ObjectiveThe Meyers and McKeever (MM) classification is widely used for posterior cruciate ligament (PCL) tibial avulsion fractures; however, it fails to comprehensively reflect fracture characteristics and morphology due to its exclusive reliance on plain radiographs, which may result in suboptimal treatment decisions. Computed tomography (CT) scanning and three-dimensional computed tomography (3DCT) reconstruction can provide a more detailed visualization of articular fracture configurations, enabling the development of effective treatment strategies. Therefore, we developed a novel classification system for PCL tibial avulsion fractures based on fracture characteristics on 3DCT images, systematically evaluated and compared classification accuracy and reliability with the MM classification.MethodsPatients aged 18 years or older who underwent plain radiographs and CT examinations that confirmed PCL tibial avulsion fractures from June 2020 to Jan 2025 were included. A novel 3DCT-based classification system was established by considering three key fracture characteristics: fracture displacement degree, fracture line numbers, and fracture involvement regions. To verify the reliability and accuracy of the novel 3DCT-based and MM classification systems, intra- and inter-rater reliability assessments were performed. Additionally, the consistency and discrepancy in fracture patterns between the two classification systems were systematically described.ResultsUltimately, 53 patients (40 males and 13 females) with PCL tibial avulsion fractures were enrolled in the final study (mean age 42.9, range 22–65). The novel 3DCT-based classification system consisted of four principles and seven categories. The intra-rater reliability of the MM classification demonstrated substantial agreement, whereas the 3DCT-based classification exhibited perfect agreement. The inter-rater reliability of both classifications displayed substantial agreement, and the novel classification had higher reliability values. In addition, approximately 22.6% of non-displaced fracture types, along with some type II and III fractures identified through radiographs, exhibited differing fracture characteristics when evaluated using 3DCT.ConclusionThe novel 3DCT-based classification is more reliable, simplified, and intuitive than the MM classification. This novel classification system allows for a more accurate description of these fractures and reduces the risk of misdiagnosis based on radiographs. Additionally, it provides valuable guidance for preoperative planning and the selection of appropriate treatment strategies.
Stroke remains one of the leading causes of disability and death worldwide, resulting in significant social and economic costs. Effective post-stroke rehabilitation, including physiotherapy, occupational therapy, speech therapy and psychological support, is crucial for improving motor and cognitive functions and quality of life in patients. In recent decades, there has been dynamic development of multimedia therapeutic tools, such as virtual reality (VR), robotics, mobile applications and telemedicine. These technologies allow for the personalisation of exercises, greater patient engagement and monitoring of therapy progress. The introduction of VR systems, computer games and motion controllers has revolutionised motor and cognitive rehabilitation, and the use of gamification elements increases motivation and the number of repetitions of exercises performed. A review of studies confirms the effectiveness of VR and other multimedia tools in improving upper limb function, gait, balance and cognitive function and reducing the symptoms of depression after a stroke, as well as strengthening motivation for rehabilitation. Modern technologies also facilitate performing exercises at home, which is particularly important for maintaining long-term therapeutic activity. Multimedia tools are a valuable complement to traditional methods, contributing to the intensity, effectiveness and attractiveness of the post-stroke rehabilitation process.
Eric Roig-Hierro, Laia Garcia-Dalmases, Xènia Ríos-Sisó
et al.
La práctica de actividad física (AF) durante la adolescencia es esencial para el desarrollo físico, mental y social, pero no todos los colectivos tienen acceso a estos beneficios de manera equitativa. Factores como el nivel socioeconómico y cultural (NSEC), el origen migratorio y el género condicionan la frecuencia con la que las personas adolescentes participan en actividades físicas. En Cataluña, estas desigualdades adquieren relevancia en un contexto de diversidad creciente y desigualdades socioeconómicas persistentes. A partir de los datos del estudio PISA 2022 de 1524 adolescentes catalanes de 15 años, se analizó la influencia de los factores de desigualdad sobre la práctica semanal de AF. Los resultados muestran diferencias significativas en la frecuencia semanal de AF según el NSEC de las personas adolescentes (p < .001). Mientras que un NSEC alto se asocia predominantemente con frecuencias intermedias (2-4 veces/semana), un NSEC bajo muestra una sobrerrepresentación tanto en las categorías de práctica baja (0-1 vez/semana) como en la de práctica muy elevada (≥ 5 veces/semana). Con respecto al origen migratorio, los adolescentes nativos reportan una participación más elevada que aquellos de primera generación, especialmente en grados de frecuencia elevada (≥ 3 veces/semana). Con respecto al género, los chicos superan claramente a las chicas en prácticas frecuentes, con un 58.35% que realiza AF 5 veces o más por semana, frente al 33.37% de las chicas. Estas desigualdades evidencian barreras sociales, económicas y culturales que limitan el acceso de los colectivos vulnerables a la AF. Se destaca la necesidad de generar políticas que promuevan la AF equitativa, subvenciones específicas y programas de integración cultural, esenciales, para fomentar un acceso equitativo y asegurar los beneficios de su impacto en el bienestar de los y las adolescentes.
