Effect of temporary school closure due to COVID-19 on musculoskeletal function in elementary school children / Journal of Rural Medicine

Objective: In 2020, coronavirus disease-2019 (COVID-19) became the cause of a pandemic. In response, the Japan Sports Agency issued warnings about secondary damage to health, such as the threat to physical and mental well-being due to the lack of exercise in this situation. In this study, we report on cross-sectional and longitudinal examinations of standing trunk flexion to evaluate how temporary long-term school closures affected musculoskeletal function in elementary school students.Patients and Methods: All children in one public elementary school in T-city during the school years 2019 and 2020 were included in this study. A digital forward flexion meter was used to measure standing trunk flexion.Results: In this study, 284 (284/289: 98.3%) and 266 (266/274: 97.1%) children in school years 2020 and 2019, respectively, were found to have valid data for cross-sectional analysis. The standing trunk flexion did not show significant differences between grades or sexes. In the longitudinal analysis, the results of the comparison of standing trunk flexion in children for two consecutive years revealed significant differences only between grades 3 and 4 (P<0.05) and between girls in grades 3 and 4 (P<0.01), but no significant differences in other grades or among boys or girls were observed.Conclusion: Initially, we expected that there would be a difference in the results of functional assessment using standing trunk flexion depending on the period of absence from school. However, the results of this study showed no significant changes in standing trunk flexion. Moreover, since children’s musculoskeletal functions may be affected by various factors during the COVID-19 pandemic, they should be carefully monitored in the future.

Handball injuries among high school players in Japan / 体力科学

The purpose of this study was to investigate the injury patterns and risk factors of injuries among high school handball players in Japan. A total of 1299 (709 male and 590 female) subjects who played in the 2018 Japanese National High School Handball Championship participated in this study. The questionnaire on injury experience was distributed two weeks before the championship and was collected at the representation meeting the day before the championship. The main results were as follows: 1) The subjects (n=625, 48.1%) reported experiences of injuries in the previous year. Female had significantly more suffer injuries than male. 2) The main body parts of injuries were the ankle, knee, and finger in traumatic injuries and the lower leg, lumber spine/lower back, and knee in overuse injuries. The main types of injuries were sprain, ligamentous rupture, and fracture in traumatic injuries and stress fracture, other bone injuries, and lesion of meniscus or cartilage in overuse injuries. The main cause of injuries was “contact with another athlete”. 3) Age, female players, and back players were associated with increased the occurrences of injuries. Goalkeepers were associated with decreased the occurrences of injuries. These results indicated that a high prevalence of injuries in high school handball players, and it is important to take preventive measures based on age, gender, and player position.

UPPER EXTREMITY MUSCLE ACTIVITIES AND STRENGTHS IN OVERHEAD THROWER DURING ECCENTRIC MUSCLE ACTION / 体力科学

PURPOSE : To determine the patterns of electromyographic (EMG) responses and torques of upper extremity muscles in overhead throwers during maximal, eccentric muscle action for shoulder flexion (Flex_Ecc), abduction (Abd_Ecc) and diagonal activities (Dia_Ecc) with full glenohumeral internal rotation, at 60, 120, and 180°/s on the dynamometer.METHODS : Seven asymptomatic subjects (7 men, 4 women) who participate in overhead sports at least three days a week volunteered to participate in this study. Subjects were randomly performed with the test procedure which consisted of at least 5 grade maximal-effort repetitions on the three different testing conditions, at 60, 120, and 180°/s on the dynamometer, while we assessed muscle activation of the anterior deltoid (AD), middle deltoid (MD), posterior deltoid (PD), upper trapezius (UT), middle trapezius (MT), lower trapezius (LT), and biceps brachii (BB) muscles by surface electromyography. EMG data was expressed as a percentage of maximum voluntary isometric contraction (%MVIC) that was obtained from the highest root mean square (RMS, 50 ms) of each muscle and was normalized and averaged.RESULT : AD muscle elicited lower muscle activity during Dia_Ecc than Flex_Ecc and Abd_Ecc (P＜0.05) while the MD, PD, UT, MT, and LT muscles elicited overall greater muscle activities during Dia_Ecc. MD and MT muscle activities were significantly greater for the faster speed than for the slower speed as 60°/s during Abd_Ecc (P＜0.05). Peak torque generated greater muscle strength for Dia_Ecc than Flex_Ecc and Abd_Ecc, and it was significantly greater for the faster speed than slower speed during Dia_Ecc (P＜0.05).CONCLUSION : Posterior upper extremity muscle activities and peak torque values were found to be dependent on eccentric muscle action for diagonal shoulder activity at the faster speed. This study provided evidence that isokinetic eccentric muscle strength testing of the posterior upper extremity muscle was effective to develop of a proper program for overhead sports athletes require forceful stability during deceleration phase.

