Changes in Lower Limb Biomechanics Across Various Stages of Maturation and Implications for ACL Injury Risk in Female Athletes: a Systematic Review.

BACKGROUND: Female athletes are four to six times more likely to sustain an anterior cruciate ligament (ACL) injury than male athletes. Jump-landing biomechanics are influenced by maturation, with post-pubertal female athletes at a heightened risk of ACL injuries. OBJECTIVE: The aim of our systematic review was to identify and summarise the current evidence regarding the changes in kinematic and kinetic risk factors associated with ACL injuries during jump-landing tasks in female athletes at various stages of maturity. METHODS: A systematic search was conducted in PubMed, CINAHL, Web of Science, SPORTDiscus, EMBASE and Scopus. Articles were included if they: (1) conducted the research on uninjured female athletes with no restriction on playing level/experience; (2) provided information regarding the stage of the maturity and the scale used for estimating the maturity status of the participants; and (3) reported a biomechanical risk factor associated with ACL injuries during jump-landing tasks across at least two different maturity groups (e.g. pre-pubertal vs post-pubertal). RESULTS: Sixteen articles involving 2323 female athletes were included in our review. A total of 12 kinematic and 8 kinetic variables were identified across these studies. Of the 12 kinematic variables reported in our review, we found strong evidence for higher peak knee abduction angle in post-pubertal female individuals compared with pre-pubertal girls (p < 0.05). With regard to the 8 kinetic variables, we found strong evidence for lower relative peak vertical ground reaction force, higher external knee abduction moment and internal rotation moment in post-pubertal compared with pre-pubertal athletes. The strength of evidence for the remaining kinematic and kinetic variables ranged from conflicting to moderate and, in some instances, could not be determined. CONCLUSIONS: Our study provides an overview of the changes in biomechanical risk factors in female athletes during jump-landing tasks at various stages of maturity. We found moderate-to-limited evidence for most kinematic and kinetic variables, highlighting the need for further research.

The Effects of Strength, Plyometric and Combined Training on Strength, Power and Speed Characteristics in High-Level, Highly Trained Male Youth Soccer Players: A Systematic Review and Meta-Analysis.

BACKGROUND: Male youth soccer players competing at a high level will typically engage in large volumes of soccer training from a young age. However, it is not known whether the high levels of habitual training that these high-performing players are exposed to limit their ability to respond to strength, plyometric or combined training interventions. OBJECTIVE: The primary aim of our systematic review and meta-analysis was to compare the specific effects of strength, plyometric and combined training with active controls (standard soccer training) on the strength, power and speed characteristics of high-level, highly trained young male soccer players. METHODS: We performed a literature search across PubMed, Scopus, CINAHL, Web of Science and SPORTDiscus to identify controlled studies that implemented strength, plyometric or combined training in high-level male youth soccer players. Participants were defined as high level or highly trained based on established guidelines related to either competition level or age-related weekly hours spent in soccer training. Studies needed to report at least one outcome of lower body strength, squat jump, countermovement jump, horizontal power, acceleration (0-10 m), speed (15-40 m) or change of direction speed. A meta-analysis was then performed using a random-effects model to determine the magnitude (Hedge's g) of training responses and whether effects differed across modes of training. RESULTS: From an initial return of 5464 papers, n = 34 studies met the inclusion criteria and provided a total sample of n = 1396 high-level male youth soccer players. Strength, plyometric and combined training resulted in improvements in strength, squat and countermovement jump, horizontal power, acceleration, change of direction speed (all p < 0.05; g = 0.73-1.08, moderate) and speed (p < 0.05; g = 0.40-0.59, small). Lower body strength was the only outcome where training mode had a significant effect (p < 0.05), with plyometric training producing small effects (g = 0.27, p < 0.05) compared with moderate effects for strength (g = 1.07, p < 0.05) and combined (g = 0.75, p < 0.05) training. Prediction intervals for overall effects (all training modes combined) showed that the greatest confidence that future training will lead to positive effects was in the squat and countermovement jump, horizontal power and acceleration (prediction intervals = 0.03-1.81). CONCLUSIONS: High-level, highly trained male youth soccer players can experience positive gains in indices of strength, power and speed from strength, plyometric and combined training, and the magnitude of gains are mostly similar across modes of training. Based on prediction intervals, there is a good level of certainty that future strength, plyometric and combined training in this population would lead to positive improvements in vertical and horizontal power and sprint acceleration.

