Field Hip Stability Isometric Test (F-HipSIT): Reliability of Assessing the Hip Posterolateral Muscle Strength in Sports Settings.

CONTEXT: The Hip Stability Isometric Test (HipSIT) is commonly employed in clinical settings for evaluating the hip posterolateral muscle strength. In this study, we introduced the "Field Hip Stability Isometric Test" (F-HipSIT) and assessed the intrarater and interrater reliability of this strength assessment specifically designed for sports settings. DESIGN: Reliability study. METHODS: Two independent raters (A and B) went to athletes' training facilities to conduct 2 sessions of F-HipSIT spaced at least 1 week apart. The average peak force value from 3 valid attempts of each leg was recorded and normalized by the participant's body mass for statistical analysis. RESULTS: Thirty male and 30 female amateur athletes took part in this study. Rater A obtained similar values in the first (0.39 [0.05] and 0.44 [0.07] kg·f/kg) and second (0.39 [0.06] and 0.45 [0.07] kg·f/kg) testing days for men and women, respectively. Rater B also found similar values in the first (0.35 [0.06] and 0.42 [0.08] kg·f/kg) and second (0.36 [0.06] and 0.45 [0.08] kg·f/kg) testing days for men and women, respectively. Excellent intrarater intraclass correlation coefficient (ICC) values were found for men (ICC = .922) and women (ICC = .930), with coefficient of variation of 6% to 8% and minimal detectable change of 0.06 to 0.10 kg·f/kg. The F-HipSIT presented good interrater reliability for men (ICC = .857) and women (ICC = .868), with coefficient of variation of 5% and minimal detectable change of 0.05 to 0.06 kg·f/kg. CONCLUSION: The F-HipSIT intrarater and interrater reliability among male and female recreational athletes supports this field test as a quick and convenient screening tool to monitor hip posterolateral muscle strength in sports settings.

Minimally Invasive Peroneal Tenodesis Assisted by Peroneal Tendoscopy: Technique and Preliminary Results.

Introduction: Peroneal disorders are a common cause of ankle pain and lateral instability and have been described in as much as 77% of patients with lateral ankle instability. Clicking, swelling, pain, and tenderness in the peroneal tendons track are frequent symptoms, but they can be confused with other causes of lateral ankle pain. The management of peroneal disorders can be conservative or surgical. When the conservative treatment fails, surgery is indicated, and open or tendoscopic synovectomy, tubularization, tenodesis or tendon transfers can be performed. The authors present a surgical technique of tendoscopy associated to minimally invasive tenodesis for the treatment of peroneal tendon tears, as well as the preliminary results of patients submitted to this procedure. Methods: Four patients with chronic lateral ankle pain who were diagnosed with peroneal brevis pathology were treated between 2020 and 2022 with tendoscopic-assisted minimally invasive synovectomy and tenodesis. Using a 2.7 mm 30° arthroscope and a 3.0 mm shaver blade, the entire length of the peroneus brevis tendon and most parts of the peroneus longus tendon can be assessed within Sammarco's zones 1 and 2. After the inspection and synovectomy, a minimally invasive tenodesis is performed. Results: All patients were evaluated at least six months after surgery. All of them reported improvement in daily activities and in the Foot Function Index (FFI) questionnaire (pre-surgery mean FFI = 23.86%; post-surgery mean FFI = 6.15%), with no soft tissue complications or sural nerve complaints. Conclusion: The tendoscopy of the peroneal tendons allows the surgeon to assess their integrity, confirm the extent of the lesion, perform synovectomy, prepare the tendon for tenodesis, and perform it in a safe and minimally invasive way, reducing the risks inherent to the open procedure.

Trunk muscles influence lower limb performance in crossfit athletes: A cross-sectional study.

INTRODUCTION: Crossfit is a sport that combines cardio-respiratory and muscle endurance, strength, flexibility, muscle power, speed, coordination, agility and balance. However, there is no information in the literature regarding functional performance of the lower limbs and the endurance of core muscles in this population. The objective of this study was to evaluate the correlation between trunk strength/endurance and lower limb function through lower limb symmetry and balance tests. METHODS: Forty-one young adults aged 19-41 years (26.3 ± 5.4) participated, 15 sedentary and 26 cross fit practitioners for at least one year. The tests were as follows: Biering-Sørensen Test of trunk extensor endurance, Trunk Flexors Endurance Test at 60°, Side Plank Endurance Test, Lumbar Dynamometry, Single-Leg Hop Test and Star Excursion Balance Test. RESULTS AND DISCUSSION: Although there were higher values, there was no significant difference (p > 0.05) between the groups for lower limb symmetry and strength of trunk flexor muscles. For balance, strength and resistance variables of trunk extensor muscles, the values found were higher in crossfit practitioners than in sedentary subjects. CONCLUSION: There is a relationship between trunk muscle strength and endurance and lower limb balance. Moreover, cross fit athletes showed higher values of trunk muscle strength/endurance and lower limb balance compared to sedentary adults.

A Novel Fixation Method of the Graft to the Fibular Head in Knee Lateral Collateral Ligament Reconstruction: Technical Note / Um novo método de fixação do enxerto para a cabeça fibular na reconstrução do ligamento colateral lateral do joelho: Nota técnica

Abstract The lateral collateral ligament (LCL) is the strongest lateral stabilizer of the knee. It provides support against varus stress and posterolateral rotation of the knee. Lateral collateral ligament injuries mostly occur together with anterior and/or posterior cruciate ligament injuries. While grades 1 and 2 injuries are treated conservatively since they are partial injuries, total ruptures, as in grade 3, require surgical treatment. In conventional LCL reconstruction methods, hamstring grafts are used, and bioscrews are used in bone-tendon fixation. Lateral collateral ligament reconstruction is usually performed as a component of multiple ligament surgery. Therefore, there is a need for a contralateral hamstring tendon or allograft. The present article aims to define a technique that does not require tendon grafts and bioscrews in fibular fixation.

