This scoping review aims (1) to map the literature dealing with neurophysiological and biomechanical aspects of back problems in athletes in order to identify valid risk-factors for their prevention, plus (2) to identify gaps in the existing research and propose suggestions for future studies. A literature search conducted with Scopus, Web of Science, MEDLINE and Cochrane Library was completed by Elsevier, SpringerLink and Google Scholar. The main neurophysiological risk factors identified leading to back problems in athletes are neuromuscular imbalance, increased muscle fatigability, muscle dysfunction and impaired motor control, whilst biomechanical risk factors include maladaptive spinal, spinopelvic and lower limb kinematics, side-to-side imbalances in axial strength and hip rotation range of motion, spinal overloading and deficits in movement pattern. However, most studies focused on back pain in the lumbar region, whereas less attention has been paid to thoracic and cervical spine problems. The range of sports where this topic has been studied is relatively small. There is a lack of research in sports in which the core muscles are highly involved in specific movements such as lifting weights or trunk rotations. A limited number of studies include female athletes and master athletes of both genders. In addition to chronic back pain patients, it is equally important to conduct research on healthy athletes with a predisposition to spine problems. Investigators should focus their empirical work on identifying modifiable risk factors, predict which athletes are at risk for back problems, and develop personalized sport-specific assessment tools and targeted prevention strategies for them. This review was registered using the Open Science Framework Registries (https://osf.io/ha5n7).
Change of direction speed (CODS) is determined by several physical aspects, such as linear sprint speed, reactive strength and power of leg muscles. It appears that core strength may also play a role in CODS, however, its relationship to CODS remains unclear. The aim of this narrative review was to analyze the literature addressing a) the relationship between core strength and CODS and b) the effect of core strength training on CODS. This analysis revealed a significant relationship between the parameters of core strength and stability (the pressure of the activated core muscles during lower limb movement and the greatest mean force output of maximum volunteered contraction) and the time in the Agility T-Test. However, this parameter was not significantly related to the strength endurance of core muscles (total time in the plank test). Core training provides a sufficient stimulus for the development of CODS in less-skilled middle-adolescent athletes, while its effectiveness decreases in higher-skilled adult athletes. These findings indicate that core muscle strength contributes significantly to the change of direction speed. Core training is therefore useful for improving CODS.
BACKGROUND: Sitting for long periods of time and lack of physical activity in young adults can cause postural deterioration leading to rapid onset of fatigue and increase the risk of back pain. We were interested in whether there are gender differences in spinal curvature among university students with a predominantly sedentary lifestyle. METHODS: 20 sedentary female (age 20 ± 0.73 years) and 39 sedentary male university students (age 20 ± 1.08 years) participated in this study. Their thoracic and lumbar curvatures were assessed while standing and sitting using a Spinal Mouse. RESULTS: In standing, 80.0% of the females and 69.2% of the males had a neutral position of the thoracic spine (33.25° and 35.33°, respectively). However, more males, 30.8%, than females, 10.0%, had hyperkyphosis (54.27° and 47.0°, respectively). Hypokyphosis was found in 10.0% of the females (18.50°) and none in the males. Similarly, 90.0% of the females and 97.4% of the males had neutral position of the lumbar spine (-33.11° and -29.76°, respectively). Increased hyperlordosis was found in 10.0% of the females and 2.6% of the males (-41.0° and -50.0°, respectively). Hypolordosis was not detected in either females or males. In sitting, on the other hand, 70.0% of the females and only 33.3% of the males had a neutral position of the thoracic spine (30.20° and 30.62°, respectively). Increased hyperkyphosis was found in 46.2% of the males (59.76°) and none of the females. 30.0% of the females and 23.1% of the males had light hypokyphosis (47.50° and 46.67°, respectively). Similarly, 70.0% of the females and only 38.5% of the males had a neutral position of the lumbar spine (7.0° and 6.6°, respectively). 35.9% of the males and only 5.0% of the females had a light hypokyphosis (16.14° and 16.0°, respectively). Slightly increased hyperkyphosis was identified in 25.6% of the males and 25.0% of the females (23.9° and 22.5°, respectively). CONCLUSION: There are significant gender differences in spinal curvature. While in the thoracic spine it was to the detriment of the males when both standing and sitting, in the lumbar spine it is related to the females only when standing. It is therefore necessary to eliminate these spinal deviations in young adults induced by prolonged sitting during university courses by appropriate recovery modalities.
