Selective Strength Training Changes the Morphology and Ankle Strength of the Peroneus Longus and the Peroneus Brevis.

This study aimed to investigate the 8-week selective training effect of the peroneus longus (PL) and the peroneus brevis (PB) on muscle morphology, echogenicity, and ankle strength and to examine post-intervention detraining effects. Twenty healthy participants without orthopedic disease in the lower extremities were assigned to either the PL intervention group (training consisted of pushing the Thera-Band® out from the ball of the foot to emphasize ankle eversion) or the PB intervention group (training consisted of pulling the Thera-Band® from the base of the fifth metatarsal to enhance ankle valgus and external rotation). Each intervention was performed three times per week for 8 weeks. The cross-sectional area (CSA), thickness, echogenicity, and ankle strength of the PL and the PB were measured before week 1 and after each training session. Detraining effects were evaluated after the 8-week intervention. The results revealed a significant interaction between within-group (week) and between-group (type of intervention) variables on CSA and ankle strength of both the PL and the PB. Over the 8-week training period, the CSA and ankle strength of the PL significantly increased in the PL intervention group, as did the CSA and ankle strength of the PB in the PB intervention group (p < 0.05). The residual effect of muscle hypertrophy was observed during the detraining period. In conclusion, 8-week selective PL and PB training interventions can increase the CSA and ankle strength of these muscles over time. Long-term selective intervention is required to improve peroneus muscle morphology and function, with separate assessments of the CSA and ankle strength of the PL and the PB.

Adaptation of Postural Sway in a Standing Position during Tilted Video Viewing Using Virtual Reality: A Comparison between Younger and Older Adults.

This study aimed to investigate the effects of wearing virtual reality (VR) with a head-mounted display (HMD) on body sway in younger and older adults. A standing posture with eyes open without an HMD constituted the control condition. Wearing an HMD and viewing a 30°-tilt image and a 60°-tilt image in a resting standing position were the experimental conditions. Measurements were made using a force plate. All conditions were performed three times each and included the X-axis trajectory length (mm), Y-axis trajectory length (mm), total trajectory length (mm), trajectory length per unit time (mm/s), outer peripheral area (mm2), and rectangular area (mm2). The results showed a significant interaction between generation and condition in Y-axis trajectory length (mm) and total trajectory length (mm), with an increased body center-of-gravity sway during the viewing of tilted VR images in older adults than in younger adults in both sexes. The results of this study show that body sway can be induced by visual stimulation alone with VR without movement, suggesting the possibility of providing safe and simple balance training to older adults.

Head impact differences in blind football between Rio 2016 and Tokyo 2020 Paralympic Games: video-based observational study.

OBJECTIVE: In Tokyo 2020 Paralympic Games, there were the rule and goal size changes at the blind football competition. This study aimed to compare the scoring and head impact characteristics during blind football competition between the Rio 2016 and Tokyo 2020 Paralympic Games using the official videos. DESIGN: Video-based observational study. PARTICIPANTS: In total, 36 blind football (men's football 5-a-side) game videos were obtained from the official International Paralympic Committee. PRIMARY AND SECONDARY OUTCOME MEASURES: Head impact was defined as the sudden contact of any object with the head. Videos were analysed to assess the number of scores and head impacts along with their corresponding details (ie, round, playing phase, scoring situation, impact situation, occurrence area, impact object, head impact site, fall and foul). RESULTS: The total number of goals scored at the Tokyo 2020 Paralympic Games was nearly double that at the Rio 2016 Paralympic Games. Regarding head impacts, a total of 2036 cases (Rio 2016, n=1105; Tokyo 2020, n=931) were evaluated. Significant differences were observed in head impact characteristics between the Rio 2016 and Tokyo 2020 Paralympic Games among seven outcomes (round, scoring situation, impact situation, occurrence area, impact object, site of head impact and fall). CONCLUSIONS: Compared with the Rio 2016 Paralympic Games, the Tokyo 2020 Paralympic Games showed an increase in the number of points scored and different head impact characteristics.

First tarsometatarsal joint mobility in hallux valgus during gait: A synchronized ultrasound and three-dimensional motion capture analysis.

