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Accurate quantification of punch force is essential for performance assessment and training optimization in combat sports. This study introduces a Custom-Built Punch Force Dynamometer using two S-type load cells and evaluates its reliability, sensitivity, and partial ecological validity under sport-specific conditions. The device was mounted vertically on a wall and tested under both controlled and sport-specific conditions. Mechanical trials were assessed using a standardized drop-weight protocol with repeated trials. Partial ecological validity involved 11 experienced athletes from striking-based combat sports performing standardized straight punches across two lab visits. Reliability metrics included intraclass correlation coefficients (ICC), standard error of measurement (SEM), and smallest worthwhile change (SWC). The dynamometer demonstrated excellent reliability during mechanical trials (ICC > 0.90) and good to excellent reliability during partial ecological validity (ICC = 0.75-0.90). SEM values were consistently lower than SWC, indicating strong measurement sensitivity. These findings support the reliability and practical utility of this device for assessing punch force in both laboratory-based research and sport-specific applications.
The purpose of this study was to compare graft failure and clinical outcomes following primary anterior cruciate ligament reconstruction (ACLR) using quadriceps tendon autograft (QA), with or without a modified Lemaire lateral extra-articular tenodesis (LET). Patients with ACL deficiency who underwent primary QA ACLR with or without LET and completed at least 2-year follow-up were included. Patients with a Beighton score ≥4, a preoperative pivot shift grade ≥2, or an intention to return to cutting and pivoting sports were offered LET. The primary outcome variable assessed was graft failure as defined by graft rupture or grade ≥2 pivot shift at any point postoperatively. Secondary outcomes included return to sport clearance rates, the International Knee Documentation Committee and Lysholm scores and postoperative complications. There were 122 undergoing QA ACLR with LET (QA + LET group) and 152 undergoing isolated QA ACLR (QA group). The QA + LET group had a significantly lower failure rate of 14.8% versus 29.6% in the QA group (P = .02). In addition, the QA + LET group had a lower residual pivot shift rate compared with the QA group (11.3% vs. 26.3% respectively; P = .01). There was no difference in graft retear rates between the 2 groups (P = .37). The QA + LET returned to sport significantly faster at 8.8 months compared with 9.7 months in the QA group (P = .038). The addition of LET to QA ACLR was associated with a significantly lower overall graft failure rate and lower percentage of patients with residual pivot shifts after ACLR compared with QA alone at 2-year follow up. However, there was no difference between the 2 groups with regard to graft retear rates. The addition of an LET to QA ACLR also allowed athletes to return to sports faster compared with QA alone. Level III, retrospective comparative study.
Persistent rotational instability following anterior cruciate ligament reconstruction (ACLR) remains one of the greatest unresolved challenges in modern sports medicine, particularly in young athletes returning to cutting and pivoting sports. Although contemporary ACLR techniques frequently provide excellent subjective outcomes, residual rotatory laxity continues to be associated with graft failure, revision surgery, and failure to return to preinjury athletic performance. Against this background, lateral extra-articular tenodesis has experienced a substantial resurgence as an adjunct procedure aimed at improving rotational control. High-level evidence in young, high-risk patients undergoing hamstring autograft ACLR has showed that lateral extra-articular tenodesis augmentation reduced graft rupture rates and persistent rotatory laxity. As the use of quadriceps tendon autograft continues to increase, it is increasingly important to determine whether the benefits observed with hamstring ACLR extend to quadriceps tendon ACLR. This evolving evidence base has significant implications for graft choice and outcomes in high-risk athletic populations.
The Bristow-Latarjet procedure is a well-established and reliable technique for managing recurrent anterior shoulder instability. Although the Bristow technique is associated with lower graft healing rates than the Latarjet, it shows better postoperative range of motion and a higher rate of return to sports. However, the arthroscopic Bristow-Latarjet procedure has a relatively steep learning curve. Building upon the classic Bristow technique, this technical note describes an open inlay Bristow procedure with button fixation that preserves the capsule. This approach is particularly suitable for beginners, offering a simple yet effective alternative.