Kyphosis , Spinal Curvatures , Female , Humans , Male , Young Adult , Lumbar Vertebrae , Posture , Sedentary Behavior , Spine , Students , Universities
BACKGROUND: Multiple sclerosis (MS) can lead to impaired upper and lower extremity function (ULEF), which reduces the quality of life (QoL). Exercise is beneficial for symptom management, but newer approaches like multi-function swing suspension training (MFSST) need further investigation. Additionally, tailoring exercises to individual needs remains a challenging area of investigation. AIM: To investigate the effect of an MFSST program on ULEF, and QoL in MS women according to the expanded disability status scale (EDSS) score. METHODS: Forty-seven MS women meeting selection criteria were randomly assigned to intervention groups A (EDSS 2-4) and B (EDSS 4.5-6.5), and the control group (EDSS 2-6.5). Intervention groups did an 8-week MFSST program with 3 × 1hr sessions/week. Prior to the intervention, and after 4, 6, and 8 weeks, the 9-hole peg test (9HPT) and the timed 25-foot walk (T25FW) test were performed for both the intervention groups and the control group. The Short Form questionnaire (SF-36) was used to measure their QoL. RESULTS: Significant main effects for time were observed in both the 9HPT (F = 52.48, p = 0.001, Pη2 = 0.78) and the T25FW (F = 85.63, p = 0.000, Pη2 = 0.859). Speed increased between the pre-test, 4th week, 6th week, and 8th week in both tests. These tests revealed significant interaction effects between group and time. The 9HPT had an F-value of 9.01 (p = 0.001, Pη2 = 0.392), while the T25FW had an F-value of 13.812 (p = 0.000, Pη2 = 0.497). Across both tests, Group B, with higher EDSS scores, demonstrated greater speed improvement over the three-time measurements (4th week, 6th week, and 8th week) than Group A. The control group did not exhibit any improvement in speed. Intervention groups showed improvement in all QoL subscales except emotional role limitation. CONCLUSIONS: An 8-week MFSST improves ULEF and QoL in women with MS, particularly those with higher EDSS scores (more than 4.5). Notably, significant improvements were observed after four weeks of the intervention. The incorporation of a variety of exercises in a single device provides a significant advantage over traditional exercise programs. Therefore, MFSST can be a valuable and efficient tool for improving symptoms and QoL in MS patients. TRIAL REGISTRATION: IRCT20220526054997N1.
Multiple Sclerosis , Humans , Female , Multiple Sclerosis/therapy , Quality of Life , Walking , Exercise Therapy , Lower Extremity , Disability Evaluation
The physical and psychological load of small-sided games (SSGs) can affect players' neuromuscular and cognitive functions. Yet, little is known about the acute performance changes after such a specific exercise in young soccer players and their association with exercise load applied. This study investigates i) the neuromuscular and perceptual-cognitive response to the SSG exercise load, and ii) the relationship between pre- and post-SSG changes in variables of performance and the respective exercise load in youth soccer players. Sixteen participants (13.6 ± 0.5 years) underwent a 30-min SSG 4v4 + GK protocol. Prior to and after the SSG they performed countermovement jump (CMJ), planned and reactive Y-shaped agility tests (PA, RA), and go/no-go task (GNG). Their subjective perception of fatigue was evaluated by visual analog scale. Fatigue induced by SSG (perception of fatigue increased by 41.56%, p = .001, g = 4.15) increased PA time (4.04%, p = .002, g = .97), RA time (6.45%, p = .003, g = 1.16), and number of errors in the response inhibition task (87.1%, p = .023, rc = .57), whilst decreased CMJ height (-6.65%, p = .014, g = .56). These performance deteriorations were not significantly associated with neither internal nor external load variables. However, a less pronounced drop in performance was related to external load variables, i.e., ∆CMJ height and ∆RA time correlated with very high-speed running (rs = .66, p = .006; rs = -.50, p = .022; respectively) and maximal speed (r = .54, p = .032; r = -.52, p = .037; respectively), whilst ∆PA time was associated with high-intensity accelerations (rs = -.76, p = .002). These findings indicate that fatigue induced by SSG affects both planned and reactive agility, decision-making in response inhibition task, and explosive strength in youth soccer players regardless of significant contribution of any robust internal or external load variables. Nonetheless, high-intensity actions within SSG partially compensate for the decrements in their agility performance and explosive strength. The load variables encountered during SSG do not fully reflect youth players' neuromuscular and perceptual-cognitive responses to sport-specific exercise.
