Isokinetic Peak Torque Improvement and Shoulder Muscle Ratios Imbalance Correction After Specific Strength Training on a New Ballistic Throwing Device: A Randomized Controlled Trial.

CONTEXT: The aim of this study was to investigate the effects of 8-week ballistic-strength-training program using a validated specific throwing device (ie, Arm/Shoulder Specific Strength Device), on isokinetic shoulders' rotation muscle-torques and ratios as well as range of motion in team handball players. DESIGN: A repeated-measures experimental design with a randomized controlled trial was used. METHODS: Twenty-six high-level competitive male U-19 team handball players were randomly assigned into training (TG, n = 15) and control (n = 11) groups. The TG undertook a twice a week for 8-week periodized throws program with an individually predetermined optimal load. The program incorporated shackled eccentric and concentric exercises using the Arm/Shoulder Specific Strength Device. Peak torques, functional, and conventional ratios for both arms at different angular velocities (60°·s-1, 180°·s-1, and 300°·s-1) were assessed over time and between groups, using an isokinetic dynamometer. RESULTS: A significant improvement for TG (P < .01; d = 1.13 [moderate]; +20.2%) of the concentric peak torques for dominant arm in external rotation was observed at 300°·s-1. Significant (P < .05-.01) increases were also noted for nondominant arm at the 3 studied angular velocities. In addition, 300°·s-1 eccentric peak torques of the dominant arm and nondominant arm have significantly improved for both external and internal rotations (P < .05; d = .99 [moderate] and d = 1.21 [large]; +15.7% and + 17.9%, respectively) with small changes at the other angular assessed velocities. Posttraining, TG's dominant arm showed significant improvements (P < .05-.01) in functional and conventional ratios at all velocities. Notably, significant differences (P < .05-.01) were observed at 60°·s-1 and across all velocities when comparing the TG with the control group. TG showed significant increase for internal rotation and external rotation shoulder range of motions (P < .05; d = 1.22-1.27 [large]), +5.0% and +7.7%, respectively). CONCLUSIONS: The specific 8-week throwing training program on the Arm/Shoulder Specific Strength Device showed significant performance improvements in almost all assessed isokinetic concentric and eccentric peak torques as well as internal and external range of motion increase for both arms while ensuring rotator cuff torque ratios and shoulder mobility in team handball real sport-specific condition.

The impact of interval training on adiponectin to leptin ratios and on blood pressures in severely obese adolescent girls: A randomized controlled trial.

Interval-training is widely implemented among populations with obesity to decrease metabolic-disorders; however, high-intensity-interval-training (HIIT) has rarely been studied in severely obese adolescent girls. Therefore, the aim of this study was to compare the effects of 8 weeks of (HIIT) or moderate-intensity interval-training (MIIT), on cardiometabolic risk factors and hormonal-ratios in severely-obese-girls. For this aim, 35 female-adolescents (14.4 ± 1.4 years) were assigned randomly into HIIT (n = 12) and MIIT (n = 12), groups and a control group (CG, n = 11). Both training groups significantly improved (p < 0.05): the body-mass, body-mass-index (BMIp95), body-fat (BF%), waist-circumference (WC), mean-arterial-pressure (MAP), with a slight increase in the HIIT group. However, HIIT induced greater improvements on the maximal oxygen uptake (VO2MAX) and the speed related (24.7 and 11.8%) compared to MIIT. Higher improvements occurred in HIIT group related to leptin and adiponectin concentrations and the A/L ratio at (p < 0.001). In conclusion, the findings indicate that both HIIT and MIIT can positively influence body composition and cardio-respiratory fitness. Given the significant correlation noted between the A/L ratio, BMIp95, BF%, and MAP post-HIIT, this training modality may be considered a more advantageous approach over MIIT for mitigating cardio-metabolic issues in severely obese adolescent girls.

Incidence and burden of 671 injuries in professional women footballers: time to focus on context-specific injury risk reduction strategies.

