The Effect of Shoulder Injury Prevention Program on Shoulder Isokinetic Strength in Young Male Volleyball Players.

The purpose of this study was to examine the effects of an eight-week 11 + S programme on isokinetic shoulder strength in young male volleyball players. Twenty-eight top-level young male volleyball players were recruited for this study. The players were randomly assigned into intervention (14 players) and control (14 players) groups. The intervention group performed the 11 + S as a warm-up before training at least three times a week for eight weeks. Dominant shoulder strength was measured using an isokinetic dynamometer at 60°/s and 180°/s. The functional deceleration ratio (FDR) was calculated as a functional strength profile. 20% FDR improvement after eight weeks of 11 + S at 180°/s (p = 0.003) were observed. No other statistically significant effects for shoulder strength improvement was observed (p > 0.05). Eight weeks of 11 + S warm-up programme improved the glenohumeral muscle imbalance by increasing the functional deceleration ratio (FDR) of shoulder muscles in young male volleyball players.

Effect of the COVID-19 pandemic on elective cataract surgery wait times.

OBJECTIVE: Lengthy wait times for cataract surgery can negatively affect patients' quality of life and increase the incidence of falls and depression. The COVID-19 pandemic has presented significant challenges to the delivery of elective cataract surgeries. The effects of the COVID-19 pandemic on cataract surgery wait times in the Alberta Health Services' Edmonton zone were studied by examining the wait times before and during the pandemic. METHODS: This study was conducted based on a retrospective population-based design. Data were compiled from a centralized database related to hospital-based cataract surgery (Royal Alexandra, Fort Saskatchewan, and WestView Health Centre) between April 2019 and March 2022 (i.e., 3 fiscal years). RESULTS: The average wait time for cataract surgery increased from 14.4 ± 1.4 weeks in 2019-2020 to 18.2 ± 2.7 weeks in 2020-2021 (p = 0.005) and then decreased to 11.5 ± 1.3 in 2021-2022 (p < 0.001). The number of completed surgeries decreased from 13,103 in 2019-200 to 9,308 (p = 0.09) and 10,365 (p = 0.1) during the next 2 years. The annual operating room time for scheduled cases was reduced to 4463 hours (p = 0.42) and 4552 hours (p = 0.15) during the pandemic compared with 5541 hours before the pandemic. However, the average waitlist size decreased from 6629 at the end of 2019-200 to 6122 (p = 0.029) and 4011 (p < 0.001) during the next 2 years. CONCLUSION: The COVID-19 pandemic resulted in significantly increased average wait times for elective cataract surgery during the first year of the pandemic. Because of a reduction of the waitlist size, the wait times decreased during the second year of the pandemic.

The effect of a shoulder injury prevention programme on proprioception and dynamic stability of young volleyball players; a randomized controlled trial.

BACKGROUND: The "FIFA 11 + Shoulder" programme has been reported to reduce the incidence of upper extremity injuries among soccer goalkeepers. It has also been recommended for overhead sports. The purpose of this study was therefore to investigate the effect of an 8-week "FIFA 11 + shoulder" (11 + S) programme on shoulder joint position sense (JPS), threshold to detect passive motion (TTDPM) and upper quarter Y Balance Test in young male volleyball players. METHODS: Thirty-two healthy young elite male volleyball players (17.49 ± 1.47 years) participated in this quasi-experimental study. Participants, recruited from two clubs participating in Iranian premier league, were randomly assigned into two groups; (1) the intervention group who performed the "FIFA 11 + shoulder" programme as their warm up protocol, three times per week, and (2) the control group who kept their routine warm up protocol meanwhile. Proprioception tests including JPS and TTDPM of internal and external rotator muscles of the dominant shoulder were recorded via the isokinetic system pro 4. The upper quarter Y Balance Test determined the shoulder dynamic stability. RESULTS: No statistically significant differences were observed for JPS and TTDPM of shoulder internal and external rotator muscles; shoulder stability however significantly increased only in the intervention group (p = 0.03, ηp2=0.02). CONCLUSION: Upper quarter dynamic stability improvement due to the 11+S programme leads to volleyball players' performance and may therefore contribute to a reduction in risk of sustaining injury if applied long-term. TRIAL REGISTRATION: The trial was retrospectively registered atIranian Registry of Clinical Trials with the number of IRCT20201030049193N1 at 04/12/2020.