Thomas W. Fenn, M.D., Dominic M. Farronato, M.D., Douglas K. Wells, M.D.
et al.
Purpose: To evaluate the accuracy of ChatGPT’s responses to frequently asked questions (FAQs) about hamstring injuries and to determine, if prompted, whether ChatGPT could appropriately tailor the reading level to that suggested. Methods: A preliminary list of 15 questions on hamstring injuries was developed from various FAQ sections on patient education websites from a variety of institutions, from which the 10 most frequently cited questions were selected. Three queries were performed, inputting the questions into ChatGPT-4.0: (1) unprompted, naïve, (2) additional prompt specifying the response being tailored to a seventh-grade reading level, and (3) additional prompt specifying the response being tailored to a college graduate reading level. The responses from the unprompted query were independently evaluated by two of the authors. To assess the quality of the answers, a grading system was applied: (A) correct and sufficient response; (B) correct but insufficient response; (C) response containing both correct and incorrect information; and (D) incorrect response. In addition, the readability of each response was measured using the Flesch-Kinkaid Reading Ease Score (FRES) and Grade Level (FKGL) scales. Results: Ten responses were evaluated. Inter-rater reliability was 0.6 regarding grading. Of the initial query, 2 of 10 responses received a grade of A, seven were graded as B, and one were graded as C. The average cumulative FRES and FKGL scores of the initial query was 61.64 and 10.28, respectively. The average cumulative FRES and FKGL scores of the secondary query were 75.2 and 6.1, respectively. Finally, the average FRES and FKGL scores of the third query were 12.08 and 17.23. Conclusions: ChatGPT showed generally satisfactory accuracy in responding to questions regarding hamstring injuries, although certain responses lacked completeness or specificity. On initial, unprompted queries, the readability of responses aligned with a tenth-grade level. However, when explicitly prompted, ChatGPT reliably adjusted the complexity of its responses to both a seventh-grade and a graduate-level reading standard. These findings suggest that although ChatGPT may not consistently deliver fully comprehensive medical information, it possesses the capacity to adapt its output to meet specific readability targets. Clinical Relevance: Artificial intelligence models like ChatGPT have the potential to serve as a supplemental educational tool for patients with orthopaedic to aid medical-decision making. It is important that we continually review the quality of they medical information generated by these artificial models as the evolve and improve.
Introduction: Early adolescence is marked by a series of anatomical and functional changes. Understanding these functional adaptations is particularly relevant for football coaches, as they influence training strategies and performance development. Objective: This study aimed to examine age-related differences in body composition parameters and handgrip strength among junior football players. Materials and Methods: Between September 2024 and August 2025, 151 male football players aged 12 (n=18), 13 (n=35), 14 (n=45), and 15 years (n=53) were assessed. Handgrip dynamometry is widely recognized in literature as a reliable measure of overall muscular strength in athletes. Two Constant hand dynamometers (model 14192-760E) were used, with participants performing maximal voluntary contractions while standing, arms fully extended and held obliquely laterally. Results: Significant anthropometric increases were observed between ages 13 and 14, whereas BMI remained consistent across age groups. Muscle mass increased from 39.06 ± 2.21% at age 13 to 41.09 ± 1.37% at age 14, while body fat percentage did not change significantly. No significant differences were observed in handgrip strength, despite notable changes in body composition. Conclusions: Handgrip strength assessment represents a practical tool for monitoring and evaluating muscular strength in adolescent athletes. The data provided by this study may serve as reference values for coaches in the region. In this cohort, early adolescence was associated with nonsignificant changes in handgrip strength, despite measurable alterations in body composition.