FRONTAL-PLANE KNEE DISPLACEMENT INDEX AS A SCREENING TOOL FOR RISK OF ANTERIOR CRUCIATE LIGAMENT INJURY / 体力科学

The aim of this study is to examine the potential of the two-dimensional posture evaluation method as a screening tool for detecting the high-risk population for anterior cruciate ligament injury.Eleven healthy adults participated in this study. They jumped from a 31 cm-high box and landed on their dominant leg. Three-dimensional knee flexion/extension, knee valgus/varus and hip adduction/abduction angle during single-legged landing were calculated. At the same time, the Frontal-plane Knee Displacement index (FKD)-the knee joint position relative to the line between the hip and ankle joint-was measured.FKD reflects the time variation of three-dimensional knee valgus and hip adduction angle very well.Our results suggest that FKD has potential as a screening tool particularly for movement occurring primarily in the frontal-plane.

EMG ANALYSIS OF UPPER EXTREMITY MUSCLES DURING ISOKINETIC TESTING OF THE SHOULDER JOINT / 体力科学

<b>Purpose</b> : This study was to investigate the patterns of electromyography (EMG) amplitude responses during maximal, eccentric muscle action with shoulder adduction and diagonal movement, at 6 different positions on the dynamometer.<b>Methods</b> : The participants for this investigation were 9 males and 5 females. Testing consisted of each subject performing eccentric muscle exercise of the dominant shoulder muscle at a velocity of 60°/sec and 180°/sec. Muscle activity values was recorded individually from six different muscles and peak torque values were extracted for each test from torque curves once. EMG data were normalized to the highest root mean square (RMS), and were expressed as a % maximum voluntary isometric contraction (%MVIC).<b>Results</b> : The posterior parts of upper extremity muscle complex generate overall high muscle activity (> 40%MVIC) during all testing for eccentric muscle activity with diagonal shoulder movement. Posterior deltoid (PD), upper trapezius (UT), and middle trapezius (MT) muscles show differences between eccentric muscle action with shoulder adduction and eccentric muscle action with diagonal shoulder movement.<b>Conclusion</b> : The present results show that an improved understanding of muscle activity patterns during different movement may benefit many fields of athletic trainers, coaches, and athletes, in addition to assisting in injury prevention for throwers, and even rehabilitation after injury.

THE EFFECTS OF ICING AFTER EXERCISE ON JUMPER'S KNEE / 体力科学

The purpose of this study was to investigate the pathologic changes of jumper's knee before and after jumping and effects of icing after jumping. Sixteen healthy college students and sixteen collegiate volleyball players with jumper's knee were divided into two groups by eight, without icing group and with icing group after jumping exercise. Without icing groups rested for 20 minutes, while with icing groups were treated with ice for 20 minutes after eighty times of jumping. Signal to noise ratio (SNR) and sectional area of patellar tendon with Magnetic Resonance Imaging and the tenderness of patellar tendon with visual analog scale were measured before and after exercise, following with or without icing and 24 and 48 hours later from the treatment. In jumper's knee group, significant increase was found in the SNR, sectional area of patellar tendon, and tenderness of patellar tendon after exercise compared to before exercise. In addition, in jumper's knee with icing group, significant decrease was found in the SNR, sectional area of patellar tendon after icing and 24 and 48 hours after icing, and the tenderness of patellar tendon after icing compared to after exercise. These results suggested that icing was an effective treatment for jumper's knee after exercise.

GENDER DIFFERENCES OF LOWER EXTREMITY KINEMATICS DURING SINGLE LEG LANDING / 体力科学

The higher anterior cruciate ligament (ACL) injury rate of females is one of the most sever athletic-related problems today. The purpose of this study is to compare the lower extremity kinematics between male and female during single leg landing.Six male and four female healthy subjects participated in this study. They jumped from a 32 cm high box and landed with the dominant leg. The landing action was filmed with three video cameras. The knee flexion, knee valgus/varus, and hip adduction/abduction angle and angle velocity were calculated.In female subjects, the knee flexion angle and hip adduction angle were greater compared to males. Also, the knee valgus velocity and hip adduction velocity were higher in females.Our results suggest that knee valgus kinematics may be related to hip adduction. It is important to evaluate hip kinematics when considering knee kinematics to prevent knee ligament injuries.

