Relationships of lower extremity and trunk asymmetries in elite soccer players.

In light of previous research highlighting the prevalence of asymmetries in soccer players and possible links to injury risks, there is a crucial gap in the biomechanical understanding of complex relationships between lower extremity and trunk asymmetries in elite soccer players. The purpose of this study was to investigate the level, relationships, and differences among twelve different parameters of strength, morphological, and neuromuscular asymmetries in elite soccer players. Methods: Elite male soccer players (n = 25, age 21.7 ± 3.9 years) were tested in the following tests: bilateral fluid distribution, hip flexor range of motion, postural stability, isokinetic strength of knee extensors and flexors, isometric lateral trunk rotation strength, eccentric strength of knee flexors, isometric bilateral strength of hip adductors, and vertical ground reaction force in counter-movement jump-free arms, counter-movement jump, squat jump, and drop jump tests. One-way ANOVA, Pearson's coefficient (r), and partial eta squared (η p 2) were used for data analysis. Results: Significant differences in asymmetries were found in elite soccer players (F11,299 = 11.01, p < .01). The magnitude of asymmetry over 10% was in postural stability and drop jump parameters. The lowest magnitudes of asymmetries were in the fluid distribution of the lower limbs and the vertical ground reaction force during the take-off phase in squat jumps. The highest asymmetries between the dominant and non-dominant sides were found in postural stability and drop jump. A total of eleven significant correlations (p < 0.05, r = 0.41-0.63, R2 = 0.17-0.40) were detected between the analyzed asymmetries in elite soccer players. The lateral trunk rotation asymmetries were significantly correlated to vertical ground reaction force asymmetries and knee extensors. Conclusion: Long-term exposure in elite soccer leads to unilateral biomechanical loading that induces abnormal strength and morphological adaptations in favor of the dominant side while linking lower limb and trunk strength asymmetries. By unraveling these complex relationships, we strive to contribute novel methods that could inform targeted training regimens and injury prevention strategies in the elite soccer community. The data should encourage future researchers and coaches to monitor and develop trunk strength linked to lower body kinematics.

Weekly Training Load Differences between Starting and Non-Starting Soccer Players.

The aim of this study was to examine the differences in the weekly training load between starters and non-starters classified based on the match starting line-up, with respect to the playing position and a training day. Notably, 31 young adult soccer players (age: 18.79 ± 1.04 years) competing in the 3rd Czech division were monitored across the season. The weekly training load was measured using a GPS system as follows: total distance covered (TD), high-speed running distance (HSR), sprint running distance (SR), and acceleration and deceleration distance (ACDC). We found higher values in three out of four observed variables (HSR, SR, and ACDC, excluding TD) for starters compared to non-starters (p < 0.05), with small to moderate effect sizes (d = 0.40-0.49). Differences were observed especially in players who were fullbacks, offensive midfielders, and forwards. Moreover, the largest differences were found in training prior to a match day for HSR, SR, and ACDC (p < 0.05). Non-starters experienced lower weekly external loads in offensive player positions, predominantly in high-intensity variables, which are essential for their physical performance. It seems that non-starters may experience potential under-loading in the training process. Coaches and practitioners should be aware of this potential risk and find an appropriate method to compensate for load discrepancies, particularly in terms of high-intensity activities.

Differences in external load among indoor and beach volleyball players during elite matches.

The aim of this cross-sectional study was to examine relationships of external load variables between beach and indoor volleyball amongst individual positions on the team. The movements of eight beach and fourteen indoor female volleyball players were recorded during elite playoff matches; in total, 2,336 three-dimensional trajectories were analyzed. Time-outs and intervals between rallies or sets were excluded from active play time. In both beach and indoor volleyball, 80% of rallies lasted up to 10 s, and players covered 4.5 to 10 m of court during 60% of rally play. Differences in dependent variables of external load were found between independent variables of sports and player positions (p < 0.05). The distance covered in beach volleyball rallies and Player Load™ parameters was significantly higher by up to 23%. The unstable court surface with sand in beach volleyball elevated explosive Player Load™ (accelerations in all three orthogonal planes of motion higher than 3.5 m/s3) in beach volleyball players compared to those of players on stable flooring in indoor. While beach volleyball blocker and defender positions showed no significant difference in parameters between each other, they differed in all parameters when compared to player positions in indoor volleyball. Indoor blocker and libero reached higher loads than setter, outside and opposite positions in various parameters. Factors that influence external load include the larger relative court areas covered by each player in beach volleyball, complexity of players' roles, and game strategy. This data adds to the knowledge of elite match demands in female volleyball. Specified agility-drill distances and times are essential for training optimization and must be supported by scientific observation. Researchers, coaches, and conditioning specialists should find this helpful for achieving a higher degree of training regulation.

