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Background: With the outbreak of Coronavirus disease 2019 (COVID-19), many studies’ attention to this world’s complexity increased dramatically. Different views on sports and physical activities have been presented, which have addressed the advantages and disadvantages of sports activities in this period differently. The purpose of this review was to investigate the physiological and psychological effects of physical activity during the COVID-19 pandemic. Methods: Using PubMed, Science Direct, Medline, and Web of Science electronic databases, this review summarizes the current knowledge of direct and indirect effects of physical activity during the COVID-19 pandemic, evaluating the advantages and drawbacks of specific exercise physiology conditions. All types of studies were assessed, including systematic reviews, case-studies, and clinical guidelines. The literature search identified 40 articles that discussed COVID-19, immune system, the relation between immune system and exercise or diet, and psychological impacts of physical activity. Results: Forty articles review showed that the immune system depends on the type, frequency, intensity, and duration of the exercise. Intense or prolonged exercise with short recovery periods can progressively weaken the immune system and increase the risk of COVID-19. One of the acute responses after moderate-intensity training is improved immune function and a decrease in inflammatory cytokines. Paying attention to dietary intakes of micro-and macronutrients in conjunction with exercise can strengthen the condition to fight against coronavirus. Exercise can also affect the psychological dimensions of the COVID-19 pandemic, including depression, anxiety, and stress, which improve community mental health during the quarantine. Conclusion: Setting appropriate physical activity based on individuals’ properties and proper diet plan may enhance the physiological and psychological body’s condition to fight against coronavirus.

Background: Rotation of the femoral component in total knee replacement (TKR) is very important for good long-term results. Malrotation of the femoral component usually requires subsequent reimplantation. We performed X-ray projections of the knee at 90° to determine proper rotation of the femoral component without use of computed tomography. Methods: The axial projection of the distal femur was measured in post-TKR cases. During the TKR operation, Whiteside’s method had been used to provide symmetrical flexion space. The exact outer rotation of the femoral component was measured by x-ray determination of the middle condylar twist angle, from the central epicondylar axis and posterior condylar axis. Results: The middle condylar twist angle was in outer rotation, with an average of 3.36° (range: 1-7.6), similar to the literature. Six of the patients underwent bilateral TKR. In total, the case series included 18 women and 15 men, with average age of 71.34 years-old (range: 56-85). As a clinical evaluation we used Knee Society Score (2011). From results 2 patients were not very satisfied with the instability TKR. Axially X-ray seemed to be only which could distribute these patients. Summary: X-ray values have the same evaluation as computed tomography. The results were 2 patients in pattern of 48, which were sufficient to extrapolate to whole population according to the statistical methods. This corresponds to 4% which we can add to evaluate satisfaction of all patients after TKR and eventually lower the total of unsatisfactory patients which is total of ¼ of total. It is also forensic reason for all patients. Our recommendation to have good results and patient satisfaction in TKR is to do x-rays before and after operation. Important are x-rays antero-posterior, lateral, and Kanekasu projection to know the rotation after TKR. Other cases without stability in flexion are nor very rarely planed for revision surgery, which is much more expensive, and burdens overall health system. 

Concussion occurs with some frequency in a variety of sports. Any trauma to the brain can also result in temporary or chronic olfactory dysfunction. The relationship between sports concussion and olfactory dysfunction is not well studied, nor do we know whether only more severe injuries result in smell impairments. Three sports players who had previously experienced either a moderate or severe concussion were compared to matched controls. Only the player with a previous severe concussion had a current olfactory impairment. We tentatively suggest that the distinction between moderate and severe concussion may represent a possible cut-off between the presence and absence of olfactory impairment in sports players.

Background: Literature on ACL injury is limited when assessing for the presence and interaction of multiple risk factors simultaneously. Identifying risk factor interaction may increase the impact of prevention programmes to target ACL injury reduction. The aim of this study was to retrospectively assess ACL injured female athletes to identify which modifiable and non-modifiable risk factors were present at the time of injury. Method: Seventeen female athletes who had sustained a non-contact ACL injury were interviewed retrospectively to assess for the presence of reported risk factors for ACL injury. Result: This retrospective analysis ACL injury cases highlighted a number of factors which were present with high frequency across this group of cases. All had non-contact ACL injury occurring during cutting or landing, which suggests a predisposing deficit in neuromuscular control. This poor neuromuscular control could be exacerbated by the presence of fatigue identified within the cohort. This poor control could be further influenced by the fact a majority of athletes had another significant injury in the 12 weeks prior to ACL injury. The restriction to training could have either decreased fatigue resistance, or potentially changed their movement pattern because of the method of injury management undertaken. Conclusion: This case series provides insight into the interaction of risk factors for ACL injury in sportswomen, with the presence of another injury disrupting training, decreasing the athletes work capacity and fatigue resistance, being compounded perceived or actually elevated levels of fatigue, leading to the potential for abhorrent movement patterns and increased injury risk.

