Virtual immersive sensorimotor training (VIST) in collegiate soccer athletes: A quasi-experimental study.

A burgeoning area of innovation in sports is the use of extended realities to provide athletes with novel training environments. Evidence has demonstrated that virtual environments can be useful therapeutic tools with demonstrated positive outcomes. The purpose of this pilot investigation was to determine the effects of virtual immersive sensorimotor training intervention by quantifying 1) the training effect measured via change in performance pre-to post-intervention on the virtual reality exercises, 2) the difference in the in clinical measures of functional sensorimotor control, 3) the injury incidence rate, and 4) on-field performance during soccer competitions. Statistical analyses were used to describe differences between an experimental and a control group. Participants were recruited from the men and women's soccer teams at two universities in the United States. Participants at one university were in the experimental group (n = 78) and received virtual immersive sensorimotor training, consisting of nine novel exercises in headset virtual reality, twice each week for six weeks. Participants at the second university were in the control group (n = 52). The virtual exercises were developed with reference to the rehabilitative principles of neuroplasticity to train various neurologic processes, contributing to overall sensorimotor control. This includes vestibular, visual and oculomotor activities, cervical neuromotor control training, movement coordination, and postural/balance exercises. The results indicate significant positive training effects pre-to post-intervention in seven of the nine training exercises (p ≤ 0.005) and improvement in clinical tests of cervical neuromotor control, balance, and inspection time (p ≤ 0.009) in the experimental group compared to the control. One of the virtual training exercises was positively associated with on-field performance (p = 0.022). No differences in injury rate or overall on-field performance metrics between the experimental and control were detected. This research study provides evidence of training and positive transfer from virtual to real-world environments, supporting the use of these novel virtual exercises to improve measures of sensorimotor control in healthy soccer athletes.

Sensorimotor training for injury prevention in collegiate soccer players: An experimental study.

OBJECTIVES: Deliver a sensorimotor training intervention; quantify the change in clinical measurements of sensorimotor control; and compare injury rate to a historical control. DESIGN: One-arm experimental pilot; Level 3. SETTING: NCAA Division II university athletic facilities. PARTICIPANTS: 75 collegiate soccer players (38 males; 37 females) were enrolled, including 30 (40%) with history of concussion, and participated in eight training sessions. OUTCOMES: Change in pre-to post-intervention for: static balance on the Sway app, near-point convergence, self-reported symptoms on the Post-Concussion Symptom Scale, cervical flexor neuromotor control/endurance, measured by the Cranial-Cervical Flexion Test and Joint Position Error test, and gaze stability on the Dynamic Visual Acuity Test. Injury incidence rate in 2018 was calculated using the number of traumatic injuries across the season and athlete exposure counts, as compared to a historical control. RESULTS: Significant improvements were obtained in static balance, cervical flexor neuromotor control/endurance, and near-point convergence (p-values<0.01-0.03). Increases in symptom report (p = 0.02) and a decline in dynamic gaze stability (p < 0.01) were observed. There were 11.8 injuries/1000 athlete exposures in 2017 and 8.9 injuries/1000 athlete exposures in 2018 after the treatment (p = 0.18). CONCLUSION: This intervention holds promise as a preventive strategy for sports-injury as a comprehensive population-based intervention.

Cholesterol production inhibitor (statin) increased angiogenesis in surgically created femoral defect in an animal model.

This study investigated the effects of dual delivery of statin and vancomycin on angiogenesis during the healing process of a femoral defect injury using tricalcium phosphate lysine (TCPL) delivery system in an animal model. The experimental design consisted of 14 rats divided into the following three groups: Group I animals (n=5) served as the intact control without treatment. Group II animals (n=5) were subjected to a surgically induced defect (2 mm, midshaft of the right femur) and implanted (IM) with TCPL capsules loaded with vancomycin (20mg) (TCPL-AB). Group III animals (n=4) were operated on in a similar fashion as Group II, and subsequently implanted with TCPL capsules loaded vancomycin (20 mg) plus statin (5 mg). The animals were euthanized at 30 days post-implantation using overdose of isoflourane. The right femurs were then harvested in addition to the vital organs, the reproductive organs, and sample of the adjacent skeletal muscles. The hard and soft tissues were evaluated histopathologically by following laboratory standard techniques. The results of this study indicated that statin plus vancomycin treated animals had increased angiogenetic activities with many blood vessels compared to the sham group and the animals also healed in a greater magnitude than the sham group (independent evaluators (p<0.001)). Histomorphometric analysis demonstrated that exposure to sustained delivery of statin resulted in increased blood vessels. It appeared there is a direct correlation of the increased angiogenesis and the increased bone formation in the statin group and this may be one of the mechanisms with which statin form bone. In conclusion, data obtained from this study demonstrated that sustained delivery of statin by TCPL resulted in a remarkable increase in angiogenic and osteogenic activities during the healing process of a femoral defect.