The relationship of three-dimensional foot morphology to clinical assessments and postural stability in adolescent male footballers.

BACKGROUND: Foot morphology is associated with altered loading of the ankle-foot complex in adolescent footballers, predisposing to pain and injury. However, usual singular plane clinical assessments do not accurately capture the 3D nature of foot morphology. A new approach is 3D laser scanning, with statistical shape model techniques creating individual-to-group comparison. However, no research exists on the adolescent, football-playing foot. Furthermore, a link between 3D foot morphology, and usual clinical and performance measures would be beneficial for practical implementation. METHODS: Four hundred forty-seven 3D foot scans from 224 elite male footballers (U12-U19) in bilateral stance were collected and further processed with statistical shape model techniques. Weighted shape parameters for individual principal components (Modes) were extracted for each foot. Centre of pressure displacement expressed as total travelled way in millimetres was calculated for bilateral and unilateral postural stability measures. Clinical assessments (Clarke's Angle, Resting Calcaneal Stance Position) were calculated on the 3D foot scans. Differences in weighted shape parameters, postural stability measures, and clinical assessments between age groups were determined by ANOVA. Correlations determined the relationship of Modes and clinical assessments to postural stability measures. Linear regression established if clinical assessments predicted the mode describing foot arch variation. RESULTS: Age groups significantly differed for Mode 1 (foot length), Mode 2 (foot arch), and Mode 5 (tibial rotation relative to the foot) (p < 0.05). Resting Calcaneal Stance Position (r = .663) and Clarke's Angle (r = -.445) were low-to-moderately correlated to Mode 2 (both p < 0.001), and linear regression found they were both significant predictors of Mode 2, though only moderately (R2 = .522). There were low correlations of foot morphology to the postural stability tests. CONCLUSION: This is the first study to describe the 3D foot morphology of male football-playing adolescents, and discover the differences between age groups. This will improve understanding and assessment of foot morphology in male adolescents because 2D techniques, as discovered in this study, do not strongly correlate to, nor predict, the 3D foot arch. Foot morphology was only lowly correlated to postural stability, thus a multifaceted program would be required for improvements.

The effect of biological maturation on foot morphology, and their relation to postural stability performance in male footballers.

BACKGROUND: Biological maturity (BM) and foot morphology (FM) can independently alter neuromuscular loading on the ankle-foot complex, potentially causing stability deficits and injury predisposition. However, the influence of BM on FM, and how much both explain neuromuscular performance in postural stability (PS) tests, has been understudied. This study aimed to investigate the effect of BM on FM, and then discover to what extent both factors explain the variance in PS performance in adolescent footballers. METHODS: Over one season, 399 three-dimensional foot scans were gathered from 72 footballers (U12-U15). PS was measured by center of pressure (COP) displacement in bilateral and unilateral stance. The Khamis and Roche equation determined maturity status (MS), while formulae from Mirwald and Khamis and Roche estimated timing of biological maturation (TBM). Principal component analysis determined nine principal components that explained the most variance in FM. An ANCOVA determined the effect of TBM on FM principal components, with covariates of age, height, weight, playing position, and foot preference. Step-wise linear regression determined the explanation of COP displacement by the above-mentioned predictors. RESULTS: There was significantly increased foot pronation during and after peak height velocity/puberty. MS and four foot principal components (foot arch and width, great toe width and length) were significant predictors in all PS tests (R2: 0.105-0.180). CONCLUSIONS: TBM had a significant effect on FM presentation, and should be a part of adolescent foot assessment. While they only explained a small amount of variance, determining MS and FM may identify those requiring additional PS attention.

Hypoxia as a potential cause of dyspareunia.