THE RELATIONSHIPS BETWEEN SHOULDER'S FUNCTION AND DAMAGE FOR HANDBALL PLAYERS / 体力科学

[Objective] The purpose of this study is to examine the relationships between shoulder's function and damage for handball players. Subjects were nine female handball players with dominant shoulder pain.[Methods] Clinical diagnosis was done from the medical doctor's opinion and MRI. Then, the shoulder joint movement was measured with X rays.[Results] Most of them had admitted a lot the impingement syndrome and the subacromial bursitis. The trunk rotation angle at zero-positions was significantly larger in the symptomatic shoulder (dominant shoulder) than in the asymptomatic shoulder (nondominant shoulder). That is, it was obvious that the damage of the shoulder changed tilting angle of scapula medially.[Conclusion] It is reported that the damage of the shoulder causes abnormality to the “scapulohumeral rhythm” by the previous research. But, these results, suggested to need to understand not only “scapulohumeral rhythm” but also movement to the position of the scapula, when the shoulder joint function was observed for the handball player mainly composed of throwing motion.

EFFECT OF POSITION AND CHANGE OF ANGLE ON ACTIVITY OF SHOULDER MUSCLES DURING SCAPULAR PLANE ABDUCTION / 体力科学

The purpose of this study is to identify the effect of position (full can, empty can) and change of angle on the activity of shoulder muscles during scapular plane abduction ; and also to examine its application to exercises used for rehabilitation of shoulder muscles. Seven healthy subjects (23.4±1.4 yr) with normal shoulder function performed scapular plane abduction with external rotation (full can) and scapular plane abduction with internal rotation (empty can) . An electromyogram was recorded with a fine wire intramuscular electrode at the supraspinatus, deltoid anterior, middle, posterior and trapezius upper with bipolar surface. The EMG activity (RMS) of each muscle was normalized by the highest EMG activity (100%RMS) during a maximum manual muscle test for each muscle (%RMS) . The %RMS of each muscle remarkably increased with a change of the angle for empty can, whereas it showed a slight increase with a change of the angle for full can. This finding suggests that the position of full can and empty can in scapular plane abduction affects the function of shoulder muscles. In addition, full can exercise is recommended in order to improve function of the supraspinatus and the muscular activity balance between the supraspinatus and the deltoid. Empty can exercise is applied to sport-specific exercise for rehabilitation of shoulder muscles.

A GENU VARUM EFFECTS ON EACH LOWER EXTREMITY MUSCLE ACTIVITY DURING LEGPRESS EXERCISE / 体力科学

[Purpose] A leg press generally included in a weight training program to develop the quadriceps. However little is known about the mechanism of the load in lower extremity by the different knee alignment. The purpose of this study is to compare the muscle activity in the different knee align ment during leg press exercise. [Methods] Four normal knee and Five gene varum performed the leg press using three stance of narrow, medium and wide stance with the load of 75%/1 RM. Surface EMG date were collected (1000Hz) from vastus medialis (VM), vastus lateralis (VL), rectus femoris (RF), adductor longus (AL), biceps lemons (HF), tibialis anterior (TA), gastrocnemius (GAS), soleus (SQL) . Integrated EMG (iEMG) values were calculated for each muscle during each rep. A video camera recorded the performing form during leg press from the frontal plane. [Results and Discussion] As the leg press was to strengthen of the thigh muscle, VM, VL and RF of both groups worked strongly. However SQL of genu varum worked as strong as the level of activity of the thigh, iEMG of the SQL showed low value significantly by using wide stance. When the genu varum group performed maximal knee flexion using the narrow, their ankle was valuus on the video screen. This result may become cause of SQL higher activity during leg press. From this we can derive the argument that it will be necessary to take that stance into consideration when athletes who are genu varum performs leg press.

