The effects of two different fatigue protocols on movement quality during anticipated and unanticipated change of directions in female soccer players.

OBJECTIVE: This study compared neuromuscular control under two fatigue protocols during anticipated and unanticipated change of direction (COD) maneuvers and evaluated their effects on the risk of non-contact ACL injuries. METHOD: Forty-five female soccer players (mean age: 22.22 ± 2.24 years; mean height: 166.24 ± 3.33 cm; mean mass: 59.84 ± 5.03 kg) were divided into three groups: functional fatigue (Soccer specific fatigue ptotocol-SOFT90), non-functional fatigue (Bruce protocol), and control group. Before and after the implementation of neuromuscular control fatigue protocols were evaluated using the cutting motion assessment score tool (CMAS). Two-dimensional (2D) videos were recorded during anticipated and unanticipated COD trials for both dominant and non-dominant legs. RESULTS: Significant time effects (p < 0.05) and group-time interactions (p < 0.05) were observed in both anticipated and unanticipated conditions for both dominant and non-dominant legs after the fatigue protocols. The functional fatigue group exhibited higher CMAS changes, indicating poorer movement quality following fatigue. Notably, the non-dominant leg displayed amplified deficits during unanticipated COD maneuvers following the functional fatigue protocol. CONCLUSIONS: Fatigue significantly impairs neuromuscular control, particularly in unanticipated COD situations, which increases the risk of non-contact ACL injuries. To mitigate this risk, coaches, trainers, and medical professionals should prioritize targeted training and injury prevention strategies, focusing on the non-dominant leg during unanticipated COD maneuvers.

The effect of multi-function swing suspension training on upper and lower extremities function and quality of life in multiple sclerosis women with different disability status.

BACKGROUND: Multiple sclerosis (MS) can lead to impaired upper and lower extremity function (ULEF), which reduces the quality of life (QoL). Exercise is beneficial for symptom management, but newer approaches like multi-function swing suspension training (MFSST) need further investigation. Additionally, tailoring exercises to individual needs remains a challenging area of investigation. AIM: To investigate the effect of an MFSST program on ULEF, and QoL in MS women according to the expanded disability status scale (EDSS) score. METHODS: Forty-seven MS women meeting selection criteria were randomly assigned to intervention groups A (EDSS 2-4) and B (EDSS 4.5-6.5), and the control group (EDSS 2-6.5). Intervention groups did an 8-week MFSST program with 3 × 1hr sessions/week. Prior to the intervention, and after 4, 6, and 8 weeks, the 9-hole peg test (9HPT) and the timed 25-foot walk (T25FW) test were performed for both the intervention groups and the control group. The Short Form questionnaire (SF-36) was used to measure their QoL. RESULTS: Significant main effects for time were observed in both the 9HPT (F = 52.48, p = 0.001, Pη2 = 0.78) and the T25FW (F = 85.63, p = 0.000, Pη2 = 0.859). Speed increased between the pre-test, 4th week, 6th week, and 8th week in both tests. These tests revealed significant interaction effects between group and time. The 9HPT had an F-value of 9.01 (p = 0.001, Pη2 = 0.392), while the T25FW had an F-value of 13.812 (p = 0.000, Pη2 = 0.497). Across both tests, Group B, with higher EDSS scores, demonstrated greater speed improvement over the three-time measurements (4th week, 6th week, and 8th week) than Group A. The control group did not exhibit any improvement in speed. Intervention groups showed improvement in all QoL subscales except emotional role limitation. CONCLUSIONS: An 8-week MFSST improves ULEF and QoL in women with MS, particularly those with higher EDSS scores (more than 4.5). Notably, significant improvements were observed after four weeks of the intervention. The incorporation of a variety of exercises in a single device provides a significant advantage over traditional exercise programs. Therefore, MFSST can be a valuable and efficient tool for improving symptoms and QoL in MS patients. TRIAL REGISTRATION: IRCT20220526054997N1.

The Effect on Flexibility and a Variety of Performance Tests of the Addition of 4 Weeks of Soleus Stretching to a Regular Dynamic Stretching Routine in Amateur Female Soccer Players.

The purpose of this study was to investigate the effects of 4 weeks of soleus stretching on ankle flexibility and dynamic balance, as well as selected monitoring and performance tests in soccer. Forty-five healthy female soccer players were randomly divided into a regular stretching group, a regular stretching group with soleus stretching, and a control group. Dynamic stretching protocols were performed for 4 weeks during three sessions per week as part of routine exercises. The regular group stretched three muscle groups (i.e., gastrocnemius, quadriceps, and hamstrings), while the regular + soleus group also stretched the soleus muscle. Before and after the stretching intervention, the ankle range of motion test, Y-balance test, drop jump test, dynamic knee valgus test, and Illinois Agility Running Test were performed. Ankle ROM, Y-balance, and DJ significantly improved in both intervention groups compared to controls. Only the regular + soleus group showed improvement in the Illinois Agility Running Test. Additionally, athletes performing the additional soleus stretching had greater improvements in ankle ROM and DJ but not in DKV or Y-balance. The results showed that adding soleus stretching into regular protocols can provide benefits for female soccer players in terms of performance parameters.