PURPOSE: To quantify the vertical translation between the first metatarsal and medial cuneiform during the stance phase of gait in young individuals with and without hallux valgus. DESIGN: This cross-sectional observational study included 34 young adults (male, n = 4; female, n = 30) who were divided into three groups according to the hallux valgus angle: control (< 20°, n = 13), mild hallux valgus (≥ 20° to < 30°, n = 12), and moderate hallux valgus (≥ 30°, n = 9). The mobility of the first tarsometatarsal joint was evaluated during the stance phase using B-mode ultrasound synchronized with a motion analysis system. RESULTS: The medial cuneiform shifted more plantar during the early phase in mild hallux valgus and during the middle and terminal phases in moderate hallux valgus than in control. The severity of the hallux valgus was correlated with a trend toward plantar shift of the medial cuneiform. The first metatarsal was located more dorsal than the medial cuneiform; however, there was no significant variation. No significant differences in the peak ankle plantarflexion angle and moment were noted between the groups. CONCLUSION: The hypermobility of the first tarsometatarsal joint, especially plantar displacement of the medial cuneiform in the sagittal plane, was found in young individuals with hallux valgus during the stance phase of gait, and the mobility increased with the severity of hallux valgus. Our findings suggest the significance of preventing hallux valgus deformity early in life.

Relationship between foot morphologic characteristic and postural control after jump-landing in youth competitive athletes.

BACKGROUND: Foot arch dynamics play an important role in dynamic postural control. Association between foot arch dynamics and postural control among adolescent athletes remains poorly explored. OBJECTIVE: To examine the relationship between foot arch dynamics, intrinsic foot muscle (IFM) morphology, and toe flexor strength and dynamic postural stability after jump landing and repetitive rebound jump performance in competitive adolescent athletes. METHODS: Based on foot arch dynamics, evaluated from relative change in the foot arch height in sitting and standing positions, 50 adolescent athletes were classified as stiff, normal, or flexible. IFM morphology was evaluated by ultrasonography. Dynamic postural stability index (DPSI) was measured as participants jumped and landed with the right leg onto a force plate, whereas repetitive rebound jumping performance was assessed using the jump height and reactive jump index. RESULTS: The stiff group had a significantly worse DPSI and vertical stability index than the normal group (p= 0.26, p= 0.44, respectively), and worse anteroposterior stability index (APSI) values than the flexible group (p= 0.005). Multivariate regression models of the relationship between the APSI and foot arch dynamics showed adequate power (probability of error = 0.912). CONCLUSIONS: Increased foot arch stiffness negatively affects dynamic balance during jump-landing, which may deteriorate their performance.

Relationship of Chronic Ankle Instability With Foot Alignment and Dynamic Postural Stability in Adolescent Competitive Athletes.

Background: Competitive adolescent athletes should be aware of the early signs of chronic ankle instability (CAI) and the connection between the condition and performance. Purpose: To investigate whether CAI is related to foot alignment and morphology as well as dynamic postural stability after a jump landing among adolescent competitive athletes with and without a history of a lateral ankle sprain and CAI. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Between July 2020 and August 2021, adolescent competitive athletes (N = 85; n = 49 boys; n = 36 girls) were classified into 3 groups using Cumberland Ankle Instability Tool (CAIT) scores: healthy athletes (n = 55), coper athletes (n = 19), and athletes with CAI (n = 11). Results of foot alignment assessments involving the leg-heel angle (LHA) and navicular height, intrinsic foot muscle morphology, dynamic postural stability index (DPSI), and other parameters were compared among the 3 groups. The relationship between the CAIT score and the LHA and dynamic postural stability and instability were examined using multiple linear regression. Results: Compared with the healthy group, the CAI group had a significantly greater LHA (8.73°± 3.22° vs 6.09°± 3.26°; P < .05), higher DPSI (0.336 ± 0.046 vs 0.298 ± 0.035), and higher vertical stability index (0.303 ± 0.048 vs 0.264 ± 0.037; P < .05 for all). Multiple regression analysis showed that the LHA (ß = -0.228; P = .033) and DPSI (ß = -0.240; P = .025) were significantly associated with the CAIT score . Conclusion: Valgus rearfoot alignment and poorer dynamic postural control were associated with CAI among adolescent athletes.

