Lateral collateral ligament complex insufficiency in recalcitrant lateral epicondylitis: MRI evaluation with arthroscopic findings.

PURPOSE: To evaluate the concomitant pathology in recalcitrant LE using MRI with arthroscopic finding correlation. METHODS: A total of 49 patients were diagnosed with chronic recalcitrant LE and divided into two: LCL complex-intact and LCL complex-involved groups by evaluating MRI as confirmed by a radiologist. Patient information for the history of steroid injection and symptom duration was extracted from the medical records. Arthroscopic images taken during arthroscopic extensor carpi radialis brevis release were evaluated to assess the quality of lateral capsule and concomitant plica. RESULTS: A total of 24 and 25 patients were included in the LCL-intact and LCL-involved groups, respectively. Among them, seven had complete RCL tears recorded in the LCL-involved group. Symptom duration (15 ± 9 vs. 22 ± 13, p = 0.029) and the number of steroid injections (3 ± 2 vs. 5 ± 3, p = 0.040) were significantly higher in the LCL-involved group than that in the LCL-intact group. A capsular tear was detected for 5 (20%) patients in the LCL-intact and 14 (56%) in the LCL-involved group (p = 0.027). Concomitant plica was observed in 15 (62%) patients in LCL-intact and seven (28%) in the LCL-involved group (p = 0.015). RC joint widening was observed in four patients in the LCL-involved group. CONCLUSION: The recalcitrant LE is highly a concomitant pathology including LCL complex insufficiency and pathologic elbow plica lesion. The risk factors of LCL insufficiency associated with refractory LE may include multiple steroid injections. Arthroscopic finding such as capsular tears and elbow drive-through signs can be suspected signs for LCL complex insufficiency.

Determining the tactical and technical level of competitive tennis players using a competency model: a systematic review.

Introduction: The aim of this systematic review is to provide an evidence-based synthesis of the literature on the topic of technical and tactical competencies of tennis players and to answer the following research questions: (1) What is the state of the art of research on technical and tactical competencies (i.e., skills and knowledge) and tennis; (2) What are the most important topics related to technical and tactical competencies in tennis players. Methods: Electronic searches were conducted in Web of Science, PubMED and SPORTDiscus (August to September 2023). This systematic review was conducted in accordance with PRISMA guidelines. To reduce risk, all published literature was searched and primary studies were included. The search terms included skills or competencies, match or play, player and tennis and excluded studies on non-competitive tennis players-notation analysis, AI method, systematic review and validation of tools. Results and discussion: Of the 390 publications found in these searches, 13 articles were considered relevant and included in this study. They were divided into three categories: (1) technical-tactical skills, (2) match situations and (3) match performance. There was clear evidence that there is a test instrument for analyzing tactical-technical skills that has sufficient reliability and validity and is of practical value to tennis coaches. The development of tactical-technical skills is influenced by method (variability between/within skills), conditions (court size, ball type) and areas of development (situational awareness, anticipation, decision making). There are differences in match and stroke performance between different quality groups (professionals, juniors), which can also be influenced by mental strength. For a comprehensive study of tennis players' abilities, the use of modern technologies is possible and necessary in the future. Future research should focus on the creation of competency models for the playing level of tennis players, which could include at least three key elements: (1) key competencies, (2) description of standards, (3) evidence.

Effects of low-volume court-based sprint interval training on anaerobic capacity and sport-specific performance in competitive tennis players.