This study investigated the extent of injury incidence and burden in a professional women football team of the Scottish Women's Premier League during two seasons. All injuries causing time-loss or required medical attention were recorded prospectively. A total of 671 injuries, 570 requiring medical attention and 101 causing time-loss were recorded in 41 players. Injuries occurring with National Team resulted in 12% of the club's international players' lay-off. Overall injury incidence was 11.1/1000-hours and burden was 368.9 days/1000-hours. Injury incidence (23.9/1000-hours vs 8.2/1000-hours) and burden (1049.8 days/1000-hours vs 215.1 days/1000-hours) were higher for match compared to training. Foremost mechanism of match injury burden was indirect-contact, which was different than the non-contact predominantly observed for training injury burden. Injury incidence, burden and patterns differed between training, match and playing positions. Tailoring injury-risk reduction strategies considering context, circumstances and playing position deserve consideration to enhance player's injury resilience in professional women footballers.

Time-loss injuries and illnesses at the FIFA world cup Qatar 2022.

The study aimed to analyse incidence and characteristics of time-loss injuries and illnesses during the FIFA World Cup Qatar 2022. Of 838 male football players, 705 consented to participate. Team medical staff reported 82 time-loss injuries, corresponding to an injury event incidence of 5.6 injuries/1000 h of total exposure (95%CI 4.5 to 7.0 injuries/1000 h), with a median of 2 time-loss injury events per team (IQR, 1 to 4.5, range 0-7). The total injury burden was 103 (95% CI 61 to 152) days per 1000 h. Muscle/tendon injuries had the highest incidence of tissue types (48 cases, 3.3/1000 h (95% CI 2.5 to 4.4), and hamstring muscle injuries were the most frequent diagnosis (16 cases, incidence 1.1/1000 h, 95% CI 0.6 to 1.8). Match injury event incidence was 20.6/1000 h (15.0 to 27.7) and training injury event incidence was 2.1/1000 h (1.4 to 3.1). The majority (52%) of sudden-onset injuries were non-contact injuries, 40% direct contact and 8% indirect contact. We recorded 15 time-loss illnesses, corresponding to an illness event incidence of 1.1 per 1000 competition days, (95% CI: 0.6 to 1.8), and illness burden of 2.1 (1.0 to 3.4) days lost per 1000 competition days. The most common illness was respiratory infection (12 cases, 80%). Match injury event incidence was the lowest in any FIFA World Cup since injuries have been monitored.

Breaking boundaries: the transformative role of exercise in managing multiple sclerosis.

Multiple sclerosis (MS) is a prevalent cause of physical disability in adults, with inflammation-induced demyelination and neurodegeneration contributing to its etiology. This comprehensive review explores the multifaceted benefits of exercise in managing MS, including improvements in aerobic capacity, balance, muscle strength, immune and hormonal functions and mood. Various exercise modalities, such as aerobic, resistance, flexibility, and balance training, are discussed, along with tailored protocols for MS patients. Recommended exercise strategies are: aerobic exercise: 2-3x/week; 10-30 minutes (40 %-60 % of maximum heart rate (HRmax), HIIT: 1x/week, five 30-90-second intervals at 90 %-100 % HRmax, Resistance training: 2-3x/week, 5-10 exercises; 1-3 sets for each exercise, 8-15 repetitions/set. The review also examines the impact of exercise on neuroplasticity, cardiovascular responses, cytokine modulation, stress hormone regulation, brain structure, and function and fatigue perception. Emphasizing the importance of exercise in enhancing the quality of life for individuals with MS, the review proposes exercise prescriptions and highlights the promising link between physical activity, brain health, and improved hormonal and immune status in MS patients. This review aims to inform future research and guide clinical practices for effective MS management.

Training strategies of 10,074 athletes from 121 countries based on human development index in early COVID-19 lockdown.