In recent years, much effort has been made to reduce the injury rate in combat sports. However, the question remains to what extent these measures are effective. Analysis of studies could provide evidence of the effectiveness of measures aimed at reducing the incidence of injuries. This scoping review aims (1) to map research articles dealing with the effectiveness of proper use of protective measures in reducing the incidence of injuries in combat sports; (2) to investigate to what extent the proper use of protective measures and compliance with sports rules help to reduce the incidence of injuries in combat sports; and (3) to identify gaps in the existing literature and suggest future research on this topic. The literature search was conducted on articles published between 2010 and 2023. The main inclusion criteria were studies investigating the effect of sports rules and protective equipment used during training or competition in combat sports on reducing the incidence of injuries. After meeting the criteria, only seven articles from boxing, karate, and taekwondo were included in this study. Results showed that mandatory head guards, along with modern thicker gloves, significantly reduced the rate of knockouts (KOs) and head injuries in boxing despite an increase in the number of head blows. However, the number of facial cuts increased significantly due to the removal of head guards as a piece of mandatory equipment. The use of mouth guards has significantly reduced the number of oral injuries. Changes in rules, such as shortening the duration of bouts, along with the introduction of greater competencies of referees in the supervision of bouts (the standing count, outclassed rule, and medical stops) have helped to reduce the rate of injuries in boxing. The application of a computerised scoring system also contributed to the rate of injuries reduction. The increase in the number of weight divisions had the same effect on U21 karate athletes. However, a higher incentive to attack the head area in taekwondo did not increase the incidence of injuries in youth athletes. It can be concluded that the proper use of protective measures (head and mouth guards) in combination with the rules established for health protection (higher competencies of referees and more weight divisions in competitions) effectively reduces the occurrence of injuries in combat sports. In all Olympic combat sports, the injury incidence should be regularly assessed using the Injury Incidence Rate (IIR) per 1000 min exposures (MEs). Nonetheless, further studies are needed to monitor how established rules (e.g., prohibited behaviour) affect the IIRs.
Prolonged periods of sitting at work can increase trunk muscle fatigue from the continuous contraction of deep trunk muscles. Insufficient activity of these muscles can decrease muscular support to the spine and increases stress on its passive structures. This can lead to reduced spinal mobility and impaired postural stability. It may also stimulate nociceptor activity leading to pain. However, frequently used recovery modalities such as muscle strengthening and stretching exercises, can be time-consuming, impractical, and difficult to implement in the workplace. Diaphragmatic breathing exercises, which increase the activity of the deep trunk muscles by raising intra-abdominal pressure, seem to be a suitable alternative. However, little is known as to what extent diaphragmatic breathing exercises contribute to the reduction of fatigue induced by prolonged sitting. This paper presents a study protocol that aims to investigate the acute effect of diaphragmatic breathing exercises on recovery of fatigue-induced changes in spinal mobility and postural stability in sedentary middle-aged adults at risk of developing non-specific low back pain. Twenty sedentary adults aged between 25 and 44 years will perform Abt's fatigue protocol, followed by 1) active recovery using diaphragmatic breathing exercises and 2) passive recovery in the form of lying on the bed, respectively. There will be 1 week of rest in-between. Pre-fatigue, post-fatigue, and after the active and passive recovery, spinal mobility and postural stability will be evaluated using the spinal mouse device and a posturography system, respectively. The electromyography will be used to determine the muscle-fatigue conditions. We hypothesize that active recovery in a form of diaphragmatic breathing exercises would be more effective in restoring spinal mobility and postural stability followed by the fatigue of back and hamstring muscles compared to passive recovery in sedentary adults. Increasing core and respiratory muscle strength via these exercises could be beneficial for overall mobility and stability of the spine. Reducing compressive stress on the passive structures of the spine may be also beneficial for lowering low back pain. Therefore, we believe that diaphragmatic breathing exercises have the possibility to be incorporated into the workplace and contribute to better back health in sedentary middle-aged adults. Clinical Trial Registration: [https://www.irct.ir/trial/67015], identifier [IRCT20221126056606N1].