Dyspareunia is genital pain before, during or after penile-vaginal sexual intercourse. The prevalence of dyspareunia ranges from 8 to 22%. Sexual intercourse concomitant with a pelvic organic lesion is likely to cause pain in most cases. However, in these cases, the pain depends not only on sexual intercourse. In its basic definition, dyspareunia in women is considered an idiopathic affection without a typical organic constitution. It is only present with penile-vaginal penetration. Long-term hypoxia in perineal muscles can cause muscle and perimuscular changes, leading to chronic pain not sufficiently responding to standard therapy. During the entrance examination to our previous study on dyspareunia, we noted significantly lower pulse oximetry levels in the perineal area of affected women. We aimed to compare pulse oximetry oxygen saturation (SpO2) of dyspareunia-affected women to healthy, pain-free women. A retrospective study was performed. The study participants were women who had participated in our previously published study on dyspareunia. This retrospective study was approved by the Ethical Committee. The study included 62 women: 31 dyspareunia-affected women in the treatment group and 31 healthy women in the control group. METHOD: During their examinations, women in the dyspareunia and control groups were measured for SpO2. The procedure was performed in the vulvo-perineal rear region, involving the commissure and the bulbospongiosus muscle. Median and mean SpO2 were compared between the treatment and control groups. Testing for sample size accuracy was performed retroactively. RESULTS: There were 31 participants in each group. The SpO2 data were skewed and did not follow a Gaussian distribution. The Mann-Whitney U test was run to determine differences in perineum oximetry between the treatment group and controls. The median SpO2 was 91 in the treatment group and 92 in the control group. This difference was statistically significant, p = 0.002. Sample size accuracy was assured by post hoc calculation. CONCLUSIONS: Idiopathic dyspareunia is inherent in cohabitation muscle pain that standard therapy could not explain nor treat. We detected clinically meaningfully decreased levels of SpO2 in affected patients. We compared pelvic oximetry between dyspareunia-affected women in the treatment and control groups. This comparison showed significant hypoxia in the perineal muscle area (p = 0.002). Our results may help us understand the source of this pain and guide treatment accordingly.

Do the Pelvic and Thorax Movements Differ between the Sexes and Influence Golf Club Velocity in Junior Golfers?

The aim of this study was to determine the differences in golf swing execution in terms of the parameters of the pelvis and thorax movement between the sexes in junior golfers and their relation to the golf club velocity. Elite female and male players (age: 15.4 ± 1.0 and 15.8 ± 1.7 years, respectively) performed 10 golf swings with a driver under laboratory conditions. Pelvis and thorax movement parameters and golf club velocities were measured using a three-dimensional motion capture system. Statistical parametric mapping analysis of pelvis-thorax coupling revealed a significant difference (p < 0.05) between boys and girls during backswing. Analysis of variance showed a significant effect of sex on the parameters of maximal pelvic rotation (F = 6.28, p = 0.02), X-factor (F = 5.41, p = 0.03), and golf club velocity (F = 31.98, p < 0.01). No significant relationship was found between pelvis and thorax movement parameters and golf club velocity in the girls. We found a significant negative relationship between the parameters of maximal thorax rotation and golf club velocity (r = -0.941, p < 0.01) and between X-Factor and golf club velocity (r = -0.847, p < 0.05) in the boys. We suggest that these negative relationships in males were caused by the influence of hormones during their maturation and biological development, where there is decreased flexibility (lower shoulders rotation and X-factor) and growth of muscle strength (higher club head velocity).

Characteristics of external loads of Hockey5s associated with the new version of U16 youth field hockey competition.

External workloads associated Hockey 5 s, the new version of youth field hockey, were evaluated in 31 elite U16 male field players (15.4 ± 0.7 years) from three national teams. Mixed-longitudinal observations for the 31 players provided complete data for 33 forwards and 43 defenders. Activities of the players during games were monitored with the GPSports SPI Elite System with a sampling frequency of 10 Hz and were analysed with GPSports Team AMS (version R1 2015.14, Australia). Observed variables did not differ between forwards and defenders, and the three periods of play were differentiated only by maximal speed in the second and third periods. The greatest distances covered were in speed zone 3 (10.0-15.9 km h-1; 35.5-38.2%) and the smallest in speed zones 4 (16.0-22.9 km h-1; 14.8-15.6%) and 5 (> 23 km h-1; 0.4-1.4%). The trends indicated high intensity levels for the entire match and by position and periods. Active time of forwards and defenders accounted for about one-half of a game's duration (~ 15.7 of 30 min). Overall, the Hockey 5s format was highly demanding of players and included relatively short intervals for recovery. The results emphasize the need for preparation that includes specific mixed anaerobic and aerobic training and also the importance of recovery during breaks.

