Sports Injury and Illness Epidemiology: Thailand Team Surveillance During the 30th Southeast Asian Games

Background: Injury and illness surveillance in sports is the first step of the injury prevention model that generates effective injury prevention measures. Objectives: To identify the incidence, severity, and causes of injuries and illness in the Thailand national team during the 30th Southeast Asian (SEA) Games. Methods: All medical encounters were documented using the International Olympic Committee (IOC) injury and illness surveillance system for multi-sport events. We recorded the daily occurrence of injuries and illnesses reported by Thailand’s medical teams over the 12 days of the competition period. Results: Among 980 Thai athletes (568 male and 412 female), that participated in the 30th SEA Games, a total of 105 injuries and illnesses were reported. There were 84 injuries and 21 illnesses which equated to an incidence of 86 injuries and 21 illnesses per 1000 athletes. The most commonly injured body part was the lower leg (14% of all injuries), followed by the shoulder and clavicle. Ligament sprain or rupture and contusion (25% of all injuries) were reported as the most common type of injury. Of all injuries, 56 were classified as needing medical attention (only), 26 caused performance restriction, and two caused complete-time loss. The most common athlete illness was respiratory illness (48% of all illnesses) followed by gastrointestinal illness (19% of all illnesses). One-third (7 out of 21) of athlete illnesses restricted the athlete's performance, and the remaining 14 only required medical attention. Conclusions: Overall, 8% of athletes incurred at least one injury during the competition, and 2% suffered from an illness. Lower leg injury and respiratory illness were the most common, which is similar to other multi-sport events. Based on the research data, injury prevention, especially of ligamentous sprain and lower limb injuries, should be the focus in multi-sport events.

Effects of Aerobic Exercise Concurrent with Caffeine Supplementation on Weight and Body Fat Among Overweight Women

Background: Obesity and overweight are among serious global epidemics that significantly threaten human health, especially among women. Objectives: This study aimed to assess the concurrent effects of 6-week caffeine supplementation with moderate-intensity aerobic exercise on weight and body fat among overweight women. Methods: Thirty overweight females (age: 36.47 ± 6.48 years; BMI: 27.61 ± 1.54 kg/m2; mean ± SD) with a sedentary lifestyle were recruited to the study. The participants were randomly allocated to the experimental group, EC (exercise + caffeine) group, who took 100 milligrams of caffeine of the “API” brand supplement 30 minutes before exercise training (n = 15) or control group, EP (exercise + placebo) (n = 15). All participants performed moderate-intensity aerobic exercise with an intensity of 40 to 60% of heart rate reserve based on the individual's exercise test for 30 minutes, three days a week for six weeks. Measurements, including the percentage of body fat, waist circumference, and skinfold (suprailiac, abdominal), were done two times, at baseline and after six weeks of exercising. Results: There were no significant differences between control and experimental groups related to weight (P = 0.22), percentage body fat (P = 0.88), and other measurements after six weeks. Conclusions: 6 weeks of caffeine supplementation combined with moderate-intensity aerobic exercise without dietary interventions couldn’t make a significant reduction in weight and central or total body fat among overweight women.

Reconstruction of Anterior Cruciate Ligament Over 50 Years Old? Yes, or No

Background: The aim of the study is to compare the results of anterior cruciate ligament reconstruction (ACL-R) in people aged more than 50 and under 30 years of age. Methods: A total of 64 patients with ACL rupture were evaluated for eligibility. Thirty-two patients with ACL rupture, aged more than 50 years (54.38 ± 1.26) were matched in all of the background factors, with 32 patients suffering from ACL rupture under 30 years old. They were followed for clinical and functional results at six and on average 45.58 months after surgery. These evaluations included the Lachman test, KT-1000, International Knee Documentation Committee (IKDC) score, Lysholm knee score (LKS), return to exercise activity, post-operative satisfaction rate, and pain intensity based on Visual Analogue Scale (VAS) and rates of extension and flexion loss. Results: Our findings indicated that knee stability, return to exercise activity, LKS and IKDC scores, as well as pain intensity and satisfaction were significantly improved in both groups. Indeed, the satisfaction rate of patients over 50 years at six months after surgery was less than those under 30 years (P < 0.001); however, it was approximately similar to the group under 30 years of age in the final follow-up (P > 0.05). The rate of return to sports activity was also lower in patients over 50 years. Conclusions: The comparable results at the patients with < 30 years demonstrated that arthroscopic ACL-R in patients over 50 years of age with no or mild DJD has good results.