Acute Effects of Selective Strength Exercise on the Peroneus Longus and Brevis.

The peroneus muscles are muscles that mainly act in ankle eversion and can be divided into PL and PB, which have different but important roles in foot and ankle functions. Therefore, PL and PB dysfunction can lead to foot and ankle issues, making. selective strength exercise necessary. This study aimed to identify the effect of two different exercise techniques on PL and PB morphologies. Two interventions were performed on separate days: the PL intervention, in which a Thera-Band® was placed on the ball of the foot and pushed out from the contact point, and the PB intervention, in which the Thera-Band® was pulled from the base of the fifth metatarsal. Cross-sectional area (CSA) and thickness of the peroneus muscles at 25% (showing the PL morphology) and 75% (showing the PB morphology) proximal to the line connecting the fibular head and lateral malleolus, as well as ankle strength was measured before and immediately after the interventions and at 10, 20, and 30 min later. A repeated-measures two-way analysis of variance was conducted to identify differences in the effects of the interventions on the PL and PB. Main and interaction effects on CSA, thickness, and ankle strength, with a significant increase in CSA and thickness in the proximal 25% in the PL intervention and the distal 75% in the PB intervention immediately after implementation, were observed (p < 0.05). The transient increase in muscle volume due to edema immediately after exercise indicates the acute effect of exercise. The CSA and thickness of the proximal 25% in the PL intervention and the distal 75% in the PB intervention increased immediately after the intervention, indicating that these interventions can be used to selectively exercise the PL and PB.

The Features of Foot Morphology and Intrinsic Foot Muscle Property in Adolescent Swimmers: An Ultrasound-Based Study.

This cross-sectional study aimed to investigate the relationship between foot shape and intrinsic foot muscles (IFMs) in adolescent swimmers compared with other athletes. Foot morphology of swimmers was compared with other athletes of comparable age and a competition level (n = 32 [64 feet]; a total of 64 feet; 128 feet in two groups). Foot morphology and variables of IFMs were measured using a three-dimensional foot scanner and an ultrasound imaging system, respectively. Multiple linear regression analysis with forced entry was performed to clarify the association of the thickness and the cross-sectional area (CSA) of IMFs with the navicular height in both sitting and standing positions. Navicular height in a standing position, the thickness of the abductor hallucis (AbH) and the flexor digitorum brevis (FDB), as well as the CSA were significantly lower in swimmers compared with other athletes (p < 0.05). A larger CSA for the flexor hallucis brevis (FHB) was observed in swimmers than in other athletes (p < 0.01). The navicular height of swimmers in sitting and standing positions was positively correlated with the thickness and the CSA of the FHB and the FDB (p < 0.05). Multiple regression analysis showed that navicular height was associated with the CSA of the FDB in both sitting and standing positions (ß = 0.395; p < 0.002, ß = 0.201; p < 0.018). This study showed that the navicular height of elite adolescent swimmers was lower than that of other athletes. Furthermore, the swimmers' high navicular height was associated with the CSA of the FDB, suggesting that the FDB might be more involved in the formation of the medial longitudinal arch than the AbH.

Effects of Rearfoot Eversion on Foot Plantar Pressure and Spatiotemporal Gait Parameters in Adolescent Athletes.