Background: SCI Action Canada partnered with researchers to adapt an evidence-based leisure-time physical activity (LPTA) counselling service (Get-in-Motion (GIM). A satellite GIM service called Passez à l’action was established within a French-speaking context for persons with physical disabilities. An understanding of the determinants that infl uenced the implementation and functioning of the GIM service within the Adaptavie context are required to maximize the potential of other community-based LTPA services being successfully introduced in similar organizations. Purpose: The case study objectives are to: 1) describe the characteristics and implementation contexts of two leisure-time physical activity counselling services for Canadians with a physical disability and the adoption process that took place when the protocol was translated to a new context, and 2) elucidate, from the point of view of the service providers, the organizational determinants that could have facilitated and/or hindered the implementation and functioning of these services. Methods: Guided by the Consolidated Framework for Implementation Research, focus groups were held with the directors and staff of each service. Mixed-content and thematic analyses were then used to determine overarching themes. Results: Findings suggest that the presence of service innovators fosters ownership of the service and facilitates ongoing staff training and support. A thoughtful implementation plan should be included as a component of translation between contexts. Conclusions: Lessons learned and recommendations for future translation of similar evidence-based services to additional contexts are discussed.

Systemic arterial hypertension (SAH) is considered an important risk factor for the development of cardiovascular diseases. The aim of the present study was to verify the effects of a short cardiovascular rehabilitation program (CR) in hypertensive subjects. The clinical pilot study involved a sample composed of 11 hypertensive subjects. It was evaluated the weight, height, body mass index (BMI), waist and hip circumference, waist hip ratio, systolic blood pressure (SBP), diastolic blood pressure (DBP) and six-minute walk test (6-MWT) before and after CR. CR was performed twice a week for 60 minutes. The results shown that after CR occurred a reduction of waist circumference (99.86±8.7 to 95.2±8.6 cm, p=0.0002) and hip circumference (110.18±14.75 to 105.00±12.7 cm p=0.01) values. About the mean distance walked in the 6-MWT there was an increase after the CR program (335.9±123.5 m to 554.56±87.9 m, p=0.000). In conclusion, the results suggest that a short CR is an effective for the treatment of hypertensive subjects. After 16 CR sessions, functional and musculoskeletal capacity was improved, evaluated by 6-MWT. Furthermore, the short CR program decreased waist and hip circumferences, being an important option for these subjects. Although. There were no changes in baseline blood pressure levels.

Introduction: Acupuncture is a practice that has been used to treat multiple medical conditions for thousands of years and is one of the most popular alternative treatments applied in Western medical practice. Acupuncture is a modality that has significant potential for further integration into the treatment of sports medicine conditions. Methodology: The search strategy in this review included electronic databases-MEDLINE, Cochrane Library, PubMed, Web of Science, and Science Direct. Randomized controlled trials and systematic reviews were preferred for article inclusion, but other study types were included when the number or quality of evidence was limited. Results: Back pain, neck pain, shoulder pain, and knee pain related to OA tend to respond well to acupuncture treatment. There is evidence to support the use of acupuncture for the short-term treatment of plantar fasciitis, although long-term efficacy data is lacking. Acupuncture may be a useful treatment modality for epicondylitis and Achilles tendinopathy, but the current data is limited. While acupuncture may improve athletic performance and prevent Delayed-Onset Muscle Soreness (DOMS) symptoms, there is little current evidence to support this use. Conclusion: Further studies are needed to assess the usefulness of acupuncture in sports medicine. However, there is good evidence for the current use of acupuncture in treatment of multiple pain conditions.

Background: Experimentally-induced delayed-onset muscle soreness of large muscle groups is frequently used in as an injurious model of muscle pain. We wanted to develop an experimental model of DOMS to to mimic overuse injuries from sports where repeated finger flexion activity is vital such as rock climbing. The aim of this pilot study was to evaluate the utility of a ‘finger trigger device’ to induce DOMS in the fingers, hands, wrists and lower arms. Methods: A convenient sample of six participants completed an experiment in which they undertook finger exercises to exhaustion after which measurements of pain, skin sensitivity to fine touch, forearm circumference and grip strength in the hand, wrist and forearm were taken from the experimental and contralateral non-exercised (control) arms. Results: Pain intensity was greater in the experimental arm at rest and on movement when compared with the control arm up to 24 hours after exercise, although the location of pain varied between participants. Pressure pain threshold was significantly lower in the experimental arm compared with the control arm immediately after exercises locations close to the medial epicondyle but not at other locations. There were no statistical significant differences between affected and non-affected limbs for mechanical detection threshold, forearm circumference or grip strength. Conclusion: Repetitive finger flexion exercises of the index finger by pulling a trigger against a resistance can induced DOMS. We are currently undertaking a more detailed characterization of sensory and motor changes following repetitive finger flexion activity using a larger sample.