The aim of this study was to investigate relationships between changes in training practices and human development index (HDI) levels, and identify strategies employed by athletes who consistently maintained their training quantity during the first 100 days of the COVID-19 pandemic. A total of 10,074 athletes (5290 amateur and 4787 professional athletes from 121 countries) completed an online survey between 17 May to 5 July 2020. We explored their training practices, including specific questions on training frequency, duration and quantity before and during lockdown (March-June 2020), stratified according to the human development index (HDI): low-medium, high, or very high HDI. During the COVID-19 lockdown, athletes in low-medium HDI countries focused on innovative training. Nevertheless, women and amateur athletes experienced a substantial reduction in training activity. Performance-driven athletes and athletes from higher HDI indexed countries, were likely to have more opportunities to diversify training activities during lockdowns, facilitated by the flexibility to perform training away from home. Factors such as lockdown rules, socioeconomic environment, and training education limited training diversification and approaches, particularly in low-medium and high HDI countries. Athletes (amateurs and professionals) who maintained the quantity of training during lockdown appeared to prioritize basic cardiovascular and strength training, irrespective of HDI level. Modifying training and fitness programs may help mitigate the decrease in training activities during lockdowns. Customized training prescriptions based on gender, performance, and HDI level will assist individuals to effectively perform and maintain training activities during lockdowns, or other challenging (lockdown-like) situations.

Supporting athletes during a challenging situation: recommendations from a global insight of COVID-19 home-based training experience.

BACKGROUND: For athletes, overcoming obstacles in challenging situations like pandemic home training is crucial. Strategies and approaches in this context are not well-documented. Our study aims to investigate such a scenario from a performance standpoint, based on a major global crisis: the COVID-19 pandemic and lockdown. METHODS: This cross-sectional study surveyed athletes without disabilities using online questionnaires (35 languages) from May to July 2020. Questions included aspects of alternative routines, training monitoring, recovery, sleep patterns, injury occurrence/prevention based on structured answers, and an open-ended question on lockdown training experiences. RESULTS: Of the 11,762 athletes from 142 countries, 63% were male, including at World-Class, International, National, State and Recreational levels. During lockdown, 25% athletes used innovative or modern ways to maintain or improve fitness e.g., virtual reality and tracking devices (favoring World-Class level, 30%). Many athletes, regardless of gender (43%) watched video competitions to improve/maintain their mental skills and performance [World-Class (47%) and International (51%)]. Contact frequency between athletes and their coaches was mainly at least once a week (36%), more among higher-level (World-Class/International) than lower-level athletes (27 vs. 16%). Higher-level athletes (≥ 54%) monitored training load and were assisted by their coaches (21%). During lockdown, stretching (67%) was considered one of the primary means of recovery, especially for higher-level athletes (> 70%). Compared to pre-lockdown, about two-thirds of athletes reported "normal" or "improved" sleep quality and quantity, suggesting a low sleep quality pre-lockdown. On average, 40% utilized injury prevention exercises (at least) once a week [World-Class (51%) and International (39%)]. Most injury occurrences during lockdown involved the knee (18%), ankle (16%), and back (9%). Four key themes emerged regarding lockdown experiences: remote training adaptation (e.g., shifting training focus), training creativity (e.g., using household items), performance enhancement opportunities (e.g., refocusing neglected aspects), and mental and motivation challenges. CONCLUSIONS: Both male and female athletes, particularly those of higher levels, displayed some adaptalibity during the COVID-19 lockdown, employing innovative approaches and technology for training. Many athletes implemented load monitoring, recovery, and attentive of injury prevention, while optimizing their sleep quality and quantity. Athletes demonstrated their abilities to navigate challenges, and utilized different coping strategies in response to the lockdown's constraints.

Using artificial intelligence for exercise prescription in personalised health promotion: A critical evaluation of OpenAI's GPT-4 model.