Comparing the Stiffness of Peroneus Longus Tendon Versus Hamstrings in Anterior Cruciate Ligament Reconstruction: A Biomechanical Study

Background: The use of autografts originating from either hamstring tendons or peroneus longus tendons is a surgical option in anterior cruciate ligament (ACL) reconstruction. Objectives: This research aimed to compare the tensile strength between the hamstring tendon and the peroneus longus tendon in ACL reconstruction. The hypothesis of this study was: Peroneus longus grafts have tensile strength equal to hamstring grafts based on living donor patients. Methods: This cross-sectional study was a biomechanical study examining means and standard deviations (SD) by comparing the tensile strength of peroneus longus tendons and hamstring tendons when used as autograft donors in ACL reconstruction. Results: In this study, 51 patients with reconstructive ACL were enrolled. The mean diameter of the hamstring tendon was 7.86 with SD ± 0.69, while the mean diameter of peroneus longus tendon was 7.67 with SD ± 0.63. The mean diameter of the peroneus longus graft was not significantly different. The mean displacement on the hamstring tendon was 2.44 with SD ± 0.42, while the peroneus longus tendon was 2.06 with SD ± 0.14. The peroneus longus tendon had significantly more tensile strength compared to the hamstring tendon. Conclusions: Diameter of the peroneus longus graft was not significantly different from the hamstring graft. However, the peroneus longus graft had more tensile strength than the hamstring graft based on living donor patients.

Study of Anthropometric and Body Composition Variables in the Overweight/Obese, Sedentary Elderly Men Using WATERinMOTION Aqua Training: A cross-Sectional Study

Background: The effect of aqua training on human body composition still causes inconsistency. Objectives: This study was set to identify the effects of WATERinMOTION (WiM) as a water-based exercise on anthropometric and body composition variables without dietetic supervision in overweight/obese, sedentary elderly men. Methods: Participants (n = 70; age: 70.5 ± 4.4 years) derived by purposive and accessible selection were randomly distributed to either a one-month WiM aqua training group (n = 35, two weekly sessions each included 55 minutes on WiM aqua training) or a control group (n = 35, at the same time in sitting state). Anthropometric measures (height, weight, and waist circumference [WC]) and body composition variables (body mass index [BMI], fat mass [FM], total body water [TBW], and free fat mass [FFM]) were evaluated pre/post-study. Results: Upon analysis, statistically significant changes (P ≤ 0.05) were set on weight, BMI, and FM by comparing pre/post study for the WiM group. Furthermore, comparing groups at post disclosed a significant change in anthropometric measures (weight and WC) and body composition variables (BMI, FM, TBW, and FFM). Conclusions: A short-run, non-diet-supervised WiM program suggests supporting a loss in weight, FM, and BMI in overweight/obese, sedentary elderly men.

Validity and Reliability of the Sport Readiness Questionnaire Focused on Musculoskeletal Injuries

Background: The pre-participation physical evaluation (PPE), which includes a musculoskeletal system evaluation, identifies factors that may be a risk for athletes while practicing sport. Thus, the Sport Readiness Questionnaire, focused on musculoskeletal injuries (MIR-Q) was developed to screen athletes at risk of future injuries or worsening pre-existing injuries during training or competition. However, the criterion-related validity and reliability of the MIR-Q have not yet been analyzed. Objectives: To test the criterion-related validity and reliability (internal consistency and test-retest) of the MIR-Q. Methods: One hundred and twenty adult athletes from different sports (17 women) completed the MIR-Q and underwent a physical orthopedic examination (POE) performed by an orthopedic physician. At least one affirmative answer on the MIR-Q, as well as one positive finding on the POE, was considered “a risk factor for sport injury”. The validity was assessed from sensitivity, specificity, and accuracy measurements. Internal consistency was obtained through the KR-20 test. Reliability was measured using the test-retest method in a 7-14-day interval with a sub-sample (n = 41) and verified by the Kappa index. Results: Eighty-one (67.5%) questionnaires contained positive responses. The sensitivity of the MIR-Q against POE was high (84.4%), while specificity and accuracy were considered moderate, with values of 42.7% and 58.0%, respectively. Internal consistency was moderate (KR-20 = 0.57), and test-retest was reduced (K = 0.30; P = 0.02). Conclusions: The MIR-Q was associated with high values of validity and low values of reliability. The questionnaire may be an alternative tool for musculoskeletal screening during PPE in limited medical settings (sports OR orthopedic physician) conditions. Future studies should investigate the predictive validity of the MIR-Q, and psychometric properties of the questionnaire with younger athletes.

