CHARACTERISTICS OF SPORTS INJURIES IN TAEKWONDO ATHLETES IN PHYSICAL TRAINING

ABSTRACT Introduction: Taekwondo is one of the main events of the Olympic Games. It mainly uses hands and feet for fighting or confrontation and the competition is extremely fierce. Therefore, Taekwondo is more prone to muscle, bone, and joint sports injuries. Objective: To understand the characteristics of taekwondo sports injuries. Methods: Using the literature and questionnaire survey methods, mathematical statistics is used to investigate the sports injuries of young Taekwondo athletes. Results: Among 100 young Taekwondo athletes, 93individuals had different degrees of sports injuries, accounting for 93%, and 7had no sports injuries, accounting for only 7%. The total number of injuries was 160 or 1.6injuries per capita. Conclusions: Athletes should improve their ideological understanding and training level and pay attention to the timely treatment of acute injuries, which can effectively reduce sports injuries. Level of evidence II; Therapeutic studies - investigation of treatment results.

Exercise medicine and physical activity promotion: core curricula for US medical schools, residencies and sports medicine fellowships: developed by the American Medical Society for Sports Medicine and endorsed by the Canadian Academy of Sport and Exercise Medicine

Regular physical activity provides a variety of health benefits and is proven to treat and prevent several non-communicable diseases. Specifically, physical activity enhances muscular and osseous strength, improves cardiorespiratory fitness, and reduces the risk of hypertension, coronary heart disease, stroke, type 2 diabetes, mental health disorders, cognitive decline and several cancers. Despite these well-known benefits, physical activity promotion in clinical practice is underused due to insufficient training during medical education. Medical trainees in the USA receive relatively few hours of instruction in sports and exercise medicine (SEM). One reason for this shortage of instruction is a lack of curricular resources at each level of medical education. To address this need, the American Medical Society for Sports Medicine (AMSSM) assembled a group of SEM experts to develop curricular guidance for exercise medicine and physical activity promotion at the medical school, residency and sports medicine fellowship levels of training. After an evidence review of existing curricular examples, we performed a modified Delphi process to create curricula for medical students, residents and sports medicine fellows. Three training level-specific curricula emerged, each containing Domains, General Learning Areas, and Specific Learning Areas; options for additional training and suggestions for assessment and evaluation were also provided. Review and comment on the initial curricula were conducted by three groups: a second set of experts in exercise medicine and physical activity promotion, sports medicine fellowship directors representing a variety of fellowship settings and the AMSSM Board of Directors. The final curricula for each training level were prepared based on input from the review groups. We believe enhanced medical education will enable clinicians to better integrate exercise medicine and physical activity promotion in their clinical practice and result in healthier, more physically active patients.

Internet Survey of Risk Factors Associated With Training and Competition in Dogs Competing in Agility Competitions

Objective: To describe risk factors associated with training and competition in relation to frequency and severity of injuries experienced by agility dogs.Procedures: An internet-based survey collected data on competition level variables and training level variables. The primary outcome was history of any injury and a secondary outcome considered history of severe injury (injury lasting > 3 months). Logistic regression was used to estimate associations and final models were obtained via backward selection to identify the strongest associations within variables.Results: There were 4,197 dogs included in this analysis. Injury was reported for 1,737 (41.4%) dogs and severe injury was reported for 629 (15.0%). In the model with competition level factors, jumping 4” (OR: 1.50) or 2–4” (OR: 1.31) over shoulder height compared to jumping 0–2” lower and competing at national events was associated with increased injury risk, while competing 6+ times on rubber matting was associated with lower risk (OR: 0.62). Training level variables associated with injury risk were age starting jump, teeter, and weave training, with the highest risk observed for dogs starting jump training between 3 and 18 months but starting weave and teeter training after 18 months of age.Conclusion and Clinical Relevance: Many variables thought to be associated with injury risk were not significant in the final model. Starting jump training at an earlier age was associated with greater risk of injury relative to starting after 18 months. It is possible that the high impact of jump training before skeletal maturity may increase the risk of injuries or musculoskeletal conditions. The increased risk of injury in dogs that jump 2–4, or 4+ inches higher than shoulder height may be due to increased biomechanical forces during takeoff and landing. Faster dogs may be at higher risk of injury; handlers planning competition around big events or competing at the national level are likely to have faster dogs, and may be less likely to compete on rubber matting. These data provide valuable current insight into the possible effects that training and competition variables may have on injury risk in agility dogs.

