The association between the Healthy Eating Index (HEI-2015) score and body composition among Iranian soccer players and referees: a cross-sectional study.

For an optimal performance, soccer players and referees need to consume a high-quality diet. The Healthy Eating Index (HEI) is a tool that can estimate diet quality and has been shown to be associated with body composition. The aims of the present study were first to determine the HEI-2015 score of the diets consumed by athletes and second its association with different body composition parameters of athletes. We conducted a cross-sectional study on 198 soccer players and referees. Dietary intakes were recorded using a validated food frequency questionnaire (FFQ), and HEI scores were calculated. Body composition parameters were measured using the bioelectrical impedance analysis. The mean score for the HEI-2015 was 65⋅04. A multiple linear regression model showed significant associations of the HEI-2015 score with percent body fat (PBF), percent muscle mass (PMM), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) in male soccer players aged <18 years, body mass index (BMI) in male soccer players aged ≥18 years and BMI and waist-to-height ratio (WHtR) in male soccer referees after adjustment for covariates (P < 0⋅05). The mean overall score for the HEI-2015 shows that Iranian soccer players and referees have an acceptable quality of diet. We also found significant associations between the HEI-2015 score and different body composition parameters in male soccer players and referees but we did not find any significant association in female athletes (P > 0⋅05).

Effect of Persian acupressure (Ghamz) on Patients with Knee Osteoarthritis: A Single-Blinded Parallel Clinical Trial.

BACKGROUND: Many patients choose complementary and alternative medicine (CAM) to treat various conditions. Among osteoarthritis patients, acupressure is a popular CAM treatment. In Iran, Ghamz (a Persian acupressure technique) uses for musculoskeletal ailments like knee pain. AIMS: To examine the potential efficacy of Ghamz on osteoarthritis outcomes. DESIGN: Clinical Trial. SETTINGS: Randomized, single-blind, sham-controlled clinical trial. PARTICIPANTS/SUBJECTS: Eighty patients with diagnosed knee osteoarthritis, age over 35 years old. METHODS: Eighty adult patients with confirmed knee osteoarthritis from three outpatient clinics were recruited. Participants were randomly assigned either to intervention or placebo groups using sham acupressure. The primary outcomes included Knee injury and Osteoarthritis Outcome Score (KOOS) parameters and pain scores measured using the visual analog scales (VAS). RESULTS: Seventy-two individuals completed the trial and were included in the analysis. At baseline, there was no difference between the mean scores of both outcomes. After the intervention, the group receiving Ghamz therapy experienced an improvement in KOOS parameters, including symptoms, pain, activity daily livings, sport, recreation function, and quality of life. The mean pain score in the intervention group was significantly decreased from 5.89 at the beginning study to 4.11 at the end of the study, while the pain score did not change substantially in the sham group. These findings remained consistent after adjusting for covariates of age, weight, and pre-treatment. CONCLUSIONS: This study supports evidence that Ghamz therapy provides an effective option for short-term knee pain relief in patients with knee osteoarthritis. Additional studies are recommended to confirm these findings.

A Randomized Crossover, Pilot Study Examining the Effect of Acupuncture in the Management of Competitive Anxiety in Athletes.

Background: Excessive competitive anxiety induces adverse effects on athletic performance and planning efficient management methods is crucial. Objectives: We aimed to assess the effects of acupuncture on competitive anxiety. Methods: In this cross-over study, 20 male soccer players under 21 years (U-21) were randomized equally into acupuncture or control groups. The acupuncture group received acupuncture on fifteen anxiety-related points and the control group received acupuncture on fifteen points unrelated to anxiety for thirty minutes. We measured the participants' resting heart rate and galvanic skin conduction and asked them to answer the Competitive State Anxiety Inventory-2 (CSAI-2) questionnaire at baseline and the end of the intervention. Results: We detected a significant treatment effect in the cognitive anxiety level (-1.05 ± 0.91; p = 0.02) but not in the somatic anxiety level (-0.46 ± 1.68; p = 0.43), Sport Self-Confidence (-1.06 ± 2.21; p = 0.11), heart rate (0.20 ± 2.2; p = 0.93), and skin conductance (-0.50 ± 0.77; p = 0.19). Conclusion: Based on these results, acupuncture might decrease cognitive anxiety but might not affect somatic anxiety.