Resumo O ligamento colateral lateral (LCL) é o estabilizador lateral mais forte do joelho. Ele fornece suporte contra o estresse varus e a rotação de posterolateral do joelho. As lesões de LCL ocorrem principalmente com lesões do ligamento cruzado anterior e/ou posterior. Enquanto as lesões grau 1 e 2 são tratadas de forma conservadora, uma vez que são lesões parciais, rupturas totais, como no grau 3, requerem tratamento cirúrgico. Utilizam-se enxertos isquiotibiais nos métodos convencionais de reconstrução da LCL e bioscrews na fixação do tendão ósseo. A reconstrução do LCL é geralmente realizada como um componente de cirurgia de ligamento múltiplo. Portanto, há necessidade de um tendão contralateral ou aloenxerto. O presente artigo tem como objetivo definir uma técnica que não exija enxertos tendíneos e bioscrews na fixação fibular.

Nutritional Strategies in the Rehabilitation of Musculoskeletal Injuries in Athletes: A Systematic Integrative Review.

It is estimated that three to five million sports injuries occur worldwide each year. The highest incidence is reported during competition periods with mainly affectation of the musculoskeletal tissue. For appropriate nutritional management and correct use of nutritional supplements, it is important to individualize based on clinical effects and know the adaptive response during the rehabilitation phase after a sports injury in athletes. Therefore, the aim of this PRISMA in Exercise, Rehabilitation, Sport Medicine and Sports Science PERSiST-based systematic integrative review was to perform an update on nutritional strategies during the rehabilitation phase of musculoskeletal injuries in elite athletes. After searching the following databases: PubMed/Medline, Scopus, PEDro, and Google Scholar, a total of 18 studies met the inclusion criteria (Price Index: 66.6%). The risk of bias assessment for randomized controlled trials was performed using the RoB 2.0 tool while review articles were evaluated using the AMSTAR 2.0 items. Based on the main findings of the selected studies, nutritional strategies that benefit the rehabilitation process in injured athletes include balanced energy intake, and a high-protein and carbohydrate-rich diet. Supportive supervision should be provided to avoid low energy availability. The potential of supplementation with collagen, creatine monohydrate, omega-3 (fish oils), and vitamin D requires further research although the effects are quite promising. It is worth noting the lack of clinical research in injured athletes and the higher number of reviews in the last 10 years. After analyzing the current quantitative and non-quantitative evidence, we encourage researchers to conduct further clinical research studies evaluating doses of the discussed nutrients during the rehabilitation process to confirm findings, but also follow international guidelines at the time to review scientific literature.

Prevalência de quadros álgicos em praticantes de brazilian jiu-jitsu / Prevalence of algic conditions in brazilian jiu-jitsu practitioners / Prevalencia de condiciones álgicas em practicantes brazilian de jiu-jitsu

Objetivo: Identificar a prevalência de queixas álgicas em praticantes de Brazilian Jiu-Jitsu (BJJ), as queixas que levaram ao afastamento dos treinamentos e as queixas de lesões prévias. Métodos: Trata-se de um estudo transversal, observacional e descritivo que incluiu praticantes regulares de BJJ do sexo masculino, com idades entre 18 e 40 anos. Foi elaborado um questionário para identificar o perfil dos praticantes: idade, graduação, tempo de prática da arte marcial, frequência de treinos, prática de outras atividades física e frequência. Para a investigação das queixas álgicas, foi aplicado o Questionário Nórdico de Sintomas Osteomusculares ­ QNSO, versão em português adaptada. Os dados foram registrados no programa Microsoft Excel 365 e foi realizada estatística descritiva. Resultados: Os 52 participantes da pesquisa possuíam idade média de 32 anos e tempo médio de 9 anos de prática de Jiu-Jitsu, 50% deles possuía graduação de faixa azul. Os praticantes apresentaram 45 relatos de queixas na semana anterior a aplicação do QNSO, 76 relatos no ano anterior, 43 relatos que levaram os praticantes a se afastarem do treinamento e 20 relatos de lesões prévias no ano anterior. Conclusão: A maior prevalência de queixas nos 7 dias prévios a aplicação do QNSO, ocorreu em joelhos, coluna lombar e quadril-coxas, e nos 12 meses prévios ocorreu em joelhos, coluna lombar e ombros. A maior prevalência que levou os praticantes ao afastamento dos treinamentos nos 12 meses prévios ocorreu em joelhos, coluna lombar e tornozelo-pés, e as queixas de lesões prévias ocorreram em joelhos, punhos e ombros.

Objective: To identify the prevalence of pain complaints in Brazilian Jiu- Jitsu (BJJ) practitioners, the complaints that led to withdrawal from training and the complaints of previous injuries. Methods: This is a cross-sectional, observational and descriptive study that included regular male BJJ practitioners aged between 18 and 40 years. A basic questionnaire was created to collect variables: age, graduation, time practicing martial art, frequency of training, practice of other physical activities and frequency. For the investigation of pain complaints, the Nordic Questionnaire of Musculoskeletal Symptoms - NQSO, adapted Portuguese version, was applied. Data were recorded in the Microsoft Excel 365 program and descriptive statistics were performed. Results: The 52 research participants had average an age of 32 years old and average time of 9 years of BJJ practice, 50% of them were blue belt graduation. The practitioners presented 45 reports of complaints in the week before the application of NQSO, 76 reports in previous year, 43 reports that led to withdrawal training and 20 reports of previous injuries in the previous year. Conclusion: The highest prevalence of complaints in the previous 7 days of the application of NQSO occurred in the knees, lumbar spine and hip- thighs, and in the previous 12 months occurred in the knees, lumbar spine and shoulders. The major prevalence that led to withdrawal training in the previous 12 month occurred in the knees, lumbar spine and ankle-foots, and the complaints of previous injuries occurred in the knees, wrists and shoulders.