Development of body composition, lower body physical characteristics and clubhead speed in skilled junior golfers.

BACKGROUND: The physical characteristics of golfers have a strong relationship with the clubhead speed (CHS), which is the main indicator of energy produced during a golf swing. However, perennial observations of development in CHS, physical characteristics, and body composition, and their long-term effects on CHS are lacking. Therefore, this study aimed to evaluate the lower body physical characteristics and body composition parameters and their relationship with clubhead speed during one and over a two-year period in junior golfers. METHODS: Nineteen skilled, male, junior golfers participated in this study. RESULTS: A significant positive relationship (P<0.05) was found between improvement in CHS and increase in the body height (r=0.56), increase in peak power of the countermovement jump (r=0.55), and squat jump (r=0.52). A near-significant positive relationship was found between improvement in CHS and increases in the fat-free mass (r=0.42; P=0.06) and peak torque of the knee extensor at an angular velocity of 60° s-1 (r=0.44; P=0.07). CONCLUSIONS: Thus, we recommend that golf coaches work on muscle strengthening and conditioning with their players, focusing on: 1) the increase of the active muscle mass as opposed to the total body mass in relation to the acceleration of CHS; and 2) exercises to develop the muscle power (vertical jumping) and maximum lower limb strength (knee extension).

Elite young soccer players have smaller inter-limb asymmetry and better body composition than non-elite players.

Body composition (BC) and inter-limb anthropometric asymmetries (LA) may influence the physical performance of soccer players. This study aimed to determine differences in BC and LA among soccer across four performance levels. The study involved 110 male soccer players participating in Czech senior teams who were grouped into four different performance levels (i.e. G1: national team, G2: 1st division, G3: 2nd division, G4: 3rd division). The following BC and LA parameters were compared among groups: body height, body mass, absolute fat-free mass, relative fat-free mass (FFMrel), percentage of fat mass (FM), total body water (TBW), intracellular water (ICW), extracellular water (ECW), phase angle, and bilateral muscle mass differences in the upper and lower extremities. Significant differences were observed in BC parameters among all groups (λ = 0.06, F75,246 = 5.38, p = 0.01, ηp 2 = 0.62). High-performance players (i.e. G1, G2) had significantly (p < 0.01) lower FM than lower performance players (i.e. G3, G4). The lowest values of FFMrel, relative TBW, relative ICW and ECW were detected in the lowest-performance players (i.e. G4). Significantly lower bilateral muscle mass differences were detected in G1 players (2.71 ± 1.26%; p < 0.01) compared with G4 players (3.95 ± 1.17%). G1 and G2 players had a higher proportion of muscle mass in the torso (p < 0.01) and upper limbs than G3 and G4 (p < 0.01). Elite and high-performance players have better BC and lower inter-limb anthropometric asymmetries compared with low-performance level players.

Speed and power-related gene polymorphisms associated with playing position in elite soccer players.

Heritability studies on sport-related traits accepted that endurance, speed, power, and strength abilities include an active genetic predisposition to elite soccer participation. This study evaluates the influence of selected genetic variants on performance in speed, power, and strength laboratory tests on a group of elite soccer players, including their playing position. A ninety-nine male elite soccer players were compared to controls (n = 107) and tested for quadriceps and hamstrings isokinetic strength at speed 60°/s, 180°/s, and 300°/s, jump performance, and genotypes of ACTN3 (R577X, rs1815739), ACE (I/D, rs1799752), NOS3 (Glu298Asp, rs1799983), AMPD1 (34C/T, rs17602729), UCP2 (Ala55Val, rs660339), BDKRB2 (+9/-9, rs5810761) and IL1RN (VNTR 86-bp). The ACTN3 XX homozygotes in defenders had lower quadriceps and hamstring isokinetic strength in all tested speeds than ACTN3 RX and RR genotypes (p < 0.05). The ACTN3 RR homozygotes in defenders had higher quadriceps strength in all tested velocities than the RX heterozygotes (p < 0.05). We also found other associations between playing-position in soccer and increased strength of lower limbs for AMPD1 CC and NOS3 Glu/Glu genotypes, and IL1RN*2 allele carriers. Total genetic score regression explained 26% of the variance in jump performance and isokinetic strength. The ACTN3 R allele, NOS3 Glu/Glu genotypes, and IL1RN*2 allele pre-disposed the attackers and defenders playing position in elite soccer, where those positions have higher strength and power measures than midfielders. Midfielders have lower strength and power conditions than other playing positions without relation to strength and power genes.

