS scores, a notable reduction in TAS was evident from the pre-injury assessment (4.4 ± 1.2) to the final follow-up (3.8 ± 1.3; p < 0.001). Moreover, 44.9% of patients did not resume their pre-injury activity levels. The regression analysis demonstrated no statistically significant correlation between MRI-detected injury severity, demographic factors (age, gender, BMI), and ATRS outcomes (R² = 0.094, adjusted R² = -0.011).ConclusionMRI-detected injury severity does not significantly predict long-term functional outcomes in patients with CMSI, even though most patients achieved excellent ATRS scores. However, nearly half of the patients did not return to their pre-injury activity levels. These findings suggest that additional factors might influence recovery, and further research is needed to elucidate these factors in non-athletic patients.Level of evidenceLevel IV, Retrospective case series.

Abstract 4137678: Maximal Oxygen Uptake Prediction From Resting and Submaximal Variables of Cardiopulmonary Exercise Testing by Using Machine Learning Methods

Background: Cardiorespiratory fitness, as measured by maximal oxygen consumption (VO2max) during a cardiopulmonary exercise test (CPET), is a prognostic indicator for longevity and adverse cardiovascular event prevention. This study aims to formulate a regression model utilizing resting and submaximal variables during CPET evaluation in the general population to predict VO2max. Methods: We used 13,535 CPET results on cycle ergometer collected by the UCLA Exercise Physiology Research Laboratory over eight years. Patients were divided into a normal group (NG; n=1,400) and an other group (OG; n=12,135). The inclusion criteria for the NG were: the absence of any known clinical diagnosis, BMI &lt;30, no current use of beta blocker, and VO2max &gt;85% of the predicted value for age and sex (Wasserman equation). OG refers to all other patients not in NG. Models were trained and evaluated for each group using stratified 5-fold cross-validation. We also trained different models using only resting variables (R-VARS) and resting and submaximal exercise variables (R+S-VARS). Feature importance was assessed using Shapely additive explanations (SHAP) values to identify how the feature related to the VO2max prediction. Results: The regression models were trained on the NG, OG, and total (N+OG) groups. The optimal models were Bayesian Ridge for the NG and Light Gradient Boosting Machine for the other two groups. The mean (standard deviation) R2 when using only R-VARS was 0.67(0.037) for the NG, 0.54 (0.014) for the OG, and 0.55 (0.009) for the N+OG. When using R+S-VARS, performance increased to 0.82 (0.014) for the NG, 0.80 (0.010) for the OG, and 0.8 (0.008) for the N+OG. Chronotropic index (ci), body mass index (BMI), VO2 at the first ventilatory threshold (VO2h1kg), minute ventilation at the second ventilatory threshold (VEH2), and forced expiratory volume (FEV1) were important features across the models trained with R+S-VARS. CI, BMI, and VEH2 had a negative effect, while VO2h1kg, FEV1 had positive effect on VO2max prediction. Conclusion: Our VO2max prediction model demonstrated remarkable accuracy in this dataset representing a generally healthy, non-athlete population using R+S-VARS. Particularly noteworthy was the enhanced performance within subgroups exhibiting a lower VO2max. This methodology offers a means to assess VO2max for individuals who might not achieve maximal exhaustion during CPET due to non-cardiopulmonary reasons.

Effect of psychological skills training on reaction time and strategic thinking in competitive badminton- a systematic review