The Yo-Yo Intermittent Test is frequently used to monitor changes in athletes' performance in response to different interventions. However, the question remains as to whether, and to what extent, retakes of this test would contribute to these changes. This case study sought to determine the magnitude of practice effects, involving test repetition, on performance in the Yo-Yo Intermittent Recovery Test. A recreational soccer player performed four attempts of the Yo-Yo Intermittent Recovery Test-Level 1 (YYIR1) with a week's rest in between. The same participant repeated this test protocol (four attempts of the YYIR1) again after six months. Changes in distance covered, level achieved, maximal oxygen uptake, and heart rate between the first and last attempt were assessed. The smallest worthwhile change (SWC), the coefficient of variation (CV), and the 2CV were calculated to identify a trivial, a possibly meaningful, and a certainly meaningful change in YYIR1 performance. The distance covered in the first set of measurements increased from 1320 m to 1560 m (15.4%), which corresponds to a 4.6% increase in the level achieved (from 16.6 to 17.4). Similarly, the distance covered in the second set of measurements increased from 1280 m to 1560 m (17.9%), which corresponds to a 5.5% increase in the level achieved (from 16.5 to 17.4). The participant's performance changes fell outside of the SWC and the CV, but not the 2CV during both sets of measurements. These improvements in YYIR1 performance may be ascribed to practice with repeated attempts of the test by improving running technique at the turning point and/or by simply increasing the linear speed. This fact should always be kept in mind when interpreting the effects of training. Practitioners should differentiate between practice effects associated with repeated test execution and adaptation induced by conducting sport-specific training.
This study investigates the effect of exercise-induced fatigue on change of direction performance and serve precision among young tennis players. A group of 21 players (age 12.90 ± 0.76 years), ranked among the top 50 players on the national tennis federation scale and the top 300 on the "Tennis Europe" scale, participated in the study. They underwent a standardized physiological load protocol using the "300-m running test" which consists of consecutive runs for 15 shares of 20 m (15 × 20). Its intensity was determined using the Borg Rating of Perceived Exertion (RPE) scale where subjects evaluated their level of experienced load on a scale from 0 to 10. Prior to and after the protocol, they performed a pre-planned change of direction T-test and serve precision test. Results showed significant increase of time in the T-test (from 11.75 ± 0.45 s to 12.99 ± 0.4 s, p = 0.00) and decrease in serve precision parameter from (6.00 ± 1.04 to 4.00 ± 1.26, p = 0.00) after the fatigue test protocol. The RPE increased from 5 to 9, after the fatigue protocol, indicating the desired fatigue effect. These findings indicate that exercise-induced fatigue impairs change of direction performance and serve precision among young tennis players.
Biological maturity can affect performance on motor tests, thus young players can have advantages or disadvantages during testing by being more or less mature than their peers of the same chronological age. The aim of this study was to investigate the effects of biological age on speed, agility, and explosive power in young tennis players. Fifty tennis players (age 12.3 ± 1.2 years, height 156.7 ± 12.8 cm, body mass 45.9 ± 8.9 kg) who were ranked up to 50th place in the ranking of the National Tennis Association, as well as up to 300th place on the international "Tennis Europe" ranking, participated in the study. They were divided into three groups according to their maturation status, that is, the peak height velocity (PHV) maturity offset: pre-PHV [<0] (n = 10); circa-PHV [0 to 1] (n = 10); and post-PHV [>1.5] (n = 25). They performed tests of speed (5, 10, and 20 m sprints), agility (20 yards, 4 × 10 yards, T-test, TENCODS, and TENRAG), and explosive power (countermovement jump, one-leg countermovement jump, squat jump, long jump, and one-leg triple jump). Results showed significantly higher height of the vertical jump in the post-PHV group compared to the pre-PHV group, in the range of ~16% to ~27%. Moreover, linear and change of direction speed was significantly faster in the post-PHV group compared to the pre-PHV group, in the range of ~5% to ~8%. Height of the squat jump and speed in the T-test were significantly better in the post-PHV group compared to the circa-PHV group, in the range of ~7% to ~15%, while height of the single-leg triple jump was significantly higher in the circa-PHV group compared to the pre-PHV group by ~7%. This study showed that tennis players of older biological age achieve better results in almost all variables of speed, agility, and explosive power compared to players of younger biological age. Coaches should be aware of the differences found in physical performance and consider the practical implications that maturation can have in the long-term development of young tennis players.