The consumption of zero-labeled beverages has increased as an alternative to sugar-rich beverages. Although these products are primarily characterized by reduced energy and sugar contents, their mineral and trace element compositions may vary depending on formulation-related factors. The mineral and trace element contents of zero-labeled and regular beverages in Korea were compared. A total of 86 commonly consumed processed beverages were selected as 1:1 matched pairs across major beverage categories. Energy, macronutrient, and sodium data were obtained from nutrition labels, while the contents of macro-minerals (calcium, phosphorus, magnesium, and potassium) and trace minerals (iron, copper, zinc, manganese, molybdenum, chromium, and selenium) were determined by inductively coupled plasma-mass spectrometry. Beverage pH was also measured. Zero-labeled products contained significantly lower energy and sugar levels than regular beverages. Potassium content was significantly higher in zero-labeled carbonated beverages (12.17 vs. 6.73 mg/100 g), and both the potassium and molybdenum contents were higher in zero-labeled energy drinks. Zinc content was significantly lower in zero-labeled mixed beverages. Selenium content was higher in zero-labeled beverages than in regular beverages overall (1.88 vs. 0.87 µg/100 g), particularly in carbonated beverages, sports drinks, and mixed beverages. Other minerals and trace elements did not differ significantly between the groups overall. Beverage pH did not differ between the groups, but was positively correlated with potassium, manganese, and chromium contents. These findings indicate that zero-labeled beverages do not substantially differ from regular beverages in overall mineral and trace element provision but potentially contribute to greater dietary exposure to select minerals in specific beverage categories.
Evidence-based nutrition guidance for female athletes remains limited relative to that available for males; in part, this has contributed to widespread reliance on social media for dietary information. Whilst social media can enhance health communication, it also facilitates the rapid dissemination of unverified, commercially driven nutrition claims. This narrative review critically synthesises the current scientific literature underpinning four prevalent claims targeting nutrition close to exercise for active females; (1) fasted training is harmful for all females, (2) menstrual cycle-related hormonal fluctuations require sex-specific hydration strategies, (3) carbohydrate differences by sex and menstrual cycle phase, and (4) precise protein timing is essential for optimal adaptation in females. Despite social media and 'influencer' claims of no evidence in humans for many of the claims, there is some, albeit limited, evidence. This review evaluates the available research and the evidence supporting these claims to provide practical advice for active females. Collectively, this review demonstrates that many widely circulated nutrition claims directed at active females lack robust scientific support. The findings emphasise the importance of individual context, including training load, energy availability, environmental conditions and total dietary intake, over rigid, sex-specific nutrition rules. Improved translation of female-specific sports nutrition research into accurate, accessible public messaging is urgently needed to counter persistent misinformation in digital media.
Quintana-Cepedal, M, Bailen-Garcia, T, Riestra-Cendan, S, Crespo, I, and Olmedillas, H. Sex differences in maximal and endurance adductor strength: implications for athlete screening and return to play. J Strength Cond Res XX(X): 000-000, 2026-Lower maximal and endurance adductor strength have been identified as modifiable risk factors contributing to groin injury. However, there are currently no data examining the relationship between these 2 variables. This study aimed to determine if maximal hip adduction strength can be predicted by performance on the Brazilian Adductor Performance Test (BAPT) in competitive female and male athletes from different sports. Secondary aims were to compare strength output between female and male athletes in all tests. Baseline demographic characteristics were collected alongside the Hip and Groin Outcome Score and adductor strength. Maximal isometric hip adductor strength was assessed during the 5-second squeeze test, whereas the BAPT evaluated adductor endurance. Linear mixed-effects models were developed with maximal isometric adductor strength as the dependent variable. Strength was quantified as absolute strength (N), normalized strength (N·kg-1), and normalized torque (N·m·kg-1). A total of 131 healthy athletes (n = 253 limbs, 54% female; ≥ Tier 2) were included in the study. This final count excludes 9 limbs that failed to meet the eligibility criteria. The BAPT could not predict maximal strength (R2 = 0.049 to 0.11); however, model fit improved when sex was included as a covariate (R2 = 0.23 to 0.50). Male subjects performed significantly more repetitions in the endurance test (28 vs. 21, d = 0.84) and exhibited higher maximal strength (N·m·kg-1 = 3.08) compared with female subjects (N·m·kg-1 = 2.34; d = 1.23). Because hip adductor maximal and endurance strength correlate poorly, each test evaluates a particular physical capacity and, as such, should not be used interchangeably. Our findings suggest that clinicians should use both tests to screen for potential deficits in either endurance or maximal adduction strength.