Objetivo: Identificar la prevalencia de quejas de dolor en practicantes de Brazilian Jiu-Jitsu (BJJ), las quejas que llevaron a la retirada del entrenamiento y las quejas de lesiones anteriores. Métodos: Se trata de un estudio transversal, observacional y descriptivo que incluyó practicantes regulares de BJJ del sexo masculino, con edades entre 18 y 40 años. Se elaboró un cuestionario para identificar el perfil de los practicantes: edad, grado, tiempo de práctica del arte marcial, frecuencia de entrenamiento, práctica de otras actividades físicas y frecuencia. Para la investigación de las quejas de dolor, se aplicó el Cuestionario Nórdico de Síntomas Musculoesqueléticos ­ CNSO, versión portuguesa adaptada. Los datos se registraron en el programa Microsoft Excel 365 y se realizó estadística descriptiva. Resultados: Los 52 participantes de la investigación tenían una edad promedio de 32 años y un tiempo promedio de práctica de BJJ de 9 años, el 50% de ellos tenían graduación de cinturón azul. Los practicantes presentaron 45 reportes de denuncias en la semana anterior a la aplicación de la CNSO, 76 reportes en el año anterior, 43 reportes que llevaron a los practicantes a retirarse del entrenamiento y 20 reportes de lesiones anteriores en el año anterior. Conclusión: La mayor prevalencia de quejas en los 7 días previos a la aplicación de la CNSO se presentó en rodillas, columna lumbar y cadera-muslos, y en los 12 meses anteriores se presentó en rodillas, columna lumbar y hombros. La prevalencia más alta que llevó a los practicantes a retirarse del entrenamiento en los 12 meses anteriores ocurrió en rodillas, columna lumbar y tobillo-pie, y las quejas de lesiones previas ocurrieron en rodillas, muñecas y hombros.

Exercise Selection and Common Injuries in Fitness Centers: A Systematic Integrative Review and Practical Recommendations.

Weight resistance training (RT) is an essential component of physical conditioning programs to improve the quality of life and physical fitness in different ages and populations. This integrative review aimed to analyze the scientific evidence on the relationship between exercise selection and the appearance of musculoskeletal injuries in physical fitness centers (PFC). The PubMed or Medline, EMBASE or Science Direct, Google Scholar and PEDro databases were selected to examine the available literature using a Boolean algorithm with search terms. The review process was performed using the five-stage approach for an integrative review and it was reported according to the PRISMA in Exercise, Rehabilitation, Sport Medicine and Sports Science (PERSiST) guidelines. A total of 39 peer-reviewed articles (Price index = 71.7%) met the inclusion criteria and evaluated the link between exercise selection and the incidence of injuries in exercisers who regularly attend PFC. Most injuries occur to the shoulders, elbows, vertebrae of the spine, and knees. Although the injury etiologies are multifactorial, the findings of the reviewed articles include the impacts of overuse, short post-exercise recovery periods, poor conditioning in the exercised body areas, frequent use of heavy loads, improper technique in certain exercises, and the abuse of performance- and image-enhancing drugs. Practical recommendations addressed to clinical exercise physiologists, exercise professionals, and health professionals are given in this paper. The exercise selection in RT programs requires professional supervision and adhering to proper lifting techniques and training habits that consider the anatomical and biomechanical patterns of the musculoskeletal structures, as well as genetic, pedagogical, and methodological aspects directly related to the stimulus-response process to mitigate the occurrence of RT-related injuries in PFC.

Simulation for damaged parts recognition of sports injury biological images / Simulação para reconhecimento de partes danificadas em imagens biológicas de lesões esportivas de alta intensidade / Simulación para el reconocimiento de partes dañadas en imágenes biológicas de lesiones deportivas

ABSTRACT Introduction To reduce or avoid injuries during high-intensity sports and help treat the injured part, the method of recognizing biological images of the damaged part is a crucial point of current research. Objective To reduce the damage caused by high-intensity sports and improve the efficiency of injury treatment, this article explores the method of identifying damaged parts in biological imaging of high-intensity sports injuries. Methods A method is proposed to recognize damaged parts of biological images of high-intensity sports injuries based on an improved regional growth algorithm. Results A rough segmented image developed in black and white is obtained with the main body as the objective and background. Based on approximate segmentation, the region growth algorithm is used to accurately recognize the damaged region by improving the selection of the hotspots and the growth rules. Conclusion The recognition accuracy is high, and the recognition time is shorter. The algorithm proposed in this work can improve the precision of recognizing the damaged parts of the biological image of the sports injury and shorten the recognition time. It has the feasibility to determine the damaged parts of sports injuries. Level of evidence II; Therapeutic studies: investigation of treatment results.

RESUMO Introdução Para reduzir ou evitar lesões durante esportes de alta intensidade e auxiliar no tratamento da parte lesada, o método de reconhecimento de imagens biológicas da parte lesada é um ponto crucial das pesquisas atuais. Objetivo Para reduzir os danos causados por esportes de alta intensidade e melhorar a eficiência do tratamento de lesões, este artigo explora o método de identificação de partes danificadas em imagens biológicas de lesões esportivas de alta intensidade. Métodos é proposto um método para reconhecer partes danificadas de imagens biológicas de lesões esportivas de alta intensidade com base em um algoritmo de crescimento regional aprimorado. Resultados Uma imagem áspera segmentada desenvolvida em preto e branco é obtida com o corpo principal como objetivo e fundo. Com base na segmentação aproximada, o algoritmo de crescimento da região é usado para reconhecer com precisão a região danificada, melhorando a seleção de pontos quentes e regras de crescimento. Conclusão a precisão do reconhecimento é alta e o tempo de reconhecimento é menor. O algoritmo proposto neste trabalho pode melhorar a precisão do reconhecimento das partes danificadas da imagem biológica da lesão esportiva e encurtar o tempo de reconhecimento. Tem a viabilidade de determinar as partes danificadas de lesões esportivas. Nível de evidência II; Estudos terapêuticos: investigação dos resultados do tratamento.