The rise of artificial intelligence (AI) applications in healthcare provides new possibilities for personalized health management. AI-based fitness applications are becoming more common, facilitating the opportunity for individualised exercise prescription. However, the use of AI carries the risk of inadequate expert supervision, and the efficacy and validity of such applications have not been thoroughly investigated, particularly in the context of diverse health conditions. The aim of the study was to critically assess the efficacy of exercise prescriptions generated by OpenAI's Generative Pre-Trained Transformer 4 (GPT-4) model for five example patient profiles with diverse health conditions and fitness goals. Our focus was to assess the model's ability to generate exercise prescriptions based on a singular, initial interaction, akin to a typical user experience. The evaluation was conducted by leading experts in the field of exercise prescription. Five distinct scenarios were formulated, each representing a hypothetical individual with a specific health condition and fitness objective. Upon receiving details of each individual, the GPT-4 model was tasked with generating a 30-day exercise program. These AI-derived exercise programs were subsequently subjected to a thorough evaluation by experts in exercise prescription. The evaluation encompassed adherence to established principles of frequency, intensity, time, and exercise type; integration of perceived exertion levels; consideration for medication intake and the respective medical condition; and the extent of program individualization tailored to each hypothetical profile. The AI model could create general safety-conscious exercise programs for various scenarios. However, the AI-generated exercise prescriptions lacked precision in addressing individual health conditions and goals, often prioritizing excessive safety over the effectiveness of training. The AI-based approach aimed to ensure patient improvement through gradual increases in training load and intensity, but the model's potential to fine-tune its recommendations through ongoing interaction was not fully satisfying. AI technologies, in their current state, can serve as supplemental tools in exercise prescription, particularly in enhancing accessibility for individuals unable to access, often costly, professional advice. However, AI technologies are not yet recommended as a substitute for personalized, progressive, and health condition-specific prescriptions provided by healthcare and fitness professionals. Further research is needed to explore more interactive use of AI models and integration of real-time physiological feedback.

Lighting the way: Exploring diurnal physical performance differences in school-aged visually impaired children and adolescents.

Circadian rhythms play a pivotal role in governing various physiological processes, including physical performance. However, in individuals deprived of light perception, such as the blind, these circadian rhythms face disruption. This study aimed to explore the influence of disturbed circadian rhythms on short-term maximal physical performance in children and adolescents with visual impairment. Forty-five volunteers participated in this study, comprising 17 blind, 13 visually impaired, and 15 sighted participants. The participants underwent a series of tests assessing maximal isometric strength performance across two days. To mitigate the influence of morning session fatigue on the evening results, each participant group performed in two separate testing sessions (i.e. in the morning (7:00 h) and in the evening (17:00 h)) on non-consecutive days in a randomized and counterbalanced setting, with approximately 36 h of recovery time between sessions. To mitigate the impact of inter-individual differences on mean values and to account for the influence of age and sex on the studied variables, data were normalized. The outcomes revealed a significant diurnal variation in maximal isometric strength performance among sighted individuals, with peak performance observed in the evening. This pattern aligns with their well-entrained circadian rhythm. In contrast, blind and visually impaired individuals did not display significant diurnal variation, signaling disrupted circadian rhythms due to the absence of light perception. These findings emphasize the crucial consideration of circadian rhythms in assessments of physical performance, especially among participants with visual impairments.

Exploring Growth, Maturity, and Age as Injury Risk Factors in High-Level Youth Football.

Rapid somatic growth and biological maturity status may affect injury patterns in youth football, yet firm conclusions cannot be drawn from the existing research. We aimed to explore growth velocity, maturity, and age as injury risk factors in 95 academy players (11.9-15.0 years), using anthropometric (height and body mass), maturity (skeletal age), injury, and football exposure data collected prospectively over three seasons (2016/17-2018/19). We compared the relative quality of mixed-effects logistic regression models with growth velocity for 223 growth intervals (average 113 days) included as fixed effects and adjusted for age (chronological or skeletal) plus load (hours/week). Associations were considered practically relevant based on the confidence interval for odds ratios, using thresholds of 0.90 and 1.11 to define small beneficial and harmful effects, respectively. We observed harmful effects of older age on overall (OR: 2.61, 95% CI: 1.15-5.91) and sudden onset (1.98, 1.17-3.37) injury risk. Significant associations (p<0.05) were observed for higher body mass change and greater maturity on sudden onset injuries, and for higher hours/week on gradual onset, bone tissue, and physis injuries. Future studies should include larger samples, monitoring athletes from pre-adolescence through maturation, to enable within-subject analyses and better understand the relationship between growth, maturation, and injuries.