BACKGROUND: Foot malalignment can augment the risk of lower-extremity injuries and lead to musculoskeletal disorders. This study aimed to clarify the contribution of rearfoot alignment to plantar pressure distribution and spatiotemporal parameters during gait in healthy adolescent athletes. METHODS: This retrospective study included 39 adolescent athletes who were divided into the rearfoot eversion and control groups according to a leg heel angle of 7°. A total of 78 legs were analyzed (45 and 33 legs in the rearfoot eversion [women, 53.3%] and control groups [women, 48.5%], respectively). Gait was assessed using an in-shoe plantar pressure measuring system and a wearable inertial sensor. RESULTS: The foot plantar pressure distribution in the hallux was higher in the rearfoot eversion group than that in the control group (p = 0.034). Spatiotemporal parameters showed that the foot pitch angle at heel strike was significantly larger in the rearfoot eversion group than that in the control group (24.5° vs. 21.7°; p = 0.015). Total sagittal range of motion of the ankle during the stance phase of gait was significantly larger in the rearfoot eversion group than that in the control group (102.5 ± 7.1° vs. 95.6 ± 15.8°; p = 0.020). Logistic regression analysis revealed that plantar pressure at the hallux and medial heel and foot pitch angle at heel strike were significantly associated with rearfoot eversion. CONCLUSIONS: Our findings suggest that rearfoot eversion affects the gait patterns of adolescent athletes. Notably, leg heel angle assessment, which is a simple and quick procedure, should be considered as an alternative screening tool for estimating plantar pressure and spatiotemporal gait parameters to prevent sports-related and overuse injuries in adolescent athletes.

Effect of postural differences on the activation of intrinsic foot muscles during ramp-up toe flexion in young men.

BACKGROUND: Intrinsic foot muscle exercises are used in clinical and sports practice to improve performance. Force generation during toe flexion is greater in the standing posture than in the sitting posture; nonetheless, the mechanism underlying the activation of intrinsic foot muscles during force generation and whether there exists a difference between these two postures still remain unclear. RESEARCH QUESTION: Are the activities of intrinsic foot muscles affected by standing and sitting postures during gradual force generation? METHODS: Seventeen men participated in the laboratory based cross-sectional study. Each participant performed a force ramp-up toe flexion task from 0% to 80% of the maximal toe flexor strength (MTFS) in sitting and standing postures. High-density surface electromyography signals obtained during the task were determined by calculating the root mean square (RMS). Additionally, modified entropy and coefficient of variation (CoV) were calculated at 20-80 % MTFS for each 10 % MTFS. RESULTS: The RMS between the two postures indicated an interaction effect (p < 0.01). Post-hoc analyses revealed that intrinsic foot muscle activity during the ramp-up task was significantly higher in the standing posture than in the sitting posture at 60 % MTFS (67.53 ± 15.91 vs 54.64 ± 19.28 % maximal voluntary contraction [MVC], p = 0.03), 70 % MTFS (78.11 ± 12.93 vs 63.28 ± 18.65 % MVC, p = 0.01), and 80 % MTFS (81.78 ± 14.07 vs 66.90 ± 20.32 % MVC, p = 0.02). In the standing posture, the modified entropy at 80 % MTFS was lower than that at 20 % MTFS (p = 0.03), and the CoV at 80 % MTFS was higher than that at 20 % MTFS (p = 0.03). SIGNIFICANCE: These results indicated that posture selection is important for high-intensity exercises of the intrinsic foot muscles, such as resistance training. Thus, improving performance related to toe flexor strength might be more effective when conducted under adequate weight-bearing situations, such as in the standing posture.

Characteristics of Wheelchair Basketball Falls During the Tokyo 2020 Paralympics by Sex and Physical Impairment Classification: A Video-Based Observational Study.

OBJECTIVE: The aim of the study is to evaluate the fall characteristics of wheelchair basketball players by sex and impairment classification using the official videos of the Tokyo 2020 Summer Paralympic Games. DESIGN: This was a video-based observational study. In total, 42 men's and 31 women's wheelchair basketball game videos were obtained from the official International Paralympic Committee. The videos were analyzed to assess the number of falls, playing time of the fall, playing phase, contact, foul judgment, fall location/direction, and the body part that first impacted the floor. RESULTS: A total of 1269 falls (men, n = 944; and women, n = 325) occurred. The analysis of men demonstrated significant differences in rounds, playing phase, location of fall, and body part first impacted. Women demonstrated significant differences in all categories except in rounds. Comparisons by functional impairment showed different trends for men and women. CONCLUSIONS: The detailed observation of videos suggested that men are more likely to have dangerous falls. There is a necessity for discuss the prevention measures based on sex and impairment classification.

Head Impact in Blind Football During the Tokyo Paralympics: Video-Based Observational Study.