Morning (Fasting) vs Afternoon Resistance Exercise in Individuals With Type 1 Diabetes: A Randomized Crossover Study.

OBJECTIVE: To determine the effect of morning exercise in the fasting condition vs afternoon exercise on blood glucose responses to resistance exercise (RE). RESEARCH DESIGN AND METHODS: For this randomized crossover design, 12 participants with type 1 diabetes mellitus [nine females; aged 31 ± 8.9 years; diabetes duration, 19.1 ± 8.3 years; HbA1c, 7.4% ± 0.8% (57.4 ± 8.5 mmol/mol)] performed ∼40 minutes of RE (three sets of eight repetitions, seven exercises, at the individual's predetermined eight repetition maximum) at either 7 am (fasting) or 5 pm. Sessions were performed at least 48 hours apart. Venous blood samples were collected immediately preexercise, immediately postexercise, and 60 minutes postexercise. Interstitial glucose was monitored overnight postexercise by continuous glucose monitoring (CGM). RESULTS: Data are presented as mean ± SD. Blood glucose rose during fasting morning exercise (9.5 ± 3.0 to 10.4 ± 3.0 mmol/L), whereas it declined with afternoon exercise (8.2 ± 2.5 to 7.4 ± 2.6 mmol/L; P = 0.031 for time-by-treatment interaction). Sixty minutes postexercise, blood glucose concentration was significantly higher after fasting morning exercise than after afternoon exercise (10.9 ± 3.2 vs 7.9 ± 2.9 mmol/L; P = 0.019). CGM data indicated more glucose variability (2.7 ± 1.1 vs 2.0 ± 0.7 mmol/L; P = 0.019) and more frequent hyperglycemia (12 events vs five events; P = 0.025) after morning RE than after afternoon RE. CONCLUSIONS: Compared with afternoon RE, morning (fasting) RE was associated with distinctly different blood glucose responses and postexercise profiles.

Overnight fasting compromises exercise intensity and volume during sprint interval training but improves high-intensity aerobic endurance.

BACKGROUND: The combined effects of sprint interval training (SIT) and exercising in the fasted state are unknown. We compared the effects of SIT with exogenous carbohydrate supplementation (SIT-CHO) and SIT following overnight fast (SIT-Fast) on aerobic capacity (peak oxygen consumption: V̇O2peak) and high-intensity aerobic endurance (time-to-exhaustion at 85% V̇O2peak [T85%]). METHODS: Twenty male cyclists were randomized to SIT-CHO and SIT-Fast. Both groups performed 30-second all-out cycling followed by 4-minute active recovery 3 times per week for 4 weeks, with the number of sprint bouts progressing from 4 to 7. Peak power output (PPO) and total mechanical work were measured for each sprint interval bout. The SIT-CHO group performed exercise sessions following breakfast and consumed carbohydrate drink during exercise, whereas the SIT-Fast group performed exercise sessions following overnight fast and consumed water during exercise. Before and after training, V̇O2peak and T85% were assessed. Blood glucose, non-esterified fatty acids, insulin and glucagon concentrations were measured during T85%. RESULTS: Overall PPO and mechanical work were lower in SIT-Fast than SIT-CHO (3664.9 vs. 3871.7 J/kg; P=0.021 and 10.6 vs. 9.9 W/kg; P=0.010, respectively). Post-training V̇O2peak did not differ between groups. Baseline-adjusted post-training T85% was longer in SIT-Fast compared to SIT-CHO (19.7±3.0 vs. 16.6±3.0 minutes, ANCOVA P=0.038) despite no changes in circulating energy substrates or hormones. CONCLUSIONS: Our results suggest that SIT-Fast compromises exercise intensity and volume but still can have a greater impact on the ability to sustain high-intensity aerobic endurance exercise compared to SIT-CHO.