Evaluation of Visual Skills in Soccer Referees and Assistant Referees.

Background: As a soccer referee or an assistant referee, having perfect visual skills is mandatory, which will help make quick and accurate decisions in the field of the play and during matches; however, this skill is not well studied among referrers. This study aimed to assess the visual skills of referees and assistant referees. Methods: Men's professional referees and assistant referees working for the Iran football federation were investigated in 2019. The visual skill investigation consists of the evaluation of static visual acuity, color vision, stereoacuity, intraocular pressure, confrontation test, and eye anatomical assessment with slit lamp. The statistical analysis was performed using the SPSS software Version 18. Results : In this study, 159 men's professional referees and assistant referees with a mean age of 35.52±5.39 were selected. The results of this study showed that 1.88% of the referees and assistant referees had color blindness dyschromatopsia) and 3.14% of them needed more follow-up examinations. The mean spherical equivalent of examined eyes was -0.42D in the right eye and -0.16 D in the left eye. Conclusion: Our results showed that referees and assistant referees both had some kind of visual skill deficiencies. As visual skills are among the fundamental skills for success in referees in dynamic sports such as soccer, all of them must undergo visual skill assessments during the precompetition period to avoid any errors in judgment due to visual disturbances.

Using the Systems Biology Approach and Molecular Method to Investigate the Role of the Dopaminergic Pathway in Osteoarthritis: A Case Control Study.

OBJECTIVE: Osteoarthritis is the most common type of arthritis and one of the leading causes of job loss and motor disabilities. Recently, the involvement of dopaminergic pathways and dopamine receptor genes has been considered in this disease. Therefore, studying and comparing the expression pattern of these receptor genes can lead to a greater understanding of the pathogenesis of this disease. METHODS: In this research, we used the systems biology approach to investigate the role of the dopaminergic pathway in osteoarthritis. Then the gene expression pattern of dopamine receptor genes was examined in an osteoarthritis patientgroup in comparison with healthy individuals by Real-time PCR method. RESULTS: The analysis of the transcriptome dataset of osteoarthritis identified some genes in the dopaminergic pathway and the six most important genes in this disease are in the network with a significant relationship to dopamine receptors which differentially expressed compared to health groups. Statistical analysis of the case control study showed a significant difference (P-value<0.05) in DRD1 and DRD2 family in the patients in comparison to healthy individuals. DISCUSSION: We attained the significant expression pattern of dopamine receptors in the blood of osteoarthritis patients which could be useful to identify new strategies for the diagnosis, management, or treatment of this disease.

Neck pain and low back pain in relation to functional disability in different sport activities.

This population-based, cross-sectional study aimed to determine the frequency of neck pain, low back pain (LBP) and also the LBP related functional disability in five sport categories including football, volleyball, basketball, wrestling, and other sports in one of the Iranian sport Olympiads. The prevalence of neck pain and LBP in different time points was evaluated with the use of an interview questionnaire. A visual analogue scale was used to evaluate the athlete's current pain. Furthermore, the functional disability related to LBP was assessed by the Athletes Disability Index Questionnaire (ADI). A total of 452 male athletes aging between 12 and 20 were screened. Three hundred seventy-seven participants responded to the questionnaires in which their mean age (standard deviation) was 15.95 (1.25). Collectively, the life-time prevalence of neck pain and LBP in all the athletes was 38.8% and 42.0%, respectively. The highest risk of neck pain at all-time points was observed among basketball players compared to other sport groups (P<0.05). The risk of LBP in most time points was the least among wrestlers (P<0.05). The ADI score was significantly higher among basketball players (13.89%) compared to volleyball players and wrestlers (P<0.05). Our study revealed a high prevalence of neck pain and LBP among Iranian young male athletes. A higher risk of neck pain and LBP among basketball players predisposes this sport at high risk of developing spine injuries which needs further consideration.

Cardiorespiratory Fitness and Body Composition of Soccer Referees; Do These Correlate With Proper Performance?