Relationship Between Physical Activity Level and Muscle Markers in a Population-Based Sample of Children and Adolescents

Objectives: The study aimed was to investigate the relationship between physical activity (PA) levels and muscle markers in healthy children and adolescents. Methods: This cross-sectional study was conducted in 2020 among school students from Isfahan, Iran. Using cluster sampling, 159 students aged 7 to 18 years were selected. In addition to the physical examination, the PA level was assessed using a valid questionnaire. The serum levels of aspartate aminotransferase (AST), lactate dehydrogenase (LDH), creatine kinase (CK), and alanine aminotransferase (ALT) were measured. Statistical analysis was performed using the Pearson correlation test. Results: The samples included 79 girls and 80 boys with a mean age (standard deviation) of 12.72 (3.06) years and a mean body mass index of 18.30 (3.70) kg/m2. The mean AST and CPK were significantly higher in boys than in girls (P < 0.05). Participants with higher PA levels had significantly lower LDH and ALT than other participants (-0.20, P = 0.003, and 0.044 P = 0.295, respectively). There was no significant relationship between PA level and muscle enzyme levels. Conclusions: The findings of this study indicated that higher PA level was associated with lower serum muscle markers other than LDH. This suggests that the best types of PA for children and adolescents are those activities with rest sets to prevent muscle damage.

The Effects of Forearm Kinesio-Taping on Hand Grip Strength and Endurance in Female Squash Elites

Background: Hand grip plays a fundamental role in most daily and athletic activities of the upper extremities. Objectives: The study compared the effect of various methods of forearm Kinesio-taping (KT) on the hand grip strength and endurance of Iranian elite squash players during their sporting activities at different times. Methods: Thirty-three female squash players were assigned to a quasi-experimental study, and KT was applied on their dominant forearm (on the flexor area, on the extensor area, and placebo taping). Grip strength was evaluated before, immediately, 30, and 60 minutes after KT, and grip endurance was also assessed before and 60 minutes after KT using MIE digital grip analyzer. Friedman and Kruskal-Wallis tests were used to analyze the results of grip strength, and ANOVA and the sample t-test were applied to analyze the grip endurance data. Results: The findings revealed no significant differences within the grip strength at different phases (P > 0.05). However, p values for the outcomes of KT on the flexor area‎, KT on the extensor area‎, and placebo mode were respectively 0.145, 0.178, 0.065 in each phase of the evaluation. A significant difference ‎among KT groups and the LSD test revealed a significant increase in grip endurance in the mode of KT on the extensor area, whereas there have been no significant differences in grip endurance in KT on flexor (P = 0.785) and extensor (P = 0.457) areas. Conclusions: There was no obvious superiority of the various methods of forearm ‎ KT ‎ on grip strength at different times; nevertheless, KT was an efficient method for retaining grip endurance in squash players with no significant differences between the flexor and extensor locations.

Let Us Let the Spectators Back in!

: COVID-19 has stricken the world since the beginning of 2020. The pandemic is not controlled yet, and also the new variants of the virus are rapidly spreading. To reduce the virus's person-to-person transmission rate, health authorities and the government applied limitations to all activities (including sports activities). As a result, all football matches and team training worldwide were suspended for a limited period until a reduced infection risk was recognized. Even though training and competitions were gradually resuming worldwide, no spectators were allowed to attend any matches. After the successful experience of resuming football matches and tournaments following tight restrictions in keeping the players, staff, and organizers safe, it is time to let the spectators back in the stadiums and establish the needed guidelines. This commentary will highlight the most important aspects and issues that need to be addressed if the football federation and associations decide to let the spectators back into the stadiums, as football will lose its enthusiasm and financial turnover.

Effect of High-Intensity Interval Training on Endothelial Function in Type 2 Diabetic Females

Background: Flow-mediated dilation (FMD) is a noninvasive approach to examine endothelial function. Objectives: The purpose of this study was to investigate the effect of 12 weeks of high-intensity interval training (HIIT) on FMD and circulating levels of adropin and nitric oxide (NO) in females with type 2 diabetes. Methods: Thirty females with type 2 diabetes were randomly assigned into two equal groups of HIIT and control. The exercise program consisted of three sessions a week for 12 weeks. Each training session included 4 × 4-minute running intervals at 85 - 95% of maximal heart rate (HRmax) with 3-minute active recoveries at 50 - 60% of HRmax. Circulating levels of adropin, NO, glucose, HbA1c, insulin, HOMA-IR, as well as lipid profile, and body composition parameters were measured before and after the intervention. Results: A significant increase of FMD% was observed after the intervention in the HIIT group (P = 0.001). In addition, the circulation levels of adropin and NO enhanced as a result of HIIT (P = 0.012 and P < 0.001, respectively). There were also significant positive effects on the levels of lipid profile (except for HDL), FBS, and HbA1c; as well as on the insulin resistance and the body composition variables. There were no significant changes in the control group except an increase in the total cholesterol levels (P < 0.01). Conclusions: The results showed that 12 weeks of the HIIT program could improve the endothelial function, glucose-related indices, lipid profile, and body composition variables in females with type 2 diabetes.