Biological Markers of Training Level among Qualified Greco-Roman Wrestlers

BACKGROUND: The article presents the dynamics of biochemical indicators showing the tension of body functional systems in qualified Greco-Roman wrestlers at the pre-competition stage. Biochemical indicators can be regarded as the markers of training level, as a reflection of adaptive changes during performing training loads. AIM: The study aims to examine the adaptive reactions of body internal systems in wrestlers to the load performed at the stage of pre-competition training. METHODS: The methodological basis of the study is the examination of the reaction of body functional systems in wrestlers (n = 24) in response to the load performed at the stage of pre-competition training. The basis of the studied indicators of wrestlers’ organisms is the dynamics of the enzymatic activity (ALT and AST), the activity of creatine phosphokinase, and the balance of anabolic and catabolic processes in the course of a 2-week macrocycle of the pre-competition training. RESULTS: A high level of enzymatic activity (ALT and AST) was noted as the response to shock training load in the first and the second training macrocycles against the background of a negative trend during the entire sports event, which indicates a directed decrease in the heart’s tension muscle, being an indicator of adaptive changes occurring in wrestlers’ body energy. The high variability of AST indicators on the first day and creatine phosphokinase throughout the entire pre-competition training pointed out an individual level of adaptive reactions of the athletes’ bodies in response to the training load taken. CONCLUSIONS: The results of the study have shown notable dynamics in the indicators of the enzymatic activity of AST, creatine phosphokinase, and the hormone cortisol in a series of shock training loads, as the response to adaptive changes in body energy systems, the value of which should be considered during the pre-competition training.

Psychological Impact of COVID-19 on Emergency Medicine Trainee Residents in Saudi Arabia: A Cross-Sectional Quantitative Study

Background: Psychological stress has been high among healthcare workers on the frontlines fighting coronavirus disease 2019 (COVID-19). Emergency medicine (EM) residents are members of the frontline care teams in the fight against COVID-19, which puts them at a higher risk of psychological stress compared to other medical trainees. This study examined the psychological impact of this pandemic on EM trainee residents in Saudi Arabia.Methods: This cross-sectional quantitative study used a survey sent to EM trainee residents throughout Saudi Arabia. The questionnaire collected demographic data and included questions evaluating stress, anxiety, depression, and burnout experienced while working during the pandemic.Results: Of the 100 respondents eligible for inclusion, 85% were aged between 25 and 30, 32% were in the R1 training level, 52% were training in the Central region of Saudi Arabia, 92% were directly managing patients with COVID-19, 19% had been infected with COVID-19, 54% were satisfied with the personal protective equipment available, 52% were satisfied with the psychological support provided, and only 8% were aware of the psychological support program. Smokers (p-value = 0.025) and those training in the Southern region (p-value = 0.047) experienced the highest levels of anxiety. Those aged 31 to 35 (p-value = 0.014), smokers (p-value = 0.015), those in the R3 training level (p-value = 0.036), and those with relatives who had contracted COVID-19 (p-value = 0.02) reported the highest levels of depression. Those aged 36 to 40 (p-value = 0.015), who were married (p-value = 0.038), and those training in the Northern and Central regions (p-value = 0.002) experienced the highest levels of stress. Those aged 31 to 35 (p-value = 0.041), smokers (p-value = 0.044), and those with relatives who had contracted COVID-19 (p-value = 0.043) showed the highest levels of burnout.Conclusions: EM trainee residents have been exposed to significantly high psychological affectation during the COVID-19 pandemic. Psychological support was underutilized if trainee residents were aware of it at all. Awareness workshops or on-the-job orientation for EM residents regarding psychological support is required.