The purpose of this study was to identify if concussion knowledge and attitude scores differed between collegiate student-athletes with immediate or delayed concussion reporting. There were 67 student-athletes who were divided into 'Immediate' (N = 35) and 'Delayed' (N = 32) reporting of non-obvious concussions. Participants completed the Rosenbaum Concussion Knowledge and Attitudes Survey (RoCKAS) questionnaire, which is composed of a concussion knowledge index (CKI, 0-24) and attitude index (CAI, 15-75) with higher scores reflecting better performance. Groups were compared with a pooled two-sample t test, and a binary logistic regression was performed with three predictors (CKI, CAI, Symptoms). There were no group differences for CKI Score (Immediate: 20.2 ± 2.9 vs Delayed: 19.8 ± 2.5; t(65) = 0.68, p = 0.501, d = 0.17), but the Delayed group had a significantly higher CAI score (Immediate: 51.9 ± 6.8 vs Delayed: 55.8 ± 9.1, t(65) = -2.00, p = 0.050, d = -0.49). Higher CKI (OR: 1.31, 95% CI [1.03, 1.75]) and Symptoms (OR: 1.05, 95% CI [1.00, 1.09]) increased the unit odds of Immediate report, but higher (safer) CAI had lower unit odds of Immediate report (OR: 0.89, 95% CI [0.79, 0.98]). Concussion reporting remains a complex process which likely includes intrinsic (i.e. knowledge and attitude) factors, non-modifiable factors (e.g. symptoms), and environmental factors which challenges sports medicine clinician's ability to increase athlete's self-report of potential concussions.
To investigate the epidemiological characteristics of injuries sustained at the under 20s (U20) Men's European Lacrosse Championships. Injury surveillance data was prospectively collected during the 2024 U20 European Lacrosse Championships (Wrocław, Poland). A standardized electronic reporting system based on the 2020 IOC consensus statement was used. Injury incidence was reported per 1000 match-player-hours (match-p-h). A total of 55 match-related injuries were reported with an injury incidence rate of 88.7 injuries per 1000 match-p-h (66.8-115.5 CI). The majority of injuries were non-time-loss (82%, 72.6 per 1000 match-p-h 52.9-97.1 CI), 15% resulted in time-loss (>24 hours lost due to injury, 12.9 per 1000 match-p-h 5.6-25.4 CI) and 4% reported as unknown (3.2 per 1000 match-p-h 0.4-11.7 CI). Most injuries had a time-loss lasting between 0-1 day (73%; 64.5 per 1000 match-p-h 46.1-87.9 CI). The onset of injury was predominantly as a result of sudden-acute trauma (73%; 64.5 per 1000 match-p-h 46.1-87.9 CI), with contact mechanisms accounting for 67% (59.7 per 1000 match-p-h 42.0-82.3 CI). The most frequent injuries reported were anterior thigh muscle contusion (9%; 8.1 per 1000 match-p-h 2.6-18.8 CI), calf muscle injury (9%; 8.1 per 1000 match-p-h 2.6-18.8 CI), ankle sprain (7%, 6.5 per 1000 match-p-h 1.8-16.5 CI) and knee contusion (7%, 6.5 per 1000 match-p-h 1.8-16.5 CI). The injury incidence during the 2024 U20 Men's European Lacrosse Championships was high compared to similar youth field sports, though most injuries did not result in time-loss. The findings should be used to inform preparations for future age-group international lacrosse tournaments.