Extracorporeal shock wave therapy for treating dyspareunia: A prospective, randomized, double-blind, placebo-controlled study.

BACKGROUND: Dyspareunia is a genital pain during or after penile-vaginal sexual intercourse. It is a painful spasm of the pelvic muscles that partly or entirely disables vaginal penetration. OBJECTIVES: We examined the effect of extracorporeal shock wave therapy (ESWT) on idiopathic non-organic dyspareunia in women. A prospective, randomized, double-blind, placebo-controlled study was conducted. METHODS: The study included 62 women who reported dyspareunia. Patients in the treatment and placebo groups received ESWT perineally weekly for 4 consecutive weeks; placebo patients received placebo stand-off treatment. The grade of dyspareunia was estimated by using the Marinoff Dyspareunia Scale and subjective pain intensity on a visual analog scale (VAS) before and after treatment. Follow-ups were conducted 1, 4 and 12 weeks after the final ESWT session. RESULTS: The study included 61 women. The treatment but not placebo group differed by the Marinoff Dyspareunia Scale and VAS. Differences before and after treatment within groups were all P<0.001 and between groups, P<0.001. Pain reduction was always>30%. The effect sizes were both large: Marinoff 0.825 and VAS 0.883. CONCLUSIONS: ESWT significantly reduced subjective pain in our women treated for dyspareunia.

Isokinetic Strength, Vertical Jump Performance, and Strength Differences in First Line Professional Firefighters Competing in Fire Sport.

The purpose of our study was to investigate peak torque (PT) of knee extensors (KE) and knee flexors (KF), bilateral and unilateral strength asymmetries in isokinetic testing and vertical jump height (JH), vertical ground reaction force (VGRF), and force differences (ΔVGRF) between legs during different jump tests in professional first-line firefighters (n = 15) competing in fire sports disciplines. There was a significant effect of jump type on JH (F2,44 = 7.23, p < 0.05), VGRF (F2,44 = 16.03, p < 0.05), and ΔVGRF (F2,44 = 3.45, p < 0.05). Professional firefighters achieved a mean JH of 50.17 cm in the countermovement jump free arms and high PT of KEs (3.15 Nm/kg). No significant differences (p > 0.05) and small effect sizes (d < 0.3) were found between the legs when PTs were assessed. We found a slightly higher (d = 0.53) unilateral strength ratio in non-dominant legs (58.12 ± 10.26%) compared to dominant legs (55.31 ± 7.51%). No effect of laterality was found among limb comparisons, but a higher unilateral isokinetic strength ratio was found in non-dominant legs of firefighters. A high level of strength (PT of KEs > 3 times body weight) and vertical jump performance is comparable to the performance of elite athletic populations.

Isokinetic strength, bilateral and unilateral strength differences: variation by age and laterality in elite youth football players / Fuerza isocinética, diferencias de fuerza bilaterales y unilaterales: variación por edad y lateralidad en futbolistas juveniles de élite