RESUMEN Introducción Para reducir o evitar lesiones durante los deportes de alta intensidad y ayudar a tratar la parte lesionada, el método de reconocimiento de imágenes biológicas de la parte dañada es un punto crucial de la investigación actual. Objetivo Para reducir el daño causado por los deportes de alta intensidad y mejorar la eficiencia del tratamiento de lesiones, este artículo explora el método de identificación de partes dañadas en imágenes biológicas de lesiones deportivas de alta intensidad. Métodos Se propone un método para reconocer partes dañadas de imágenes biológicas de lesiones deportivas de alta intensidad basado en un algoritmo de crecimiento regional mejorado. Resultados Se obtiene una imagen segmentada rugosa revelada en blanco y negro con el cuerpo principal como objetivo y fondo. Basado en la segmentación aproximada, el algoritmo de crecimiento de la región se utiliza para reconocer con precisión la región dañada mejorando la selección de los puntos calientes y las reglas de crecimiento. Conclusión la precisión del reconocimiento es alta y el tiempo de reconocimiento es más corto. El algoritmo propuesto en este trabajo puede mejorar la precisión del reconocimiento de las partes dañadas de la imagen biológica de la lesión deportiva y acortar el tiempo de reconocimiento. Tiene la viabilidad de determinar las partes dañadas de las lesiones deportivas. Nivel de evidencia II; Estudios terapéuticos: investigación de los resultados del tratamiento.

Reducing the sports injury through function movement biological image data screening / Reduzindo lesões esportivas por meio da triagem de dados biológicos de imagens de movimento / Reducción de las lesiones deportivas mediante la detección de datos biológicos por imágenes en movimiento

ABSTRACT Introduction Among the many cases of sports injuries, the incidence of musculoskeletal injuries remains high. After a musculoskeletal injury occurs, athletes often need to suspend training and undergo rehabilitation. A suitable sport mode requires athletes to have sufficient joint range of motion, core stability, and balance ability in different positions to complete various complex movements in training and competition. Objective The paper analyzes the impact of warm-up exercises before the test on the test results of functional sports biological image data screening ( FMS TM ) and provides references for unifying test conditions, checking the reliability of FMS TM repeated tests, and discussing the comparability of the research results. Methods The paper used the same password and process to test 12 young male volleyball professional athletes without warm-up and warm-up. The two-dimensional motion analysis system Dartfish Pursuit 8.0 was used to analyze the video data recorded by the two cameras simultaneously. Results In the two tests before and after, the hurdle step score (1.75±0.62 vs. 2.42±0.52) and the total score (13.50±2.20 vs. 16.42±2.15) were significantly higher than those without the warm-up test (P<0.01). Besides, in squats (1.58±0.67 vs. 1.92±0.67), straight lunges (2.00±0.43 vs. 2.50±0.52), active straight leg lifts (1.50±0.67 vs. 2.00±0.60), rotation stability (1.42) ±0.52 vs. 1.92±0.29) showed a significant increase in the score (P<0.05). Conclusions Warm-up exercises before the test can improve the test results. This abnormal movement pattern observed only by visual inspection may not truly reflect the "dysfunction" of the movement. In the case of ignoring the pre-test warm-up factors, feedback on sports performance and formulating training strategies, this conclusion of predicting injury risk and evaluating training effects may have specific limitations in its reference value. Level of evidence II; Therapeutic studies - investigation of treatment results.

RESUMO Introdução Dentre os diversos casos de lesões esportivas, a incidência de lesões musculoesqueléticas permanece elevada. Após a ocorrência de uma lesão musculoesquelética, os atletas geralmente precisam suspender o treinamento e se submeter à reabilitação. Um modo de esporte adequado requer que os atletas tenham amplitude de movimento articular suficiente, estabilidade central e capacidade de equilíbrio em diferentes posições para completar vários movimentos complexos em treinamento e competição. Objetivo o artigo analisa o impacto dos exercícios de aquecimento antes do teste sobre os resultados dos testes de triagem de dados de imagens biológicas esportivas funcionais (FMSTM) e fornece referências para unificar as condições de teste, verificar a confiabilidade de testes FMSTM repetidos e discutir a comparabilidade dos resultados da pesquisa . Métodos O artigo utilizou a mesma senha e processo para testar 12 jovens atletas profissionais do sexo masculino de voleibol sem aquecimento e com aquecimento. O sistema de análise de movimento bidimensional Dartfish Pursuit 8.0 foi usado para analisar os dados de vídeo gravados pelas duas câmeras simultaneamente. Resultados Nos dois testes antes e depois, a pontuação do hurdle step (1,75 ± 0,62 vs. 2,42 ± 0,52) e a pontuação total (13,50 ± 2,20 vs. 16,42 ± 2,15) foram significativamente maiores do que aqueles sem o teste de aquecimento ( P <0,01). Além disso, em agachamentos (1,58 ± 0,67 vs. 1,92 ± 0,67), estocadas retas (2,00 ± 0,43 vs. 2,50 ± 0,52), levantamentos ativos de perna reta (1,50 ± 0,67 vs. 2,00 ± 0,60), estabilidade de rotação (1,42) ± 0,52 vs. 1,92 ± 0,29) mostrou um aumento significativo na pontuação (P <0,05). Conclusão Os exercícios de aquecimento antes do teste podem melhorar os resultados do teste. Este padrão de movimento anormal observado apenas por inspeção visual pode não refletir verdadeiramente a "disfunção" do movimento. No caso de ignorar os fatores de aquecimento pré-teste, feedback sobre o desempenho esportivo e formulação de estratégias de treinamento, esta conclusão de prever o risco de lesões e avaliar os efeitos do treinamento pode ter limitações específicas em seu valor de referência. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción Entre los muchos casos de lesiones deportivas, la incidencia de lesiones musculoesqueléticas sigue siendo alta. Después de que ocurre una lesión musculoesquelética, los atletas a menudo necesitan suspender el entrenamiento y someterse a rehabilitación. Un modo de deporte adecuado requiere que los atletas tengan suficiente rango de movimiento articular, estabilidad central y capacidad de equilibrio en diferentes posiciones para completar varios movimientos complejos en el entrenamiento y la competencia. Objetivo El documento analiza el impacto de los ejercicios de calentamiento antes de la prueba en los resultados de las pruebas de detección de datos de imágenes biológicas deportivas funcionales (FMSTM) y proporciona referencias para unificar las condiciones de prueba, verificar la confiabilidad de las pruebas FMSTM repetidas y discutir la comparabilidad de los resultados de la investigación. Métodos El documento utilizó la misma contraseña y proceso para evaluar a 12 jóvenes atletas profesionales de voleibol sin calentamiento y con calentamiento. El sistema de análisis de movimiento bidimensional Dartfish Pursuit 8.0 se utilizó para analizar los datos de video grabados por las dos cámaras simultáneamente. Resultados En las dos pruebas antes y después, la puntuación del paso de valla (1,75 ± 0,62 frente a 2,42 ± 0,52) y la puntuación total (13,50 ± 2,20 frente a 16,42 ± 2,15) fueron significativamente más altas que aquellas sin la prueba de calentamiento ( P <0,01). Además, en sentadillas (1,58 ± 0,67 vs 1,92 ± 0,67), estocadas rectas (2,00 ± 0,43 vs 2,50 ± 0,52), levantamientos activos de piernas rectas (1,50 ± 0,67 vs 2,00 ± 0,60), estabilidad de rotación (1,42) ± 0,52 vs. 1,92 ± 0,29) mostró un aumento significativo en la puntuación (P <0,05). Conclusión Los ejercicios de calentamiento antes de la prueba pueden mejorar los resultados de la prueba. Este patrón de movimiento anormal observado solo por inspección visual puede no reflejar realmente la "disfunción" del movimiento. En el caso de ignorar los factores de calentamiento previos a la prueba, la retroalimentación sobre el rendimiento deportivo y la formulación de estrategias de entrenamiento, esta conclusión de predecir un riesgo de lesión y evaluar los efectos del entrenamiento puede tener limitaciones específicas en su valor de referencia. Nivel de evidencia II; Estudios terapéuticos: investigación de los resultados del tratamiento.

