Effects of Exercise Intervention (with and without Joint Mobilization) in Patients with Adhesive Capsulitis: A Systematic Review and Meta-Analysis.

This review aimed to investigate the effects of exercise and exercise with joint mobilization on shoulder range of motion (ROM) and subjective symptom recovery in patients with adhesive capsulitis (AC). Related Studies published from 2000 to 2021 that were peer-reviewed and for which pre-and post-values could be calculated were extracted from PubMed, CINAHL, SPORTDiscus, and Web of Science. Nine studies met our inclusion criteria. As a result of calculating the standard mean difference (SMD) and 95% confidence intervals (CI), both exercise and exercise with joint mobilization showed a large effect on shoulder ROM and subjective outcomes. The combination showed a more significant effect than exercise alone on shoulder flexion (SMD = -1.59 [-2.34, -0.65]), extension (SMD = -1.47 [-2.05, -0.89]), internal rotation (SMD = -1.77 [-2.17, -1.36], external rotation (SMD = -2.18 [-2.92, -1.44]), and abduction ROM (SMD = -1.99 [CI -3.86, -0.12]). Patients who performed exercise alone showed a higher effect of improvement in subjective function (SMD = 3.15 [2.06, 4.24]) and pain (SMD = 4.13 [1.86, 6.41]). Based on these results, an AC rehabilitation exercise program should be developed by adjusting the amount of exercise and joint mobilization by identifying the patient's needs, subjective symptoms, and ROM.

Incidence of Sport Injuries in the Manchester 2019 World Taekwondo Championships: A Prospective Study of 936 Athletes from 145 Countries.

We aimed to describe injury incidence and patterns at the 2019 World Taekwondo Championships (WTC), and to compare them with those of previous WTCs, based on new World Taekwondo (WT) competition rules, medical codes, and the Protector and Scoring System (PSS). This prospective cohort study utilized data obtained through the WT Injury Surveillance System. All athletes with injuries were evaluated by on-site sports medicine specialists, and ultrasonography was used to assess all musculoskeletal injuries. Of 936 athletes, 60 injuries were recorded (6.4 injuries/100 athletes, 95% confidence intervals [CI]: 4.8-8.0), and 4.5% (n = 42) sustained at least one injury. Males had a higher risk of sustaining injuries than females (incidence rate ratio: 1.57; 95% CI: 0.89-2.76). The most common sites, type, and mechanism were lower extremities (n = 26, 43.33%), contusion/hematoma/bruises (n = 33, 55.0%), and contact with another athlete (n = 50, 83.33%). Overall, the injury patterns associated with the mechanism of injury were similar in both the 2019 and 2017 WTCs. Refined WT competition rules and a re-established PSS at the 2019 WTC reduced the overall and severe injury incidence. Our findings can help revise Taekwondo competition rules, enhance protective equipment, optimize on-site venue medical systems, and develop injury prevention projects.

Determination of the Strongest Factor and Component in a Relationship between Lower-Extremity Assessment Protocol and Patient-Oriented Outcomes in Individuals with Anterior Cruciate Ligament Reconstruction: A Pilot Study.

Although the Lower-Extremity Assessment Protocol (LEAP) assesses multidimensional aspects of a patient with anterior cruciate ligament (ACL) injury, there is a need to reduce the dimensionality of LEAP items to effectively assess patients. Therefore, the present study aimed to establish the validity of LEAP and to determine associated factors and components in a relationship between LEAP and the International Knee Documentation Committee (IKDC) questionnaire. Fifteen patients who had ACL reconstruction more than 1 year and less than 5 years earlier were recruited. Patients performed LEAP, including muscular strength, fatigue index, static balance, drop landing, and functional hopping assessment. They also completed the IKDC questionnaire and the Tegner Activity Score. Factor analysis and stepwise regression analysis were performed. The 14 components of LEAP were categorized into four factors (functional task, muscle strength, neuromuscular control, and fatigue), which accounted for 83.8% of the cumulative variance by factor analysis. In the stepwise regression analysis, the functional task (R2 = 0.43, p = 0.008) in factors and single-leg hop (R2 = 0.49, p = 0.004) in components were associated with patient-oriented outcomes, respectively. In conclusion, the functional task and single-leg hop may be used for providing valuable information about knee joints to patients and clinicians.

Ankle Instability Patients Exhibit Altered Muscle Activation of Lower Extremity and Ground Reaction Force during Landing: A Systematic Review and Meta-Analysis.

This review aimed to investigate characteristics of muscle activation and ground reaction force (GRF) patterns in patients with ankle instability (AI). Relevant studies were sourced from PubMed, CINAHL, SPORTDiscus, and Web of Science through December 2019 for case-control study in any laboratory setting. Inclusion criteria for study selection were (1) subjects with chronic, functional, or mechanical instability or recurrent ankle sprains; (2) primary outcomes consisted of muscle activation of the lower extremity and GRF during landing; and (3) peer-reviewed articles with full text available, including mean, standard deviation, and sample size, to enable data reanalysis. We evaluated four variables related to landing task: (1) muscle activation of the lower extremity before landing, (2) muscle activation of the lower extremity during landing, (3) magnitude of GRF, and (4) time to peak GRF. The effect size using standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated for these variables to make comparisons across studies. Patients with AI had a lower activation of peroneal muscles before landing (SMD = -0.63, p < 0.001, CI = -0.95 to -0.31), greater peak vertical GRF (SMD = 0.21, p = 0.03, CI = 0.01 to 0.40), and shorter time to peak vertical GRF (SMD = -0.51, p < 0.001, CI = -0.72 to -0.29) than those of normal subjects during landing. There was no significant difference in other muscle activation and GRF components between the patients with AI and normal subjects (p > 0.05). Altered muscle activation and GRF before and during landing in AI cases may contribute to both recurrent ankle and ACL injuries and degenerative change of articular.

Association between Cigarette Smoking and Physical Fitness Level of Korean Adults and the Elderly.

Although previous studies have examined the relationship between smoking and physical fitness, they only considered current smoking status and the same fitness measurements regardless of age. This study investigated differences in physical fitness based on tobacco smoking habits. A total of 2830 non-elderly adults (NEA; 19-64 years) and 629 elderly (65-89 years) participated in the study, using data extracted from a Korean national database. One-way ANCOVA and ANOVA were conducted to analyze the results. The subjects were classified into three groups (smokers, those who had quit, and never-smokers). In NEA men, a significant difference was observed in 50-m dash (p = 0.003) and 20-m shuttle-run (p < 0.001), while in elderly men differences were only seen in sit-ups (p = 0.015). In the case of NEA and elderly women, no significant differences were observed in physical fitness levels (p > 0.05). The decreased fitness level due to smoking was more noticeable in men than in women, and in NEA more than in elderly persons. A non-smoking policy and customized training based on age or gender are necessary to increase fitness and improve health conditions.