Sprint interval training (SIT) is a potent exercise strategy to enhance athletes' anaerobic capacity in a time-efficient manner. This study aimed to investigate the impact of low-volume, court-based SIT on the anaerobic capacity and sport-specific performance in competitive tennis players. Twenty-four competitive collegiate tennis players were randomly assigned to either the SIT group (n = 12; three sessions per week of court-based repeated-sprint training) or the traditional endurance training (ET) group (n = 12; three sessions per week of 45-min continuous treadmill running, n = 12) for a 6-weeks intervention. Baseline and post-intervention assessments included the Wingate Anaerobic Test, elimination rate of blood lactate (BLAer), tennis-specific repeated sprint ability (RSA), and the Yo-Yo Intermittent Recovery Test Level 2 (YoYo-IR2). The results showed that SIT group demonstrated significant improvements in peak and average power during the Wingate test (p = 0.07; p < 0.001), along with a notable increase in YoYo-IR2 performance (7.8% increase, p = 0.04). Significant decreases were observed in both mean (5.1% decrease, p = 0.02) and sum RSA time (5.2% decrease, p = 0.02) in the tennis-specific RSA assessments. Additionally, the SIT group showed significantly higher effective training time and TRIMP in the 90-100% HRmax zone compared to the ET group (p < 0.01). This study underscores the potential benefits of low-volume, court-based SIT in enhancing anaerobic capacity and sport-specific performance in competitive tennis players, in comparison to traditional ET.

Tennis Coaches' Self-Determined Motivation and Achievement Goals: Links between Coach-Created Motivational Climate, Work Engagement, and Well-Being.

Tennis coaches display significant influence, catalyzing changes in athlete performance, motivation, and overall well-being. Research on coaches' motivations and their impact on coaching style, work, and well-being is limited, especially in individual sports like tennis. Based on self-determination (SDT) and achievement goal (AGT) theories, the aim of the present study was to examine the relationships of coaches' self-determined motivation (intrinsic, extrinsic, and amotivation), basic psychological needs satisfaction (autonomy, relatedness, and competence), and achievement goals (self-improvement-SI, self-enhancement-SE, self-transcendence-ST) with their coach-created empowering-disempowering motivational climate, work engagement, and well-being (subjective vitality). Participants were 106 tennis coaches from Greece (66 males and 40 females), with an average age of 41.30 ± 12.54 years and coaching experience ranging from six months to 40 years. Data was collected through online questionnaires. Correlation analysis revealed that intrinsic and extrinsic motivation, satisfaction of the three basic psychological needs, and achievement goals were found to be positively related to an empowering climate, work engagement, and subjective vitality. Coaches' amotivation was positively related to a disempowering climate. Multiple regression analyses showed that autonomy and ST achievement goals significantly predicted tennis coaches' empowering motivational climate, while none of the independent variables were significant predictors of the disempowering motivational climate. Additionally, intrinsic motivation and ST goal significantly predicted tennis coaches' work engagement, while autonomy and ST goal significantly predicted their subjective vitality. It is advisable for forthcoming coach education initiatives to consider these findings as an additional justification for tennis coaches to incorporate multiple perspectives into their coaching methodologies.

Benefits of Table Tennis for Children and Adolescents: A Narrative Review.

This study aims to review the scientific evidence regarding the effects of table tennis practice on children and adolescents. Studies were searched in three electronic databases (PubMed, Scopus, and SportDiscus) from their inception up to May 2024. The methodological quality of the included studies was assessed using the 10-point Physiotherapy Evidence Database (PEDro) and Methodological Index for Non-Randomized Studies (MINORS). A total of twelve studies were examined, with interventions involving children with intellectual disabilities, ADHD, DCD, ASD, and typically developing children. A variety of training programs were assessed over durations ranging from 6 weeks to 1 year in the studies included. Table tennis was shown to positively impact various domains, including executive function, motor skills, visual perception, graphomotor function, gross motor skills, coordination capacity, behavioral inhibition, and social behavior. Nonetheless, it is imperative to expand the number of studies on children and adolescents with diverse conditions to more comprehensively evaluate the benefits of table tennis for each specific condition.

Relationship between Interlimb Asymmetries and Performance Variables in Adolescent Tennis Players.