Time-efficient screening of lower extremity biomechanics to identify potential injurious movement patterns is crucial within athletic medicine settings. When considering biomechanical risk factors for anterior cruciate ligament injuries, several screening tests have been used to assess dynamic knee valgus. Current methods involving 3-dimensional motion capture systems are considered gold standard for such assessment; however, these methods are time consuming and require expensive materials. This study investigated the use of 2-dimentional kinematic evaluation during a standardized vertical jump athletic assessment to screen for potential lower extremity risk of injury. 50 collegiate athletes, 25 male and 25 female, from various sports participated in the study. The vertical jump was chosen because it is a common performance evaluation test that is regularly performed several times a year, providing consistent opportunities for screening while not creating additional obligations for the student athletes. Results showed that the 2-dimentional evaluation method had strong correlations (P<0.0001) with the gold standard 3-dimensional evaluation, suggesting that an accelerated 2-dimentional screening process can be used as a first step to screen for potential injurious lower extremity movement patterns.

Background: There is paucity in studies reporting long-term results following anterior cruciate ligament (ACL) rupture. A UK national ligament registry (NLR) designed to collect demographic, clinical and outcome data on patients undergoing ACL reconstruction was launched in 2013. There was therefore an emergent question on the role of such registry as an additional source of evidence. Study aims: A framework analysis aimed to provide a basis for the evaluation of outcomes following ACL management and formulate a structure of the evidence, which can be derived from the registry. Methods: A systematic approach was adopted to select relevant studies. Qualitative thematic and meta-narrative analyses were conducted. Level-1 registry data were recorded for all primary ACL reconstruction procedures from January to June 2016. Registry data content and validity were evaluated. Results: Seven studies were suitable for analyses yet none defined the pattern of meniscal injury following initial treatment. When reported the incidence varied markedly between 23% and 80%. There was evidence of collection of at least one principal outcome measure in at least 85% of participants across all studies. Thematic analysis identified four key domains of outcome measures (1) intervention selection, (2) Knee stability evaluation, (3) Patient reported outcomes, (4) Radiographic evaluation and risk of secondary osteoarthritis. Graft choice, rate of meniscal and chondral injuries and cumulative risk of revision surgery had incomplete and inconsistent reports. Comparison of demographic and clinical data with the first registry report demonstrated: predominately younger patient population; older female patients at time of intervention; and higher incidence of meniscal tears. Conclusions: Registry data driven quality and research improvement open a new paradigm in ACL reconstruction evidence base and future practice. Early observations have consolidated the importance of associated meniscal injuries in the management of ACL rupture. Further work is needed to improve registry data completeness, accuracy and validity. A proposed data migration process using available technologies can help harmonise data collection without the added burden on clinical services.

As people get older, chronic diseases become an important reason of disability while a decline in physical functions is related to aging among the elders, which may lead to dependency and isolation of the older adults. Body asymmetry and imbalance body alignment can bring added stress to the joint structures that can cause dysfunction of the joint, ligaments, tendons, bursas, and related muscles, which in return brings about problem while walking or during activities of daily living. Joint Functional Screening (JFS) is a systemic clinical examination with clinical reasoning of the entire human joints body, with or without causative limitation to derive a holistic analysis of musculoskeletal system. JFS profile helps to assess body disorder of older people. This clinical screening include documentation of balance of the body, lower and upper body strength, joints flexibility, body composition, and body alignment. This is an innovation build to profile a normal musculoskeletal state to decode any anomaly in an otherwise a normal subject, who might be preparing to take up any activities in one’s lifespan that could elicit an injury which could be prevented. JFS could be a useful tool for physiotherapists, exercise therapist or even the personal trainers to screen a body prior to rehabilitative or an exercise program; and this clinical screening is presently a best guidance to prevent risk of fall or injury among individual healthy people and older adult.