The integration of neurofeedback-based games into educational programs has garnered attention due to their potential to enhance cognitive abilities. This study examines the impact of the neurofeedback game Mindflex on the attention levels of university students during physical education classes. A randomized controlled design was employed, with participants divided into two groups: experimental and control. The experimental group participated in physical education lessons incorporating Mindflex neurofeedback training, while the control group followed the standard physical education curriculum. A total of 80 students, aged 18 to 22, were evenly distributed between the experimental and control groups. Pre- and post-test assessments were conducted using the Chinese version of the Stroop Color and Word Test (C-SCWT) to measure attention levels. Data were analyzed using paired and independent t-tests, with effect sizes calculated to assess the magnitude of observed changes. The experimental group demonstrated statistically significant improvements in attention levels with a large effect size (d = −3.62), while the control group showed no substantial changes (d = 0.07). These findings highlight the effectiveness of integrating neurofeedback games into physical education. The study also emphasizes the feasibility and practicality of using portable, cost-effective neurofeedback tools, such as Mindflex, in university settings. By demonstrating the potential of neurofeedback games to enhance attention, the study provides a foundation for future research and the application of such innovative tools.
Introduction
According to data, 5% of people in Europe and 6% of people in Poland are vegetarians. Therefore, an increasing percentage of pregnant women will follow a plant-based diet. During pregnancy, the need for vitamins and minerals increases, and the proper balance and possible supplementation of a vegetarian diet are crucial for proper fetal development and a pregnant woman's health.
Aim of study
This study aims to evaluate and compare information regarding the adequacy of a vegetarian diet for pregnant women and its impact on maternal outcomes, fetal development, newborn health and lactation.
Materials and methods
The search methodology incorporated the terms “vegetarian diet” or “plant-based diet” or “vegan” AND “pregnancy” or “pregnant” or “health benefits”, along with variations of these terms, found in many scientific databases. Publications issued before 2019 and case reports were excluded.
Conclusion
There is a consensus that a plant-based diet is safe during both pregnancy and lactation. Nevertheless, it may be associated with many nutrient deficiencies. A vegetarian diet promotes a lower incidence of excessive weight gain, which results in a less frequent occurrence of EWG-related complications. There was no higher prevalence of premature births or infant mortality. The occurrence of gestational diabetes, small gestational age/low birth weight and congenital anomalies require further study. Breastfeeding during a vegetarian diet is possible, but appropriate supplementation is recommended.
Afzaal Hussain, Muhammad Adeel Zahid, Usama Ahmed
et al.
Machine learning-based sports activity recognition has captured a lot of interest in recent years. Automatic activity recognition not only reduces cost and time but is very helpful in analyzing health-sensitive data acquired using smart wearable technology. Gym activity recognition by incorporating smart wearable technology comes within the scope of this topic. This paper present a system for classifying gym activities using feature engineering techniques applied to time series data. The collected time series data consists of an athlete’s body movement using an internal 3-axis accelerometer build into the zephyr bio-harness 3 device. The data were gathered by implementing a six-week fitness routine trying to target six muscle groups, preceded by one day of rest and recovery each week. The raw time-series data of the accelerometer is transformed to extract new features from it for identifying gym activities. The feature engineering techniques applied in this research are not limited to gym activity recognition but can be extended to any domain involving time-series data. The collected data was just three features, which are the reading of the tri-axial accelerometer signal as vertical, lateral, and sagittal axes. In order to formulate new features, basic concepts of statistics and mathematics were applied to the data. furthermore, we trained six GridSearchCV-based classifiers on the extracted features and tested their performance in four different types of experiments.
Soyib Tajibaev, Shukhratulla Allamuratov, Bekir Erhan
et al.
Background and Study. Vertical jump performance is a critical factor in volleyball, significantly influencing actions like spiking, blocking, and serving. Accurate assessment of jump height is essential for optimizing training strategies, especially at the elite level.
Purpose: The aim of this study was to evaluate the validity and reliability of a novel computerized diagnostic equipment (CDE-A, Patent No. 001144) designed for precise measurement of vertical jump height in volleyball players.
Materials and Methods. The study involved the development and validation of the CDE-A system to assess vertical jump performance. Participants included elite volleyball players from the Uzbekistan national team, various club teams, and students from the State University of Physical Education and Sports of Uzbekistan. The system's accuracy and reliability were tested through rigorous procedures, including data storage and analysis capabilities for maximum jump height and functional performance. The research involved developing and testing a specialized device (CDE-A) to evaluate elite volleyball players' vertical jump capabilities. Participants included 18 athletes aged 13–14, 16 athletes aged 15–16, and 50 students from the Uzbekistan State University of Physical Education and Sports. Measurements were conducted across age groups and educational levels. A pedagogical experiment compared traditional training (control group, CG) with specialized exercises for agility and jumping endurance (experimental group, EG).