Background: Badminton is a competitive sport requiring physical, tactical, and mental skills. In addition to physical abilities, such as speed, agility, and endurance, psychological skills are essential in determining an athlete's performance. Quick reaction time and practical strategic thinking are two critical elements needed in badminton matches, where athletes must react quickly to opponents and make strategic decisions under pressure. Psychological skills training, which includes attention regulation, stress management, visualization, and emotion regulation, has been identified as an essential factor supporting improving athletes' performance in various sports. However, not many studies have empirically reviewed the effect of psychological skills training on reaction time and strategic thinking, especially in competitive badminton. Study Objectives: This study aims to systematically review the existing literature on the effect of psychological skills training on reaction time and strategic thinking in competitive badminton. As such, the study seeks to identify and evaluate the existing evidence regarding the effectiveness of psychological skills training in improving these two critical components and their implications for enhancing athletes' performance on the field. Materials and Methods: This study is a systematic review that follows the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Research articles published during a given year and relevant to this topic are collected from various academic databases, including PubMed, Scopus, and Google Scholar. Studies that met the inclusion criteria were those that explored psychological skills training in the context of badminton or similar sports and that assessed the impact on reaction time and strategic thinking. Exclusion criteria were applied to irrelevant studies that did not have sufficient empirical data or used non-athlete populations. The study selection process involves screening the title and abstract, followed by a full-text analysis of the eligible articles. Data from each study that met the criteria were analyzed and synthesized to evaluate the consistency of the findings and provide a comprehensive picture of the effects of psychological skills training. Results: Most of the studies reviewed showed that psychological skills training positively impacted the reaction time of badminton athletes. Training in relaxation, concentration, and visualization techniques has proven effective in helping athletes shorten the response time to game stimuli. In addition, strategic decision-making abilities on the field have also improved significantly through the application of psychological skills, especially when athletes are faced with high-pressure situations. These studies also show that psychological skills training improves physical performance and helps athletes manage anxiety and increase self-confidence, which affects the quality of tactical decisions made during games. Conclusion: Based on the results of this systematic review, psychological skills training significantly improves reaction time and strategic thinking in competitive badminton. Techniques such as visualization, stress management, and attention focus impact quick response and decision-making in the field. Thus, integrating psychological skills training into badminton athlete training programs can effectively improve competitive performance. Further research is needed to explore the long-term implementation of this training and its effectiveness at different levels of competition.

El béisbol: un deporte exigente con la función visual

Sports vision is an emerging optometric discipline that seeks to improve visual fusion to obtain better sport performance. The relevant visual skills during sport practice depend on the type of sport played and, in the case of team sports, also on the playing position and task performed. Baseball is a fast-action sport that is very visually demanding. In this work, a literature review and analysis of the studies that investigate important aspects of vision in baseball practice has been carried out. Most of the studies reviewed focus on the analysis of the visual skills of batters, as batting is a highly visually demanding task. The results of the research show that baseball players have better visual skills than the non-athlete population, with dynamic visual acuity, eye movements, eye-hand-body coordination, response time and anticipation being among the most important for a good visual performance of the athletes. Studies show significant differences in certain visual skills depending on athlete-level and/or their playing position.

From Strikers to Keepers: Somatotype of Football Players from Slovakia.

This study aims to analyze and compare the somatotypes of professional football players from Slovakia with a non-athletic population. Comparative analysis of professional soccer players by their positions, goalkeepers (n = 4; 8%), defenders (n = 16; 32%), strikers (n = 15; 30%), and midfielders (n = 15; 30%), in average age 16.88 ± 1.29 years, based on selected anthropometric parameters, somatotype components, and the resultant somatotype using the Heath-Carter method. The average somatotype of the soccer players was categorized as an ectomorphic mesomorph (40%). Goalkeepers showed significantly greater body height (BH 187.98 ± 3.166 cm) and weight (BW 82.33 ± 4.922 kg) than midfielders (BH 179.25 ± 6.126 cm; p = 0.03; BW 68 ± 6.304 kg; p = 0.014) and strikers (BH 176.04 ± 4.998 cm; p = 0.026; BW 68.93 ± 6.591 kg; p = 0.026). Defenders had significantly greater BH (182.14 ± 4.853 cm; p = 0.026) than strikers. Goalkeepers also had a significantly higher BMI than midfielders (23.28 ± 0.698 vs. 21.14 ± 1.282 kg/m2; p = 0.02) and greater epicondylar width of the humerus (EWH 7.36 ± 0.14 cm) compared to strikers (EWH 6.79 ± 0.308 cm; p = 0.014). The average somatotype values identified goalkeepers [2.0-4.1-3.1], defenders [1.6-3.9-3.2], and strikers [1.7-4.2-2.9] as ectomorphic mesomorphs, while midfielders were identified as mesomorph-ectomorphs [1.6-3.7-3.6]. The results highlight the importance of somatotype in player position suitability and its impact on physical attributes in football.

Recovery of heart rate and heartrate variability after a maximal cardiopulmonary exercise test in novice female runners.