The purpose of the present study was to experimentally assess the effect of cognitive strategies of association and dissociation while running on central nervous activation. A total of 30 long distance runners volunteered for the study. The study protocol consisted on three sessions (scheduled in three different days): (1) maximal incremental treadmill test, (2) associative task session, and (3) dissociative task session. The order of sessions 2 and 3 was counterbalanced. During sessions 2 and 3, participants performed a 55 min treadmill run at moderate intensity. Both, associative and dissociative tasks responses were monitoring and recording in real time through dynamic measure tools. Consequently, was possible to have an objective control of the attentional. Results showed a positive session (exercise+attentional task) effect for central nervous activation. The benefits of aerobic exercise at moderate intensity for the performance of self-regulation cognitive tasks are highlighted. The used methodology is proposed as a valid and dynamic option to study cognitions while running in order to overcome the retrospective approach.

Background: To determine the spectrum of shoulder pathologies suffered by surfers. Methods: Prospective descriptive study. Surfers with shoulder injuries who were referred to a sub-speciality orthopaedic shoulder private practice situated on the Northern beaches of Sydney (Australia) were recruited over a three-year period. Results: 42 shoulders in 37 subjects were included-12 acute injuries (29.3%), 9 acute on chronic (22%) and 20 chronic injuries. Average age 48 years (range 20-72 years). Seventeen subjects (46%) had manual occupations and 20 subjects (54%) had office-based occupations. Spectrum of pathologies included rotator cuff tendon tears, long head of biceps tendon pathology, labral tears, acromioclavicular and glenohumeral joint osteoarthritis. Discussion: There is a wide spectrum of acute and chronic shoulder injuries sustained by surfers. The most common presentation was for chronic pathology. The average age of 48 suggests that age may play a role in attritional/degenerative change and therefore an increased likelihood of injury.

The purpose of this study was to assess the peculiarities of vertebral pain syndrome, parameters of physical performance and quality of life indices in women of older age depending on the presence of vertebral fractures (VF). This study was performed with participation of 215 women aged 50-89 years old which were divided into two groups: first one-women without any previous osteoporotic fractures (n=143), second group - patients with VF in thoracic and/or lumbar spine (n=72). The presence and intensity of pain in the thoracic and lumbar spine were evaluated using the 11-component visual analog scale (VAS), physical performance-with following functional tests: 3-, 4- and 15-meter tests (gait speed), static balance (a side-by-side position, a semi-tandem position and a full-tandem position), 8-feet test and «five timed chair stands» (coordination and strength), hand grip strength (by dynamometer), measurement of arterial pressure (systolic and diastolic), heart and respiratory rates, breath holding, chest excursion (mean and on the inhalation and the exhalation), lateral trunk lean, Schober and Thomayer tests. It was demonstrated that the intensity of vertebral pain (pain at the time of investigation, the most common level of pain, pain in the best periods of the disease) and some physical performance tests (lateral trunk lean and chest excursion (mean index, during the inhalation and exhalation), hand grip strength, 15-meter gait speed test and five-repetition sit-to-stand test) are significantly worse in women with VF than corresponding parameters in persons without fractures. It should be taken into account during the assessment of physical performance and development of rehabilitation programs for older age women with vertebral fractures.

Osteoarthritis of the hand is a chronic condition that involves hand joints, but receives less attention. Few studies have investigated the use of ultrasound therapy and laser therapy for the treatment of hand osteoarthritis. The objective was to evaluate the effect of the conjugated treatment of therapeutic ultrasound and laser therapy on the pain and joint function of a patient with hand osteoarthritis. The is case of a woman, 57 years old, with a diagnosis of osteoarthritis on hand for 3 years, presenting constant pain and worsening after manual activities. The pain and function were evaluated, respectively, by Visual Analog Scale (VAS) and Australian Canadian Osteoarthritis Hand Index questionnaire (AUSCAN). After 12 sessions using ultrasound and laser therapy application, there was an expressive improvement in the pain and functional indexes of the patient. The combined application of therapeutic ultrasound and laser therapy, through the unified field action of the therapies used, proved to be efficient in reducing pain and improving the functionality.

Anthropometric characteristics, represent one of the most important subsystems within the “system” of man, and which can be in affected by physical exercises in the direction of the desired transformation. Very often the anthropometric parameters (height and weight) are used in the assessment of the morphological status of an individual, and on the basis of the results of Body Mass Index (BMI) bring certain estimates and conclusions. BMI as a statistical measures, is used in many public health campaigns as an approximate measure of the ideal body mass and the degree of nutrition of a population. The main goal of the research was to determine and analyze differences in BMI parameters between male and female students, aged 18±0.5 years, and determine the trend of changes. Using the T-test module, the obtained results confirmed that there are statistically significant differences in body height (t=8,17; p<0.001) and body weight (t=5,29; p<0.001), while in BMI values there are not statistically significant differences (t=-0.68, p>0.001). Based on BMI values, a positive trend of somatic changes of both poles is evident.