SUMMARY: The purpose of this study was to investigate the effect of age on peak torque (PT) relative strength measures of knee extensors (KE) and knee flexors (KF), bilateral strength ratio (Q:Q, H:H), and ipsilateral strength ratio (H:Q) in youth elite male football players.Elite male players (n = 70) from four age categories (U16: n = 20, U17: n = 20, U19: n = 15, U21: n = 15) performed isokinetic strength tests using a Cybex dynamometer. Results show a significant effect of age on PTKE (F3,142 = 4.54, p = 0.005, = 0.09) and PTKF (age: F3,142 = 3.07, p = 0.030, = 0.06). No significant effect of age on unilateral (F3,142 = 1.05, p = 0.375, = 0.02) or ipsilateral strength ratio (F3,142 = 2.63, p = 0.053, = 0.06) was found. Results revealed significant differences in PTKE for nondominant limbs between U16 and U21. Higher bilateral differences were detected for flexors (H:H = 7.94-11.47 %, Q:Q = 7.97-9.29 %) compared to extensors. Our study showed that 17-year-old players have levels of strength similar to U19 players. A higher bilateral difference of knee flexors than extensors was found, suggesting that more attention should be paid to knee flexors. No effect of laterality was found for strength and strength asymmetries. Future research should also focus on ipsilateral strength ratio in late stage of maturation.

RESUMEN: El objetivo de este estudio fue investigar el efecto de la edad en las medidas de fuerza relativa de torque máximo (TM) de los extensores de rodilla (ER) y flexores de rodilla (FR), la relación de fuerza bilateral (Q: Q, H: H) y la relación de fuerza ipsilateral (H: Q) en jugadores de fútbol masculino de élite en 70 sujetos de cuatro categorías de edad (U16: n = 20, U17: n = 20, U19: n = 15, U21: n = 15). Se realizaron pruebas de fuerza isocinética utilizando un dinamómetro Cybex. Los resultados mos- traron un efecto significativo de la edad en TMER (F3,142 = 4,54, p = 0,005, = 0,09) y TMFR (edad: age: F3,142 = 3,07, p = 0,030, = 0,06). No se observó efecto significativo alguno de la edad sobre la fuerza unilateral (F3,142 = 1,05, p = 0,375, = 0,02) o relación de fuerza ipsilateral (F3,142 = 2,63, p = 0,053, = 0,06). Los resultados indicaron diferencias significativas en TMER para miembros no dominantes entre U16 y U21. Se detectaron mayo- res diferencias bilaterales para los flexores (H:H = 7,94-11,47%, Q:Q = 7,97-9,29 %) en comparación con los extensores. Nues- tro estudio mostró que los jugadores de 17 años tienen niveles de fuerza similares a la de los jugadores sub-19. Se observó una mayor diferencia bilateral de flexores de rodilla que de extensores, lo que sugiere que se debe prestar más atención a los flexores de rodilla. No se encontró un efecto de lateralidad para fuerza y asimetrías de fuerza. Los estudios futuros también deben centrarse en la relación de fuerza ipsilateral en la etapa tardía de maduración.

Unilateral and Bilateral Strength Asymmetry among Young Elite Athletes of Various Sports.

Background and objective: Type of physical activity may influence morphological and muscular asymmetries in the young population. However, less is known about the size of this effect when comparing various sports. The aim of this study was to identify the degree of bilateral asymmetry (BA) and the level of unilateral ratio (UR) between isokinetic strength of knee extensors (KE) and flexors (KF) among athletes of three different types of predominant locomotion in various sports (symmetric, asymmetric and hybrid). Material and methods: The analyzed group consisted of young elite athletes (n = 50). The maximum peak muscle torque of the KE and KF in both the dominant (DL) and non-dominant (NL) lower limb during concentric muscle contraction at an angular velocity of 60°·s-1 was measured with an isokinetic dynamometer. Results: Data analysis showed a significant effect of the main factor (the type of sport) on the level of monitored variables (p = 0.004). The type of sport revealed a significant difference in the bilateral ratio (p = 0.01). The group of symmetric and hybrid sports achieved lower values (p = 0.01) of BA in their lower limb muscles than those who played asymmetric sports. The hybrid sports group achieved higher UR values (p = 0.01) in both lower limbs. Conclusions: The results indicate that sports with predominantly symmetrical, asymmetrical, and hybrid types of locomotion affected the size of the BA, as well as the UR between KE and KF in both legs in young athletes. We recommend paying attention to regular KE and KF strength diagnostics in young athletes and optimizing individual compensatory exercises if a higher ratio of strength asymmetry is discovered.

Anthropometric, Body Composition, and Morphological Lower Limb Asymmetries in Elite Soccer Players: A Prospective Cohort Study.