Jump rope training effects on health- and sport-related physical fitness in young participants: A systematic review with meta-analysis.

The aim of this systematic review with meta-analysis was to assess the available body of published peer-reviewed articles related on the effects of jump rope training (JRT) compared with active/passive controls on health- and sport-related physical fitness outcomes. Searches were conducted in three databases, including studies that satisfied the following criteria: i) healthy participants; ii) a JRT programprogramme; iii) active or traditional control group; iv) at least one measure related to health- and sport-related physical fitness; v) multi-arm trials. The random-effects model was used for the meta-analyses. Twenty-one moderate-high quality (i.e., PEDro scale) studies were meta-analysed, involving 1,021 participants (male, 50.4%). Eighteen studies included participants with a mean age <18 years old. The duration of the JRT interventions ranged from 6 to 40 weeks. Meta-analyses revealed improvements (i.e., p = 0.048 to <0.001; ES = 0.23-1.19; I2 = 0.0-76.9%) in resting heart rate, body mass index, fat mass, cardiorespiratory endurance, lower- and upper-body maximal strength, jumping, range of motion, and sprinting. No significant JRT effects were noted for systolic-diastolic blood pressure, waist-hip circumference, bone or lean mass, or muscle endurance. In conclusion, JRT, when compared to active and passive controls, provides a range of small-moderate benefits that span health- and sport-related physical fitness outcomes.

Quantification of Pre-Season and In-Season Training Intensity across an Entire Competitive Season of Asian Professional Soccer Players.

The aim of this study was to quantify the training load in two microcycles (Ms) from pre- and another two from in-season and to analyze playing position influences on the load experienced by professional soccer players. Nineteen Asian athletes, including four central defenders, four wide defenders, six central midfielders, three wide midfielders, and two strikers participated in this study. The micro-electromechanical system was used to collect training duration, total distance, and data from Zone 1 (0−3.9 km·h−1), Zone 2 (4−7.1 km·h−1), Zone 3 (7.2−14.3 km·h−1), Zone 4 (14.4−19.7 km·h−1), and Zone 5 (>19.8 km·h−1), heart rate maximum (HRmax), and average (HRavg). The load was reduced on the last day of the Ms, with the exception of Zone 5, in M1, where higher values were found on the last day. Significant differences were observed between central and wide defenders for distance covered in Zone 4 (effect-size: ES = −4.83) in M2 and M4 (ES = 4.96). Throughout all the Ms, a constant HRmax (165−188 bpm) and HRavg (119−145 bpm) were observed. There was a tendency to decrease the load on the last day of the Ms. In general, there were higher external training loads in Ms from the pre-season than in-season. Wide defenders and wide midfielders showed higher distances covered with high-intensity running.

Clinical utility and reproducibility of surface electromyography in individuals with chronic low back pain: a protocol for a systematic review and meta-analysis.

INTRODUCTION: Chronic low back pain (CLBP) is one of the most common disorders presenting in primary healthcare. Kinematic studies of low lumbar pelvic mobility allied with surface electromyography (sEMG) may assist in the assessment and management of CLBP. However, the applicability in the use of sEMG in the clinical setting remains uncertain. In this protocol, we aim to review the clinical utility and reproducibility of the sEMG component of these kinematic studies in patients with CLBP. METHODS AND ANALYSIS: This protocol was informed by the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) and results will be reported in line with the PRISMA. Searches will be conducted on PubMed, Scopus, Web of Science, Embase, CINAHL and Google Scholar databases, along with a comprehensive review of grey literature. Two reviewers will conduct the searches and independently screen them, according to title and abstract. Two independent reviewers will then assess the full-text versions of those selected articles and assess the risk of bias using the defined protocol inclusion criteria. The risk of bias within the studies included will be assessed via the Quality Assessment of Diagnostic Accuracy Studies tool, V.2 and the Grading of Recommendations Assessment, Development and Evaluation guidelines will be used to assess certainty of evidence for recommendations based on the risk of bias findings. Meta-analysis will be conducted where appropriate on groups of studies with low heterogeneity. In instances of higher heterogeneity, meta-synthesis will instead be completed, comparing results in terms of increased or decreased clinical utility and/or reproducibility of sEMG. ETHICS AND DISSEMINATION: Ethics approval was not required for this research. It is anticipated that the results will influence the use, interpretation and further development of sEMG in management and assessment of these patients. PROSPERO REGISTRATION NUMBER: CRD42021273936.