Improvement in the multiple sclerosis functional composite score by multi-function swing suspension training program.

BACKGROUND: Physical activity has been considered as a promising approach to slow down the disease process in Multiple Sclerosis (MS) patients. The functional impairments of MS have been studied in detail, while evidence of the efficacy of exercise training interventions on the Multiple Sclerosis functional composite (MSFC) score in these patients is limited. The aim of this study was to investigate the improvement in MSFC score by multi-function swing suspension training program (MFSST) in the women with MS. METHODS: The patients were divided into two groups as the intervention and control groups. A total of 47 MS patients completed the MSFC components at baseline and after the intervention: the timed 25-foot walk (T25FW); the 9-hole peg test (9HPT); and paced auditory serial addition test (PASAT). Z scores were created for each test based on control means. RESULTS: The MSFC score, 9HPT, T25FW, and PASAT showed a significant increment in comparison with the baseline levels in the four, six, and eight weeks following the first exercise session (all p<0.05). These differences in the control group were not significant. The improvement in the MSFC score and the component Z-scores in the intervention groups was found from the fourth week onwards. CONCLUSIONS: The study findings highlight that the progression of MS disability can be partially compensated by physical exercise. Overall, these results indicate that MFSST can be used as an effective treatment method in patients suffering from MS. Longer (years) exercise studies with larger samples of MS patients, with different MS subtypes, and of different sex, are needed to evaluate the effect of other types of exercise interventions on the MSFC score in MS patients with different disabilities.

The effect of aquatic training on static and semi-dynamic balance of patients with chronic ischemic stroke: A randomized clinical trial.

OBJECTIVES: This study aims to investigate the effect of six-week aquatic exercise on the static and semi-dynamic balance of male patients with chronic ischemic stroke (CIS). PATIENTS AND METHODS: This randomized clinical trial (RCT) included a total of 36 male CIS patients (mean age 60.2±6.7 years; range, 40 to 70 years) between January 2015 and January 2017. The patients were randomly divided into three groups consisting of 12 patients in each group: (i) exercising in shallow water, (ii) exercising in deep water, and (iii) control group. Training sessions were held three days a week for six weeks, and the control group did not participate in these sessions. The balance of the patients was checked using the Biodex balance system in two stages. RESULTS: There was no significant difference between the two intervention groups (shallow and deep) in terms of the balance assessment post-test (p>0.05), yet there was a statistically significant difference between the two intervention groups (shallow and deep) with the control group in terms of the semi-dynamic balance (total) score, (p<0.05); the semi-dynamic balance (total) of the two intervention groups (shallow and deep) was higher than that of the control group (p<0.05). CONCLUSION: Our study results indicate that exercise in both depths is a suitable solution to improve balance, particularly semi-dynamic balance (total) in male CIS patients. Accordingly, aquatic training has a positive effect on balance in male stroke patients and we can prescribe this protocol as a useful remedy for these patients.

The effects of fatigue on knee kinematics during unanticipated change of direction in adolescent girl athletes: a comparison between dominant and non-dominant legs.

This study was aimed to compare the knee kinematic parameters between dominant and non-dominant legs of adolescent female athletes during change of direction (CoD) in fatigued and unpredictable settings. Knee kinematic parameters on 49 athletes (mean± SD; age = 14.69 ± 0.14 years; mass = 49.05 ± 1.22 kg; height = 1.61 ± 0.08 m) during CoD before and after performing the Bruce protocol and also in predictable and unpredictable setting situations were collected. Kinematic data were recorded at a sampling rate of 200 Hz. The results showed that the dominant leg had significantly 18.7% more flexion (p = 0.001, η = 0.95), 7.1% less valgus (p = 0.001, η = 0.95) and 0.32% lower tibia rotation (p = 0.003, η = 0.16) compared to the non-dominant leg in predictable and pre-fatigue (p < 0.05) conditions. With unpredictable and post-fatigue conditions the dominant limb again demonstrated 17.4% (p = 0.001, η = 0.67), greater knee flexion, 6.8% (0.003,η = 0.97) lower knee valgus and 1.4% (p = 0.001, η = 0.71) less tibiarotation. In conclusion, there may be an increased risk of injury withthe non-dominant leg due to changes in kinematic parameters caused by fatigue and unpredictable CoD manoeuvres.