BACKGROUND: To prevent the risk of stair descent falls and associated injuries in the older adults, it is important to understand the factors that affect this frequent locomotion of daily living. The fact that falls are in most cases the result of the interaction between intrinsic and extrinsic factors is very often underestimated when designing test protocols. RESEARCH QUESTION: This study aimed at evaluating balance control during and immediately after step down onto an unstable surface. METHODS: Physically active men and women aged 60-69 years (n = 28) and 70-79 years (n = 18) were asked to perform a step down onto a foam pad and stand still for 30 s (restabilization phase). Centre of pressure (CoP) velocity and standard deviation of CoP sway in anteroposterior and mediolateral direction were evaluated during the step down (CoP VAP, CoP VML, CoP SDAP, CoP SDML) and in the first 5 s of restabilization (CoP VAP5, CoP VML5, CoP SDAP5, CoP SDML5). In addition, time to complete step was investigated. RESULTS: Participants aged 70-79 years presented worse ML balance control after step down onto an unstable surface than their younger counterparts. This was represented by the significantly higher values of CoP SDML5 and CoP VML5 (p = 0.022 and p = 0.017). No other significant differences were detected. SIGNIFICANCE: Age is associated with a more significant ML center of pressure velocity and sway after step down onto a foam pad in physically active older adults. Exercises aimed at improving ML balance control in unstable conditions should be the subject of physical interventions even in older adults with overall good state of health and physical fitness.
Exercise , Postural Balance , Male , Humans , Female , Aged , Exercise Therapy , Physical Examination , Locomotion
High-intensity intermittent performance in soccer is widely assessed using the yo-yo intermittent recovery level 2 test (YYIR2). This test is usually associated with aerobic-anaerobic performance. However, less is known about the direct or indirect contributions of abilities, including the anaerobic component. This study aims to propose a three-level model of factors contributing to YYIR2 performance, based on the investigation of relationships with aerobic endurance, repeated-sprint ability (RSA), and the linear and change-of-direction speed and power variables. Eighteen soccer players performed the YYIR2, with a 20-m shuttle run test (20mSR), an RSA test with change-of-direction, 5-m and 20-m sprints, and a 505 test, countermovement jump, squat jump, and drop jump. The results showed a significant relationship between the YYIR2 distance and the 20mSR distance (r = 0.721, p = 0.001), as well as with the RSA test mean time (r = -0.594, p = 0.009). In the second level, the 20mSR distance performance was not associated with any of the speed and power variables. However, the RSA test mean time correlated with the 5-m sprint (r = 0.587, p = 0.010), 20-m sprint (r = 0.702, p = 0.001), and 505 test (r = 0.585 p = 0.011) performance. In the third level, the 20-m sprint time was related to the squat jump (r = -0.577 p = 0.012) and countermovement jump (r = -0.768 p < 0.001) heights. In addition to aerobic endurance, this study highlights the importance of the anaerobic component in YYIR2 performance. More specifically, aerobic endurance (52%) and RSA (36%) are the main determinants of YYIR2 performance. Subsequently, the RSA performance is determined by the linear (34-49%) and change-of-direction speed (35%), while the explosive power of lower limbs contributes to sprinting performance (33-59%). Coaches should focus on the development of these abilities to improve the high-intensity intermittent performance of soccer players.
Athletic Performance , Running , Soccer , Male , Humans , Exercise Test/methods , Posture
The knowledge of the COVID-19 symptomatology has increased since the beginning of the SARS-CoV-2 pandemic. The symptoms of nervous system involvement have been observed across the spectrum of COVID-19 severity. Reports describing difficulties of nerve roots are rare; the affection of brain and spinal cord by SARS-CoV-2 is of leading interest. Our aim therefore is to describe the radicular pain deterioration in the group of nine chronic lumbosacral radicular syndrome sufferers in acute COVID-19. The intensity of radicular pain was evaluated by the Visual Analogue Scale (VAS). The VAS score in acute infection increased from 5.6 ± 1.1 to 8.0 ± 1.3 (Cohen's d = 1.99) over the course of COVID-19, indicating dramatic aggravation of pain intensity. However, the VAS score decreased spontaneously to pre-infection levels after 4 weeks of COVID-19 recovery (5.8 ± 1.1). The acute SARS-CoV-2 infection worsened the pre-existing neural root irritation symptomatology, which may be ascribed to SARS-CoV-2 radiculitis of neural roots already compressed by the previous disc herniation. These findings based on clinical observations indicate that the neurotropism of novel coronavirus infection can play an important role in the neural root irritation symptomatology deterioration in patients with chronic pre-existing lumbosacral radicular syndrome.