Simulation of recognition method of damaged parts of high-intensity sports injury images / Simulação do método de reconhecimento de partes danificadas em imagens de lesões esportivas de alta intensidade / Simulación del método de reconocimiento de partes dañadas en imágenes de lesiones deportivas de alta intensidad

ABSTRACT Introduction: When athletes are performing sports training, many movements are of high intensity, and that training is repetitive, resulting in wear and tear on some injured parts. Objective: Sports athletes can damage parts of the body in high - intensity exercise. During the processing, it is necessary to identify and analyze the damaged parts in the image. However, the current relevant methods have low accuracy and different problems of efficiency and quality. Methods: In this paper, a Fish Swarm Algorithm is proposed to identify high-intensity motion damage images. According to the combination of adaptive threshold and mathematical morphology, the contour of the damaged part of the image is extracted. Results: The above-mentioned method can improve the accuracy of identifying damaged parts of sports injury images, shorten the recognition time, and has certain feasibility in determining sports injury parts. Conclusions: This method can be widely used in high-intensity sports injuries. Level of evidence II; Therapeuticstudies - investigation of treatment results.

RESUMO Introdução: Quando os atletas estão realizando treinamento esportivo, muitos movimentos são de alta intensidade, e esse treinamento é repetitivo, resultando em desgaste de algumas partes lesionadas. Objetivo: Os atletas podem danificar partes do corpo em exercícios de alta intensidade. Durante o processamento, é necessário identificar e analisar as partes danificadas da imagem. No entanto, os métodos atuais relevantes têm baixa precisão e problemas de eficiência e qualidade diferentes. Métodos: Neste artigo, um algoritmo Fish Swarm é proposto para identificar imagens danificadas por movimento de alta intensidade. Com base na combinação de limiar adaptativo e morfologia matemática, o contorno da parte danificada da imagem é extraído. Resultados: O método acima mencionado pode melhorar a precisão da identificação das partes danificadas das imagens de lesões esportivas, encurtar o tempo de reconhecimento e tem alguma viabilidade para determinar as partes das lesões esportivas. Conclusões: este método pode ser amplamente utilizado em lesões esportivas de alta intensidade. Nível de evidência II; Estudos terapêuticos- investigação dos resultados do tratamento.

RESUMEN Introducción: Cuando los deportistas realizan entrenamientos deportivos, muchos movimientos son de alta intensidad, y ese entrenamiento es repetitivo, lo que genera desgaste en algunas partes lesionadas. Objetivo: Los deportistas pueden dañar partes del cuerpo en el ejercicio de alta intensidad. Durante el procesamiento, es necesario identificar y analizar las partes dañadas en la imagen. Sin embargo, los métodos relevantes actuales tienen baja precisión y diferentes problemas de eficiencia y calidad. Métodos: En este artículo, se propone un algoritmo Fish Swarm para identificar imágenes de daño por movimiento de alta intensidad. Según la combinación de umbral adaptativo y morfología matemática, se extrae el contorno de la parte dañada de la imagen. Resultados: el método mencionado anteriormente puede mejorar la precisión de la identificación de las partes dañadas de las imágenes de lesiones deportivas, acortar el tiempo de reconocimiento y tiene cierta viabilidad para determinar las partes de las lesiones deportivas. Conclusiones: este método puede ser ampliamente utilizado en lesiones deportivas de alta intensidad. Nivel de evidencia II; Estudios terapéuticos- investigación de los resultados del tratamiento.

Lesiones de Lisfranc: repercusión clínico-funcional / Lisfranc lesions: clinical-functional repercussion

Resumen: Objetivo: Valoración clínica-funcional de pacientes con lesión de Lisfranc sin causa laboral ni deportiva tratados en nuestro centro. Material y métodos: Se analizaron 13 pacientes con lesión de Lisfranc sin causa laboral ni deportiva, divididos en dos grupos, lesiones de alta energía y de baja energía. Valoración del retorno a la actividad laboral y deportiva previa a la lesión y el uso de calzado y plantillas posteriormente. Se recogen las puntuaciones del test AOFAS y EVA postoperatorio así como la aparición de complicaciones posteriores a la recuperación de la lesión. Resultados: El grupo de alta energía lo formaron siete pacientes que fueron intervenidos en una media de 7.3 días; cuatro presentaron secuelas postquirúrgicas. De estos pacientes, un paciente no pudo reincorporarse a su actividad laboral previa y dos pacientes no pudieron realizar el deporte que practicaban previamente a la lesión. El AOFAS fue de 79.4 y el EVA de 2.8. En el grupo de baja energía encontramos seis pacientes intervenidos en 5.6 días de media. Todos ellos pudieron reincorporarse a su actividad laboral y deportiva previa. El AOFAs fue de 84.8 y el EVA de 1.6. En ninguna de las variables estudiadas se observaron diferencias estadísticamente significativas. Conclusión: Los pacientes con lesión de Lisfranc fuera del ámbito laboral y deportivo presentan buenos resultados clínicos y funcionales.