The Paradoxical Effect of Creatine Monohydrate on Muscle Damage Markers: A Systematic Review and Meta-Analysis.

BACKGROUND: Several studies have examined the effect of creatine monohydrate (CrM) on indirect muscle damage markers and muscle performance, although pooled data from several studies indicate that the benefits of CrM on recovery dynamics are limited. OBJECTIVE: This systematic review and meta-analysis determined whether the ergogenic effects of CrM ameliorated markers of muscle damage and performance following muscle-damaging exercises. METHODS: In total, 23 studies were included, consisting of 240 participants in the CrM group (age 23.9 ± 10.4 years, height 178 ± 5 cm, body mass 76.9 ± 7.6 kg, females 10.4%) and 229 participants in the placebo group (age 23.7 ± 8.5 years, height 177 ± 5 cm, body mass 77.0 ± 6.6 kg, females 10.0%). These studies were rated as fair to excellent following the PEDro scale. The outcome measures were compared between the CrM and placebo groups at 24-36 h and 48-90 h following muscle-damaging exercises, using standardised mean differences (SMDs) and associated p-values via forest plots. Furthermore, sub-group analyses were conducted by separating studies into those that examined the effects of CrM as an acute training response (i.e., after one muscle-damaging exercise bout) and those that examined the chronic training response (i.e., examining the acute response after the last training session following several weeks of training). RESULTS: According to the meta-analysis, the CrM group exhibited significantly lower indirect muscle damage markers (i.e., creatine kinase, lactate dehydrogenase, and/or myoglobin) at 48-90 h post-exercise for the acute training response (SMD - 1.09; p = 0.03). However, indirect muscle damage markers were significantly greater in the CrM group at 24 h post-exercise (SMD 0.95; p = 0.04) for the chronic training response. Although not significant, a large difference in indirect muscle damage markers was also found at 48 h post-exercise (SMD 1.24) for the chronic training response. The CrM group also showed lower inflammation for the acute training response at 24-36 h post-exercise and 48-90 h post-exercise with a large effect size (SMD - 1.38 ≤ d ≤ - 1.79). Similarly, the oxidative stress markers were lower for the acute training response in the CrM group at 24-36 h post-exercise and 90 h post-exercise, with a large effect size (SMD - 1.37 and - 1.36, respectively). For delayed-onset muscle soreness (DOMS), the measures were lower for the CrM group at 24 h post-exercise with a moderate effect size (SMD - 0.66) as an acute training response. However, the inter-group differences for inflammation, oxidative stress, and DOMS were not statistically significant (p > 0.05). CONCLUSION: Overall, our meta-analysis demonstrated a paradoxical effect of CrM supplementation post-exercise, where CrM appears to minimise exercise-induced muscle damage as an acute training response, although this trend is reversed as a chronic training response. Thus, CrM may be effective in reducing the level of exercise-induced muscle damage following a single bout of strenuous exercises, although training-induced stress could be exacerbated following long-term supplementation of CrM. Although long-term usage of CrM is known to enhance training adaptations, whether the increased level of exercise-induced muscle damage as a chronic training response may provide potential mechanisms to enhance chronic training adaptations with CrM supplementation remains to be confirmed.

