Evan Andreyo, Casey Unverzagt, Thomas Dos'Santos
et al.
# Background
Women’s basketball has a high incidence of anterior cruciate ligament (ACL) injuries, many of which occur during change of direction (COD) movements. Evaluating movement quality during these maneuvers can provide valuable insight into an athlete’s ACL injury risk.
# Purpose
The primary aim of this study was to assess the reliability of the Cutting Movement Assessment Score (CMAS) in female basketball players when utilized by physical therapists (PTs) with varying levels of clinical experience and expertise.
# Study Design
Cross-sectional study
# Methods
Qualitative movement assessment was conducted using 2-dimensional video recording of a 45° change of direction (COD) task of 20 female basketball players and scored using the CMAS. Intra-rater and inter-rater reliability were assessed across two experts with ≥8 years of clinical experience and orthopaedic and sports clinical specializations, and one novice rater with <2 years of clinical experience and no board certifications. Intra- and inter-rater reliability for total CMAS scores were evaluated using intraclass correlation coefficients (ICCs). Agreement for individual CMAS items was assessed using percent agreement and kappa coefficients.
# Results
The CMAS demonstrated excellent intra-rater reliability (ICC = 0.96) and moderate inter-rater reliability (ICC = 0.67) for total scores across all three raters. For individual CMAS items, intra-rater percentage agreement was excellent (80-100%), and kappa coefficients were moderate to excellent (k = 0.59-1.00). Inter-rater percentage agreement for individual items was moderate to excellent (60-90%), and kappa coefficients were slight to excellent (k = 0.12-0.79).
# Conclusion
The CMAS can be a reliable tool for evaluating COD movement quality among PTs at various levels of clinical experience and expertise, although the identification of movement faults may have a relationship with years of clinical experience. The findings of this investigation suggest stronger intra-rater reliability than inter-rater reliability.
# Level of Evidence
Level 3
Katarzyna Czechowska, Aleksandra Świerczewska, Piotr Komasara
et al.
Introduction and purpose
Diabetes mellitus as one of the most pressing global health challenges of the 21st century, affects millions worldwide and contributes significantly to mortality by damaging multiple organs and burdens healthcare systems. The global rise in diabetes, especially Type 2 is driven by lifestyle changes and aging populations. Diabetes impacts more than just blood sugar levels, leading to numerous complications that reduce quality of life. The review aims to explore the latest studies, innovations, and emerging possibilities in diabetes treatment.
Material and methods
The review was based on research of articles published from 2019 to 2025 on the PubMed database. The analysis summarizes recent trials, updated guidelines, and expert insights to highlight current trends and future directions in diabetes care.
Results
SGLT2 inhibitors help control blood sugar in type 2 diabetes and offer added benefits like weight loss, heart and kidney protection, and potential in treating NAFLD/NASH. GLP-1 receptor agonists also improve blood sugar, reduce cardiovascular risk, and slow kidney disease, with tirzepatide showing the greatest HbA1c and weight reductions. DPP-4 inhibitors, especially sitagliptin and vildagliptin, lower heart failure and stroke risk, though saxagliptin may raise heart failure risk. Pioglitazone improves PCOS outcomes and IVF success, and may help manage MASH when combined with SGLT2 inhibitors. Teplizumab, the first FDA-approved immunotherapy for type 1 diabetes, preserves insulin production by protecting β-cells.
Conclusions
Recent advances in diabetes treatment include updated guidelines promoting personalized care, new dual GIP/GLP-1 receptor agonists, and expanded use of SGLT2 inhibitors for heart and kidney protection. Research is also progressing in GLP-1 RAs for type 1 diabetes, immunotherapies like Teplizumab, and stem cell therapies aiming for a cure.
Juliano Hermes Scalvi, Fernando Scchorr Grossl, Rafael Cunha Laux
et al.
Introdução: A aptidão física refere-se à habilidade de realizar atividades físicas ou musculares de maneira satisfatória. Este estudo tem como objetivo analisar o conhecimento acadêmico dos alunos do curso de educação física bacharelado em relação à aptidão física e ao exercício de levantamento terra. Materiais e Métodos: Realizou-se um estudo transversal, aplicando um questionário com perguntas semiestruturadas sobre o levantamento terra. A população e a amostra foram constituídas por alunos do curso de educação física bacharelado de uma Universidade em Chapecó-SC. Resultados: Os principais resultados foram obtidos com valores específicos. Conclusão: Conclui-se que os participantes deste estudo têm conhecimento sobre o exercício de levantamento terra, mas enfrentam algumas dificuldades na sua execução.