COVID-19 , Intervertebral Disc Displacement , Radiculopathy , Back Pain , Humans , Radiculopathy/diagnosis , Radiculopathy/etiology , SARS-CoV-2
While force-velocity-power characteristics of resistance exercises, such as bench presses and squats, have been well documented, little attention has been paid to load, force, and power-velocity relationships in exercises engaging core muscles. Given that power produced during lifting tasks or trunk rotations plays an important role in most sport-specific and daily life activities, its measurement should represent an important part of the test battery in both athletes and the general population. The aim of this scoping review was 1) to map the literature related to testing methods assessing core muscle strength and stability in sport and rehabilitation, chiefly studies with particular focus on force-velocity-power characteristics of exercises involving the use of core muscles, 2) and to identify gaps in existing studies and suggest further research in this field. The literature search was conducted on Cochrane Library databases, Scopus, Web of Science, PubMed and MEDLINE, which was completed by SpringerLink, Google Scholar and Elsevier. The inclusion criteria were met in 37 articles. Results revealed that among a variety of studies investigating the core stability and core strength in sport and rehabilitation, only few of them analyzed force-velocity-power characteristics of exercises involving the use of core muscles. Most of them evaluated maximal isometric strength of the core and its endurance. However, there are some studies that assessed muscle power during lifting tasks at different loads performed either with free weights or using the Smith machine. Similarly, power and velocity were assessed during trunk rotations performed with different weights when standing or sitting. Nevertheless, there is still scant research investigating the power-velocity and force-velocity relationship during exercises engaging core muscles in able-bodied and para athletes with different demands on stability and strength of the core. Therefore, more research is needed to address this gap in the literature and aim research at assessing strength and power-related measures within cross-sectional and intervention studies. A better understanding of the power-force-velocity profiles during exercises with high demands on the core musculature has implications for designing sport training and rehabilitation programs for enhancement of athletes' performance and/or decrease their risk of back pain.
Balance and core stabilization exercises have often been associated with improved athlete performance and/or decreased incidence of injuries. While these exercises seem to be efficient in the prevention of injuries, there is insufficient evidence regarding their role in sport-specific performance and related functional movements. The aim of this scoping review is (1) to map the literature that investigates whether currently available variables of postural and core stability are functionally related to athlete performance in sports with high demands on body balance and spinal posture and (2) to identify gaps in the literature and suggest further research on this topic. The literature search conducted on MEDLINE, Scopus, Web of Science, PubMed, and Cochrane Library databases was completed by Google Scholar, SpringerLink, and Elsevier. Altogether 21 articles met the inclusion criteria. Findings revealed that postural stability plays an important role in performance in archery, biathlon, gymnastics, shooting, and team sports (e.g., basketball, hockey, soccer, tennis). Also core stability and strength represent an integral part of athlete performance in sports based on lifting tasks and trunk rotations. Variables of these abilities are associated with performance-related skills in cricket, cycling, running, and team sports (e.g., baseball, football, hockey, netball, soccer, tennis). Better neuromuscular control of postural and core stability contribute to more efficient functional movements specific to particular sports. Training programs incorporating general and sport-specific exercises that involve the use of postural and core muscles showed an improvement of body balance, back muscle strength, and endurance. However, there is controversy about whether the improvement in these abilities is translated into athletic performance. There is still a lack of research investigating the relationship of body balance and stability of the core with sport-specific performance. In particular, corresponding variables should be better specified in relation to functional movements in sports with high demands on postural and core stability. Identifying the relationship of passive, active, and neural mechanisms underlying balance control and spinal posture with athlete performance would provide a basis for a multifaced approach in designing training and testing tools addressing postural and core stability in athletes under sport-specific conditions.