Children and adolescents represent a challenging population due to their incomplete physical development, and lack of specific criteria for interpreting electrocardiography (ECG) in children and adolescent athletes. We aimed to investigate the prevalence and clinical significance of short PR interval in pediatric and adolescent athletes undergoing pre-participation cardiac screening. This is a cross-sectional study, where a total of 1310 athletes (age range: 7-18 years) underwent a comprehensive screening including medical history, physical examination, 12-lead ECG, echocardiography, and exercise testing under stress at Exercise and Sports Medicine Unit, University of Molise, Campobasso Italy between January 2023 and June 2024. Short PR interval prevalence and clinical significance were evaluated by frequency analysis and association with cardiac symptoms, respectively. Short PR interval (< 120 ms) was present in 26.9% of athletes, while using a z-score threshold of - 2 as the age- and sex-adjusted lower limit of normal, 3.82% of the athletes met criteria for a short PR interval. No significant associations were found between short PR interval and cardiac symptoms: syncope, palpitations, chest pain, exercise-induced arrhythmias, or need for additional diagnostic testing beyond standard screening (p > 0.05). Isolated short PR interval was not associated with adverse cardiac findings among children and adolescent athletes following pre-participation screening, supporting its interpretation as a benign age-dependent variant. However, long-term outcome data are needed to confirm these observations.
This study examined the effects of an eight-week exergaming (EG) program compared with traditional aerobic exercise on dual-task performance and prefrontal hemodynamics in middle-aged and older adults. Thirty-three older adults (21 females, 12 males; mean age = 64.2 ± 5.5 years) were randomly assigned to either an EG group (n = 16) or an aerobic exercise (AE) group (n = 17). Both groups completed supervised moderate-intensity training thrice per week for 30 minutes per session. Before and after the intervention, the participants performed a Stroop task under single-task, slow dual-task, and fast dual-task conditions. Behavioral accuracy was recorded, and prefrontal oxygenated, deoxygenated, and total hemoglobin concentrations were analyzed utilizing functional near-infrared spectroscopy. Physical fitness measures included estimated VO₂max, chair stand, arm curl, and timed up-and-go performance. Both interventions substantially enhanced VO₂max (p <.001), chair stand repetitions (p =.009), and timed up-and-go performance (p <.001). Behavioral findings exhibited elevated accuracy across all task conditions after training (p <.001). The EG group displayed superior performance only in the fast dual-task condition (p =.005), whereas no between-group differences were observed in single-task or slow dual-task conditions. Hemodynamic analyses revealed significant reductions in oxygenated (p <.003) and total hemoglobin (p =.015) over time, with larger reductions observed in the EG group. Deoxygenated hemoglobin did not show significant effects. Both training modalities improved physical fitness and task performance. EG provided additional benefits under the most demanding dual-task condition and was associated with more efficient prefrontal activation.
Exposure to the optical environment-often referred to as visual experience-profoundly influences human physiology and behavior across multiple time scales. In controlled laboratory settings, stimuli can be held constant or manipulated parametrically. However, such exposures rarely replicate real-world conditions, which are inherently complex and dynamic, generating high-dimensional datasets that demand rigorous and flexible analysis strategies. This tutorial presents an analysis pipeline for visual experience datasets, with a focus on reproducible workflows for human chronobiology and myopia research. Light exposure and its retinal encoding affect human physiology and behavior across multiple time scales. Here we provide step-by-step instructions for importing, visualizing, and processing viewing distance and light exposure data. This includes time-series analyses for working distance, biologically relevant light metrics, and spectral characteristics. The tasks are standardized through the open-source R package LightLogR. By leveraging a modular approach, the tutorial supports researchers in building flexible and robust pipelines that accommodate diverse experimental paradigms and measurement systems.