Factors Influencing Trainees’ Interest in Breast Imaging

Purpose: To gauge the level of interest in breast imaging (BI) and determine factors impacting trainees’ decision to pursue this subspecialty. Methods: Canadian radiology residents and medical students were surveyed from November 2020 to February 2021. Training level, actual vs preferred timing of breast rotations, fellowship choices, perceptions of BI, and how artificial intelligence (AI) will impact BI were collected. Chi-square, Fisher’s exact tests and univariate logistic regression were performed to determine the impact of trainees’ perceptions on interest in pursuing BI/women’s imaging (WI) fellowships. Results: 157 responses from 80 radiology residents and 77 medical students were collected. The top 3 fellowship subspecialties desired by residents were BI/WI (36%), abdominal imaging (35%), and interventional radiology (25%). Twenty-five percent of the medical students were unsure due to lack of exposure. The most common reason that trainees found BI unappealing was repetitiveness (20%), which was associated with lack of interest in BI/WI fellowships (OR = 3.9, 95% CI: 1.6-9.5, P = .002). The most common reason residents found BI appealing was procedures (59%), which was associated with interest in BI/WI fellowships (OR, 3.2, 95% CI, 1.2-8.6, P = .02). Forty percent of residents reported an earlier start of their first breast rotation (PGY1-2) would affect their fellowship choice. Conclusion: This study assessed the current level of Canadian trainees’ interest in BI and identified factors that influenced their decisions to pursue BI. Solutions for increased interest include earlier exposure to breast radiology and addressing inadequacies in residency training.

Features of changes in heart rate variability indices in driving school cadets with different levels of preparedness

The research was carried out on two independent experimental groups of boys and girls. The first was observed in traffic conditions, the second during the period of auto-simulator training. The HRV indices were determined: HR - heart rate, IN - index of tension of regulatory systems, AMo - amplitude of the mode, LF/HF - index of vagosympathetic interaction. A pronounced sympathetic reaction of more prepared cadets to the training load with the subsequent restoration of the studied characteristics was revealed. Key words: heart rate variability, autonomic regulation, vagosympathetic interaction, driver training, level of preparedness.

Factors impacting cumulative dissipated energy levels and postoperative visual acuity outcome in cataract surgery

Purpose To determine factors impacting cumulative dissipated energy (CDE) and postoperative best-corrected visual acuity (BCVA) in phacoemulsification. Design Review of 1102 cases at University of California, San Francisco (UCSF) and at Zhongshan Ophthalmic Center (ZOC), China. Subjects Patients who underwent cataract surgery at UCSF 03/2014–03/2019 and at ZOC 10/2018–05/2019. Methods Patient demographics, medical history, routine ocular examination, and surgical information, including disassembly method, complications, and surgeon training level were recorded. Univariable and multivariable regression models were used to determine factors associated with CDE and good postoperative BCVA (20/40 or better) at 1 month. Outcome measures CDE, postoperative BCVA. Results In multivariable analysis, patient age at time of surgery, diabetes, degree of nuclear sclerosis (NS), white-to-white corneal diameter, disassembly method, preoperative BCVA, surgeon training level, and surgical center were significantly associated with CDE. Log10CDE increased by 0.20–0.31 for patient age ≥ 70 years, by 0.07 if the patient had diabetes, by 0.12–0.41 for NS grade ≥ 2, by 0.48 per 10 mm increase in white-to-white corneal diameter, by 0.34–0.47 for disassembly method other than non-stop chop, by 0.16 per unit increase in preoperative logMAR BCVA, and by > 0.09 when phacoemulsification was performed by residents early in their training. Log10CDE was 0.33 higher at UCSF than ZOC. In multivariable analysis, worse baseline visual acuity and age above 90 years at time of surgery decreased the odds of good BCVA (OR = 0.26 per unit increase in preoperative logMAR BCVA; OR = 0.12 for age > 90); comorbid retinal issues decreased the odds of good postoperative BCVA (OR = 0.13–0.39); greater anterior chamber depth (ACD) or shorter axial length (AL), increased the odds of good postoperative outcome (OR = 2.64 per 1 mm increase ACD, OR = 0.84 per 1 mm increase AL). Conclusions Cataract grade determined by slit lamp exam and, for the first time, older patient age, were noted to be important predictors of high CDE. CDE was not a risk factor for postoperative BCVA measured at postoperative 1 month. When surgery was performed by trainees under supervision, lower training level was associated with higher CDE, but not with worse postoperative BCVA.