Tennis is an individual sport characterised by high-intensity action, including sprints and changes of direction (COD). However, there is a gap in the knowledge of limb asymmetries in adolescent tennis players and their association with performance. The aim of this study was to investigate the relationship between asymmetry in vertical and horizontal jump tests (CMJ and HJ) and COD with lower limb performance variables in adolescent tennis players. Forty-five adolescent tennis players (age: 13.81 ± 1.08 years; height: 167.64 ± 9.9 cm; body mass: 57.48 ± 10.94 kg; body mass index: 20.27 ± 2.18 kg/m2) performed the CMJ test (unilateral and bilateral), horizontal jumps (unilateral and bilateral), 25 m sprint, and 180° COD test. The single-leg countermovement jump showed the greatest asymmetries among the different tests (6.62 ± 9.35%). Notable negative relationships were found between CMJ asymmetry and COD asymmetry with unilateral horizontal jump variables (r = -0.30 to -0.53). In addition, CMJ asymmetry showed notable relationships with CMJR (r = 0.49) and COD180R (r = 0.29), whereas COD asymmetry showed a notable relationship with COD180L (r = 0.40). On the other hand, HJ asymmetry showed no notable relationships with any variable. The main findings of this study indicate that greater imbalances in the CMJ and COD tests are associated with a reduced capacity to perform unilateral horizontal jumps. These results suggest the incorporation of training protocols to reduce interlimb asymmetries in growing athletes to improve their performance. This practical application is important for coaches and physical trainers who aim to improve the physical performance of adolescent tennis players. Greater asymmetry results in a reduced ability to produce unilateral horizontal force.

Enhancing Tennis Practice: Sensor Fusion and Pose Estimation with a Smart Tennis Ball.

This article demonstrates the integration of sensor fusion for pose estimation and data collection in tennis balls, aiming to create a smaller, less intrusive form factor for use in progressive learning during tennis practice. The study outlines the design and implementation of the Bosch BNO055 smart sensor, which features built-in managed sensor fusion capabilities. The article also discusses deriving additional data using various mathematical and simulation methods to present relevant orientation information from the sensor in Unity. Embedded within a Vermont practice foam tennis ball, the final prototype product communicates with Unity on a laptop via Bluetooth. The Unity interface effectively visualizes the ball's rotation, the resultant acceleration direction, rotations per minute (RPM), and the orientation relative to gravity. The system successfully demonstrates accurate RPM measurement, provides real-time visualization of ball spin and offers a pathway for innovative applications in tennis training technology.

High Neural Efficiency in Unconscious Perceptual Processing among Table Tennis Athletes: An Event-Related Potential Study.

BACKGROUND: Neural efficiency refers to the brain's ability to function with reduced resource expenditure while maintaining high performance levels. Previous research has demonstrated that table tennis athletes have greater neural efficiency at the conscious level. However, it is unknown whether they exhibit greater neural efficiency at the unconscious level. Therefore, this study aims to investigate unconscious perceptual processing and neural efficiency in elite table tennis athletes through tasks involving the judgment of spin serves. METHODS: Fifty healthy, right-handed individuals participated in this study, including 25 elite table tennis athletes and 25 control participants without professional training experience. To evaluate the unconscious perceptual characteristics of both groups, we used a combination of masked priming paradigm and event-related potential techniques. RESULTS: The behavioral results reveal that, compared to the control group, the table tennis athletes displayed reduced reaction times (p < 0.001) and increased priming effects (p < 0.001) under unconscious conditions. The electrophysiological findings indicated that both groups elicited N1, N2, and P2 components. Notably, compared to the control group, the table tennis athletes exhibited significantly lower amplitude responses at the occipital lobe electrodes PO3, POz, PO4, O1, Oz, and O2 (p < 0.001). CONCLUSIONS: These results further support the neural efficiency hypothesis, indicating that prolonged professional training enhances athletes' capacities for specialized unconscious cognitive processing.

Physiotherapy practices in the clinical assessment of lateral elbow tendinopathy: An international survey.