This paper proposes an AI-based diagnostic method using MRI images for rotator cuff injuries to assist in treatment by segmenting tear areas and assessing tear severity. A multi-model deep learning network based on Unet + FPN architecture was developed to automatically segment rotator cuff injury images and determine tear grades. A dataset of 376 patients with 5640 images was used for training, with an additional 94 patients and 1410 images reserved for testing. To optimize segmentation, a tailored matching strategy was applied, achieving an Intersection over Union (IoU) of 0.79 ± 0.01 and a Dice coefficient of 0.75 ± 0.01, indicating high accuracy in segmenting tear areas. For tear severity indicators, the accuracy of estimating retraction (ER) reached 0.92 ± 0.02, and the accuracy of estimating stop tear width (ESTW) reached 0.79 ± 0.01. As the first AI algorithm specifically developed for diagnosing rotator cuff injuries, this platform demonstrates promising accuracy in both tear segmentation and severity assessment, aiming to support doctors in providing efficient, accurate diagnoses of rotator cuff tears.
Ahmad Alwi Nurudin, Heny Setyawati, Sugiharto Sugiharto
et al.
This study aims to investigate the impact of coach encouragement feedback circuit training (CEFCT) on the level of fitness, grit, and technical performance of youth sepak takraw athletes. A randomised control trial (RCT) design during 8 weeks was adopted. There were 80 young male sepak takraw athletes allocated into two groups: the CEFCT group (n = 40, 17.4 ± 1.22 years) and the control group (CG, n = 40, 17.5 ± 1.24 years). Paired sample t-test showed significant differences in fitness, grit and technical performance in CEFCT (all, p < .05) and CG (all, p < .05) from pre-test until post-test. In the 2-way ANOVA repeated measures test, we observed a significant time effect on physical fitness (all p < .05), along with a group effect (p < .05); however, there was no effect on the CMJ parameter (p > .05). Moreover, there was an interaction time * group in some parameters (p < .05), but it was not found in 10-mST (p > .05). At the same time, we found a time effect on grit (all, p < .05), but no difference in the group effect (all, p > .05). Furthermore, there was a time * group interaction on grit-maintaining interest (MI) (p < 005), but it was not found in grit-continuing efforts (CE) (p > .05). Finally, we found that there was an effect of time (all, p < .05) simultaneously with group (all, p < .05), but there was no time * group interaction (all, p > .05). The coach must apply encouragement during the circuit to increase the level of physical fitness, grit and technical performance of youth sepak takraw athletes.
Objective Antimicrobial resistance is a significant global health challenge, exacerbated by unnecessary antibiotic prescribing. Respiratory tract infections (RTIs) are common reasons for antibiotic prescribing in primary care, despite most being viral or bacterial infections that are self-limiting. C-reactive protein (CRP) point-of-care tests (POCTs) are promising tools to support antibiotic stewardship by guiding the management of lower RTIs (LRTIs). The aim of this study was to develop best practice guidance for using CRP POCT in the management of LRTIs in primary care.Design Scoping review findings informed guidance statements, which were then evaluated through a three-round Delphi process with an expert panel via web-based questionnaires. Statements focused on intended use, detection of bacterial LRTIs, communication strategies, device features, performance and ease of use of CRP POCT.Setting and participants The panel of experts included 19 healthcare professionals across several specialties, including general practitioners, community pharmacists, hospital pharmacists and respiratory physicians.Main outcome measures Panellists rated each guidance statement using a 5-point Likert scale, with acceptance, revision or rejection determined using predefined cut-off scores for medians and interquartile ranges. Statements were revised between rounds using the feedback provided by panellists.Results In the first round, 49 statements were evaluated; 16 were accepted, nine removed and 24 revised for the second round. Of the 24 statements evaluated in the second round, 17 were accepted and seven were revised. In the third round, consensus was reached on four of the seven statements presented, resulting in 37 final guidance statements. These statements covered key areas, including the appropriate use of CRP POCTs to guide antibiotic prescribing, CRP cut-off values, integration with clinical decision rules, device performance and operational considerations, training requirements and financial reimbursement. The panel emphasised the need for structured guidelines to align CRP POCT use with clinical context and highlighted its role in improving diagnostic confidence while supporting antibiotic stewardship.Conclusions This study provides a set of best practice guidance statements to support the use of CRP POCT in the management of LRTIs in primary care. Dissemination and further research are required to assess their impact.
Karolina Maliszewska, Izabela Oleksak, Iwona Welian-Polus
et al.
Introduction and purpose
Sleep apnea is a disturbance of sleep that affects about 10% of adult population and is not easily detected due to unspecific symptoms. The aim of this literature review is to present, respectively, obstructive sleep apnea and central sleep apnea symptoms and integrate the available data in the literature regarding the pathogenesis and treatment methods.