The aim of this study was to identify and compare parameters related to anthropometry, body composition (BC), and morphological asymmetry in elite soccer players in nine age categories at the same soccer club (n = 355). We used a bio-impedance analyzer to measure the following indicators of BC: body height (BH); body mass (BM); relative fat-free mass (FFMr); percentage of fat mass (FM); and bilateral muscle mass differences in the lower extremities (BLD∆). Age showed a significant influence on all parameters observed (F64,1962 = 9.99, p = 0.00, λ = 14.75, η2p = 0.25). Adolescent players (from U16 through adults) had lower FM values (<10%) compared to players in the U12-U15 categories (>10%). The highest FFMr was observed in the U18 category. Players in the U12 and U13 categories showed more homogenous values compared to older players. With increasing age, significantly higher FFMr was observed in the lower extremities. An inter-limb comparison of the lower extremities showed significant differences in the U17 category (t27 = 2.77, p = 0.01) and in adult players (t68 = 5.02, p = 0.00). Our results suggest that the end of height growth occurs around the age of 16 years, while weight continues to increase until 20 years. This increase is not linked to decreasing FM, nor to the FFMr, which remains stable. We found morphological asymmetries between limbs in players of the U17 category and in adult players.

Extracorporeal shock wave therapy for treatment of vulvodynia: a prospective, randomized, double-blind, placebo-controlled study.

BACKGROUND: Currently, there are no effective therapy strategies for idiopathic, non-organic vulvodynia in women. ESWT (extracorporeal shock wave therapy) is a nonsurgical/noninvasive technique widely used to treat musculoskeletal diseases, muscle spasticity and hypertonia, renal and biliary calculi and urological disorders. AIM: We examined the effects of ESWT on vulvodynia in women. DESIGN: A prospective, randomized, double-blind, placebo-controlled study was conducted between 2015 and 2018 following a feasibility study. SETTING: Obstetrics and Gynecology Hospital departments. POPULATION: The study included 62 women with vulvodynia for at least 3 months. METHODS: The women were randomly assigned to either a treatment group (N.=31) or a placebo group (N.=31). The patients in the treatment group received perineally applied ESWT weekly (3000 pulses each for four consecutive weeks). The energy flux density was 0.25 mJ/mm2, frequency 4 Hz, focus zone 0-30 mm, therapeutic efficacy 0-90 mm, stand-off II. The device used was a standard electromagnetic shock wave unit with a focused shock wave handpiece. The position of the shock wave transducer was changed six times after every 500 pulses. Patients in the placebo group underwent the same treatment procedure, but the handpiece was provided with a placebo stand-off that disabled energy transmission. Subjective pain was self-evaluated by each patient using two tools before and after treatment: a 10 cm linear visual analogue scale (VAS, 0-10) and a cotton-swab test (CST, Goetsch scale 0-4). Follow-ups were done 1, 4, and 12 weeks post-ESWT. RESULTS: In all, 61 women completed the study. We tested for differences in the VAS and CST within and between the treatment and placebo groups. The testing was between before treatment and particular follow-up. We found significant changes in the treatment group. Reductions in VAS (P<0.01) and CST (P<0.01) were observed at all three follow-ups. At all assessments, pain reduction was always >30%. In the placebo group there were no statistically significant changes between before and after treatment. There were no differences between the treatment and placebo groups before treatment but statistically significant differences at all three follow-ups (VAS P<0.01); CST P<0.01). CONCLUSIONS: ESWT seems to reduce pain perception in our treatment group. Thus, we are encouraged to explore this technique further. CLINICAL REHABILITATION IMPACT: The method is easily replicable, inexpensive, and without known side effects.

Erratum: Bujnovsky, D., et al. Physical Fitness Characteristics of High-level Youth Football Players: Influence of Playing Position. Sports 2019, 7, 46.

The authors wish to make the following correction to this paper [...].

How do novice and improver walkers move in their home environments? An open-sourced infant's gait video analysis.