BACKGROUND AND PURPOSE: Understanding physiotherapy practices is important to identify variations from empirical evidence and highlight requirements for training. This survey explored international physiotherapy practices for assessment of lateral elbow tendinopathy (LET). METHODS: Two hundred ninety-nine surveyed physiotherapists from eight member countries of the International Federation of Manual and Orthopaedic Physical Therapists completed the survey. Respondents rated their frequency of use (never, rarely, sometimes, often, and always) for items related to: patient history; diagnostic tests; grip and upper limb strength; cervical and neurological assessment; and medical imaging. To establish practices, the five response categories were dichotomised into routine practice (often, always) and not-routine practice (sometimes, rarely, never). A response rate of ≥70% for each dichotomy was used to determine whether an assessment item was deemed routine practice or not, with items not meeting either criterion considered neither routine nor not-routine practice. RESULTS: Most respondents were from United States (63%). The 'chair pick up test', 'cervical special tests', and 'plain radiograph' met our criteria for not routine practice (i.e., 70%, 72%, and 71%, respectively). All other assessment items did not meet the criteria to be considered routine or not-routine practice. CONCLUSION: The chair pick-up test, cervical spine special tests (e.g., Spurling's test), and plain radiography appear to not be routinely used in the assessment of LET. The finding that no assessment technique met the criteria for routine use may imply that physiotherapists adopt a nuanced approach to selecting clinical assessment items as opposed to routinely applying tests.

Kinematics characteristics of key point of interest during tennis serve among tennis players: a systematic review and meta-analysis.

The objective of this systematic review and meta-analysis was to provide an overview of kinematic parameters associated with key points of interest in the tennis serve. The research was conducted according to the PRISMA guideline without date restriction. Google scholar, Science Direct, PubMed/Medline, Mendeley, and Science.gov databases were scanned to find relevant studies. Only English peer-review original article focused on joint body angles at trophy position, racket low point and ball impact were retained. The review, quality appraisal, and data extraction from selected studies were performed independently by two reviewers. A meta-analysis was carried out on the most studied joint parameters. Among the 2,844 records identified, 27 articles were included. The wide variety of methods used required data homogenization for comparison purposes. Trunk inclination (25.0 ± 7.1°) and front knee flexion (64.5 ± 9.7°) were the most studied parameters for trophy position. Shoulder lateral rotation (130.1 ± 26.5°) was systematically evaluated for racket low point. At ball impact, shoulder elevation (110.7 ± 16.9°) and elbow flexion (30.1 ± 15.9°) were the most considered joint angles. The systematic review revealed that many kinematic parameters were not quantified at the various key points of interest. Knowledge of the kinematics is essential for understanding the gesture, implementing training methods, and improving the performance.

Tennis player actions dataset for human pose estimation.

Tennis is a popular sport, and integrating modern technological advancements can greatly enhance player training. Human pose estimation has seen substantial developments recently, driven by progress in deep learning. The dataset described in this paper was compiled from videos of researchers' friend playing tennis. These videos were retrieved frame by frame to categorize various tennis movements, and human skeleton joints were annotated using COCO-Annotator to generate labelled JSON files. By combining these JSON files with the classified image set, we constructed the dataset for this paper. This dataset enables the training and validation of four tennis postures, forehand shot, backhand shot, ready position, and serves, using deep learning models (such as OpenPose). The researchers believe that this dataset will be a valuable asset to the tennis community and human pose estimation field, fostering innovation and excellence in the sport.

Effects of extracorporeal shockwave therapy versus ultrasonic therapy and deep friction massage in the management of lateral epicondylitis: a randomized clinical trial.

The study's goal was to compare and evaluate the benefits of deep friction massage and ultrasonic therapy (US) vs extracorporeal shockwave therapy (ESWT) for people with lateral epicondylitis. This double-blind, parallel-arm randomized clinical trial was conducted after ethical approval on a sample of 80 subjects with lateral epicondylitis. Participants were enrolled based on predefined eligibility criteria. They were randomly allocated to groups A and B. Group A received ESWT, while Group B received the US combined with deep friction massage. Data was collected using the Numeric Pain Rating Score (NPRS) and Patient-rated tennis elbow evaluation questionnaire (PRTEE) at baseline, at 3rd, and at 7th week of treatment. On the basis of the normality of the data, a non-parametric test was applied to evaluate between-group and within-group differences. P value ≤ 0.05 was considered significant. There was a significant difference between groups (p < 0.001). Comparisons of PRTEE scores at 3rd week and 7th week of intervention were found significant for both groups (p < 0.001). While considering between-group comparisons based on percentile scores of PRTEE at baseline, 3rd and 7th week of intervention, in group A Median (IQR) at the baseline was 24.00 (5.00), at 3rd week, 10.00 (5.00) and 7th week was 1.50 (2.50) and in group B Median (IQR) at the baseline was 25.00 (4.00), at 3rd week 19.50 (4.50) and at 7th week was 11.50 (2.50). The results were significant in both groups (p = 0.000), but between-group analysis revealed that ESWT is more effective in patients with lateral epicondylitis.