Materials and methods
A review of literature was performed using PubMed and Google Scholar database. The search criteria included keywords such as sleep apnea, obstructive sleep apnea treatment, central sleep apnea treatment.
State of knowledge
Sleep disturbances that involve breathing can be categorized as obstructive sleep apnea (OSA) and central sleep apnea. First one is associated with the obstruction of the upper airways and the second one – with malfunctioning breathing generator in the pontomedullary breathing pacemaker. Symptoms are unspecific which makes diagnostic process difficult. However, the right diagnosis and treatment may prevent patients from developing many cardiovascular diseases. Treatment options for OSA include: CPAP, reducing body weight, changing sleep position, braces and surgeries; for CSA: CPAP and acetazolamide.
Conclusions
OSA and CSA need to be further investigated in order to find more precise ways of diagnosis and treatment, as these diseases remain underreported. It is worth noting, that these conditions predispose to serious diseases, e.g. stroke. Therefore, developing new treatment techniques would beneficial for the health of population.
Skeletal muscle operates as a near-constant volume system; as such muscle shortening during contraction is transversely linked to radial deformation. Therefore, to assess contractile properties of skeletal muscle, radial displacement can be evoked and measured. Mechanomyography measures muscle radial displacement and during the last 20 years, tensiomyography has become the most commonly used and widely reported technique among the various methodologies of mechanomyography. Tensiomyography has been demonstrated to reliably measure peak radial displacement during evoked muscle twitch, as well as muscle twitch speed. A number of parameters can be extracted from the tensiomyography displacement/time curve and the most commonly used and reliable appear to be peak radial displacement and contraction time. The latter has been described as a valid non-invasive means of characterising skeletal muscle, based on fibre-type composition. Over recent years, applications of tensiomyography measurement within sport and exercise have appeared, with applications relating to injury, recovery and performance. Within the present review, we evaluate the perceived strengths and weaknesses of tensiomyography with regard to its efficacy within applied sports medicine settings. We also highlight future tensiomyography areas that require further investigation. Therefore, the purpose of this review is to critically examine the existing evidence surrounding tensiomyography as a tool within the field of sports medicine.
1 Department of Orthopedics, University Medical Center, Rostock, Germany 2 Department of Orthopedics, University Medical Center, Erlangen, Germany 3 Department of Trauma Surgery, Friedrich Alexander University Erlangen-Nuremberg, Germany 4 Department of Sports Orthopedics, Sports Medicine, Sports Traumatology, Klinikum Bamberg, Germany 5 Section of Wilderness Medicine, Department of Emergency Medicine, University of Colorado School of Medicine, Denver, USA 6 School of Clinical and Applied Sciences, Leeds Becket University, Leeds, UK
N. Jayanthi, Stephanie Kleithermes, L. Dugas
et al.
Background: There are no clinical longitudinal studies exploring the associations between sport specialization and intense training patterns and injuries in young athletes. Purpose: To prospectively determine the relationship between young athletes’ degree of sport specialization and their risk of injuries and reinjuries. Study Design: Case-control study; Level of evidence, 2. Methods: Young athletes aged between 7 and 18 years presenting for sports-related injuries or sports physical examinations were recruited from either sports medicine clinics or pediatric/family medicine offices. Each participant completed a baseline survey at enrollment and an identical follow-up survey every 6 months for 3 years. Surveys assessed training patterns and injuries. Injury type (acute, overuse, or serious overuse) and clinical diagnosis were also recorded from electronic medical records. Results: Of the 1208 participants who provided consent, 579 (48%) completed the baseline survey and first follow-up survey at 6 months (mean age, 14.1 ± 2.3 years; 53% female). Of this sample, 27% (158/579) of participants were uninjured, and 73% (421/579) were injured, with 29% (121/421) of injuries classified as reinjuries. Consistent with previous studies, over the 3-year study period, the degree of sport specialization had an effect such that more specialized athletes were significantly more likely to be injured (P = .03) or have an overuse injury (P = .02) compared with less specialized athletes after adjusting for potential confounders. Additionally, female athletes were more at risk for all injuries (P = .01) and overuse injuries (P = .02) after adjusting for covariates. Finally, young athletes who trained in weekly hours in excess of their age or who trained twice as many hours as their free play were significantly more likely to be injured on univariate analysis (both P < .001). Conclusion: Our study confirms that over time, young athletes, and in particular young female athletes, were more likely to be injured and sustain an overuse injury if they had a higher degree of sport specialization. Similarly, those athletes whose training hours exceeded thair age or whose sports hours exceeded their free play by a factor of greater than 2 were also more likely to develop injuries and overuse injuries.