Snus use in football: the threat of a new addiction?

The use of Snus, an oral nicotine pouch, is becoming increasingly common in English professional football. As a nicotine product, Snus raises important questions about health and performance for practitioners. The purpose of this short communication is to explain the current regulatory status of Snus, performance relatedeffects, and associated health outcomes. Further, based on player statements and evidence from the general public, we argue that Snus is used as a coping mechanism to deal with the stressors of professional football. Accordingly, the communication concludes with guidance for club-level multidisciplinary interventions to support player welfare, aimed at reducing Snus use as well as future research recommendations.

A new statistical approach to training load and injury risk: separating the acute from the chronic load.

The relationship between recent (acute) training load relative to long-term (chronic) training load may be associated with sports injury risk. We explored the potential for modelling acute and chronic loads separately to address current statistical methodology limitations. We also determined whether there was any evidence of an interaction in the association between acute and chronic training loads and injury risk in football. A men's Qatar Stars League football cohort (1 465 players, 1 977 injuries), where training load was defined as the number of minutes of activity, and a Norwegian elite U-19 football cohort (81 players, 60 injuries), where training load was defined as the session rating of perceived exertion (sRPE). Mixed logistic regression was run with training load on the current day (acute load) and cumulative past training load estimated by distributed lag non-linear models (chronic load) as independent variables. Injury was the outcome. An interaction between acute and chronic training load was modelled. In both football populations, we observed that the risk of injury on the current day for different values of acute training load was highest for players with low chronic load, followed by high and then medium chronic load. The slopes varied substantially between different levels of chronic training load, indicating an interaction. Modelling acute and chronic loads separately in regression models is a suitable statistical approach for analysing the association between relative training load and injury risk in injury prevention research. Sports scientists should also consider the potential for interactions between acute and chronic load.

Lactate-induced autophagy activation: unraveling the therapeutic impact of high-intensity interval training on insulin resistance in type 2 diabetic rats.

Impaired autophagy is a hallmark of diabetes. The current study proposed to investigate if high intensity interval training (HIIT) induced lactate accumulation could stimulate autophagy in type 2 diabetic male rats. 28 male Wistar rats were randomly assigned into four groups: Healthy Control (CO), Diabetes Control (T2D), Exercise (EX), and Diabetes + Exercise (T2D + EX). Diabetes was induced by feeding high-fat diet and administrating single dose of streptozotocin (35 mg/kg). After becoming diabetic, the animals in the exercise groups (EX and T2D + EX) performed an eight-week HIIT (4-10 interval, 80-100% Vmax, 5 days per week). Serum levels of lactate, glucose and insulin as well as the levels of lactate, pyruvate, lactate transporter monocarboxylate transporter 1 (MCT1), phosphorylated mitogen-activated protein kinases (p-MAP 1 and 2), phosphorylated extracellular signal-regulated protein kinases 1 and 2 (p-ERK 1 and 2), mammalian target of rapamycin (p-mTOR), ribosomal protein S6 kinase beta-1 (p-70S6k), p90 ribosomal S6 kinases (p-90RSK), autophagy related 7 (ATG7), Beclin-1, microtubule-associated protein 1A/1B, and 2A/2B -light chain 3 levels (LC3-I), (LC3- II), (LC3I/LC3II) in soleus muscle were measured. Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) and serum glucose was lower in T2D + EX compared to T2D group (P < 0.0001). While serum and soleus muscle levels of lactate was not different between T2D and T2D + Ex, the levels of Pyruvate (P < 0.01), MCT1, p-ERK1/2, p-mTOR, p70S6k, P-90RSK, ATG7, LC3-II, and LC3-II/LC3I ratios were higher in T2D + EX compared to T2D group (P < 0.0001). We concluded that eight weeks of high-intensity interval training could activated ERK/P90SRK while inhibiting mTOR/P70S6K signaling pathway in lactate dependent manner. It means increased autophagy which resulted in improve insulin resistance (IR) and reduce blood glucose.