BACKGROUND: The elite-level referee is exposed to similar physical demands to those placed on a midfield soccer player. They have an important responsibility to implement the rules of the game. So, good health and performance of soccer referees have a great importance. OBJECTIVES: The purpose of this study was to assess the cardiorespiratory fitness and body composition of all 78 soccer referees officiating at the Iranian Premier League and determine the correlation between these parameters and performance. PATIENTS AND METHODS: In a cross-sectional study, all referees selected for the competitions were enrolled. Participants underwent exercise stress test, pulmonary function test and body composition assessment. Then the weekly scores of each referee, assessed by qualified supervisors of national federation were obtained using the FIFA standard form throughout the season (34 weeks) and registered. RESULTS: Among 78 participants (including 32 center and 46 side referees), mean and standard deviation of age, body mass index, percent of body fat, VO2max and performance scores were 37 ± 3.8, 23.6 ± 2.1, 20.7 ± 3.9, 59.9 ± 7.1 and 85.8 ± 0.25, respectively. No significant correlation between referees' mean score and selected parameters were found. CONCLUSIONS: It seems that the acquired scores of top-class referees may be influenced by multiple factors other than the laboratory findings of cardiopulmonary fitness and body composition.

Acupuncture Anxiolytic Effects on Physiological and Psychological Assessments for a Clinical Trial.

In a randomized controlled trial we examined the effect of acupuncture on anxiety of the adolescent football players prior to the competition using psychological and physiological markers. A total of 45 athletes were equally allocated to either acupuncture group, sham group, or wait-list control group. Thereafter, all participants were asked to complete an anxiety questionnaire before and after the intervention. Their heart rate and skin conductance were also examined before and after the intervention. The results of ANOVA on posttest scores showed that acupuncture had a significant effect on cognitive anxiety (p = 0.001) and somatic anxiety (p < 0.001) but not on self-confidence (p > 0.05). Furthermore, the results showed that acupuncture significantly decreased the skin conductance in acupuncture group compared to sham group (p = 0.006) and wait-list control group (p < 0.001). In conclusion, the results suggested that acupuncture has the capacity to decrease cognitive anxiety and somatic anxiety prior to competition in adolescent athletes, while this was accompanied by significant physiological changes. This trial is registered with IRCT138904074264N1 (IRCT is a Primary Registry in the WHO Registry Network).

Morphine/Codeine Ratio, a Key in Investigating a Case of Doping.

INTRODUCTION: Consumption of codeine can lead to positive urine test for morphine in athletes. Morphine is classified as a prohibited doping drug while Codeine is not. Morphine/codeine ratio is used in forensic medicine to distinguish the consumption of codeine from abuse of morphine and other narcotics. CASE PRESENTATION: We present an athlete with positive urine test for morphine with a history of consumption of codeine. The disciplinary committee came to conclusion that the athlete had not consumed morphine and did not violate doping code based on morphine/codeine ratio. CONCLUSIONS: Analysis of codeine to morphine metabolism rate is needed when we are using morphine/codeine ratio to rule out abuse of narcotics. WADA should consider analysis for the CYP2D6 alleles (main metabolizer of codeine) in case of including morphine/codeine ratio in future prohibited list. The possibility of ultra-rapid CYP2D6 cannot be ruled out in certain results of morphine/codeine near the cut point.

How the Iranian Football Coaches and Players Know About Doping?

BACKGROUND: Nowadays, doping is an intricate dilemma. Football is the nationally popular sport in Iran. On the other hand, doping is a serious health hazard sport faces today. Studies dealing with athletes' knowledge, attitudes and behavior concerning doping in football are scarce. OBJECTIVES: Therefore, we aimed to investigate the knowledge and attitudes toward doping among the football coaches and players. PATIENTS AND METHODS: In a cross sectional study, 375 participants (239 football players and 136 coaches) were studied. A specially made questionnaire was applied. In this study, football teams of different provinces of the country were selected by randomized clustered sampling and questionnaires were distributed among coaches and players. RESULTS: Knowledge of football coaches and players in three categories of doping definitions, recognition of prohibited drugs and side effects of anabolic steroids was poor or moderate in 45.3%, 88.5% and 96.5%, respectively. CONCLUSIONS: Football players and coaches have poor knowledge about doping in Iran. Moreover, they believe in some inappropriate myths without any scientific or rational basis.It seems necessary to design a comprehensive educational program for all of the athletes and coaches in Iran.