This review paper analyzes the response of renal function during two types of exercise: 1) exercise of increasing intensity and 2) exercise of submaximal intensity and prolonged duration. During an effort of increasing intensity there is a decrease in renal blood flow that, theoretically, could compromise renal function. However, several studies seem to show that the kidney has self-regulatory mechanisms that allow maintaining the filtration fraction. On the other hand, ultra resistance exercises, such as ironman, are becoming more frequent. Knowing the renal response to this type of exercise is essential to apply knowledge to emergency situations such as dehydration or hyponatremia.

Purpose: This study aimed to identify physical activity, enjoyment, and factors for future activity between an active video game (AVG) condition and self-paced exercise (SPE) among college-aged students. Methods: Thirty college-aged volunteers (age=22±1.68 years) completed 4-45 minute physical activity sessions (2 AVG; 2 self-paced). A survey and a brief structured interview followed. Results: Overall, participants expended more calories, accumulated more steps, and more physical activity during SPE; however, participants in the AVG condition met daily exercise recommendations. The majority of participants (81%) enjoyed playing the AVG. Autonomy and competence were found as common themes among those who preferred the SPE condition; whereas, lack of knowledge and exercise variety were emergent themes among those who preferred AVG. Conclusions: This study provides evidence that college students could meet daily exercise recommendations by participating in AVG interventions; although AVGs that provided autonomy and allowed users to demonstrate competence would be preferable.

Background: The study aimed to evaluate the effects of a 4-week Bergamot Polyphenolic Fraction (BPF Gold; Bergamet Sport) supplementation on serum nitric oxide (NO), asymmetric dimethyl-arginine (ADMA), Endopat indices of endothelial function and maximal oxygen uptake (V_ O2max) of athletes. Methods: The effects of dietary supplementation (BPF Gold, 650 mg twice a day for 4 weeks) and placebo administration on flow-mediated dilatation (via Endopat measurements), serum markers (NO, ADMA), lipid profile, and V_ O2max were analysed in 30 athletes both before and after dietary protocols. Results: Significant differences between pre- and post-intervention baseline NO levels were observed after BPF Gold dietary protocol. Higher post-intervention baseline NO level was observed after BPF Gold diet compared with placebo. Moreover BPF Gold Sport increased baseline NO concentration (ΔNO). The positive correlation was observed between baseline post-intervention NO concentration and maximal oxygen uptale and also between ΔNO and ΔVO2max in response to BPF Gold supplementation. There was an association between a higher Edopat values of endothelial function and higher V O2max after Bergamet Sport diet compared with lower values of placebo. Conclusions: These findings suggest that an increase in NO release in response to BPF Gold Sport supplementation may play a central role in cardiovascular adaptive mechanisms and enhanced exercise performance in athletes.

Background: Epidemiological studies report that females experience greater rates of concussion when compared with males. Biomechanical factors may result in greater post-impact head velocities and accelerations for a given force for females when compared with males. Purpose: To quantify the magnitude, frequency, duration and distribution of impacts to the head and body in rugby league match activities for females versus males. Design: Prospective descriptive epidemiological study. Methods: 21 female and 35 male amateur rugby league players wore wireless impact measuring devices (X2Biosystems; xPatch) behind their right ear over the mastoid process during match participation across a single season. All impact data were collected and downloaded for further analysis. Results: Male amateur rugby league players experienced more head impacts than female amateur rugby league players (470 ±208 vs. 184 ±18; t(12)=-3.7; p=0.0028; d=1.94) per-match over the duration of the study. Male amateur rugby league players recorded a higher median resultant Peak Linear Acceleration (PLA(g)) (15.4 vs. 14.6 g; F(824,834)=51.6; p<0.0001; t(1658)=-3.3; p=0.0012; d=0.10) but a lower median resultant Peak Rotational Acceleration (PRA(rad/s2) (2,802.3 vs. 2,886.3 rad/s2; F(831,827)=3.1; p<0.0001; t(1658)=5.7; p<0.0001; d=0.13) when compared with female amateur rugby league players Conclusion: Females recorded lower median values for PLA(g) and Head Impact Telemetry severity profile (HITSP) for all positional groups but had a higher PRA(rad/s2) for Hit-up Forwards (HUF) and Outside Backs (OSB’s) when compared with male HUF and OSB’s. Females also recorded more impacts to the side of the head (48% vs. 42%) and had a higher 95th percentile resultant PRA(rad/s2) (12,015 vs. 9,523 rad/s2) to the top of the head when compared with male rugby league players.