ABSTRACT: Head impacts during blind football are common and have high injury rates; however, their characteristics and impact are still underreported. We compared head impact characteristics in blind football players with and without falls on all 18 official blind football match videos from the Tokyo 2020 Paralympic games. The rate of head impacts with falls was significantly higher in the preliminary phase, offense phase, and during dribbling. Significant differences in the region of the head impacted were also observed among the impact subjects/objects. The findings in this study would contribute to the development of injury prevention measures to minimize head injuries from head impact in blind football.

Association of the intrinsic foot muscles and plantar fascia with repetitive rebound jumping and jump landing in adolescent athletes: An ultrasound-based study.

BACKGROUND: The characteristics of foot structure in adolescents and adults are different, affecting sports performance and leading to the progression of foot and lower extremity disorders. RESEARCH QUESTION: This study aimed to investigate the relationship between the intrinsic foot muscles (IFM) and plantar fascia morphology and the repetitive rebound jumping and jump landing ability in adolescent athletes. METHODS: A total of 60 adolescent athletes (35 boys and 25 girls) participated in this study. B-mode ultrasonography was used to obtain images of the IFM and plantar fascia morphology [thickness and cross-sectional area (CSA) of the abductor hallucis (AbH), flexor hallucis brevis (FHB), flexor digitorum brevis (FDB), and thickness of the plantar fascia]. The repetitive rebound jump performance was evaluated using the Optojump™ system. Participants were instructed to jump five times continuously with one leg, jumping as high as possible with minimal ground contact time. The jump landing was assessed by measuring the dynamic posture stability index (DPSI) using forward one-legged jump landings. RESULTS: The thickness and CSA of the AbH and FDB were positively correlated with the jump height and reactive jump index. The DPSI score was significantly correlated with the thickness of the AbH, but not with other IFMs or plantar fascia. In the multiple regression analysis, only the thickness of the FDB was associated with the jump height and reactive jump index, indicating that FDB thickness might facilitate adolescent athletes to jump higher with minimal contact time in repetitive rebounding movements. SIGNIFICANCE: The IFM (especially FDB) should be focused on when examining sports performance in adolescent athletes.

Effect of flexion-resist and extension-assist knee orthosis on electromyographic activities of quadriceps during lateral stepping.

Knee orthoses can potentially reduce muscular activities of the quadriceps. The aim of this study was to investigate the effect of a custom flexion-resist and extension-assist knee orthosis on electromyographic activities of quadriceps during lateral stepping (step-up and step-down). Flexion resistance and extension assistance mechanisms were set by a pair of linear springs built into the orthotic knee joints. Electromyography (EMG) signals were collected from rectus femoris (RF), vastus medialis obliquus (VMO), and vastus lateralis (VL) during lateral step-up and lateral step-down activities in 7 healthy young adults. Peak normalized root mean square (RMS) EMG signals of each muscle, as well as VMO:VL ratio, were compared between orthotic and nonorthotic conditions using the Wilcoxon signed-rank test. The knee orthosis significantly reduced the normalized RMS EMG signals of the RF and VL during lateral stepping ( p < 0.05). No significant difference was found in the VMO. The VMO:VL ratio significantly ( p < 0.05) increased under orthotic condition. The experiments demonstrated that the knee orthosis reduces the peak normalized RMS EMG signals of RF and VL, and alter the VMO:VL ratio of quadriceps in healthy young adults. Therefore, this study suggests that the flexion-resist and extension-assist knee orthosis may be effective in reducing muscular activities of RF and VL, which may alleviate patellofemoral loading. Future studies should delve into the effects of the knee orthosis in individuals with patellofemoral pain.

Characteristics of Falls Among Men's Wheelchair Rugby Players in the Rio 2016 and Tokyo 2020 Summer Paralympic Games: A Video Analysis.