Electromyographic Activity of Shoulder Muscle at Different Positions During External Rotation / 体力科学

Electromyographic activity of the shoulder muscle at 20 and 90°abduction (20 Abd, 90 Abd) during external rotation was investigated in seven healthy men with no history of injury or instability of the shoulder joint.<BR>Electromyography (EMG) was recorded using intramuscular fine-wire electrodes inserted into the M. Supraspinatus, M. Infraspinatus and M. Teres minor, and with bipolar surface electrodes on the middle and posterior parts of M. Deltoid anti the upper and middle parts of M. Trapezius. To compare activity in different muscles, the integrated EMG (iEMG ) activity of each muscle was normalized.<BR>M. Infraspinatus and M. Teres minor showed significantly higher activity at both the 20 Abd and 90Abd compared with the middle and posterior parts of M. Deltoid and upper parts of M. Trapezius. M. Supraspinatus, the middle and posterior parts of M. Deltoid, and upper and middle parts of M. Trapezius all showed a difference in activity level between the two positions.<BR>These findings suggest that when M. Infraspinatus and M. Teres minor contribute to external rotation as a stabilizer and prime mover, consecutively, M. Supraspinatus, the middle and posterior parts of M. Deltoid, and upper and middle parts of M. Trapezius function according to the positions. Moreover, the activity of the upper and middle parts of M. Trapezius in 90Abd should influence stabilization, adduction and upward rotation of the scapula. Therefore, we conclude that the external rotation position is closely related to shoulder muscle activity and coordination.

Electromyographic analysis of shoulder muscles during shoulder external rotation with reference to load magnitude / 体力科学

Electromyographic muscle activities of the shoulder muscles during shoulder external rotation with reference to load magnitude were studied in 8 healthy male subjects without history of shoulder injuries. In addition, we discussed the relationship between rotator cuff muscles and superficial muscles. The subjects performed shoulder external rotation from 60°internal rotation to 45° external rotation at 20° of shoulder abduction and 20° of flexion. A Cybex dynamometer used to prescribe angle and velocity of the shoulder movement. At the same time, intramuscular wire electrodes were inserted into the supraspinous, infraspinous and teres minor muscles, and then surface electrodes were placed over the posterior deltoid and middle trapezius muscles. The load magnitude ranged 2-18 Nm and the angle velocity was set at 15 deg/sec. The rotator cuff muscles became significantly to be activated from 2 Nm (the supraspinous and infraspinous m.) and from 4-5 Nm (the teres minor m.) compared with the muscle activity during non-load. The superficial muscles became significantly to be activated from 4-7 Nm (the posterior deltoid m.) and from 3-6 Nm (the middle trapezius m.) compared with the muscle activity during non-load. Within the load range (18 Nm 46.8% MVC), %iEMG of the rotator cuff muscles was always larger than that of the superficial muscles. Therefore, we concluded that the contribution of the rotator cuff muscles was larger than that of the superficial muscles up to 3-4 Nm, and activities of the superficial muscles increased gradually from 3-4 Nm during shoulder external rotation.

The effect of strength training in muscle and nerve is memorized and reinforced by retraining / 体力科学

The purpose of this study was to prove the hypothesis that the effect of strength training is memorized and reinforced by retraining. Untrained university-age men participated in this training program. The retraining leg was subjected to 5 weeks of isometric training, 17 weeks of detraining and 5 weeks of retraining in knee extension. The contralateral training leg was subjected to 5 weeks of isometric training during the same period as the retraining phase of the retraining leg. Maximal isometric torque of knee extension increased after the 5-week training and remained at the trained level during the 17week detraining period. Torque gain by retraining of the retraining leg was 2.6 times greater than that of the contralateral training leg. These changes in isometric torque corres-ponded with changes in iEMG of the vastus lateralis. The cross-sectional area of the quadriceps femoris muscle did not change with training. Results support the hypothesis that the effect of strength training is memorized and reinforced by retraining. In addition, results show that these adaptations would be explained by recruitment and rate coding of motor units.

Shoulder injuries caused by throwing during water polo / 体力科学

A study was conducted to investigate the influence on the shoulder joint of throwing during water polo. One hundred sixty-seven water polo players were interviewed about injuries caused by water polo, and 70 players claimed to have had shoulder pain.<BR>In 21 players, clinical examinations were performed, and in 31 players, assessment of external rotation stability was made. Then three-dimensional analysis of hand-to-hand shoot motion was performed in 7 players.<BR>The results were as follows;<BR>1. The painful phases of the throwing motion were the take-back phase and the acceleration phase, the pain being present at the anterior and lateral portions of the shoulder joint, <BR>2. Assessment of stability revealed that the external rotation displacement on the affected side was significantly larger than that on the control side in the injured players.<BR>3. Analysis of hand-to-hand shoot motion revealed that the external rotation angle in the acceleration phase was significantly larger in non-injured subjects than in the injured.<BR>4. The external rotation angle after ball contact was increased in the injured, but decreased in the non-injured.<BR>5. To prevent injury, it appears important to catch and throw the ball using the upper extremity and rotation of the trunk in a high body position in the water, and to strengthen the muscles of the shoulder.