Effect of the FIFA 11+ on Landing Patterns and Baseline Movement Errors in Elite Male Youth Soccer Players.

CONTEXT: There is no evidence regarding the effect of the FIFA 11+ on landing kinematics in male soccer players, and few studies exist regarding the evaluating progress of interventions based on the initial biomechanical profile. OBJECTIVE: To investigate the effect of the FIFA 11+ program on landing patterns in soccer players classified as at low or high risk for noncontact anterior cruciate ligament injuries. DESIGN: Randomized controlled trial. SETTING: Field-based functional movement screening performed at the soccer field. PARTICIPANTS: A total of 24 elite male youth soccer players participated in this study. INTERVENTION: The intervention group performed the FIFA 11+ program 3 times per week for 8 weeks, whereas the control group performed their regular warm-up program. MAIN OUTCOME MEASURES: Before and after the intervention, all participants were assessed for landing mechanics using the Landing Error Scoring System. Pretraining Landing Error Scoring System scores were used to determine risk groups. RESULTS: The FIFA 11+ group had greater improvement than the control group in terms of improving the landing pattern; there was a significant intergroup difference (F1,20 = 28.86, P < .001, ηp2=.591). Soccer players categorized as being at high risk displayed greater improvement from the FIFA 11+ program than those at low risk (P = .03). However, there was no significant difference in the proportion of risk category following the routine warm-up program (P = 1.000). CONCLUSIONS: The present study provides evidence of the usefulness of the FIFA 11+ program for reducing risk factors associated with noncontact anterior cruciate ligament injuries. The authors' results also suggest that soccer players with the higher risk profile would benefit more than those with lower risk profiles and that targeting them may improve the efficacy of the FIFA 11+ program.

The effects of 10-week core stability training on balance in women with multiple sclerosis according to Expanded Disability Status Scale: a single-blinded randomized controlled trial.

BACKGROUND: The Expanded Disability Status Scale (EDSS) Score is one of the most extensively accepted clinical grading scales which used to the assessment of neurological impairment and disability in multiple sclerosis (MS). AIM: The aim of this study was to analyse the effect of 10-week core stability training (CST) program on balance in women with relapsing-remitting MS according to EDSS Score. DESIGN: A blind randomized controlled trial. SETTING: The Department of Sports Injuries and Corrective Exercise at the Shahid Bahonar University of Kerman. POPULATION: Sixty-nine MS women. METHODS: They were randomly assigned into two groups as the intervention group and the control group. These groups were categorized into three subgroups according to the EDSS as follows: subgroup A (EDSS 2.5 to 3.5), subgroup B (EDSS 3.5 to 4.5), and subgroup C (EDSS 4.5 to 5.5). The intervention group performed a CST program for 10 weeks and to evaluate static and dynamic balance performance in pre-and post-tests, the Biodex Stability System (BSS) have been used. In addition, the participants' core muscle function was evaluated using the endurance and isometric muscle strength tests. RESULTS: The results show a significant difference between post-test variables of the core muscles function, static and dynamic balances in interventional subgroups in comparison with the control subgroups. The improved balance order has been given as subgroup C > B > A. CONCLUSIONS: The CST program could be suggested as an efficient clinical intervention for improving dynamic and static balance in the MS women due to the improvement of core muscle function, especially for the EDSS Score more than 3.5. CLINICAL REHABILITATION IMPACT: The CST could be performed as an efficient clinical intervention for improving dynamic and static balance in MS women due to the improvement of core muscle function. The present protocol could be helpful for the patients with MS especially for the EDSS Score more than 3.5.

The effects of selective Pilates versus extension-based exercises on rehabilitation of low back pain.

INTRODUCTION: Chronic non-specific low back pain (LBP) may lead to functional impairment and physical disability. The aim of this study was to compare the effects of selective Pilates (SP) and extension-based (EB) exercises on pain, lumbar spine curvature, lumbar forward flexion range of motion (ROM), and physical disability in such individuals. MATERIALS AND METHODS: In this randomized clinical trial, Forty-seven patients with chronic non-specific LBP (Mean of age: 39.7 years) were randomly allocated into either SP (N = 16), EB (N = 15), or control (N = 16) groups. The measurements included pain intensity, physical disability, lumbar forward bending ROM, and lumbar spine curvature at the baseline, after receiving the 6-week interventions, and also following one month of cessation of the exercises The analysis of co-variance (ANCOVA) and Post-hoc Bonferroni tests were administered to compare the three groups after the interventions and one month later (P < 0.05). RESULTS: More significant improvement was observed in SP group compared to the subjects receiving EB exercises in terms of pain, ROM, and physical disability (P < 0.001), however, there was no significant difference between the two experimental groups for lumbar curvature (P > 0.05). Furthermore; in follow-up, the patients in SP group significantly achieved a higher level of pain intensity improvement and lumbar flexion ROM than the EB exercises (P < 0.001). CONCLUSIONS: It is estimated that core muscles activation and improving lumbopelvic rhythm in SP training may play a role in decreasing pain and physical disability in chronic LBP patients. Further high-quality studies are required to investigate the details of this mechanism.

