Simultaneous bilateral shoulder dislocation during pilates reformer exercise: A case report.

INTRODUCTION: Simultaneous bilateral shoulder dislocations are extremely rare occurrences and are rarely associated with exercise. CASE DESCRIPTION: We present an unusual case of bilateral simultaneous shoulder dislocation which occurred during an unsupervised Pilates Reformer exercise session. A 41-year-old female felt sudden severe pain and forward displacement in both shoulders during abduction and external rotation. Bilateral anterior shoulder dislocation was confirmed with initial X-rays in the emergency department. Spontaneous reduction of the right shoulder was observed in the emergency room and then the left side was reduced under general anesthesia. Physical therapy modalities, exercises for shoulder girdle and core strength were implemented as conservative management. The patient returned to desk work and had pain-free range of motion with satisfactory strength on both sides in the fourth week and performed daily life activities without any symptoms in the tenth week. CONCLUSION: This case highlights the importance of training under supervision of an exercise instructor, even if it is considered a "so-called safe" exercise method.

The Effects of Virtual Reality Nonphysical Mental Training on Balance Skills and Functional Near-Infrared Spectroscopy Activity in Healthy Adults.

CONTEXT: Athletic skills such as balance are considered physical skills. However, these skills may not just improve by physical training, but also by mental training. The purpose of this study was to investigate the effects of mental training programs on balance skills and hemodynamic responses of the prefrontal cortex. DESIGN: Randomized controlled trial. METHODS: Fifty-seven healthy adults (28 females, 29 males), aged between 18-25 years, participated in this study. Participants were randomly assigned to 3 groups: virtual reality mental training (VRMT) group, conventional mental training (CMT) group, and control group. The training program included action observation and motor imagery practices with balance exercise videos. The VRMT group trained with a VR head-mounted display, while the CMT group trained with a non-immersive computer screen, for 30 minutes, 3 days per week for 4 weeks. At baseline and after 4 weeks of training, balance was investigated with stabilometry and Star Excursion Balance Test (SEBT). Balance tests were performed with simultaneous functional near-infrared spectroscopy (fNIRS) imaging to measure prefrontal cortex oxygenation. RESULTS: For the stabilometry test, at least 1 variable improved significantly in both VRMT and CMT groups but not in the control group. For SEBT, composite reach distance significantly increased in both VRMT and CMT groups but significantly decreased in the control group. For separate directional scores, reach distance was significantly increased in both mental training groups for nondominant leg posterolateral and posteromedial directions, and dominant leg posterolateral direction, while nondominant posteromedial score was significantly increased only in the VRMT group. Between-group comparisons showed that dominant leg posteromedial and posterolateral score improvements were significantly higher than control group for both mental training groups, while nondominant leg improvements were significantly higher than control group only for the VRMT group. The fNIRS oxyhemoglobin levels were not significantly changed during stabilometry tests. However, oxyhemoglobin levels significantly reduced only in the control group during SEBT. CONCLUSIONS: Our findings suggest that both mental training interventions can significantly improve balance test results. Additionally, VRMT may have some advantages over CMT. These findings are promising for the use of mental training in prevention and rehabilitation for special populations such as athletes and older adults.

The Effects of Virtual Reality Nonphysical Mental Training on Coordination and Skill Transfer in Healthy Adults.

CONTEXT: Mental training is a promising method to improve motor skills. However, transfer of these improvements to different skills or functional activities is still unclear. The purpose of this study was to investigate the effects of mental balance training programs on motor coordination and skill transfer. DESIGN: Randomized controlled trial. METHODS: Fifty-seven healthy adults (28 females and 29 males) aged between 18 and 25 years participated in this study. Participants were randomly assigned to 3 groups: virtual reality (VR) mental training group, conventional mental training group, and control group. The training program included action observation and motor imagery practice with balance exercise videos. The VR mental training group trained with a VR head-mounted display and the conventional mental training group trained with a nonimmersive computer monitor for 30 minutes, 3 days per week, for 4 weeks. Coordination skills were tested with 2 separate custom-made obstacle course tests (OCT-1 and OCT-2). OCT tests included crouching, turning, leaning, stepping over, changing direction, walking on various surfaces, or using repeated hand and arm movement tasks. OCT-1 was used to investigate the effects of mental exercises on coordination skills, and OCT-2 to investigate transfer effects for novel tasks. Test time (total and corrected) and error types (minor, major, and total) were recorded. Touching an obstacle without changing its position was classified as a minor error, and changing its position was a major error. RESULTS: OCT-1 test time and number of errors significantly decreased in the VR mental training and conventional mental training groups, but not in the control group. The number of minor errors was only decreased in the VR mental training group. For OCT-2, total and corrected time were not significantly different between the groups. However, both training groups were significantly superior to the control group for all types of errors. CONCLUSIONS: Our findings suggest that both training interventions can significantly improve coordination and skill transfer test results. In addition, VR mental training may have some advantages over conventional mental training. These findings are promising for the use of mental training for prevention and rehabilitation in special populations.