Using wet-bulb globe temperature meters to examine the effect of heat on various tennis court surfaces.

In this study, we evaluated the thermal environments of different tennis courts using wet-bulb globe temperature (WBGT) meters. WBGT meters were installed in an outdoor hard court, sand-filled artificial grass court, and clay court (a softball field), and measurements were taken hourly from 9:00 to 17:00 on weekdays from June 1 to September 21, 2022. The results were compared with data from different courts and the nearest Japan Meteorological Agency station (JMA WBGT) based on the Japan Sports Association's guidelines for exercise to prevent heat stroke. The median WBGT on each court was significantly higher for hard courts at the "Warning" (25 ≤ JMA WBGT < 28) level or above, sand-filled artificial grass courts at the "Severe Warning" (28 ≤ JMA WBGT < 31) level or above, and clay courts at the "Danger" (31 ≤ JMA WBGT) level than the JMA WBGT. Compared with the JMA WBGT, hard and sand-filled artificial grass courts are played on under particularly hot conditions. The results of this study could indicate to tournament organizers and coaches the importance of measuring the WBGT on each court surface from an early stage to prevent heat-related incidents.

Preliminary Application of Infrared Thermography to Monitoring of Skin Temperature Asymmetries in Professional Padel Players.

The aim of the present study was to evaluate skin temperature (Tsk) asymmetries, using infrared thermography, in professional padel players before (PRE), after (POST) and 10 min after training (POST10), and their relationship with perceptual variables and training characteristics. Thermal images were taken of 10 players before, after and 10 min after a standardized technical training. After training, Tsk of the dominant side was higher than before training in the anterior forearm (30.8 ± 0.4 °C vs. 29.1 ± 1.2 °C, p < 0.01; ES = 1.9), anterior shoulder (31.6 ± 0.6 °C vs. 30.9 ± 0.6 °C, p < 0.05; ES = 1.0) posterior arm (29.5 ± 1.0 °C vs. 28.3 ± 1.2 °C, p < 0.05; ES = 1.0), and posterior forearm (30.8 ± 0.9 °C vs. 29.3 ± 1.6 °C, p < 0.05; ES = 1.1). Likewise, these differences were significant POST10 in the anterior arm, anterior forearm, anterior shoulder, posterior arm and posterior forearm. Comparing the different moments of measurement (PRE, POST and POST10), the temperature was higher POST10 in all the regions analyzed except for the shoulder, abdominals, and lower back. Also, correlations were found between fatigue variation and temperature variation between limbs (Tsk dominance), and no correlation was found except between age and posterior thigh (|r| = 0.69; p < 0.05), and between the racket mass and anterior knee (|r| = 0.81; p < 0.01). In conclusion, infrared thermography allows monitoring of skin asymmetries between limbs in professional padel players, but these asymmetries were not related to overall fatigue variation, overall pain variation, years of experience and training hours.

Tennis Injuries Among German League Players: Investigating Patterns and Epidemiology of Acute and Chronic Injuries.