Ramadan intermittent fasting and its association with health-related indices and exercise test performance in athletes and physically active individuals: an overview of systematic reviews.

OBJECTIVE: To systematically review, summarise and appraise findings of published systematic reviews, with/without meta-analyses, examining associations between Ramadan fasting observance (RO), health-related indices and exercise test performances in athletes and physically active individuals. DESIGN: Overview of systematic reviews with assessment of reviews' methodological quality. DATA SOURCES: PubMed, Web of Science, Scopus, Cochrane Database of Systematic Reviews, SPORTDiscus, ProQuest, PsycINFO and SciELO. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Systematic reviews with/without meta-analyses examining associations of RO with health-related indices and exercise performances in athletes and physically active individuals. RESULTS: Fourteen systematic reviews (seven with meta-analyses) of observational studies, with low-to-critically-low methodological quality, were included. Two reviews found associations between RO and decreased sleep duration in athletes and physically active individuals. One review suggested athletes may experience more pronounced reductions in sleep duration than physically active individuals. One review found associations between RO and impaired sleep quality in athletes and physically active individuals. RO was associated with decreased energy, carbohydrate and water intake in adult-aged athletes, but not adolescents. One review suggests RO was associated with athletes' increased feelings of fatigue and decreased vigour. No association was found between RO and athletes' lean mass or haematological indices. RO was unfavourably associated with changes in athletes' performance during high-intensity exercise testing. CONCLUSION: Continuance of training during RO could be associated with athletes' mood state disturbances, decreased sleep duration and performance decline during high-intensity exercise testing, while preserving lean mass. However, careful interpretation is necessary due to the low-to-critically-low methodological quality of the included reviews.

Large-scale sporting events during the COVID-19 pandemic: insights from the FIFA World Cup 2022 in Qatar with an analysis of patterns of COVID-19 metrics.

The 2022 FIFA World Cup (FIFA-WC) held in Qatar presented unique challenges, given the potential for rapid transmission of coronavirus disease 2019 (COVID-19) among over 1.4 million international fans attending the event. This study aimed to investigate the impact of the FIFA-WC 2022 on COVID-19 cases, deaths, and reproduction rate (R0) in Qatar. Additionally, it sought to understand the implications of hosting large-scale events during a pandemic without COVID-19 restrictive measures, providing critical insights for future decision-making. Data from "Our World in Data" were analysed for three distinct periods: one week before the FIFA-WC (week-preWC), the four weeks of the event (week-1WC to week-4WC), and one week after (week-postWC). The results revealed a significant increase in COVID-19 cases during week-3WC and week-4WC (compared to week-preWC) in Qatar, followed by a subsequent decrease during the week-postWC. Notably, Qatar experienced a more pronounced surge in positive cases than the global trend. Regarding COVID-19-related deaths, Qatar's peak occurred during week-2WC, while globally deaths peaked from week-3WC to week-postWC. Nevertheless, Qatar's death toll remained relatively low compared to the global trend throughout the event. The findings highlight that the FIFA-WC 2022 in Qatar demonstrated the feasibility of organizing large-scale sporting events during a pandemic with appropriate measures in place. They emphasize the importance of high vaccination coverage, continuous monitoring, and effective collaboration between event organizers, healthcare authorities, and governments. As such, the event serves as a valuable model for future gatherings, underlining the significance of evidence-based decision-making and comprehensive public health preparedness.