Vitamin D levels on sports injuries in outdoor and indoor athletes: a cross-sectional study.

OBJECTIVE: Having vitamin D levels within normal limits is important for bone and muscle health and its deficiency may increase the risk of injury. The aim of this cross-sectional study was to investigate whether vitamin D levels are different in indoor and outdoor athletes and its levels increase the risk of injury. MATERIAL AND METHODS: Serum vitamin D levels were measured in Caucasian adolescent athletes, who admitted to the sports medicine polyclinic due to a routine health check or injury. The study was carried out at 38°26' north latitude in Izmir between June and September 2019. After the physical examination of the injured athletes, the diagnoses were made accompanied by the findings obtained by imaging methods in cases of necessity. RESULTS: A total of 256 athletes, including swimmers (n = 87), basketball players (n = 104), and football (n = 65) players aged 13.2 (± 2.2) years, were investigated. The average serum vitamin D (25(OH)D) level in athletes was 29.2 (±10.0) ng/mL (6.0-66.0 ng/mL). Forty-six of all athletes (18%) had vitamin D deficiency, with a mean value of 15.7 (±4.0) ng/mL, and 93 of them (36.3%) had vitamin D deficiency with a mean value of 25.2 (±2.4) ng/mL. While vitamin D levels were significantly higher in football players (32 ng/mL) than in other athletes (p < 0.05), it was similar in basketball players (27 ng/mL) and swimmers (26 ng/mL) (p > 0.05). Vitamin D levels (26 ng/mL) of the injured athletes were significantly lower than those of the non-injured athletes (30 ng/mL) (p = 0.001). Bone injuries were significantly related to Vitamin D levels (p < 0.001) but not with muscle injuries (p > 0.05). CONCLUSION: Frequency of vitamin D deficiency and insufficiency is higher in indoor athletes andis especially associated with risk of bone injuries . In order to examine the effect of vitamin D level on bone mineral density, comprehensive prospective studies are required.

Effects of Long-Duration Home Isolation Linked to the COVID-19 Pandemic on Mental Health of Adolescent Athletes.

PURPOSE: To assess whether adolescent athletes were affected or not in terms of mental health by the long duration at home linked to isolation enforced during the COVID-19 pandemic. METHOD: The study included 940 team athletes, 274 individual athletes, and 131 nonathlete controls aged 12-17 years. Demographic data were obtained with a form including questions about age, sex, sports type, and physical activity status (type, duration, and frequency) during the isolation period. Participants completed the Children's Revised Impact of Event Scale-13, Center for Epidemiological Studies Depression Scale for Children, and State-Trait Anxiety Inventory for Children. RESULTS: Among participants, 88% did not meet the physical activity recommendations for children and adolescents, while 42.8% felt depressed. Depressive symptoms were present in 38.1% of boys and 59.7% of girls, with girls (6.4%) having higher posttraumatic stress symptoms than boys (3.5%). Among athletes, depressive and anxiety symptoms were lower compared with nonathlete controls (P < .01). Posttraumatic stress symptoms were lower among athletes than nonathlete controls for girls (team vs control, P = .006; individual vs control, P = .002) but similar for boys (P > .05). The depression (P = .518), state (P = .866), and trait anxiety (P = .507) symptoms were similar between team athletes and individual athletes. CONCLUSION: Though adolescent athletes' depression, anxiety, and posttraumatic stress symptoms were significantly lower than nonathlete controls, athletes also had high depression levels. These findings show the need to take precautions to protect the psychological health of not only nonathletes, but also athletes in the pandemic period.

The effect of isolation on athletes' mental health during the COVID-19 pandemic.

OBJECTIVE: We aimed to explore whether the mental health status of professional athletes was affected by the isolation period in which organized sports were suspended due to the COVID-19 pandemic. METHODS: A total of 612 volunteers between the ages of 18-38 enrolled in the study, 418 of them were athletes engaged in team sports or individual sports and 194 of them were non-athletes. Participants completed the Depression - Anxiety - Stress Scale 21 (DASS-21), the Impact of Events Scale-Revised (IES-R) and International Physical Activity Questionnaires (IPAQ). Non-parametric methods were used for comparisons between groups. The presence of a linear relationship was tested with the Spearman Correlation Test. A value of p < 0.05 was accepted statistically significant. RESULTS: A total of 571 participants, 372 males and 199 females, completed the study. Depression and anxiety symptoms were lower in athletes compared to non-athletes (p < 0.05). Depression, anxiety and stress symptoms were similar in team athletes and individual athletes (p = 0.232, p = 0.444, p = 0.116; respectively). The post-traumatic stress symptoms were lower in male team athletes than female team athletes (p = 0.020) and non-athletes (p < 0.001). Depression, anxiety and stress symptoms were found to be similar in men and women (p > 0.05). There was a negative correlation between physical activity level and mental health symptoms (p < 0.05). CONCLUSION: The mental health status of athletes was better than non-athletes, and the positive effect of sport, which was done until the break due to the isolation period, on mental health continued. These findings show that physical activity may help to protect mental health.