Prevalence of Urinary Incontinence in CrossFit Practitioners before and during the COVID-19 Quarantine and its Relationship with Training Level: An Observational Study

Objective To compare the prevalence of urinary incontinence (UI) before and during the COVID-19 quarantine in CrossFit women and their relationship with training level. Methods A cross-sectional study was performed among 197 women practicing CrossFit. The inclusion criteria were nulliparous women, between 18 and 45 years old, who had trained, before quarantine, in accredited gyms. The exclusion criteria were not following the COVID-19 prevention protocols and having UI on other occasions than just sport. An online questionnaire was emailed containing questions about frequency, duration, and intensity of training and data related to the COVID-19 pandemic. The participants were invited to answer whether they were infected with COVID-19 and what treatment/recommendation they have followed. Whether UI stopped among participants, they were asked about the possible reasons why this happened. The training intensity was categorized as “the same,” “decreased” or “increased.” Results The mean age of the participants was 32 years old and most (98.5%) could practice CrossFit during the pandemic. There was a decrease in training intensity in 64% of the respondents. Exercises with their own body weight, such as air squat (98.2%), were the most performed. Urinary incontinence was reported by 32% of the participants before the COVID-19 pandemic, and by only 14% of them during the pandemic (odds ratio [OR] = 0.32 [0.19–0.53]; p < 0.01; univariate analysis). Practitioners reported that the reason possibly related to UI improvement was the reduction of training intensity and not performing doubleunder exercise. Conclusion The reduction in the intensity of CrossFit training during the COVID-19 quarantine decreased the prevalence of UI among female athletes.

Spatiotemporal inflection points in human running: Effects of training level and athletic modality

The effect of the different training regimes and histories on the spatiotemporal characteristics of human running was evaluated in four groups of subjects who had different histories of engagement in running-specific training; sprinters, distance runners, active athletes, and sedentary individuals. Subjects ran at a variety of velocities, ranging from slowest to fastest, over 30 trials in a random order. Group averages of maximal running velocities, ranked from fastest to slowest, were: sprinters, distance runners, active athletes, and sedentary individuals. The velocity-cadence-step length (V-C-S) relationship, made by plotting step length against cadence at each velocity tested, was analyzed with the segmented regression method, utilizing two regression lines. In all subject groups, there was a critical velocity, defined as the inflection point, in the relationship. In the velocity ranges below and above the inflection point (slower and faster velocity ranges), velocity was modulated primarily by altering step length and by altering cadence, respectively. This pattern was commonly observed in all four groups, not only in sprinters and distance runners, as has already been reported, but also in active athletes and sedentary individuals. This pattern may reflect an energy saving strategy. When the data from all groups were combined, there were significant correlations between maximal running velocity and both running velocity and step length at the inflection point. In spite of the wide variety of athletic experience of the subjects, as well as their maximum running velocities, the inflection point appeared at a similar cadence (3.0 ± 0.2 steps/s) and at a similar relative velocity (65–70%Vmax). These results imply that the influence of running-specific training on the inflection point is minimal.