Effect of low power laser treatment on a traumatized disc in a rat model.

This study investigated the effects of low power laser on the healing process of a traumatized disc in an animal model. The experimental design consisted of 14 rats divided into the following three groups: Animals in group I (n = 5) served as controls with no surgery. Animals in group II (n = 5), the sham group, received a surgically created defect in the disc at L4/L5 level and received no other treatment. Animals in the third group (n = 4) received a similar defect to L4/L5 in similar fashion as described for animals in the sham group (group II) with the exception that they received laser of 830 nm wavelength treatment or irradiation for a period of 4 weeks. The animals were euthanized at 30 days post-implantation using overdose of isoflurane. The discs were then harvested in addition to the vital organs, the reproductive organs, and sample of the adjacent skeletal muscles. The hard and soft tissues were evaluated histopathologically by following laboratory standard techniques. The results of this study indicated that the discs of the laser treated animals healed in a greater magnitude than the sham group. Image analysis revealed that there was more disc formation in the laser irradiated animals than the sham. In conclusion, data obtained from this study demonstrated that laser irradiation delivered on traumatized discs resulted in a remarkable increase in discs regeneration and healing following trauma.

Cholesterol production inhibitor (statin) increased bone healing in surgically created femoral defect in an animal model.

This study investigated the effects of dual delivery of statin and vancomycin on the healing process of a femoral defect injury using tricalcium phosphate lysine (TCPL) delivery system in an animal model. The experimental design consisted of 14 rats divided into the following three groups: Group I animals (n=5) served as the intact control without treatment. Group II animals (n=5) were subjected to a surgically induced defect (2 mm, midshaft of the right femur) and implanted (IM) with TCPL capsules loaded with vancomycin (20mg) (TCPL-AB). Group III animals (n=4) were operated on in a similar fashion as Group II, and subsequently implanted with TCPL capsules loaded vancomycin (20 mg) plus statin (5 mg). The animals were euthanized at 30 days post-implantation using overdose of isoflourane. The right femurs were then harvested in addition to the vital organs, the reproductive organs, and sample of the adjacent skeletal muscles. The hard and soft tissues were evaluated histopathologically by following laboratory standard techniques. The results of this study indicated that statin plus vancomycin treated animals healed in a greater magnitude than the sham group (independent evaluators (p<0.001)). Histomorphometric analysis demonstrated that exposure to sustained delivery of statin resulted in increased in cortical width compared to the sham and control groups (p<0.05). Furthermore, the periosteal area was significantly greater than the areas observed in sham group (p<0.05). Image analysis revealed that there were more bone formation in the vancomycin and statin exposed animals than the sham. Overall, the use of TCPL system was able to deliver statin in a sustained manner without eliciting any adverse effects on the reproductive, vital organs and the muscles. In conclusion, data obtained from this study demonstrated that sustained delivery of statin resulted in a remarkable increase in osteogenic activity.

Effects of sustained release of statin by means of tricalcium phosphate lysine delivery system in defect and segmental femoral injuries on certain biochemical markers in vivo.

Statins, which are 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors are widely used for the treatment of hyperlipidemia, and recent studies and animal data suggest that statins promote osteogenesis and increase bone strength. However, little is known about the effects of statins delivered by sustained delivery system to a target site of a defect and segmental bone fractures on certain biochemical markers including reproductive hormones. The purpose of this study was to develop a targeted statin delivery system using Tricalcium Phosphate Lysine (TCPL) for defect and segmental femoral injuries and evaluate the effects on alkaline phosphatase, total protein, malinodialdehyde, glutathione, total cholesterol, testosterone, luteinizing hormone, statins, and follicle-stimulating hormone. Because of the influence oral intake of statins might have on certain body organs, we also examine the histomorphology of the vital and reproductive organs of the animals receiving statins for a period of 30 days and 12 weeks post surgery. Simvastatin used in this study significantly increased fracture healing and without significant influence on the body weights and the weights and morphology of the vital and reproductive organs. There was a significant reduction in the cholesterol levels on the 3rd week in both phases of the study and at the conclusion of the study the difference in the cholesterol levels was no more significant in both phases. Other biochemical markers including plasma LH, FSH and testosterone levels were not affected by active treatment with simvastatin. In conclusion, short and long-term simvastatin treatment delivered at a fracture target site did not influence vital and reproductive organs, the systemic levels of the biochemical markers studied, but was able to effectively stimulate bone formation in simple and complicated segmental fractures.

