Isokinetic Knee Muscle Strength Parameters and Anthropometric Indices in Athletes with and without Hyperextended Knees.

Background and Objectives: Hypermobility has been linked to decreased knee performance, including isokinetic and isometric knee strength. This study aimed to determine whether athletes with and without knee hyperextension have different hamstring-to-quadriceps strength (H/Q) ratios and to investigate the associations between knee hyperextension indices and H/Q ratios and anthropometric characteristics. Materials and Methods: The sample consisted of 47 healthy male athletes without knee injuries aged 23.48 ± 3.54 years. The variables included the degree of knee hypermobility, isokinetic parameters of the leg musculature, and anthropometric indices. Differences between athletes with and without hyperextension were calculated using an independent sample t-test, effect sizes, and discriminant analysis, while associations between the variables were checked by Pearson's correlation coefficient and multiple regression analysis. Results: Athletes with hyperextended knees had shorter legs (t value = -2.23, p = 0.03, moderate ES) and shins (t = -2.64, p = 0.01, moderate ES) and a lower H/Q ratio at an angular velocity of 60°/s (t = -2.11, p = 0.04, moderate ES) than those in the nonhyperextended group did; these differences were supported by discriminant analysis (Wilks' L = 0.60, p = 0.01). An increase in the H/Q ratio at an angular velocity of 60°/s was associated with the degree of knee hypermobility (R = -0.29, p = 0.04). Conclusions: This research showed that athletes with knee hypermobility have weaker hamstring strength and thus a lower H/Q strength ratio at lower angular velocities. These findings suggest that targeted strength training programs for leg (i.e., hamstrings) muscles should help individuals with knee hypermobility.

Evaluation of Physical Literacy in 9- to 11-Year-Old Children: Reliability and Validity of Two Measurement Tools in Three Southeastern European Countries.

The awareness of the importance of physical literacy (PL) is globally increasing; however, knowledge of the applicability of PL measurement tools in southeastern Europe is limited. The aim of this study was to evaluate the reliability and validity of translated versions of the CAPL-2 and PLAYself questionnaires in 9- to 11-year-old elementary school children from Croatia, Bosnia and Herzegovina, and Montenegro. The participants were 303 children (141 girls; all 9 to 11 years of age) from Croatia (n = 71), Bosnia and Herzegovina (n = 162), and Montenegro (n = 70), enrolled in regular elementary school. The participants were tested throughout a test-retest procedure using two PL evaluation tools, i.e., the Canadian Assessment of Physical Literacy (shorter version, CAPL-2) and the Physical Literacy Assessment of Youth (PLAYself) questionnaires. With an intraclass correlation (ICC) of 0.70-0.80 for specific questionnaire subscales and 0.84 for the total score, PLAYself was found to be reliable. With Kappa values of 0.11-0.23 and a percentage of absolute agreement of less than 62%, CAPL-2 appeared to be less reliable. Factors related to sport participation were significantly positively associated with the PLAYself score, indicating its proper validity. In conclusion, we suggest the usage of the PLAYself questionnaire in further studies examining PL in children of a similar age in the region. Future studies in other age groups and languages are also warranted.

Injury Occurrence in Amateur Rugby: Prospective Analysis of Specific Predictors over One Half-Season.

Background and objectives: The incidence of injuries in rugby is extremely high, but studies have rarely examined the predictors of injury in amateur players. This study aimed to systematically analyse sports and injury factors as potential predictors of musculoskeletal injuries in senior-level amateur rugby players. Methods: The participants in this study were 101 senior-level rugby players from Croatia (average of 24.64 years old). At baseline, all participants were tested on sociodemographic and anthropometric parameters (age, body height and mass), consumption of dietary supplements, preseason injury status and training volume, and sport factors (position in game). Data on injury occurrence (dependent variable), prevalence of pain, training status, and characteristics of the played match were surveyed prospectively once a week during the three-month period (one half-season). Results: The logistic regression revealed a higher injury occurrence in forward players of the 1st row, 2nd row (OR = 5.07; 95% CI: 1.64-15.69), and center (OR = 4.72; 95% CI: 1.28-14.31), with reference to outside back players. When observed univariately, higher body mass, higher level of competition, more weekly training sessions, self-perceived pain, and playing with pain were significant injury risk factors. The multivariate logistic regression identified pre-season injury (OR = 1.30, 95% CI: 1.09-1.52), higher level of the game/match (OR = 1.44, 95% CI: 1.13-1.76), higher body mass (OR = 1.03, 95% CI: 1.01-1.05), and pain prevalence (OR = 5.71, 95% CI: 3.22-7.70) as multivariate predictors of injury occurrence over the season. Conclusion: The results of this study showed that among sport factors, the playing position, level of competition, and training exposure represent major injury risk factors. Therefore, in order to reduce the number of injuries, special emphasis should be placed on the specific tackling technique of forward players, which could both increase their situational efficiency and protect them from injuries. Additionally, perceived pain, injury history, and playing with injury were noted among injury factors as the ones that can be predictors of future injuries. In that manner, it is important that coaching and medical staff monitor players with previous injuries and with pain symptoms in order to act preventively against injury occurrence.