Results. The CDE-A device demonstrated high reliability and precision in measuring vertical jump height. Key features include the capability to store maximal jump data in computer memory and analyze its functional significance for training and performance evaluation. The device enables coaches to monitor and enhance athletes' jump performance with greater efficiency and accuracy.
Conclusions. This research highlights the utility of the CDE-A system for assessing and improving vertical jump capabilities in volleyball players across all age groups. The study underscores its potential to revolutionize training methodologies by providing coaches with reliable, evidence-based insights into athletes' performance. The findings offer a foundation for further advancements in jump height measurement technologies and their application in sports science. This study establishes the CDE-A as a valuable tool for sports performance evaluation, with implications extending to volleyball and other sports requiring explosive jump abilities.
(1) Background: This study aims to investigate the correlation between heart rate variability (HRV) during exercise and recovery periods and the levels of anxiety and depression among college students. Additionally, the study assesses the accuracy of a multilayer perceptron-based HRV analysis in predicting these emotional states. (2) Methods: A total of 845 healthy college students, aged between 18 and 22, participated in the study. Participants completed self-assessment scales for anxiety and depression (SAS and PHQ-9). HRV data were collected during exercise and for a 5-min period post-exercise. The multilayer perceptron neural network model, which included several branches with identical configurations, was employed for data processing. (3) Results: Through a 5-fold cross-validation approach, the average accuracy of HRV in predicting anxiety levels was 89.3% for no anxiety, 83.6% for mild anxiety, and 74.9% for moderate to severe anxiety. For depression levels, the average accuracy was 90.1% for no depression, 84.2% for mild depression, and 82.1% for moderate to severe depression. The predictive R-squared values for anxiety and depression scores were 0.62 and 0.41, respectively. (4) Conclusions: The study demonstrated that HRV during exercise and recovery in college students can effectively predict levels of anxiety and depression. However, the accuracy of score prediction requires further improvement. HRV related to exercise can serve as a non-invasive biomarker for assessing psychological health.
Sports-related concussion has been examined extensively in collision sports such as football and hockey. However, historically, lower-risk contact sports such as soccer have only more recently garn...
Medical emergencies. Critical care. Intensive care. First aid
Ali Jasem Buabbas, Madawi Anwar Al-Mass, Basma Awad Al-Tawari
et al.
Abstract Background Children and adolescents are becoming the most prolific users of smart technology (ST) devices due to the numerous advantages presented by these devices. However, the overuse of ST devices can have detrimental impacts on health. Therefore, the aim of this study was to investigate the pattern of ST device use among school students in Kuwait and the possible associated health problems. Methods This cross-sectional survey used a pretested questionnaire to collect data from students of different educational levels within the governmental sector: primary, secondary and high school. Chi-square tests were applied to find associations or significant differences between the categorical variables, in which p < 0.05 was considered statistically significant. Results This study included 3015 students, of whom 53.6% were female. The sample had an equal distribution of primary (33.8%), secondary (32.4%) and high school students (33.8%). Almost all of the participants (99.7%) owned a ST device, chiefly smartphones (87.7%). Most of the students used ST devices for > 4 total hours per day on average, which is categorised as “overuse”. Among those overusing ST devices, the symptoms most commonly experienced included headaches (35.0%), sleep disturbances (36.6%) and neck/shoulder pain (37.7%). Students who used ST devices for < 1 h per session experienced eye-related problems. Moreover, students who played sports on a regular basis were more likely to spend less time per session on ST devices. The prolonged use of ST devices was associated with higher reporting of seizures, eye squints and transient vision loss. Conclusion The overuse of ST devices per day and per session by school-aged children has the potential to have a detrimental impact on their health, as has been noticed among students in Kuwait. Healthcare professionals, school authorities and parents could use these results to plan strategies to change ST device use behaviours among schoolchildren.
To date, information on the problem is contradictory and ambiguous. It is difficult to trace cause – effect relationships between the condition of hard dental tissues, oral fluid, the dental status of swimmers, and the characteristics of the water environment of training pools. The article presents an analysis and systematization of literature on the dental condition in swimming athletes, as well as formulates modern ideas on the subject and highlights topics for further research.