Abstract: Objective: Clinical and functional evaluation of patients with Lisfranc lesion without work or sport cause and treated in our center. Material and methods: Thirteen patients with Lisfranc lesion without occupational or sports causes were divided into two groups, high-energy and low-energy injuries. Were analyzed the return to work and sports activity prior to the injury and the use of footwear and insoles after the injury. Also were assessed AOFAS and EVA postoperative score and posterior complications after lesion recovery. Results: High-energy group included 7 patients who underwent surgery on an average of 7.3 days. Of the total of patients, 4 presented post-surgical sequelae. Of these patients, one patient was unable to return to their previous work activity and two patients were unable to practice the usual sports activity. The AOFAS was 79.4 and EVA 2.8. In the low energy group, we found six patients operated on 5.6 days on average. All of them were able to return to their previous work and sports activity. The AOFAS were 84.8 and the EVA 1.6. Statistically significant differences were not observed in any of the variables studied. Conclusion: Patients with Lisfranc injury out of laboral or sports background present good clinical and functional results.

[Lisfranc lesions: clinical-functional repercussion]. / Lesiones de Lisfranc: repercusión clínico-funcional.

OBJECTIVE: Clinical and functional evaluation of patients with Lisfranc lesion without work or sport cause and treated in our center. MATERIAL AND METHODS: Thirteen patients with Lisfranc lesion without occupational or sports causes were divided into two groups, high-energy and low-energy injuries. Were analyzed the return to work and sports activity prior to the injury and the use of footwear and insoles after the injury. Also were assessed AOFAS and EVA postoperative score and posterior complications after lesion recovery. RESULTS: High-energy group included 7 patients who underwent surgery on an average of 7.3 days. Of the total of patients, 4 presented post-surgical sequelae. Of these patients, one patient was unable to return to their previous work activity and two patients were unable to practice the usual sports activity. The AOFAS was 79.4 and EVA 2.8. In the low energy group, we found six patients operated on 5.6 days on average. All of them were able to return to their previous work and sports activity. The AOFAS were 84.8 and the EVA 1.6. Statistically significant differences were not observed in any of the variables studied. CONCLUSION: Patients with Lisfranc injury out of laboral or sports background present good clinical and functional results.

OBJETIVO: Valoración clínica-funcional de pacientes con lesión de Lisfranc sin causa laboral ni deportiva tratados en nuestro centro. MATERIAL Y MÉTODOS: Se analizaron 13 pacientes con lesión de Lisfranc sin causa laboral ni deportiva, divididos en dos grupos, lesiones de alta energía y de baja energía. Valoración del retorno a la actividad laboral y deportiva previa a la lesión y el uso de calzado y plantillas posteriormente. Se recogen las puntuaciones del test AOFAS y EVA postoperatorio así como la aparición de complicaciones posteriores a la recuperación de la lesión. RESULTADOS: El grupo de alta energía lo formaron siete pacientes que fueron intervenidos en una media de 7.3 días; cuatro presentaron secuelas postquirúrgicas. De estos pacientes, un paciente no pudo reincorporarse a su actividad laboral previa y dos pacientes no pudieron realizar el deporte que practicaban previamente a la lesión. El AOFAS fue de 79.4 y el EVA de 2.8. En el grupo de baja energía encontramos seis pacientes intervenidos en 5.6 días de media. Todos ellos pudieron reincorporarse a su actividad laboral y deportiva previa. El AOFAs fue de 84.8 y el EVA de 1.6. En ninguna de las variables estudiadas se observaron diferencias estadísticamente significativas. CONCLUSIÓN: Los pacientes con lesión de Lisfranc fuera del ámbito laboral y deportivo presentan buenos resultados clínicos y funcionales.

Current clinical practice and return-to-sport criteria after anterior cruciate ligament reconstruction: a survey of Brazilian physical therapists.

BACKGROUND: Adherence to the use of recommended measures/criteria for return to sport clearance after anterior cruciate ligament reconstruction is crucial for successful rehabilitation. OBJECTIVES: The purpose of this study was to describe the current clinical practice of Brazilian physical therapists that treat patients after anterior cruciate ligament reconstruction, including the measures/criteria used to support the decision-making process regarding return to sport. The secondary aim was to investigate factors associated with the use of the most recommended measures/criteria for return to sport. METHODS: An electronic survey questionnaire was sent to Brazilian physical therapists. The survey consisted of questions about demographics and professional and clinical practice data related to anterior cruciate ligament reconstruction postoperative rehabilitation and return to sport criteria. Descriptive statistics and chi-square tests were used for analyses. RESULTS: A sample of 439 professionals participated in the survey. Only 6.4% of the physical therapists use the most recommended measures/criteria for return to sport after anterior cruciate ligament reconstruction. Professional certification in Sports Physical Therapy was the only factor associated with the use of these recommended measures/criteria (p=0.02). The measures most used for return to sport clearance were related to physical factors (65.3% to 75.1%), such as range of motion and muscle strength. A small number of professionals use questionnaires to assess functional (16.6%) and psychological (19.1%) aspects of their patients to support the decision-making process. CONCLUSION: In their clinical practice, most Brazilian physical therapists do not use the recommended measures/criteria for return to sport after anterior cruciate ligament reconstruction.

Orofacial trauma and mouthguard use in Brazilian rugby union players.