This randomized, double-blind, placebo-controlled study investigated whether intensive periodized training combined with multi-strain probiotics affects training adaptation and exercise performance in amateur runners. Thirty amateur runners were randomly assigned to receive either a multi-strain probiotic (PG, n = 15) or a placebo (CG, n = 15) during a four-week, intensive periodized training program. Two participants withdrew from the PG. Before and after the intervention, comprehensive laboratory, physical, and psychological assessments were conducted to evaluate training adaptation and exercise performance. Linear mixed-effects models indicated that intensive period training improved body composition, VO2peak, and Wpeak, accompanied by increased cortisol levels and a reduced testosterone-to-cortisol ratio. Probiotic supplementation alongside training attenuated biomarkers of exercise-induced muscle damage and endocrine disturbance, including Alanine aminotransferase levels, reduced athlete burnout scores, and modulated the fecal Firmicutes/Bacteroidetes ratio. Significant group × time interactions were observed for several key bacterial taxa. Intensive period training effectively enhances exercise performance and body composition. Probiotic supplementation might provide additional benefits related to training adaptation, gut microbiota modulation, and athlete burnout attenuation.
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To investigate preoperative systematic magnetic resonance imaging (MRI) evaluation of subscapularis (SSC) lesions using the digitation sign by medical practitioners with various levels of experience. A retrospective analysis was conducted on patients who underwent arthroscopy-assisted rotator cuff repair between April 2023 and September 2024. The inclusion criteria required preoperative 1.5 Tesla MRI scans with standardized protocols within 2 months of surgery. Patients were divided into SSC tears and intact groups based on intraoperative arthroscopic findings. Preoperative MRI images were independently evaluated by medical students, residents, orthopedic fellows, and attending doctors, blinded to arthroscopic findings. The sensitivity and specificity of SSC tear detection were analyzed for each group. Arthroscopic findings were assessed in real time by the single surgeon and documented in the operative reports. Out of 152 patients, 73 (48.0%) had arthroscopically confirmed SSC tears. Sensitivities for detecting SSC tears via the digitation sign were 57.5%, 72.6%, 80.8%, and 82.1%, respectively. There was a statistically significant difference in medical students (57.5%) and residents (72.6%) (P = .035). The specificity was low across all groups (54.4%, 63.3%, 32.9%, and 50.0% for medical students, residents, fellows, and attending doctors). Higher training levels correlated with improved sensitivity but worsened specificity, suggesting overdiagnosis by more experienced practitioners. The digitation sign is a valuable tool for SSC tear detection but has limitations. These findings highlight the need for enhanced observer training and a cautious approach to interpreting the digitation sign in isolation. Combining multiple imaging findings and contextual clinical information is essential for reducing diagnostic errors and improving patient outcomes. Level III, retrospective case-control study.
CrossFit® has experienced rapid global growth, yet scientific research often fails to reflect the realities of training and competition in this sport. Studies frequently rely on inconsistent terminology, non-specific testing protocols, and heterogeneous samples, limiting the ecological validity and practical application of findings. This critical commentary aims to evaluate the methodological challenges in CrossFit® research and to highlight the importance of contextualizing scientific inquiry through the perspectives of coaches actively working within the sport. A targeted review of the CrossFit® literature was conducted, with a focus on sampling descriptions, testing protocols, and training monitoring approaches. In addition, semi-structured interviews were conducted with five national and international-level CrossFit® coaches. Analysis of coach responses was used to contextualize gaps in the literature. Coaches reported relying primarily on competition results, training observations, and subjective feedback to guide programming, rather than standardized physical testing or technology-based monitoring. The remote nature of many coach-athlete relationships further complicates data collection and training analysis. CrossFit® research must improve its methodological rigor by adopting sport-specific assessments, clearly defining participant characteristics, and embracing the realities of coaching practice. Integrating qualitative insights and prioritizing ecological validity will help bridge the gap between science and the sport's unique demands.