While the effect of a variety of exercises on postural balance control has been extensively studied, less attention has been paid to those requiring sport-specific skills. Therefore there is a need to analyze the literature and elucidate changes in postural balance control after exercises performed in conditions close to a particular sport. This scoping review aims (i) To map the literature that addresses postural sway aspects of acute responses to general and sport-specific exercises and their underlying physiological mechanisms, and (ii) To identify gaps in the existing literature and propose future research on this topic. The main literature search conducted on MEDLINE, Web of Science, Scopus, PubMed, and Cochrane Library databases was completed by SpringerLink, Elsevier, and Google Scholar. A total of 60 articles met the inclusion criteria. Findings identified that among a variety of studies evaluating the effects of exercise on postural balance control, only few of them were conducted under sport-specific conditions (i.e., while shooting in biathlon or pentathlon, and after simulated or match-induced protocols in combat and team sports). Therefore, more research is still needed to address this gap in the literature and aim research at investigation of postural sway response to sport-specific exercises. Further analysis of the literature showed that the type, intensity and duration of exercise play a key role in increased postural sway. Whole body and localized muscular fatigue of the trunk, neck and lower limbs is considered to be a main factor responsible for the magnitude of balance impairment in an initial phase of recovery and speed of its readjustment to a pre-exercise level. Other likely factors affecting postural stability are hyperventilation and deterioration of sensorimotor functions, though some contribution of muscle damage, dehydration, hyperthermia or dizziness cannot be excluded. A better understanding of the physiological mechanisms of balance impairment after exercises performed under simulated fatigue induced protocol, close to conditions specific to a particular sport, has implications for designing smart exercise programs tailored to individual needs to improve athlete performance with high demands on postural stability and/or decrease their risk of injuries.
Balance, together with other motor qualities, plays an important role in the successful execution of specific gymnastic skills. However, it is also not clear whether different demands on dynamic balance and power produced by lower limb can be observed in sport-specific differences among gymnasts of various modalities. The question also is as to what extent isokinetic leg muscle strength contributes to anterior and posterior postural stability in gymnasts. Therefore, the aim of the study was i) to compare variables of dynamic balance and isokinetic leg muscle strength in rhythmic, artistic, and aerobic gymnasts, and ii) to investigate the relationship of reach distances in anterior, posteromedial, and posterolateral directions, as well as the composite score in the Y-balance test with an isokinetic muscle strength during knee extension and flexion at different velocities in female gymnasts of various disciplines. Altogether seven aerobic, five artistic, and six rhythmic gymnasts performed the Y-balance test and isokinetic leg muscle strength test at 60°/s, 180°/s, and 300°/s. Results showed significant between-group differences in the composite score in the Y-balance test of the dominant (F = 3.536, p = .041) and non-dominant symmetry (F = 4.804, p = .015). Similarly, average power produced during knee extension and knee flexion at 60°/s, 180°/s and 300°/s differed significantly among these groups (all at pË0.05). In addition, there was a significant relationship between the composite score of the dominant limb symmetry and isokinetic dominant limb extension strength at 60°/s (r = .54), 180°/s (r = .87), and 300°/s (r = .84) in aerobic gymnasts. The composite score of the dominant limb symmetry was also associated with isokinetic dominant limb extension strength, albeit only at 60°/s in both artistic (r = .60) and rhythmic gymnasts (r = .55). Such between-group differences may be ascribed to their different demands on maintenance of balance under dynamic conditions and leg muscle power within their sport specializations. Taking into account significant association between the dominant limb symmetry and isokinetic dominant limb extension strength, it may be concluded that both muscle strength and fast speeds contribute to dynamic balance in adolescent gymnasts.