Previous studies have shown delayed cardiac vagal reactivation after high-intensity endurance exercise when estimated with heartrate variability (HRV). However, the recovery dynamics of RR intervals (RRI) and HRV after a maximal incremental exercise test have been studied less in non-athletic population and especially in females. The main aim of the study was to examine the recovery dynamics of RRI and HRV immediately after a maximal cardiopulmonary exercise test (CPET) in adult females. Twenty-eight healthy, novice recreational female runners (33.7 ± 4.2years) were selected to participate in this study from a larger group of participants (Run RCT). RRIs were collected continuously during a controlled rest, a CPET on a treadmill and a 15-min controlled, passive recovery. Minute-by-minute recovery dynamics were analyzed. The dynamic phase of RRI and heart rate recovery (HRR) (from 192.2 ± 9.9 to 111.4 ± 2.4, P < 0.001) occurred during the first 4.5min with HRR of 36 ± 10 beats during the first minute of the recovery. Resting heart rate was negatively associated (r = - 0.53, P = 0.016) with HRR during the recovery. No recovery of root mean square of successive RRIs (RMSSD) was detected during the 15-min recovery. RMSSD was 15.0 ± 9.2% of resting values at the end of the recovery. No recovery of vagal-derived HRV was detected immediately after a CPET in novice recreational female runners despite marked changes in sympathovagal balance, detected by rapid recovery of RRI during the first 5min after exercise cessation.

The habitual degree of weight loss might be associated with specific fat and protein intakes during a period of weight maintenance in athletes used to weight variations: preliminary results from the WAVE study

Weight variations are common in sporting life, with important inter-individual variability in the degree of an athlete's habitual weight loss. As a part of the WAVE study (NCT04107545), the main objective of this preliminary study was to determine whether the habitual degree of weight loss was associated with anthropometric, body composition, nutritional or psychometric profiles during a period of weight maintenance in athletes accustomed to weight variations. We hypothesized that athletes accustomed to a higher habitual degree of weight loss may have a higher body weight and body fat mass, and may present a more controlled diet regimen and cognitive restriction than athletes with a lower habitual degree of weight loss. During a period of weight maintenance, 62 athletes (24.0 ± 5.3 years; 26 women) completed anthropometry and body composition measurements, a 48-hours food diary and self-reported questionnaires to determine their weight variation practice, nutritional profile and mood state. Athletes were stratified within inter- and intra-quartile groups according to their habitual degree of weight loss. Athletes with a higher habitual degree of weight loss were those who consumed more protein (P < .001) and less fat (P = .01) as a proportion of total energy compared with those losing less weight, without any difference in body composition between the groups. The rapid weight loss score was significantly higher in individuals losing more weight (P < .001) and no difference was observed for the mood state profile. The present results suggest a potential control of nutritional regulation during a period of weight maintenance in order to spare fat-free mass and favor fat mass loss in athletes who are routinely losing more weight. Fat-free mass may be the main nutritional driver due to low body fat mass in athletes, which may limit the “catch-up fat” phenomenon commonly observed in nonathletic population.

Racial and Gender Differences in Cardiorespiratory Fitness and Atrial Fibrillation.

The expanding field of cardiorespiratory fitness (CRF) in individuals with and without atrial fibrillation (AF) presents a complex landscape, demanding careful interpretation of the existing research. AF, characterized by significant mortality and morbidity, prompts the exploration of strategies to mitigate its impact. Increasing physical activity (PA) levels emerges as a promising avenue to address AF risk factors, such as obesity, hypertension, and diabetes mellitus, through mechanisms of reduced vasoconstriction, endothelin-1 modulation, and improved insulin sensitivity. However, caution is warranted, as recent investigations suggest a heightened incidence of AF, particularly in athletes engaged in high-intensity exercise, due to the formation of ectopic foci and changes in cardiac anatomy. Accordingly, patients should adhere to guideline-recommended amounts of low-to-moderate PA to balance benefits and minimize adverse effects. When looking closer at the current evidence, gender-specific differences have been observed and challenged conventional understanding, with women demonstrating decreased AF risk even at extreme exercise levels. This phenomenon may be rooted in divergent hemodynamic and structural responses to exercise between men and women. Existing research is predominantly observational and limited to racially homogenous populations, which underscores the need for comprehensive studies encompassing diverse, non-White ethnic groups in athlete and non-athlete populations. These individuals exhibit a disproportionately high burden of AF risk factors that could be addressed through improved CRF. Despite the limitations, randomized control trials offer promising evidence for the efficacy of CRF interventions in patients with preexisting AF, showcasing improvements in clinically significant AF outcomes and patient quality of life. The potential of CRF as a countermeasure to the consequences of AF remains an area of great promise, urging future research to delve deeper to explore its role within specific racial and gender contexts. This comprehensive understanding will contribute to the development of tailored strategies for optimizing cardiovascular health and AF prevention in all those who are affected.

Combining Sound and Deep Neural Networks for the Measurement of Jump Height in Sports Science.