Long Term and Intensive Use of Ophthalmic Topical Corticosteroids and the Risk of Positive Doping Test in Athletes: A Case Report.

INTRODUCTION: We express the detection of the prohibited substance prednisone, prednisolone in player's urine sample by long and intensive use eye steroid drops. CASE PRESENTATION: In a rare case in Iranian football, a player's urine sample had corticosteroids. After all investigations, it was demonstrated that systemic effects can be induced by using long-term of ophthalmic prednisone. CONCLUSIONS: It seems to be required to investigate the systemic effects on long term and excessive use of topical corticosteroid drops can have on the result of the sample analysis and showing positive results.

Patellofemoral pain syndrome and modifiable intrinsic risk factors; how to assess and address?

Patellofemoral pain syndrome (PFPS) is a very common disorder of the knee. Due to multiple forces influencing the patellofemoral joint, clinical management of this ailment is particularly intricate. Patellofemoral pain syndrome has a multifactorial nature and multiple parameters have been proposed as potential risk factors, classified as intrinsic or extrinsic. Some of the intrinsic risk factors are modifiable and may be approached in treatment. A number of modifiable risk factors have been suggested, including quadriceps weakness, tightness of hamstring, iliopsoas and gastrosoleus muscles, hip muscles dysfunction, foot overpronation, tightness of iliotibial band, generalised joint laxity, limb length discrepancy, patellar malalignment and hypermobility. In general, the routine approach of physicians to this problem does not include assessment and modification of these risk factors and therefore, it may negatively affect the management outcomes. Changing this approach necessitates an easy and practical protocol for assessment of modifiable risk factors and effective and feasible measures to address them. In this review, we aimed to introduce assessment and intervention packages appropriate for this purpose.

The effect of an ecological imagery program on soccer performance of elite players.

PURPOSE: Despite the acknowledged impact of imagery on performance, ecologically sound studies investigating imagery and its effects on performance subcomponents in real games are surprisingly limited. The aim of this study was to investigate the effects of imagery training on passing improvement in elite soccer players. METHODS: Sixty nine soccer players taking part in the national championship leagues in four age categories including U16, U19, U21 and over 21 were randomly assigned to the imagery and control groups. Interventional group participants completed an 8 week video-aided, cognitive imagery program on how to make a perfect soccer pass. RESULTS: Performance analysis through close video analysis showed that successful pass rate increased significantly in the intervention group compared to control (OR = 1.19, P=0.002, (95%)CI = 1.06-1.33). Further analysis revealed that the results are statistically significant in U16 and U21 but not other categories. CONCLUSIONS: We concluded that successful soccer passing through real competitions as a multidimensional and critical open skill could be enhanced by an ecologically sound method of mental imagery.

Sudden cardiac death in young athletes; a literature review and special considerations in Asia.

Sudden cardiac death (SCD) in a young athlete is rare, but catastrophic. Exercise acts as a risk factor for SCD in people with cardiovascular disease. A diversity of cardiovascular disorders including hypertrophic cardiomyopathy, congenital coronary anomalies, arrhythmogenic right ventricular dysplasia, dilated cardiomyopathy, aortic rupture due to Marfan syndrome, myocarditis, valvular disease and electrical disorders (Wolff-Parkinson-White syndrome, long QT syndrome, Brugada syndrome), as well as commotio cordis represent the common causes of SCD in young athletes.As the outcome of lethal cardiovascular disorders is not reversible except in few cases, effective measures should be addressed to reduce the burden of sudden cardiac death in young athletes. Currently, two types of recommendations are proposed by American and European countries.It seems that there are some special considerations in Asia, entirely different from North America or Europe, which warrant more comprehensive research on epidemiology and etiology of SCD in young Asian athletes by country and evaluation of current national preventive strategies and their achievements in decreasing the risk. Using these data and considering regional restrictions, an expert group will be able to plan a practical and feasible preventive strategy.