Wheelchair rugby is a contact sport in which falls are common and injury rates are high, yet the characteristics of the falls are still under-reported. We investigated the fall characteristics of men's wheelchair rugby players by functional classification, using all 36 official match videos from the Rio 2016 and Tokyo 2020 summer Paralympic Games. The videos were analyzed to evaluate the number of falls, playing time when the fall occurred, playing phase (offense or defense), contact with other players, foul judgement, direction of the fall, and the body part first in contact with the floor. All 182 men's wheelchair rugby players (Rio 2016, 94; Tokyo 2020, 88) were classified as low-point players or high-point players depending on their functional classification. A total of 200 falls were detected, 27 (13.5%) for low-point players and 173 (86.5%) for high-point players. Significant differences were noted between low-point players and high-point players in the direction of the fall and body part first in contact with the floor. High-point players had more falls in the forward and left-right directions, whereas low-point players were characterized by a higher percentage of falls in the left-right and backward directions. Additionally, high-point players landed on the floor with their hands with high frequency, whereas low-point players landed with their elbows and shoulders more often. Our findings suggest the significance of devising measures to prevent falls during men's wheelchair rugby games according to their functional classification.

Analysis of wheelchair falls in team sports at the Paralympic Games: video-based descriptive comparison between the Rio 2016 and Tokyo 2020 games.

OBJECTIVES: To identify the fall characteristics of athletes in wheelchair rugby and wheelchair basketball during the Tokyo 2020 Paralympic Games and descriptively compare these with those of the Rio 2016 Paralympic Games. DESIGN: Cross-sectional analysis. PRIMARY AND SECONDARY OUTCOME MEASURES: We obtained video footage from the International Paralympic Committee of the Tokyo 2020 Paralympic Games that included 8 teams from each of the 18 wheelchair rugby and 10 wheelchair basketball games (men and women). The data were analysed to evaluate the number of falls, class difference (low or high pointer), time of play during the fall, phase of play, contact with other athletes, fall direction, fall location and the body part that first contacted the floor during the fall. These data from the Rio 2016 and Tokyo 2020 games were compared. RESULTS: Overall, 430 falls (rugby, 104; men's basketball, 230 and women's basketball, 96) occurred (average per game ±SD: 5.8±3.1, 23.0±5.4 and 9.6±5.0, respectively). Significant differences in class, direction, fall location and body part point of contact between the three sports were observed. In wheelchair rugby, falls occurred mainly in high pointers and tended to be more lateral due to contact. In wheelchair basketball, falls occurred more in female high-pointers and in male low pointers, with more forward falls due to forward contact. Unlike in the Rio 2016 games, no difference between the events based on the presence or absence of contact was observed in the Tokyo 2020 games. CONCLUSIONS: The number of falls increased in Tokyo 2020 compared with Rio 2016, with no significant difference in the characteristics of falls between the Rio 2016 and Tokyo 2020 games. Only in men's wheelchair basketball, the number of falls in low pointers significantly increased in the Tokyo 2020 games when compared with that in the Rio 2016 games.

Quantitative evaluation of the vertical mobility of the first tarsometatarsal joint during stance phase of gait.

We determined how the in vivo mobility of the first tarsometatarsal (TMT) joint can be quantified during gait. Twenty-five healthy participants (12 females) with no history of foot disorders were included. Non-invasive ultrasound (US) with a three-dimensional motion analysis (MA) system was used to evaluate the kinematic characteristics of first TMT joint during stance phase of gait. US probe was positioned longitudinally above the first TMT joint and adjusted to its proximal dorsal prominence. Gait analysis was conducted by the MA system starting with the activation of B-mode US video at 80 frames per second and 60-mm depth for simultaneous capture. During stance phase, the first metatarsal was translated dorsally with respect to the medial cuneiform, returning to a neutral level at toe-off in all subjects. During middle stance phase, the medial cuneiform was stable in males but displaced in the plantar direction in females and was the primary contributor to the differences in sagittal mobility observed between groups. Quantitatively measuring sagittal mobility of the first TMT joint could be useful for the early detection of foot abnormalities. The dynamic characteristics of the medial cuneiform during gait in healthy females may be associated with a high prevalence of hallux valgus.

Effect of thoracic expansion restriction on scapulothoracic and glenohumeral joint motion during shoulder external rotation.