Scott W. Cheatham, Russell T. Baker, Ethan M. Kreiswirth
Instrument assisted soft-tissue mobilization (IASTM) has become a popular myofascial intervention for sports medicine professionals. Despite the widespread use and emerging research, a consensus on clinical standards, such as a describing the intervention, indications, precautions, contraindications, tool hygiene, safe treatment, and assessment, does not exist. There is a need to develop best practice standards for IASTM through a universal consensus on these variables. The purpose of this commentary is to discuss proposed clinical standards and to encourage other sports medicine professionals and researchers to contribute their expertise to the development of such guidelines. Level of Evidence 5.
Cristiano D. da Silva, Dirce R. de Oliveira, Ítalo T. Perrone
et al.
Background Chocolate milk has gained recent scientific support as a recovery drink. However, it is known that high exercise-demand triggers gastrointestinal discomfort which continues post-exercise, thereby hindering this nutritional strategy. In addition, those who are lactose intolerant cannot benefit from a milk-based beverage. Thus, the aim of this preliminary study was to develop a low-fat, lactose-free, and leucine-enriched chocolate cow milk prototype (CML) representing nutrition-related recommendations for football players, as well as assess athletes’ individual subjective outcomes for gastrointestinal complaints and sensorial acceptability in a field-based setting following strenuous team-sport physical demands. Methods This study followed a single group and repeated-measured design with 10 football players (23 ± 2 yrs., 74 ± 14 kg, 174 ± 5 cm) who consumed CML following a 90-min football match simulation protocol (FMP). The total CML intake to achieve 0.150 g leucine·kg [BW]·h− 1 occurred in aliquots of 50, 30 and 20% at 0-, 45- and 75-min post-FMP, respectively. Athletes were evaluated by the prevalence, the type and severity (bloating, nausea, flatulence, and gastric reflux) of gastrointestinal complaints and sensorial acceptability (overall perception, appearance, consistency, and flavour) after drinking each aliquot in a 4-h recovery period. Results The CML showed higher scores for “Product Acceptability Index” (88%) and sensorial acceptability (~ 8 in 9-point hedonic scale). Kendall’s W with bootstrapped resample (95%CI) revealed agreement among respondents as “moderate” (overall perception, flavour) to “strong” (appearance, consistency) and with no significant agreement differences between rater response in the timeline analysis (0.57 up to 0.87; p > 0.05). Agresti-Caffo add-4 analysis (95% confidence interval, [95%CI]) revealed no differences in each time-point analysis versus baseline for athletes classified as having severe gastrointestinal symptoms, but confirmed concern with bloating (three athletes showed a transient response at 2-h and only one continued until 3-h; p = 0.051). Conclusions These preliminary findings suggest that CML presents good taste and high acceptability by the sampled athletes. Thus, CML may be an alternative sport drink for immediate post-workout supplementation to overcome the energy deficit, offer co-ingested leucine, maintain palatability and adherence including lactose intolerance following a team sport-specific fatigue. Trial registration RBR-2vmpz9, 10/12/2019, retrospectively registered.
Justyna Nowaczek, Paweł Oszczędłowski, Michalina Pytka
et al.
Summary
Introduction and purpose: The purpose od this study is to describe changes in epidemiological trends of fractures, especially osteoporotic fractures, during COVID-19 pandemic. Before the pandemic, fractures in the young population were more frequent than in elderly population, because of more active lifestyle.
A brief description of the state of knowledge: COVID-19 pandemic and lockdown has effectively reduced people’s mobility and ability to travel. This has resulted in lowered rate of traumatogenic incidents that cause fractures, including traffic accidents and accidents during performing sport. When people spend more time at their homes, incidence of household fractures is growing, especially in elderly population. Osteoporosis makes bones of elderly people more suspectible to fracture. Majority of drugs used in treatmen for osteoporosis are said not to interact with risk or severity of COVID-19 infection.
Conclusions: During the COVID-19 pandemic, geriatric fractures have become one of the severe problems for healthcare systems. Isolation at people’s homes has resulted in increased rate of fractures occuring at home, especially in elderly population. Difficulties caused by pandemic made rates of properly performed osteoporotic treatment lower, increasing risk of fractures even more. Mortality after fractures has risen even in patients with negative result of testing for COVID-19.
The female athlete triad (Triad), defined by the American College of Sports Medicine as low energy availability (LEA) with or without disordered eating, menstrual dysfunction, and low bone mineral density (BMD), is associated with stress fractures and athletes aged 16‐17 years are most susceptible.