Purpose: While injuries among elite tennis athletes are extensively documented, a notable research gap exists regarding tennis injuries among club-level players. This study examines tennis injuries in German league players, with a particular emphasis on the impact of racquet properties and court surfaces, distinguishing between chronic and acute injuries. Patients and Methods: Retrospectively analyzing data from 600 tennis players over a 1.5-year period, a standardized questionnaire covered anthropometrics, injury characteristics, equipment usage, and court surface conditions. Results: The study identified 1012 tennis-related injuries, averaging 1.7 per player. Acute injuries predominantly affected the lower extremity (56%), with ankle injuries being the most prevalent, and ligaments were the most commonly affected structures (36.4%). Chronic complaints (reported by 364 athletes) focused on the upper extremity (63.2%), primarily tendon injuries (56.8%). Racket properties exhibited no significant impact on chronic upper extremity injuries. Conclusion: This study highlights a high incidence of acute lower extremity injuries, especially ankle ligament injuries, among German league tennis players. It offers crucial insights for devising targeted injury prevention strategies applicable to amateur, semi-professional, and professional tennis players, despite finding no significant link between racquet material and chronic upper extremity injuries.

Comparing autologous blood, corticosteroid, and a combined injection of both for treating lateral epicondylitis: a randomized clinical trial.

BACKGROUND: Because lateral epicondylitis is a common musculoskeletal disorder that affects the forearm's extensor tendons, an effective therapeutic approach should reverse the degeneration and promote regeneration. This study aimed to compare the efficacies of autologous blood (AB) injection, corticosteroid (CS) injection, and a combined injection of both in treating lateral epicondylitis (LE), hypothesizing that the combined approach might offer immediate symptom resolution and a lower recurrence. MATERIALS AND METHODS: A total of 120 patients diagnosed with lateral epicondylitis were systematically distributed among three distinct therapeutic injection groups. Those in the AB group were administered 1 ml of autologous venous blood mixed with 2 ml of 2% prilocaine HCl. Participants in the CS category were given 1 ml of 40 mg methylprednisolone acetate mixed with 2 ml of 2% prilocaine HCl. Meanwhile, patients in the combined group received a mixture containing 1 ml each of autologous venous blood and 40 mg methylprednisolone acetate along with 1 ml of 2% prilocaine HCl. Prior to receiving their respective injections, a comprehensive assessment of all participants was carried out. Follow-up assessments were subsequently conducted on days 15, 30, and 90 utilizing metrics of the patient-rated tennis elbow evaluation (PRTEE) and measurements of hand grip strength (HGS). RESULTS: One patient dropped out from the combined group, and 119 patients completed the trial. No complications were recorded during the course of follow-up. By day 15, all groups had demonstrated significant PRTEE improvement, with CS showing the most pronounced reduction (p = 0.001). However, the benefits of CS had deteriorated by day 30 and had deteriorated further by day 90. The AB and AB + CS groups demonstrated sustained improvement, with AB + CS revealing the most effective treatment, achieving a clinically significant improvement in 97.4% of the patients. The improved HGS parallelled the functional enhancements, as it was more substantial in the AB and AB + CS groups (p = 0.001), corroborating the sustained benefits of these treatments. CONCLUSIONS: The study concluded that while AB and CS individually offer distinct benefits, a combined AB + CS approach optimizes therapeutic outcomes, providing swift and sustained functional improvement with a lower recurrence rate. These findings have substantial clinical implications, suggesting a balanced, multimodal treatment strategy for enhanced patient recovery in LE. LEVEL OF EVIDENCE: Randomized clinical trial, level 1 evidence. TRIAL REGISTRATION: NCT06236178.

The mediating effect of job involvement in the relationship between tennis Instructors' perceived organizational justice and turnover intentions: a multi-group analysis across generations.

Introduction: This study aimed to analyze the role of job involvement as a mediator in the relationship between tennis coaches' perceived organizational justice and their intention to leave, considering the unique professional context and demands of tennis coaching. Additionally, it sought to identify any generational differences in this model. The research categorizes perceived organizational justice into procedural and distributive justice, and job involvement into job attachment and job commitment. Methods: The study incorporated data from 201 coaches working at commercial tennis facilities nationwide. Perceived organizational justice and job involvement were measured using validated scales. The mediation model was tested using structural equation modeling (SEM), and a multi-group analysis was conducted to identify generational differences. Results: Results indicated that job involvement partially mediated the relationship between perceived organizational justice and turnover intentions, with distributive justice having a stronger total effect. The multi-group analysis revealed generational variances: distributive justice influenced turnover intentions more among the MZ generation, while procedural justice had a greater impact on the older generation. Discussion: These findings offer valuable insights for commercial tennis facilities aiming to reduce turnover and manage generational conflicts. Understanding the differential impacts of procedural and distributive justice on various generations can help tailor strategies to enhance organizational operation and employee retention. Conclusion: The study highlights the importance of perceived organizational justice and job involvement in influencing tennis coaches' turnover intentions. The generational differences observed suggest that targeted interventions based on generational characteristics can be effective in reducing turnover and improving organizational stability. Future research should explore other potential mediators and extend the model to different sports and organizational contexts.