Effects of Moderate Cycling Exercise on Blood Glucose Regulation Following Successful Clinical Islet Transplantation.

Context: Islet transplantation is effective in preventing hypoglycemia in patients with type 1 diabetes (T1D). However, it is unknown whether transplanted islets regulate plasma glucose concentrations appropriately during and after exercise in human islet transplant recipient (ITxs). Objective: To determine the effect of exercise on plasma glucose, insulin, and glucagon concentrations in ITxs compared with control subjects (CONs) without diabetes. Intervention: Participants completed two conditions in random order: 45 minutes of aerobic exercise (60% VO2peak) and 45 minutes of seated rest. Blood samples were drawn at baseline, immediately after exercise or rest, and every 15 minutes throughout a 60-minute recovery period. Postexercise (24 hours) interstitial glucose was monitored with continuous glucose monitoring (CGM). Results: Twenty-four participants (12 ITxs, 12 CONs) completed the protocol. Plasma glucose decreased more over time with exercise in ITxs compared with CONs [main effects of treatment (P = 0.019), time (P = 0.001), and group (P = 0.012)]. Plasma glucose was lower during exercise vs rest in ITxs but not CONs [treatment by group interaction (P = 0.028)]. Plasma glucose decreased more during exercise than during rest [treatment by time interaction (P = 0.001)]. One ITx and one CON experienced plasma glucose concentrations <3.5 mmol/L at the end of exercise, both of whom returned above that threshold within 15 minutes. Nocturnal CGM glucose <3.5 mmol/L was detected in two CONs but no ITxs. Conclusion: Despite a greater plasma glucose decline during exercise in ITxs, hypoglycemia risk was similar during and after exercise in ITxs compared with CONs.

Glycemic and Metabolic Effects of Two Long Bouts of Moderate-Intensity Exercise in Men with Normal Glucose Tolerance or Type 2 Diabetes.

BACKGROUND: The glycemic and insulinemic responses following 30-60 min of exercise have been extensively studied, and a dose-response has been proposed between exercise duration, or volume, and improvements in glucose tolerance or insulin sensitivity. However, few studies have examined the effects of longer bouts of exercise in type 2 diabetes (T2D). Longer bouts may have a greater potential to affect glucagon, interleukin-6 (IL-6) and incretin hormones [i.e., glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic peptide (GIP)]. AIM: To examine the effect of two bouts of long-duration, moderate-intensity exercise on incretins, glucagon, and IL-6 responses before and after exercise, as well as in response to an oral glucose tolerance test (OGTT) conducted the following day. METHODS: Twelve men, six with and six without T2D, participated in two separate conditions (i.e., exercise vs. rest) according to a randomized crossover design. On day 1, participants either rested or performed two 90 min bouts of treadmill exercise (separated by 3.5 h) at 80% of their ventilatory threshold. All participants received standardized meals on day 1. On day 2 of each condition, glucose and hormonal responses were measured during a 4-h OGTT. RESULTS: On day 1, exercise increased IL-6 at the end of the first bout of exercise (exercise by time interaction p = 0.03) and GIP overall (main effect of exercise p = 0.004). Glucose was reduced to a greater extent in T2D following exercise (exercise by T2D interaction p = 0.03). On day 2, GIP and active GLP-1 were increased in the fasting state (p = 0.05 and p = 0.03, respectively), while plasma insulin and glucagon concentrations were reduced during the OGTT (p = 0.01 and p = 0.02, respectively) in the exercise compared to the rest condition for both healthy controls and T2D. Postprandial glucose was elevated in T2D compared to healthy control (p < 0.05) but was not affected by exercise. CONCLUSION: Long-duration, moderate-intensity aerobic exercise can increase IL-6. On the day following exercise, fasting incretins remained increased but postprandial insulin and glucagon were decreased without affecting postprandial glucose. This long duration of exercise may not be appropriate for some people, and further research should investigate why next day glucose tolerance was unchanged.