Biomechanical tools capable of detecting external forces in swimming starts and turns have been developed since 1970. This study described the development and validation of a three-dimensional (six-degrees of freedom) instrumented block for swimming starts and turns. Seven force plates, a starting block, an underwater structure, one pair of handgrips and feet supports for starts were firstly designed, numerically simulated, manufactured and validated according to the Fédération Internationale de Natation rules. Static and dynamic force plate simulations revealed deformations between 290 to 376 µε and 279 to 545 µε in the anterior-posterior and vertical axis and 182 to 328.6 Hz resonance frequencies. Force plates were instrumented with 24 strain gauges each connected to full Wheatstone bridge circuits. Static and dynamic calibration revealed linearity (<inline-formula> <math display="inline"> <semantics> <mrow> <msup> <mi>R</mi> <mn>2</mn> </msup> </mrow> </semantics> </math> </inline-formula> between 0.97 and 0.99) and non-meaningful cross-talk between orthogonal (1%) axes. Laboratory and ecological validation revealed the similarity between force curve profiles. The need for discriminating each upper and lower limb force responses has implied a final nine-force plates solution with seven above and two underwater platforms. The instrumented block has given an unprecedented contribution to accurate external force measurements in swimming starts and turns.
Weronika Nawłatyna, Paulina Myszka, Piotr Pawłowski
et al.
Introduction: Nowadays, the problem of eating disorders is becoming more and more common in the society. It affects not only the youth but also adults. The canons of beauty presented by tabloids or advertisements become a benchmark of value for many people who, in pursuit of
a perfect figure, are willing to make many sacrifices even at the expense of their own health and life. It is estimated that about 8 – 9% of the population is affected by eating disorders in the form of anorexia or bulimia. Mortality constitutes about 20% of diagnosed cases. A timely diagnosed disorder can be treated mainly with the help of appropriate therapeutic techniques, which allows symptoms to resolve in a significant number of patients.
Aim: The aim of the study is to present the tasks of a nurse in care for a patient with diagnosed eating disorders in the form of anorexia.
Methods and materials: The study was based on the individual case study method. The adopted research techniques were as follows: the interview, nursing observation, measurements and the analysis of the patient’s medical record documentation. The following research tools were used for the study: the Individual Nursing Care Card, the NRS for pain assessment, the MNA for nutrition status and the Beck Depression Inventory.
Findings: During the research process, eight nursing diagnoses based on the patient's health issues were made.
Conclusions: Nursing problems in the care of a patient diagnosed with eating disorders in the form of anorexia arise from the disease and the accompanying complications.
Research on the development of competencies with PBL has grown considerably in recent years, but its consequences on psychosocial processes such as creativity, peer leadership and team cohesion in group work have not been investigated. In this paper we also analyze the differences in the competency level of 16 groups of 4 students of the Social Psychology of Sport subject of the Degree in Physical Activity and Sport Sciences as a result of their participation in a PBL methodology evaluated with rubrics. The instruments used in this experience are divided into two groups: the evaluation of competences and the evaluation of related psychological variables, the creative capacity of the sports leader, creativity and practical creativity in the workplace and in the organization) and group cohesion (version Spanish reduced GEQ). The results show an increase in all competences, although in creativity and in planning there are no significant improvements. The only psychosocial variable that has significantly improved has been Empathy and Leadership Responsibility, although the size of the effect is small. Conclusions include recommendations on the use of BPA and evaluation through rubrics.
The objective of the present study was to present the case of surgical treatment and rehabilitation of a midshaft clavicular fracture in a national wrestler. This is a case report of a 20-year-old female national wrestler who met a motorcycle accident (July 9, 2014). Postinjury radiographs revealed a midshaft clavicular fracture. She came a month after the accident. She had got a pain. Differential diagnosis revealed spiral oblique midshaft clavicular fracture. The sports medicine staff discussed surgical and nonsurgical options. A surgical procedure of internal fixation with an 8-hole anatomic clavicula plate was performed. In August 2014, she had surgery at Emirdag/Afyon County Hospital. Surgical treatment for clavicular fractures is becoming increasingly common. We suggest that new rehabilitation protocols for clavicular repairs should be investigated now that surgical treatment is being pursued more frequently. More aggressive treatment procedures and rehabilitation protocols for clavicular fractures have evolved in recent years. With these medical advancements, athletes are able to return to play much more quickly without compromising their health and safety.