Efficacy of Plyometric and TheraBand FlexBar Exercises in Tennis Elbow Patients: A Comparative Study.

Background Lateral epicondylitis is a common condition involving the arm. It is caused by degenerative changes or overuse of the tendon connecting the elbow joint to the forearm muscle. Plyometric and TheraBand FlexBar (Theraband, Akron, OH, USA) exercises can relieve elbow discomfort, soreness, and weakness. This study examines the effects of plyometric and TheraBand FlexBar exercises with ultrasound on tennis elbow patients. Methodology It is an experimental study comprising a total of 30 participants, including individuals of both genders with age groups of 20-40 years were selected by specific criteria for inclusion and exclusion. The participants were randomly assigned into two groups. Group A received plyometric exercises with ultrasound, whereas Group B received TheraBand FlexBar exercises with ultrasound. The outcome measures utilized in this study include patient-rated tennis elbow evaluation (PRTEE) and visual analog scale (VAS) for evaluating the functional disability of the hand, arm, and shoulder. Results The results showed a substantial reduction in mean values in Group A compared to Group B, with a p-value of less than 0.001, indicating that plyometric exercises with ultrasound were more effective than TheraBand FlexBar exercises. Conclusion Plyometric exercises combined with ultrasound therapy demonstrated significant reductions in discomfort and improvements in function, with plyometric exercises showing superior efficacy compared to TheraBand FlexBar exercises.

Assessment of the intensity and attractiveness of physical exercise while playing table tennis in an immersive virtual environment depending on the game mode.

BACKGROUND: It appears that active video games (AVGs) and training apps that allow for physical activity (PA) in immersive virtual reality (VR) may be useful for sports, health-enhancing PA, and physical education (PE). Therefore, research is needed to identify their potential. OBJECTIVE: The study aimed to evaluate the intensity and attractiveness of exercise during table tennis (TT) training in VR in arcade and simulation modes and to assess the potential for using such exercises in health-enhancing PA, sport, and PE. METHODS: The research used the Racket Fury: Table Tennis VR. Exercise intensity during TT training in VR was evaluated by heart rate (HR) monitoring and rating of perceived exertion (RPE 6-20). The effectiveness of short-term TT training in VR was estimated based on the user's performance in playing against an opponent with artificial intelligence (AI), satisfaction with playing TT was measured using the Physical Activity Enjoyment Scale (PACES), and the potential usefulness of the tested app in PA, sport, and PE was assessed based on a questionnaire for participating PE teachers (30 participants). RESULTS: PA intensity during TT training in VR expressed as a percentage of maximum heart rate (HRmax) was moderate but was significantly (p < 0.001; d=-0.830) higher in the easier arcade mode (69.50 ± 12.58%HRmax) than in the simulation mode (64.10 ± 9.67%HRmax). Despite the greater fatigue of respondents, user satisfaction was significantly higher in arcade mode. Users' performance when playing with AI was significantly better after 20 min of training in VR than before training. PE teachers recognize the great potential of the app. CONCLUSIONS: The application tested is characterized by a beneficial PA intensity, with its level depending on the game mode. Facilitating strokes during a game of virtual TT promotes increased intensity of exercise and increased enjoyment of the PA. Short-term TT training in VR improves playing skills in a virtual environment. PE teachers spoke highly of the app and recognized the potential for using VR technology in PA, sports, and school PE.