BACKGROUND/AIM: Rugby union represents a high-risk sport for orofacial trauma due to its impact collisions and repetitive tackles. The aim of this study was to investigate the prevalence of orofacial trauma according to mouthguard use among a sample of Brazilian rugby union players. METHODS: An online questionnaire was sent to the 16 best rugby union clubs in Brazil. The questionnaire contained questions about the training history of each athlete, prevalence of orofacial trauma, and details about mouthguard use. Only participants who reported using a mouthguard were selected for this analysis. RESULTS: A total of 244 individuals were included. The prevalence of orofacial trauma was 34.4%, and 61.9% of them did not wear a mouthguard at the time of the incident. The only type of mouthguard reported was the pre-fabricated ("boil and bite" and "ready-to-wear") type. A stronger association was observed between the reason for using a mouthguard and the outcome, whereas a lower proportion of trauma was observed among individuals who claimed mandatory mouthguard use at the gym/sport (20.0%). Time since the respondent started playing rugby union and who instructed them to use a mouthguard were not associated with orofacial trauma. CONCLUSION: Prevalence of orofacial trauma was high among this sample of rugby union players from Brazil, even with the use of pre-fabricated mouthguards. This study encourages further investigation on the use of custom-made mouthguards in rugby union and the role of coach/physical educators to reduce the prevalence of orofacial trauma.

CrossFit and the Epidemiology of Musculoskeletal Injuries: A Prospective 12-Week Cohort Study.

BACKGROUND: Despite the increasing international popularity of CrossFit, there is a paucity of scientific evidence on the risk of CrossFit-related musculoskeletal injuries (CRMIs). PURPOSE: To investigate the incidence (cumulative incidence proportion [IP] and incidence density [ID]) of CRMIs and the association of CRMIs with personal and training characteristics. STUDY DESIGN: Descriptive epidemiology study. METHODS: A prospective, 12-week descriptive epidemiology cohort study was conducted in a convenience sample of CrossFit facilities in a single Brazilian city. Printed baseline questionnaires were distributed to 13 CrossFit boxes. All participants who filled out the questionnaire and consented to participate in the study were invited to respond to an online follow-up questionnaire every 2 weeks to collect data on CrossFit training characteristics and CRMIs. A CRMI was defined as any self-reported musculoskeletal injury or pain that prevented an athlete from exercising for at least 1 day. The IP was defined as the number of new cases divided by the entire population at risk, while the ID was defined as new events divided by the total person-time exposure in hours. Logistic mixed models were developed to investigate the association of CRMIs with personal and training characteristics. RESULTS: A total of 515 CrossFit participants filled out the baseline questionnaire and provided informed consent, and 406 (78.8%) completed at least 1 follow-up measure. There were 133 participants who reported at least 1 CRMI during the study, and a total of 247 unique and new CRMIs were reported over a total estimated person-time exposure to CrossFit of 13,041 hours. The IP was 32.8% (95% CI, 28.4%-37.5%). The ID was 18.9 (95% CI, 16.6-21.3) per 1000 hours of CrossFit exposure. The shoulders (19.0%; n = 47) and lumbar spine (15.0%; n = 37) were most affected. Muscle injuries (45.3%; n = 112) and joint pain (24.7%; n = 61) were the most common CRMI types reported. Switching between prescribed and scaled down training loads (odds ratio [OR], 3.5 [95% CI, 1.7-7.3]) and previous injuries (OR, 3.2 [95% CI, 1.4-7.7]) were risk factors for a CRMI, while CrossFit experience was identified as a protective factor (OR, 0.7 [95% CI, 0.5-1.0]). CONCLUSION: In this 12-week prospective study, the ID was 18.9 CRMIs per 1000 hours of exposure; switching between training loads and previous injuries was associated with 3.5- and 3.2-fold higher odds, respectively, of sustaining CRMIs.

Musculoskeletal injuries in athletes from five modalities: a cross-sectional study.

BACKGROUND: Musculoskeletal injuries (MSK-I) are a serious problem in sports medicine. Modifiable and non-modifiable factors are associated with susceptibility to these injuries. Thus, the aim of this study was to describe the prevalence of and identify the factors associated with MSK-I, including tendinopathy and joint and muscle injuries, in athletes. METHODS: In this cross-sectional observational study, 627 athletes from rugby (n = 225), soccer (n = 172), combat sports (n = 86), handball (n = 82) and water polo (n = 62) were recruited at different sports training centres and competitions. Athlete profiles and the prevalence of MSK-I were assessed using a self-reported questionnaire. Only previous MSK-I with imaging confirmation and/or a positive physical exam by a specialized orthopaedist were considered. The association of the epidemiological, clinical and sports profiles of athletes with MSK-I was evaluated by a logistic regression model. RESULTS: The mean age was 25 ± 6 years, and 60% of the athletes were male. The epidemiological, clinical and sports profiles of the athletes were different for the five sport groups. The MSK-I prevalence among all athletes was 76%, with 55% of MSK-I occurring in a joint, 48% occurring in a muscle and 30% being tendinopathy, and 19% of athletes had three investigated injuries. The MSK-I prevalence and injury locations were significantly different among sport groups. There was a predominance of joint injury in combat sports athletes (77%), muscle injury in handball athletes (67%) and tendinopathy in water polo athletes (52%). Age (≥30 years) was positively associated with joint (OR = 5.2 and 95% CI = 2.6-10.7) and muscle (OR = 4.9 and 95% CI = 2.4-10.1) injuries and tendinopathy (OR = 4.1 and 95% CI = 1.9-9.3). CONCLUSION: There is a high prevalence of tendinopathy and joint and muscle injuries among rugby, soccer, combat sports, handball and water polo athletes. The analysis of associated factors (epidemiological, clinical and sports profiles) and the presence of MSK-I in athletes suggests an approximately 4-5-fold increased risk for athletes ≥30 years of age. The identification of modifiable and non-modifiable factors can contribute to implementing surveillance programmes for MSK-I prevention.