Specificity of the Associations between Indices of Cardiovascular Health with Health Literacy and Physical Literacy; A Cross-Sectional Study in Older Adolescents.

Background and Objectives: Cardiovascular health status (CVHS) is an important determinant of health, while it is theorized that health literacy (HL) and physical literacy (PL) could be directly related to CVHS. The aim of this study was to evaluate gender-specific associations between PL and HL and indices of CVHS in adolescence. Materials and Methods: The participants were 247 adolescents (177 females) from Split-Dalmatia county in Croatia who were tested on HL, PL, and CVHS (physical activity level (PAL) and lipid profile). The lipid profile included total cholesterol, triglycerides, high-density lipoproteins, non-high-density lipoprotein-cholesterol, and low-density lipoproteins. Gender-stratified multivariate cluster analysis (K-means clustering) was used to group participants into three homogenous groups on the basis of their HL and PL, while differences between clusters in CVHS were evidenced by analysis of the variance and consecutive post-hoc tests. Results: The lipid profile was better in girls with higher HL scores. Additionally, clusters consisting of participants with a better PL were characterized by higher PAL. We have found no evidence that HL is associated with PAL, while PL was not associated with the lipid profile. Conclusions: HL was specifically associated with direct indicators of health status (lipid profile) in girls, while PL was associated with PAL as a particular behavioral health indicator in both genders. The study highlights the necessity of including education of HL and PL in schools.

Are Health Literacy and Physical Literacy Independent Concepts? A Gender-Stratified Analysis in Medical School Students from Croatia.

Health literacy (HL) and physical literacy (PL) are concepts responsible for achieving and maintaining positive health behaviors. This study aimed to investigate gender-specific associations: (i) between PL and HL; and (ii) among HL, PL, and body composition. We observed 253 students attending health-area high schools from southern Croatia (181 girls; 16.9 ± 1.4 years). HL was assessed by the European Health Literacy Survey Questionnaire, PL by the PLAYself questionnaire, and body composition by bioimpedance analysis. The t-test was used to assess the differences between genders, and Pearson's correlation coefficients were calculated to establish the associations between variables. The results showed a similar level of HL (t-test = 0.2; p = 0.83) and PL (t-test = 0.01; p = 0.99) in boys and girls. Significant but small correlations were identified between HL and PL only in the girls (<10% of common variance). The body composition indices were significantly correlated with PL only in the boys (15−20% of common variance). Our research highlights the necessity of the independent evaluation of HL and PL in adolescence. Further studies evaluating other indices of health status in relation to PL and HL are warranted.

Echocardiographic Characterization of Left Heart Morphology and Function in Highly Trained Male Judo Athletes.

The long-term practice of judo can lead to various changes in the heart including increased dimensions of the left ventricle in diastole and thickening of the interventricular septum and the posterior wall of the left ventricle. This study aimed to assess left ventricular morphology and function in elite male judokas. A comparative cross-sectional study was conducted that included a total of 20 subjects, 10 judokas, and 10 healthy non-athletes aged 24 ± 2.85 years. Demographic and anthropometric data were analyzed. All subjects underwent a medical examination and a two-dimensional transthoracic echocardiogram. Different parameters of left ventricular morphology and function were measured and compared between athletes and non-athletes. Left ventricle mass and LV mass index were higher in judokas than in non-athletes (p < 0.05), as well as PW thickness (9.78 ± 0.89 mm vs. 8.95 ± 0.76 mm). A total of six (n = 6) of athletes had eccentric hypertrophy, while others had normal heart geometry. LVEDd, LVEDs, LVEDd/BSA, and LVEDs/BSA were significantly higher in judokas (p < 0.05). LVEDd in athletes ranged from 48 to 62 mm. These values, combined with normal diastolic function, ejection fraction, and shortening fraction, indicate that the judokas' cardiac adaptation was physiological rather than pathological.