Metabolic effects of fructose 1,6-bisphosphate in normoxic and hypoxic states of MG63 osteosarcoma cells.

Glycolysis is a very important process which contains very intricate steps that play a role in cellular performance and viability. Fructose 1,6-bisphosphate (FBP) is a glycolytic intermediate that has proven to improve cellular conditions under hypoxic and ischemic conditions. Osteoblasts are key regulators of skeletal matrix synthesis and degradation. Thus, considering FBP's positive effects on ameliorating hypoxia-induced injuries, the objective of this study was to determine its effects and comparative effects on osteoblast cells under normoxic and hypoxic states. MG63 osteoblast-like cells were cultured in 24-well culture plates and treated with high, medium and low dosages of FBP at 24, 48, and 72 hours. At the end of each time period, cellular number, damage by a malondialdehyde assay (MDA), and glutathione levels were evaluated. There was a significant increase in cell number for the low level of FBP in normoxia at 48 hours (p < 0.05). For the cells in hypoxia, there was a significant decrease in cell number for the medium level at 48 hours (p < 0.05). At 48 hours there was a significant decrease in cell damage through MDA measurement for the cells in normoxia and hypoxia when compared to the control. Cellular damage was not evident in the supernatant in either oxygen condition for the duration of the study. A significant decrease in glutathione levels was also noted for the cells in hypoxia. Cellular morphology included multiple nucleoli, vacuolated cytoplasm, abnormal cells, and web-like cytoplasm. The results indicate that FBP does protect bone cells exposed to hypoxic injuries, and while doing so, ameliorating the states of the cells in shock.

Evaluation of the male reproductive organs after treatment with continuous sustained delivery of statin for fracture healing.

The 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors (statins) are widely used for the treatment of hyperlipidemia, and recent in vitro and animal data suggest that statins promote bone formation and increase bone strength. We examined the relationship between sustained continuous delivery of statin and fracture healing rates in adult male animals with femoral segmental fractures. Because statin affects the production of cholesterol we also evaluated the influence of statin, on adrenal and testicular steroidogenesis and the morphology of the reproductive tract tissues in animals receiving statin for a period of 12 weeks post surgery. Simvastatin significantly increased fracture healing and without significant influence on the body weights and the weights of the reproductive organs. Basal plasma LH, FSH and testosterone levels were not affected by active treatment with simvastatin. Reproductive tissue morphology was unchanged by local sustained release of statin. In conclusion, long-term simvastatin treatment delivered at a fracture target site did not influence testicular reproductive and endocrine function, but was able to effectively heal complicated segmental fracture.

Effects of sustained delivery of thymoqiunone on bone healing of male rats.

The use of natural products as an alternative to conventional treatment in healing and treatment of various diseases has been on the rise in the last few decades. Nigella sativa, a natural herb has long been used as a natural medicine for treatment of many acute, as well as, chronic conditions. These include diabetes, hypertension and dermatological conditions. The specific objectives of this study were: (1) to successfully deliver the active component of black seed called Thymoqiunone (TMQ) at sustained level using TCPL drug delivery system; (2) to evaluate the physiological responses associated with sustained delivery of TMQ in femoral defect animal model (bone healing). A total of 15 adult male rats were randomly divided into three equal groups. Animals in group I served as controls, animals in group II served as sham while animals in group III served as experimental group (femur defect model). Group III animals were surgically implanted with TCPL capsule loaded with 0.02 grams of TMQ and 200 mg vancomycin. Blood samples, x-rays and body weights were collected and recorded weekly. At the end of 30 days post treatment, all animals were sacrificed and vital as well as reproductive organs were collected and analyzed histopathologically. Metabolic biochemical markers were also evaluated. The results of this study revealed the following: (i) gross anatomical observation indicated difference in healing pattern of animals in group III compared to those in group II (sham); (ii) no significant differences in all levels of cholesterol, proteins, malondialdehyde and alkaline phosphatase in all groups; (iii) no significant differences in the wet weights of vital as well as reproductive organs in all the groups. In conclusion, it appears that sustained levels of TMQ can enhance bone healing with little or no side effects on major vital and reproductive organs.