Effects of various exercise programs on postural balance control in athletes and their underlying physiological mechanisms have been extensively investigated. However, little is known regarding how challenging sport-specific conditions contribute to the improvement of body balance and to what extent these changes may be explained by sensorimotor and/or neuromuscular function adaptations. Analysis of the literature could provide useful information on the interpretation of changes in postural sway variables in response to long-term sport-specific training and their association with performance measures. Therefore, the aim of this scoping review was (1) to analyze the literature investigating postural control adaptations induced by sport-specific training and their relationship with measures of athletic performance, and (2) to identify gaps in the existing research and to propose suggestions for future studies. A literature search conducted with Scopus, Web of Science, MEDLINE and Cochrane Library was completed by Elsevier, SpringerLink and Google Scholar with no date restrictions. Overall, 126 articles were eligible for inclusion. However, the association between variables of postural balance control and measures of sport-specific performance was investigated in only 14 of the articles. A relationship between static and/or dynamic balance and criterion measures of athletic performance was revealed in shooting, archery, golf, baseball, ice-hockey, tennis, and snowboarding. This may be ascribed to improved ability of athletes to perform postural adjustments in highly balanced task demands. However, the extent to which sport-specific exercises contribute to their superior postural stability is unknown. Although there is a good deal of evidence supporting neurophysiological adaptations in postural balance control induced by body conditioning exercises, little effort has been made to explain balance adaptations induced by sport-specific exercises and their effects on athletic performance. While an enhancement in athletic performance is often attributed to an improvement of neuromuscular functions induced by sport-specific balance exercises, it can be equally well ascribed to their improvement by general body conditioning exercises. Therefore, the relevant experiments have yet to be conducted to investigate the relative contributions of each of these exercises to improving athletic performance.
Though pain is a frequent symptom of long COVID-19, little attention has been paid to vertebral algic syndrome. Therefore, we present the cases reports of two precisely selected physically active patients where vertebral algic syndrome and radiculopathy dramatically worsened in acute SARS-CoV-2 infections. The vertebral pain with radicular irritation was resistant to conservative treatment in chronic post-COVID syndrome. The neurological difficulties corresponded to the radiologic imaging presented on MRI scans. Due to the absence of standard therapeutic guidelines in literature sources, it was decided to provide routine therapeutic procedures. Spinal surgery with radicular decompression was performed within 6 months after acute SARS-CoV-2 infection. This led to the improvement of their neurological status and was in corroboration with decreases of VAS (from 9 to 0 in Patient 1 and from 7 to 1 in Patient 2). Our experience indicates that these patients benefited from the standard neurosurgical radicular decompression, and sufficient pain relief was achieved; nevertheless, the initial trigger of neurological worsening was acute SARS-CoV-2 infection.
COVID-19 , Radiculopathy , COVID-19/complications , Decompression, Surgical , Humans , Radiculopathy/surgery , SARS-CoV-2 , Post-Acute COVID-19 Syndrome
Aim: Afamin is a liver-produced glycoprotein, a potential early marker of metabolic syndrome. Here we investigated regulation of afamin in a course of the metabolic disease development and in response to 3-month exercise intervention. Methods: We measured whole-body insulin sensitivity (euglycemic hyperinsulinemic clamp), glucose tolerance, abdominal adiposity, hepatic lipid content (magnetic resonance imaging/spectroscopy), habitual physical activity (accelerometers) and serum afamin (enzyme-linked immunosorbent assay) in 71 middle-aged men with obesity, prediabetes and newly diagnosed type 2 diabetes. Effects of 3-month exercise were investigated in 22 overweight-to-obese middle-aged individuals (16M/6F). Results: Prediabetes and type 2 diabetes, but not obesity, were associated with increased serum afamin (p<0.001). Afamin correlated positively with hepatic lipids, fatty liver index and liver damage markers; with parameters of adiposity (waist circumference, %body fat, adipocyte diameter) and insulin resistance (fasting insulin, C-peptide, HOMA-IR; p<0.001 all). Moreover, afamin negatively correlated with whole-body insulin sensitivity (M-value/Insulin, p<0.001). Hepatic lipids and fasting insulinemia were the most important predictors of serum afamin, explaining >63% of its variability. Exercise-related changes in afamin were paralleled by reciprocal changes in insulinemia, insulin resistance and visceral adiposity. No significant change in hepatic lipid content was observed. Conclusions: Subjects with prediabetes and type 2 diabetes had the highest serum afamin levels. Afamin was more tightly related to hepatic lipid accumulation, liver damage and insulin resistance than to obesity.
Adiposity , Biomarkers/blood , Carrier Proteins/blood , Diabetes Mellitus, Type 2/diagnosis , Fatty Liver/diagnosis , Glycoproteins/blood , Obesity/physiopathology , Prediabetic State/diagnosis , Adult , Body Mass Index , Cross-Sectional Studies , Diabetes Mellitus, Type 2/blood , Fatty Liver/blood , Female , Follow-Up Studies , Humans , Insulin Resistance , Lipid Metabolism , Male , Prediabetic State/blood , Prognosis , Serum Albumin, Human