Analysis of Jumping-Landing Manoeuvers after Different Speed Performances in Soccer Players.

PURPOSE: Running at high speed and sudden change in direction or activity stresses the knee. Surprisingly, not many studies have investigated the effects of sprinting on knee's kinetics and kinematics of soccer players. Hence, this study is aimed to investigate indices of injury risk factors of jumping-landing maneuvers performed immediately after sprinting in male soccer players. METHODS: Twenty-three collegiate male soccer players (22.1±1.7 years) were tested in four conditions; vertical jump (VJ), vertical jump immediately after slow running (VJSR), vertical jump immediately after sprinting (VJFR) and double horizontal jump immediately after sprinting (HJFR). The kinematics and kinetics data were measured using Vicon motion analyzer (100Hz) and two Kistler force platforms (1000Hz), respectively. RESULTS: For knee flexion joint angle, (p = 0.014, η = 0.15) and knee valgus moment (p = 0.001, η = 0.71) differences between condition in the landing phase were found. For knee valgus joint angle, a main effect between legs in the jumping phase was found (p = 0.006, η = 0.31), which suggests bilateral deficit existed between the right and left lower limbs. CONCLUSION: In brief, the important findings were greater knee valgus moment and less knee flexion joint angle proceeding sprint (HJFR & VJFR) rather than no sprint condition (VJ) present an increased risk for knee injuries. These results seem to suggest that running and sudden subsequent jumping-landing activity experienced during playing soccer may negatively change the knee valgus moment. Thus, sprinting preceding a jump task may increase knee risk factors such as moment and knee flexion joint angle.

A Comparison of Glenohumeral Internal and External Range of Motion and Rotation Strength in healthy and Individuals with Recurrent Anterior Instability.

BACKGROUND: The glenohumeral joint becomes dislocated more than any other major joint because it maintains a wide range of motion and its stability is inherently weak. The most common complication following acute initial shoulder dislocation is recurrent dislocation or chronic instability. Imbalance of strength and range of motion in individuals with anterior dislocation can be a contributing factor in recurrent dislocation as well. METHODS: This case-control study consisted of 24 individuals with a mean age of 24.29±4.33 years, and a mean dislocation rate of 5.37±3.62 times. Isometric cuff strength was measured using a handheld dynamometer and for range of motion, the Leighton flexometer was used in internal and external rotational motions of both upper extremities. Independent t-test was used for data analysis. RESULTS: The internal and external range of motion of the injured glenohumeral joint was lower than the uninjured joint (P<0.001). Similarly, the internal and external rotation strength of the injured joint was lower than the uninjured joint (P<0.001). CONCLUSIONS: According to previous data, imbalance of strength and range of motion in individuals with anterior shoulder dislocation can be a contributing factor in long-term disability and increased recurrent dislocation and our finding confirm decreased range of motion and strength in our patients. Hence, proper exercise and rehabilitation plans need to be developed for those suffering from this complication.

Acute effect of different stretching methods on Illinois agility test in soccer players.

The purpose of this study was to examine the effects of static, dynamic, and the combination of static and dynamic stretching within a pre-exercise warm-up on the Illinois agility test (IAT) in soccer players. Nineteen professional soccer players (age = 22.5 ± 2.5 years, height = 1.79 ± 0.003 m, body mass = 74.8 ± 10.9 kg) were tested for agility performance using the IAT after different warm-up protocols consisting of static, dynamic, combined stretching, and no stretching. The players were subgrouped into less and more experienced players (5.12 ± 0.83 and 8.18 ± 1.16 years, respectively). There were significant decreases in agility time after no stretching, among no stretching vs. static stretching; after dynamic stretching, among static vs. dynamic stretching; and after dynamic stretching, among dynamic vs. combined stretching during warm-ups for the agility: mean ± SD data were 14.18 ± 0.66 seconds (no stretch), 14.90 ± 0.38 seconds (static), 13.95 ± 0.32 seconds (dynamic), and 14.50 ± 0.35 seconds (combined). There was significant difference between less and more experienced players after no stretching and dynamic stretching. There was significant decrease in agility time following dynamic stretching vs. static stretching in both less and more experienced players. Static stretching does not appear to be detrimental to agility performance when combined with dynamic warm-up for professional soccer players. However, dynamic stretching during the warm-up was most effective as preparation for agility performance. The data from this study suggest that more experienced players demonstrate better agility skills due to years of training and playing soccer.