BACKGROUND: Shoulder external rotation in the throwing motion involves movement of the scapulothoracic and glenohumeral joints, thoracic spine, and the thorax. Restriction of thoracic expansion may decrease scapulothoracic joint motion and compensate by excessive glenohumeral joint motion. However, it is unclear how restricting the expansion of the thorax alters shoulder motion. OBJECTIVE: To elucidate changes in scapulothoracic and glenohumeral joint movements caused by restricted thoracic expansion. METHODS: Kinematic data were obtained using an electromagnetic tracking device (Liberty; Polhemus), from 18 male participants, during shoulder external rotation in the sitting position with and without restriction of thoracic expansion. The displacements from the start position to the maximum external rotation position were compared, and Pearson's correlation coefficient was calculated. RESULTS: A significant difference was observed in the scapulothoracic posterior tilt angle (P< 0.01) and glenohumeral external rotation angle (P< 0.01). A significant positive correlation existed between scapulothoracic posterior tilt and glenohumeral external rotation (P< 0.05) with and without restriction. CONCLUSIONS: Restriction of thoracic expansion decreased scapulothoracic motion and increased glenohumeral motion. Thus, a decrease in thoracic expansion may change scapulothoracic and glenohumeral movements, which may be a risk factor for throwing injuries.

Association between sedentary behavior and depression among Japanese medical students during the COVID-19 pandemic: a cross-sectional online survey.

BACKGROUND: Sedentary behavior, particularly prevalent during the 2019 coronavirus disease (COVID-19), has been shown to lead to depression. In medical students, this could negatively affect the provision of healthcare. Thus, this study aimed to investigate the association between sedentary behavior and depression in Japanese medical students during the COVID-19 pandemic. METHODS: An online cross-sectional survey was conducted from July 30 to August 30, 2021, using anonymous questionnaire system to assess respondents' sociodemographic characteristics, physical activity, sedentary behavior among 1000 Japanese university students. Depression was assessed using the Patient Health Questionnaire-2 (PHQ-2). The data of 484 respondents (48.4%) were included in a stepwise analysis, where we set the difference between medical and non-medical students as Model 1 and that between medical students with and without depression as Model 2. For group comparisons of both models, the chi-square test was used for sociodemographic characteristics, and the Mann-Whitney U-test was used for physical activity and sedentary behavior. In Model 2, factors associated with depression among medical students were analyzed by logistic regression analysis. RESULTS: In Model 1, medical students were less physically active (p < 0.001), had longer sedentary time (p < 0.001), and had higher PHQ-2 scores (p = 0.048) than non-medical students. In Model 2, medical students with depression had longer sedentary time (p = 0.004) and longer leisure screen time than those without depression (p = 0.007). Moreover, logistic regression analysis adjusted for potential confounders showed that sedentary time (OR = 1.001, p = 0.048) and leisure screen time (OR = 1.003, p = 0.003) were significantly associated with depression among medical students. CONCLUSIONS: Based on these results, it is evident that reducing Japanese medical students' sedentary time and leisure screen time can help combat depression during the COVID-19 pandemic; thus, these results can guide the development of appropriate interventions to prevent and treat depression.

Willingness to Receive the COVID-19 Vaccination and the Psychological State of Japanese University Students: A Cross-Sectional Study.

Vaccinations may be one of the solutions to end the COVID-19 pandemic. One's psychological state may be strongly related to one's willingness to be vaccinated. This study investigated the relationship between the psychological state of Japanese university students and their willingness to be vaccinated. A self-report questionnaire on COVID-19, its vaccines (vaccination status, and perceived efficacy and safety), and psychological state (anxiety and depressive mood) was administered online, and 560 valid responses were obtained. The unvaccinated group reported significantly lower perceived vaccine effectiveness and importance than the vaccinated group. However, there were no differences in anxiety and depressive mood symptoms between the two groups. Multivariate logistic regression analysis was performed on the unvaccinated participants to identify the factors associated with their unwillingness to be vaccinated; there was a significant association between anxiety and unwillingness to receive the vaccine (p < 0.05). However, there was no significant association between depressive mood and unwillingness to receive the vaccine. The results suggest that timely psychological support for Japanese university students experiencing high levels of anxiety is important in accelerating vaccination programs.