Brazilian version of the Self-Estimated Functional Inability because of Pain questionnaire for musculoskeletal injuries relating to dance and sport: translation and cross-cultural adaptation

ABSTRACT BACKGROUND: Self-Estimated Functional Inability because of Pain (SEFIP) is a questionnaire specifically designed to measure musculoskeletal pain or discomfort. OBJECTIVE: To perform translation and cross-cultural adaptation of the SEFIP for dancers (SEFIP-dance), for use in Brazilian Portuguese. In addition, as a secondary objective, we adapted the translated version of SEFIP-dance for use among athletes or exercise practitioners (SEFIP-sport). DESIGN AND SETTING: Questionnaire translation and cross-cultural adaptation study conducted at a public university. METHODS: The Brazilian version of the SEFIP-dance questionnaire was developed following the processes of translation (involving two translators with Brazilian Portuguese as their mother tongue and fluency in English), backtranslation (involving two translators with English as their mother tongue and fluency in Brazilian Portuguese), committee review and pre-testing. SEFIP-sport was developed following the processes of content and face validation. RESULTS: SEFIP-dance was applied to 30 dancers, of mean age 22.38 years (standard deviation [SD] = 3.41), among whom 14 were men (46.66%). The participants understood 100% of the SEFIP-dance items and alternatives. SEFIP-sport was applied to 30 athletes or physical exercise practitioners, of mean age 25.09 years (SD = 8.93), among whom 25 were men (86.33%). The participants understood 100% of the ­SEFIP-sport items and alternatives. CONCLUSION: The Brazilian Portuguese versions of SEFIP-dance, translated and cross-culturally adapted for dancers, and SEFIP-sport, adapted for athletes or physical exercise practitioners, were shown to have adequate levels of understanding.

La propiocepción, método de prevención de lesiones de tobillo, en deportistas de categoría superior / The proprioception, method of preventing ankle injuries in top-level athletes

Resumen El objetivo de la investigación se enmarca en analizar el efecto propiocepción como método de prevención de lesiones de tobillo, en deportistas de la categoría superior. El estudio longitudinal y explicativo se realiza en el Centro Deportivo Olmedo de la ciudad de Riobamba, a una población de 30 jugadores que representó el 100 %. La metodología empleada se enmarca en métodos de campo exploratorio y documental bibliográfico, técnicas como la entrevista, fichas de evaluación fisioterapéuticas y test modificado de Romberg. El efecto del método de propiocepción proporciona como resultado que 17 (57 %) jugadores que presentaban molestias de tobillo, se logra disminuir a seis (20 %) jugadores, a la intervención fisioterapéutica. Para el análisis y procesamiento de los datos obtenidos en la aplicación del método, se emplea el paquete estadístico SPSS, versión 22.0 IBM.

Abstract The objective of this research is framed in analyzing the proprioception effect as a method of prevention of ankle injuries in athletes of the higher category. The longitudinal and explanatory study is carried out at the Olmedo Sports Center in the city of Riobamba, to a population of 30 players that represented 100 %. The methodology used is part of exploratory and bibliographic documentary field methods, techniques such as interview, physiotherapy assessment sheets and modified Romberg test. The effect of the method of proprioception provides as a result that 17 (57 %) players who presented ankle discomfort, is reduced to six (20 %) players to the physiotherapy intervention. For the analysis and processing of the data obtained in the application of the method, the statistical package SPSS version 22.0 IBM is used.

Prevalence of MRI-Detected Ankle Injuries in Athletes in the Rio de Janeiro 2016 Summer Olympics.

OBJECTIVE: To describe the prevalence, severity, and location of ankle injuries as assessed on magnetic resonance imaging (MRI) in athletes participating in the Rio de Janeiro 2016 Summer Olympic Games. METHODS: We analyzed all ankle MRIs that were acquired for suspected injury as reported by the National Olympic Committee medical teams and the Organizing Committee medical staff during the Rio 2016 Summer Olympics. Diagnostic imaging was performed through the Olympic Village Polyclinic. Images were interpreted retrospectively according to standardized criteria. RESULTS: A total of 11,274 athletes participated in the Games, of which 89 (8.8%) were referred for an ankle MRI. Eighty-eight of the 89 (99%) had at least 1 abnormal finding, and some had as many as 27, for an average of 6.2 abnormalities per examination. Around one-fifth of all abnormal findings were considered pre-existing (21%) and 79% were assumed to be the result of an acute or subacute injury. The highest proportion of acute/subacute injuries per athlete occurred in ball sports (7.0 injuries per examination) and in the age group >30. Most pre-existing findings per athlete were identified in the group of others (no track and field or ball sports athletes) with 2.5 findings per examination and respectively in the age group >30 (1.7). CONCLUSION: Our study demonstrated a high prevalence of acute and subacute, but also pre-existing injuries in Olympic athletes undergoing ankle MRI. Tendon injuries were the most common acute injuries, found mainly in ball sports athletes. Most pre-existing ankle injuries were identified at the ligaments.

Injury Frequency in Handball Players: A Descriptive Study of Injury Pattern in São Paulo State Regional Teams

Abstract Aim: To assess the frequency of injuries among male and female handball athletes, identifying injured anatomic parts, injury diagnostics, their severity and type. Methods: The participants were composed of 122 handball players from São Paulo state teams, being 63 male (21.2±5.3 years) and 59 female (19.9±5.3 years) athletes who were interviewed using the "Champion Profile" questionnaire. The injuries were sorted by type: acute or overuse; and severity (major, moderate, slight, minor), given by the period of absence from team activities (training sessions and matches), and our results are presented as descriptive statistics. Results: The majority of injuries was found in the lower limbs, both in female (69.6%) and male (47.4%) players, as well as the knee was the most commonly injured anatomic part, representing 33.7% and 20.8% of the total number of injuries for the respective genders. We found a higher number of major injuries in female (35.8%) and male (20.8%) players when compared to the other severity categories. The acute injuries were more common among the total sample (48%) when compared to overuse injuries (22.7%), while a sprain was the most commonly diagnosed injury. Conclusion: It was observed that Brazilian handball players demonstrated an important number of major and acute injuries, forcing them to abstain from training sessions and matches, which can lead to both team and athlete performance losses. Furthermore, we suggest the inclusion of preventive training to reduce the frequency of injuries in handball athletes.