Jump height tests are employed to measure lower-limb muscle power of athletic and non-athletic populations. The most popular instruments for this purpose are jump mats and, in recent years, smartphone apps, which compute jump height through the manual annotation of video recordings and recently automatically using the sound produced during the jump to extract the flight time. In a previous work, the afore-mentioned sound systems were presented by the authors in which the take-off and landing events from the audio recordings of jump executions were obtained using classical signal processing. In this work, a more precise, noise-immune, and robust system, capable of working in the most unfavorable environments, is presented. The system uses a deep neural network trained specifically for this purpose. More than 300 jumps were recorded to train and validate the network performance. The ground truth was a jump mat, providing a slightly better accuracy in quiet and medium quiet environments but excellent accuracy in noisy and complicated ones. The developed audio-based system is a trustworthy instrument for measuring jump height accurately in any kind of environment, providing a perfect measurement tool that can be accessed through a mobile phone in the form of an app.

Body Composition and Its Interaction with Bone Mineral Density and Biochemical and Nutritional Parameters in Chilean Adults with Overweight/Obesity and Normal Weight.

This study aimed to compare and relate the body composition (obtained through anthropometry with the pentacompartmental model and the tricompartmental model by DXA) with bone mineral density and biochemical and nutritional parameters in Chilean adults with overweight/obesity and normal weight from La Araucanía region, Chile. A case-control study was conducted with 116 adults and volunteers from the PURE cohort, collecting sociodemographic data, BMI assessment, waist-to-hip ratio (WHR), and body composition using the pentacompartmental model (5CM) and tricompartmental model (3CM) by DXA, as well as bone mineral density (BMD). Blood biochemical parameters (fasting glucose and lipid profile), physical activity (PA) measured by GPAQ, and average dietary habits (R24h) were measured. In the overweight/obesity group, the 5CM and 3CM adipose mass were indirectly and moderately correlated with PA (p < 0.05), except in the male 5CM group. In the overweight/obesity group, muscle and fat-free mass (FFM) of the 5CM and 3CM correlated directly and moderately with blood fasting glucose (BFG) and BMD (p < 0.05), except in females, where FFM was not related to BMD but was related to residual mass (p < 0.01). Independent of gender and BMI, bone mineral content was positively and highly correlated with BMD (p < 0.0000). In the male overweight/obesity group, bone, skin, and residual mass were correlated with BFG (p < 0.05). In conclusion, for the assessment of non-athletic adult populations, more routine use of the 5CM in clinical practice is recommended.

The Appearance and Performance Enhancing supplement/substance use Scale (APES): Development and preliminary psychometric analysis

BackgroundThe use of both licit and illicit appearance and performance-enhancing drugs (APED) has been recognized as a key public health concern. While it is estimated that rates of APED usage in non-athlete populations is increasing, true prevalence studies are limited by a lack of psychometrically reliable and valid measures. This paper describes the development and psychometric evaluation of a survey tool for assessing APED usage. MethodInitial items for the Appearance and Performance Enhancing Supplement/Substance Use Scale (APES) were seven licit and 13 illicit APED. Following a preliminary exploration, we evaluated the concurrent validity, internal consistency, and test-retest reliability of the APES in a community sample of 265 participants. ResultsThe APES demonstrated strong internal consistency, medium to strong concurrent validity, and good to excellent test-retest reliability. ConclusionsThese results provide preliminary support for the reliability and the validity of APES scores in assessing both licit and illicit APED usage. Future studies are recommended to replicate and extend the psychometric investigations reported here to encompass additional validation studies and populations.