Effects of Plyometric Jump Training on Balance Performance in Healthy Participants: A Systematic Review With Meta-Analysis.

Background: Postural balance represents a fundamental movement skill for the successful performance of everyday and sport-related activities. There is ample evidence on the effectiveness of balance training on balance performance in athletic and non-athletic population. However, less is known on potential transfer effects of other training types, such as plyometric jump training (PJT) on measures of balance. Given that PJT is a highly dynamic exercise mode with various forms of jump-landing tasks, high levels of postural control are needed to successfully perform PJT exercises. Accordingly, PJT has the potential to not only improve measures of muscle strength and power but also balance. Objective: To systematically review and synthetize evidence from randomized and non-randomized controlled trials regarding the effects of PJT on measures of balance in apparently healthy participants. Methods: Systematic literature searches were performed in the electronic databases PubMed, Web of Science, and SCOPUS. A PICOS approach was applied to define inclusion criteria, (i) apparently healthy participants, with no restrictions on their fitness level, sex, or age, (ii) a PJT program, (iii) active controls (any sport-related activity) or specific active controls (a specific exercise type such as balance training), (iv) assessment of dynamic, static balance pre- and post-PJT, (v) randomized controlled trials and controlled trials. The methodological quality of studies was assessed using the Physiotherapy Evidence Database (PEDro) scale. This meta-analysis was computed using the inverse variance random-effects model. The significance level was set at p <0.05. Results: The initial search retrieved 8,251 plus 23 records identified through other sources. Forty-two articles met our inclusion criteria for qualitative and 38 for quantitative analysis (1,806 participants [990 males, 816 females], age range 9-63 years). PJT interventions lasted between 4 and 36 weeks. The median PEDro score was 6 and no study had low methodological quality (≤3). The analysis revealed significant small effects of PJT on overall (dynamic and static) balance (ES = 0.46; 95% CI = 0.32-0.61; p < 0.001), dynamic (e.g., Y-balance test) balance (ES = 0.50; 95% CI = 0.30-0.71; p < 0.001), and static (e.g., flamingo balance test) balance (ES = 0.49; 95% CI = 0.31-0.67; p < 0.001). The moderator analyses revealed that sex and/or age did not moderate balance performance outcomes. When PJT was compared to specific active controls (i.e., participants undergoing balance training, whole body vibration training, resistance training), both PJT and alternative training methods showed similar effects on overall (dynamic and static) balance (p = 0.534). Specifically, when PJT was compared to balance training, both training types showed similar effects on overall (dynamic and static) balance (p = 0.514). Conclusion: Compared to active controls, PJT showed small effects on overall balance, dynamic and static balance. Additionally, PJT produced similar balance improvements compared to other training types (i.e., balance training). Although PJT is widely used in athletic and recreational sport settings to improve athletes' physical fitness (e.g., jumping; sprinting), our systematic review with meta-analysis is novel in as much as it indicates that PJT also improves balance performance. The observed PJT-related balance enhancements were irrespective of sex and participants' age. Therefore, PJT appears to be an adequate training regime to improve balance in both, athletic and recreational settings.

The correlation of force-velocity-power relationship of a whole-body movement with 20 m and 60 m sprint performance.

Sprinting ability is important for successful performance in sports. The aim of this study was to examine the correlation between force-velocity-power relationship of a whole-body movement and sprint performance. Twelve male participants performed maximal squat jumps with additional loads ranging from 0% to 100% body weight to obtain force-velocity profiles. The mean force and velocity were calculated during the push-off phase for each jump, which resulted in a force-velocity curve. The theoretical maximal force (F0), theoretical maximal velocity (V0) and theoretical maximum power (P0) were computed via extrapolation of the force and velocity data. In the second session, participants performed two 60 m sprints and the time to cover 20 m (t20), time to cover 60 m (t60), and maximum sprint velocity (Vmax) were calculated from the best 60 m trial. Correlation analyses revealed strong and significant correlations between V0 and t20 (r = -0.60), V0 and t60 (r = -0.60), P0 and t20 (r = -0.75) and P0 and t60 (r = -0.78). Multiple linear regression indicated that P0 explained 56%, 61% and 60% of the variability in t20, t60 and Vmax, respectively. Our results emphasise the importance of developing power production capabilities to improve sprint performance.