OBJECTIVE: Natural independent walking mostly occurs during infant´s everyday explorations of their home environment. Gait characteristics of infant walkers at different developmental stages exist in literature, however, data has been only collected in laboratory environments, which may reduce gait variability, therefore mask differences between developmental stages of natural gait. The aim of the study was to provide the first data set of temporal and functional gait characteristics of novice and improver infant walkers in familiar environment conditions in their home. We hypothesised that familiar environment conditions may effectively demonstrate natural gait characteristics and real differences in gait variables differing between 2 groups of developing infant walkers. METHODS: In a cross-sectional design; we used open-source videos of infants in their home environments: twenty videos of 10 novice (5 girls, 5 boys, 7-12 months) and 10 improver (4 girls, 6 boys, 8-13 months) walkers were chosen from an open-source website. 2-D video gait analysis was undertaken for these parameters: falls frequency, frequency of stops, gait cadence, and time of stance phase, swing phase, and double support. Between groups comparison for novice versus improver was investigated by Mann-Whitney U tests (p ≤ 0.05) with determination of effect size of Pearson r correlation. RESULTS: Statistically significant differences between groups with large effect sizes were found for these parameters: falls frequency (p = 0.01, r = 0.56); cadence (p = 0.01, r = 0.57); stance phase duration of right leg (p < 0.01, r = 0.63); stance phase duration of left leg (p = 0.01, r = 0.56); and double support phase duration (p < 0.01, r = 0.69). Novices scored higher in comparison with improver walkers in all the parameters except cadence. CONCLUSIONS: This study presents the first data set of functional and temporal gait parameters of novice and improver infant walkers in their home environments. As an addition to recent research, novice infants walk with lower cadence and higher falls frequency, stance phase time and double support in their familiar environments. With increasing experiences, infant´s cadence increases while the other parameters decrease.

Body composition and morphological limbs asymmetry in competitors in six martial arts / Composición corporal y asimetría morfológica de miembros en competidores en seis artes marciales

The aim of this study was to compare body composition (BC) and morphological symmetry differences among elite athletes (n = 132) in six martial arts (judo, karate, fencing, wrestling, taekwondo, kickboxing). Multivariate analysis of variances (MANOVA) was used to compare the following variables: absolute (FFM) and relative (FFMrel) value of fat free mass, percentage of fat mass (FMp), bone mass, protein mass, basal metabolic rate, absolute (TBW) and percentual (TBWp) value of total body water, segmental proportion of muscle mass, phase angle, and percent-age differences between the upper and lower limbs. MANOVA revealed significant differences in BC among the groups (λ = 0.01, F104, 256 = 10.01, p< 0.01, ηp2 = 0.67). No significant differences were observed for FMp, FFMrel, and TBWp (p>0.05). In all other BC variables, significant differences were detected (p<0.05). The comparison of paired differences between limbs revealed significantly greater fluid volume in the preferred arm compared to the non-preferred arm in karate and fencing athletes. Significant differences (p<0.05) in favour of the preferred leg in all combat athletes were detected. This study revealed morphological differences among practitioners of different martial arts and between paired limbs.

El objetivo de este estudio fue comparar la composición corporal (CC) y las diferencias de simetría morfológica entre atletas de élite (n = 132) en seis artes marciales (judo, karate, esgrima, lucha, taekwondo, kickboxing). Se utilizó el análisis multivariado de varianzas (MANOVA) para comparar las siguientes variables: valor absoluto (FFM) y relativo (FFMrel) de la masa libre de grasa, porcentaje de masa grasa (FMp), masa ósea, masa proteica, tasa metabólica basal, absoluto (TBW) y el valor porcentual (TBWp) de líquido corporal total, la proporción segmentaria de la masa muscular, el ángulo de fase y las diferencias porcentuales entre los miembros superiores e inferiores. MANOVA reveló diferencias significativas en BC entre los grupos (λ = 0,01, F104, 256 = 10,01, p <0,01, ηp2 = 0,67). No se observaron diferencias significativas para FMp, FFMrel y TBWp (p>0,05). En todas las demás variables de BC, se detectaron diferencias significativas (p<0,05). La comparación de las diferencias pareadas entre los miembros reveló un volumen de líquido significativamente mayor en el brazo dominante en comparación con el brazo no dominante en karate y atletas de esgrima. Se detectaron diferencias significativas (p<0,05) a favor de la pierna dominante en todos los atletas de combate. Este estudio reveló diferencias morfológicas entre los practicantes de diferentes artes marciales y entre las miembros emparejadas.