Flexor hallucis longus tendon transfer for Tendo Achillis reconstruction

Background: Tendo Achilles injuries are common in orthopaedic practice. Degenerative, Chronic and failed repaires requires some form of soft tissue sleeve augmentation like Flexor Hallucis longs (FHL), Peroneus Brevis (PB), Plantaris etc.. are used along with proximal Tendo Achilles advancement procedures lie V-Y plasty, musculo tendinous Recession or Turn Down Procedures. These advancement procedure leads to weakening of already compromised Tendon. So, wanted to evaluate functional outcome of FHL tendon Trans Tendinous Transfer without any Advancement procedures. Methods: 20 patients satisfying inclusion criteria underwent FHL Trans tendinous Transfer to Tendo Achilles which is secured with Interference screw into the prepared bone bed of calcaneum. Initially anterior slab in planter flexion was applied later converted to cast in neutral position which is removed at the end of 6 weeks and joint mobilization started. Results: Out of 20 patients,11 were male patients and 9 were females. Average age ranged from 22 to 65 years. 9 were chronic Tears,9 were Degenerative Tears and 2 were failed Repairs. Wound healing complications were seen in 4 cases, 1 with chronic tear, 1 with Degenerative Tear and Both Filed repairs, all of them healed eventually. ALL patients were assessed for AOFAS at 6th and 12thmonth. The mean AOFAS of each subgroup improved significantly from months 3 to 12 (Table). At the one-year follow-up, all patients achieved good functional outcome in terms of the AOFAS scoring system. Conclusions: Tendo Achilles is the common tendon injured in ankle region due to repetitive stress and degeneration. Degenerative, Chronic and failed repair injuries of Tendo Achilles requires some form of soft tissue augmentation for healing. Trans-Tendinous FHL tendon transfer for Tendo Achilles Reconstruction shows good results with minimal complications in these scenarios in non-Athletic Population.

Functional outcomes and rates of return to sport activities in a non-athlete population after the open Brostrom-Gould repair: a seven-year follow-up.

After an ankle sprain, up to 20% of patients may develop chronic lateral ankle instability (CLAI) requiring surgical treatment. The objective of this study was to investigate the functional outcomes and rates of return to sport activities in a cohort of non-athlete patients with chronic lateral ankle instability (CLAI) who underwent the opened Brostrom-Gould technique (BGT). Seventy-nine patients (seventy-nine feet) from three different centers undergoing BGT were reviewed. For clinical and functional analysis, the AOFAS ankle-hindfoot scale was applied and rates of return to sport activities were assessed. Correlation of Δ-AOFAS and rates of return to sport activities with all variables analyzed was performed. Mean AOFAS score improved from 64.6 to 97.2 (p < 0.001). Sixty-one (77.2%) returned to preinjury activities and 18 (22.8%) changed to a lower-level modality. Symptoms of instability were related to Δ-AOFAS (p = 0.020). Change in the sport activity was related to pain and symptoms of instability (p = 0.41 and p < 0.001). Recreational athlete patients who underwent the BGT demonstrated excellent functional outcomes after a mean follow-up of 7years. Residual pain and symptoms of instability after surgery were the main complaints associated with limitations in physical activities.

The Effectiveness of Advanced Cardiac Testing on Identifying Risk for Sudden Cardiac Arrest/Death in Athletes Following COVID-19 Infection During Preparticipation Examination: A Critically Appraised Topic

Clinical Scenario: Due to the potential side effects in athletes, there is a need to evaluate for cardiac-related side effects due to COVID-19 infection during preparticipation examinations. Clinical Question: Does advanced cardiac testing during preparticipation examinations in athletes who have contracted the COVID-19 virus identify cardiac abnormalities? Summary of Key Findings: The literature was searched based on athletes’ post–COVID-19 infection who were tested for risk of sudden cardiac arrest/death. The initial search yielded 32 studies, but 7 were excluded based on abstract content. Of the remaining 25 studies, 17 were excluded based on patient age or non-athletic populations. Four relevant studies met the inclusion criteria and were included. The need for cardiac screening and advanced cardiac testing was supported to identify risk of sudden cardiac arrest/death during preparticipation examinations in COVID-19–positive patients. Clinical Bottom Line: The use of advanced cardiac testing along with a comprehensive symptom and history questionnaire is essential to reduce cardiac complications due to COVID-19. Symptom-based questionnaires following COVID-19 infection can detect possible COVID-19–related cardiac abnormalities better than the standard cardiac symptom-based questionnaires alone. These combined screening measures for patients with a COVID-19 infection can safely help return athletes to sports. Strength of Recommendation: This recommendation has a strength of B based on Oxford Centre for Evidence-Based Medicine due to consistently lower quality limited evidence that supports the use of advanced cardiac testing in identifying heart-related complications and risk of sudden cardiac arrest/death in COVID-19–positive patients.

Lumbar extension peak-torque, muscle endurance and motor imagery in junior-elite basketballers with and without a history of low back pain: a pilot study.