The effect of leaf extract supplementation on exercise-induced muscle damage and muscular performance: A systematic review and meta-analysis.

This systematic review and meta-analysis investigated the effects of leaf-plant extracts typically used for tea beverages on the level of exercise-induced muscle damage. The meta-analysis was conducted by comparing measures between the leaf-extract supplements (SUPP) and placebo (PLA) conditions at 24 h and 48 h following the muscle-damaging protocols from 19 studies with 416 participants. The results showed that the SUPP condition exhibited significantly lower indirect muscle damage markers than the PLA condition at 24- and 48-h post-exercise (p < 0.05). Furthermore, oxidative stress markers were significantly lower for the SUPP condition than the PLA condition at 24-h post-exercise (p < 0.05), although not at 48-h post-exercise (p > 0.05). In addition, no differences were found for anti-oxidant status at 24- and 48-h post-exercise (p > 0.05) between conditions. Muscle performance measures significantly increased for the SUPP condition than the PLA condition at 24-h post-exercise (p < 0.05), but not at 48-h post-exercise (p > 0.05). These results demonstrate that leaf plant extracts reduces the level of various biomarkers indicative of exercise-induced stress, although its effect on anti-oxidant status remains equivocal. Nonetheless, leaf-plant extracts typically ingested as a tea beverage may be an effective recovery strategy following strenuous exercises.

Effects of muscle strengthening and cardiovascular fitness activities for poliomyelitis survivors: A systematic review and meta-analysis.

OBJECTIVE: To evaluate and assess the effectiveness of muscle strengthening and cardiovascular interventions in improving outcomes in poliomyelitis (polio) survivors. DATA SOURCES: A systematic literature search was conducted in Medline, PubMed, CINAHL, PsychINFO, Web of Science, and Google Scholar for experimental and observational studies. Study selection and extraction: Screening, data-extraction, risk of bias and quality assessment were carried out independently by the authors. The quality appraisal and risk of bias were assessed using the Downs and Black Checklist. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was followed to increase clarity of reporting. DATA SYNTHESIS: A total of 21 studies that met all the inclusion criteria were subjected to statistical analyses according to intervention (muscle strengthening or cardiovascular fitness). A random-effects meta-analysis showed a statistically significant effect for the exercise interventions favouring improvement in outcomes according to the International Classification of Functioning, Disability and Health (ICF). CONCLUSION: This review provides further insight into the effects associated with muscle strengthening and cardiovascular interventions among polio survivors, and helps to further identify the current state of research in this area. Future research is needed, focusing on individualized approaches to exercise with polio survivors and specific exercise prescription recommendations, based on established frameworks, such as the ICF.

Biomechanical and physical determinants of bowling speed in cricket: a novel approach to systematic review and meta-analysis of correlational data.

This systematic review and meta-analysis examined the influence of biomechanical and physical characteristics on ball release speed in cricket using correlation data. Search was conducted across PubMed, Cinhal, Scopus, SportDiscus and Web of Science, with eighteen studies included. The ball release speed had a moderate correlation with overall biomechanical (r = 0.42, p < 0.001) parameters and a strong correlation with physical (r = 0.65, p < 0.001) characteristics. Furthermore, individual biomechanical and physical parameters were also correlated with ball release speed. The run-up speed had a strong correlation (r = 0.50, p < 0.001) and front knee angle at ball release had a moderate correlation (r = 0.40, p < 0.001). Poorer correlations were identified for centre of mass velocity at ball release (r = 0.16, p = 0.134), front knee angle at front foot contact (r = 0.26, p = 0.015) 25 and vertical ground reaction force (r = 0.13, p = 0.659). Strong and significant correlation was found for total arm length (r = 0.65, p < 0.001) and shoulder strength (r = 0.58, p < 0.001). This review highlights the biomechanical and physical parameters that are major determinants of faster ball release speed.