Effects of aerobic exercise with or without metformin on plasma incretins in type 2 diabetes.

OBJECTIVE: Despite positive effects of incretins on insulin secretion, little is known about the effect of exercise on these hormones. Metformin can affect incretin concentrations and is prescribed to a large proportion of people with diabetes. We, therefore, examined the effects of aerobic exercise and/or metformin on incretin hormones. METHODS: Ten participants with type 2 diabetes were recruited for this randomized crossover study. Metformin or placebo was given for 28 days, followed by the alternate treatment for 28 days. On the last 2 days of each condition, participants were assessed during a non-exercise day and a subsequent exercise day. Aerobic exercise took place in the morning and blood samples were taken in the subsequent hours (before and after lunch). RESULTS: Aerobic exercise did not increase total plasma glucagon-like peptide-1 (GLP-1) or glucose-dependent insulinotropic polypeptide (GIP) in the pre- or post-lunch periods (all p>0.1). GLP-1 was higher in the pre-lunch (p=0.016) and post-lunch (p=0.018) periods of the metformin conditions compared with the placebo. Total plasma GIP was higher in the pre-lunch period (p=0.05), but not in the post-lunch period (p=0.95), with metformin compared with placebo. CONCLUSIONS: In contrast to our hypothesis, aerobic exercise did not acutely increase total GLP-1 and GIP levels in patients with type 2 diabetes. Metformin, independent of exercise, significantly increased total plasma GLP-1 and GIP concentrations in these patients.

The effect of exercise on the cardiovascular risk factors constituting the metabolic syndrome: a meta-analysis of controlled trials.

BACKGROUND: Numerous meta-analyses have investigated the effect of exercise in different populations and for single cardiovascular risk factors, but none have specifically focused on the metabolic syndrome (MetS) patients and the concomitant effect of exercise on all associated cardiovascular risk factors. OBJECTIVE: The aim of this article was to perform a systematic review with a meta-analysis of randomized and clinical controlled trials (RCTs, CTs) investigating the effect of exercise on cardiovascular risk factors in patients with the MetS. METHODS: RCTs and CTs ≥4 weeks investigating the effect of exercise in healthy adults with the MetS and published in a peer-reviewed journal up to November 2011 were included. Primary outcome measures were changes in waist circumference (WC), systolic and diastolic blood pressure, high-density lipoprotein cholesterol (HDL-C), triglycerides and fasting plasma glucose. Peak oxygen uptake ([Formula: see text]) was a secondary outcome. Random and fixed-effect models were used for analyses and data are reported as means and 95% confidence intervals (CIs). RESULTS: Seven trials were included, involving nine study groups and 206 participants (128 in exercise group and 78 in control group). Significant mean reductions in WC -3.4 (95% CI -4.9, -1.8) cm, blood pressure -7.1 (95% CI -9.03, -5.2)/-5.2 (95% CI -6.2, -4.1) mmHg and a significant mean increase in HDL-C +0.06 (95% CI +0.03, +0.09) mmol/L were observed after dynamic endurance training. Mean plasma glucose levels -0.31 (95% CI -0.64, 0.01; p = 0.06) mmol/L and triglycerides -0.05 (95% CI -0.20, 0.09; p = 0.47) mmol/L remained statistically unaltered. In addition, a significant mean improvement in [Formula: see text] of +5.9 (95% CI +3.03, +8.7) mL/kg/min or 19.3% was found. CONCLUSIONS: Our results suggest that dynamic endurance training has a favourable effect on most of the cardiovascular risk factors associated with the MetS. However, in the search for training programmes that optimally improve total cardiovascular risk, further research is warranted, including studies on the effects of resistance training and combined resistance and endurance training.