Low back pain (LBP) is common in elite athletes. Several peripheral and central factors have been identified to be altered in non-athletic LBP populations, however whether these alterations also exist in elite athletes with LBP is unknown. The aim of this study was to determine whether elite basketballers with a history of persistent LBP perform worse than those without LBP at a lumbar muscle endurance task, a lumbar extension peak-torque task, and a lumbar motor imagery task. An observational pilot study. Twenty junior elite-level male basketballers with (n=11) and without (n=9) a history of persistent LBP were recruited. Athletes completed a lumbar extensor muscle endurance (Biering-Sorensen) task, two lumbar extensor peak-torque (modified Biering-Sorensen) tasks and two motor imagery (left/right lumbar and hand judgement) tasks across two sessions (48 hours apart). Performance in these tasks were compared between the groups with and without a history of LBP. Young athletes with a history of LBP had reduced lumbar extensor muscle endurance (p<0.001), reduced lumbar extension peak-torque (p<0.001), and were less accurate at the left/right lumbar judgement task (p=0.02) but no less accurate at a left/right hand judgement task (p=0.59), than athletes without a history of LBP. Response times for both left/right judgement tasks did not differ between groups (lumbar p=0.24; hand p=0.58). Junior elite male basketballers with a history of LBP demonstrate reduced lumbar extensor muscle endurance and lumbar extension peak-torque and are less accurate at a left/right lumbar rotation judgement task, than those without LBP.

Effects of Vitamin D Supplementation in Elite Athletes: A Systematic Review.

Deficiency in vitamin D has been shown to increase the risk of injury. To synthesize current placebo-controlled randomized trials investigating the effect of vitamin D supplementation in elite athletes on (1) aerobic capacity; (2) anaerobic measures, such as strength, speed, and anaerobic power; (3) serum biomarkers of inflammation; and (4) bone health. Systematic review; Level of evidence, 1. A literature search was conducted on November 30, 2022, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Included were randomized, placebo-controlled studies of longer than 2 weeks on subjects with active participation in organized sport. Excluded were nonrandomized controlled trial study designs, vitamin D administration routes other than oral, studies that did not use vitamin D supplementation as the sole intervention, and studies with nonathletic or military populations. Out of 2331 initial studies, 14 studies (482 athletes) were included. Of the 3 studies that assessed aerobic capacity, 2 demonstrated significantly greater improvements in maximal oxygen uptake and physical working capacity-170 (P < .05) in supplemented versus nonsupplemented athletes. Measurements of anaerobic power and strength were consistently increased in supplemented groups compared with nonsupplemented groups in 5 out of the 7 studies that assessed this. Of the 6 studies that assessed sprint speed, 4 found no significant difference between supplemented and nonsupplemented groups. Aside from 1 study that found significantly lower interleukin-6 levels in supplemented athletes, measures of other inflammatory cytokines were not affected consistently by supplementation. The 4 studies that assessed markers of bone health were conflicting regarding benefits of supplementation. One study found demonstrated improvements in bone mineral density in response to supplementation (P = .02) compared with control whereas another found no significant difference between supplemented and nonsupplemented groups. However, in 3 other studies, serum biomarkers of bone turnover such as bone-specific alkaline phosphatase, parathyroid hormone, and N-terminal telopeptide appeared to be higher in subjects with lower serum vitamin D levels (P < .05). Results of this systematic review indicated that the greatest benefit of vitamin D supplementation in elite athletes may be improving aerobic endurance, anaerobic power, and strength. More research is needed to determine the effect of vitamin D supplementation on bone health and injury risk in this population.

Effects of Olympic Combat Sports on Cardiorespiratory Fitness in Non-Athlete Population: A Systematic Review of Randomized Controlled Trials

This systematic review aimed to assess the available body of published peer-reviewed articles related to the effects of Olympic combat sports (OCS) on cardiorespiratory fitness (CRF) in the non-athlete population. The methodological quality and certainty of evidence were evaluated using PRISMA, TESTEX, RoB, and GRADE scales. The protocol was registered in PROSPERO (code: CRD42023391433). From 4133 records, six randomized controlled trials were included, involving 855 non-athletes (mean age = 27.2 years old). The TESTEX scale reported all studies with a ≥ 60% (moderate-high quality) score. The GRADE scale indicated moderate to low certainty of evidence. It was only possible to perform a meta-analysis on direct methods to maximum oxygen consumption (VO2max). The main results indicated significant differences in favor of OCS compared to active/passive controls in VO2max (SMD = 4.61; 95%CI = 1.46 to 7.76; I2 = 99%; p = 0.004), while the individual results of the studies reported significant improvements in favor of the OCS on the indirect methods of the CRF. OCS improved CRF in a healthy non-athlete population of different ages, specifically showing a significant improvement in VO2max with direct tests, such as cardiopulmonary tests. However, moderate to low certainty of evidence is reported, so no definitive recommendations can be established.