Hasil untuk "Sports medicine"

R. Kreider, D. Kalman, J. Antonio et al.

Creatine is one of the most popular nutritional ergogenic aids for athletes. Studies have consistently shown that creatine supplementation increases intramuscular creatine concentrations which may help explain the observed improvements in high intensity exercise performance leading to greater training adaptations. In addition to athletic and exercise improvement, research has shown that creatine supplementation may enhance post-exercise recovery, injury prevention, thermoregulation, rehabilitation, and concussion and/or spinal cord neuroprotection. Additionally, a number of clinical applications of creatine supplementation have been studied involving neurodegenerative diseases (e.g., muscular dystrophy, Parkinson’s, Huntington’s disease), diabetes, osteoarthritis, fibromyalgia, aging, brain and heart ischemia, adolescent depression, and pregnancy. These studies provide a large body of evidence that creatine can not only improve exercise performance, but can play a role in preventing and/or reducing the severity of injury, enhancing rehabilitation from injuries, and helping athletes tolerate heavy training loads. Additionally, researchers have identified a number of potentially beneficial clinical uses of creatine supplementation. These studies show that short and long-term supplementation (up to 30 g/day for 5 years) is safe and well-tolerated in healthy individuals and in a number of patient populations ranging from infants to the elderly. Moreover, significant health benefits may be provided by ensuring habitual low dietary creatine ingestion (e.g., 3 g/day) throughout the lifespan. The purpose of this review is to provide an update to the current literature regarding the role and safety of creatine supplementation in exercise, sport, and medicine and to update the position stand of International Society of Sports Nutrition (ISSN).

S. Hayes, R. Newton, R. Spence et al.

OBJECTIVES Since Exercise and Sports Science Australia (ESSA) first published its position statement on exercise guidelines for people with cancer, there has been exponential growth in research evaluating the role of exercise pre-, during and post-cancer treatment. DESIGN AND METHODS The purpose of this report is to use the current scientific evidence, alongside clinical experience and exercise science principles to update ESSA's position statement on cancer-specific exercise prescription. RESULTS Reported in this position statement is a summary of the benefits accrued through exercise following a cancer diagnosis and the strengths and limitations of this evidence-base. An exercise prescription framework is then proposed to enable the application of cancer-specific considerations for individualisation, specificity, safety, feasibility and progression of exercise for all patients. Additional specific exercise prescription considerations are provided for the presence of haematological, musculoskeletal, systemic, cardiovascular, lymphatic, gastrointestinal, genitourinary and neurological disease- and treatment-related concerns, as well as presence of co-morbid chronic disease. Further, we also identify and discuss cancer-specific pragmatic issues and barriers requiring consideration for exercise prescription. CONCLUSIONS While for the majority, multimodal, moderate to high intensity exercise will be appropriate, there is no set prescription and total weekly dosage that would be considered evidence-based for all cancer patients. Targeted exercise prescription, which includes the provision of behaviour change advice and support, is needed to ensure greatest benefit (as defined by the patient) in the short and longer term, with low risk of harm.

刘明月, 靳沙沙, 王志勇, 付艳鑫, 张一唯, 倪隽, 武亮LIU Mingyue, JIN Shasha, WANG Zhiyong, FU Yanxin, ZHANG Yiwei, NI Jun, WU Liang

重症卒中后呼吸功能障碍常合并呼吸中枢驱动失调、呼吸泵衰竭及气道保护失效等多类复杂且异质的病理机制，传统康复模式难以满足个体化临床需求。本文综述了以精准评估为导向的整合性呼吸康复框架。该框架以多模态生理评估为基础，构建重症卒中患者呼吸功能特征图谱，进而为多学科团队制订个体化干预方案提供依据。尽管目前该领域仍面临高级别证据不足等挑战，但未来结合人工智能辅助决策与靶向神经调控技术的精准康复模式，或将为重症卒中呼吸康复的发展提供新思路。Respiratory dysfunction after severe stroke often involves multiple complex and heterogeneous pathological mechanisms, including dysregulated central respiratory drive, respiratory pump failure, and airway protection failure. Conventional rehabilitation models are difficult to meet individualized clinical demands. This paper reviews an integrated respiratory rehabilitation framework guided by precision assessment. Based on multi-modal physiological assessments, this framework constructs a respiratory function profile for patients with severe stroke, thereby providing evidence for the multi-disciplinary team to formulate individualized intervention protocols. Although the field still faces challenges such as insufficient high-level evidence, precision rehabilitation models, which integrate artificial intelligence-assisted decision-making and targeted neuromodulation technology, may provide new insights into the development of respiratory rehabilitation in severe stroke.

Wei-Cheng Chao, Asaduzzaman Khan, Jui-Chi Shih et al.

Background: Chinese-Australian adolescents face unique academic and cultural challenges that may impact their lifestyle and psychological well-being. Physical activity, screen time, and sleep are known to influence well-being. However, research on the adherence to the 24-Hour Movement Guidelines among Chinese-Australian adolescents remains limited and awaits further investigation. Objective: This study hypothesized a significant positive association between adherence to the 24-Hour Movement Guidelines for physical activity, screen time, and sleep, and the psychological well-being of Chinese-Australian adolescents. Methods: A self-reported questionnaire was distributed to two language schools in Brisbane, Australia, targeting high school students from grades 7 to 12 with Chinese-Australian backgrounds. This study used multiple linear regression modelling to examine the associations between meeting or not meeting recommendations. Meeting the 24-Hour Movement Guidelines was defined as ≥60 min/day of moderate to vigorous physical activity (MVPA), ≤2 h/day of recreational screen time, and 9–11 h/night of sleep. Results: Out of 251 participants (average age: 13.31 years; 58% female), only 20.3% met two or three recommendations, while 43.3% met one, and 36.2% met none. The most common compliance was meeting only the screen time guideline alone (48%), while 9.6% met either MVPA + screen time or screen time + sleep. The regression analysis showed that meeting at least MVPA (β = 1.41, 95% CI: 0.07 to 2.74) or at least sleep (β = 1.40, 95% CI: 0.19 to 2.60) was associated with better psychological well-being. Notably, meeting MVPA and sleep guidelines was significantly associated with higher well-being (β = 3.83, 95% CI: 1.06–6.60). From the results, adherence to additional 24-Hour Movement Guidelines was associated with improved psychosocial well-being. However, a small proportion of adolescents met all the guidelines. Conclusions: Greater adherence to physical activity and sleep guidelines is linked to better psychological well-being among Chinese-Australian adolescents. These results highlight the importance of promoting healthy behaviours and implementing public health strategies to enhance education on exercise and sleep, particularly at the school and family levels, to support adolescents’ psychological well-being.

Xiuxia Wang, Junjie Chen, Guangxin Cheng

With the rapid development of artificial intelligence (AI) technology, its application in college physical education has gradually shifted from marginal exploration to system integration. Based on literature review, case study and empirical data analysis, this paper systematically explores the multi-dimensional application of AI technology in college physical education, including sports performance analysis, personalized training, teaching management optimization and intelligent evaluation. The results show that AI can effectively improve teaching efficiency, scientific training and objectivity of evaluation, while promoting the precision and fairness of physical education. Through surveys and data comparisons of multiple colleges and universities, this paper verifies the significant effectiveness of AI in improving students' sports performance, reducing sports injury rates, and improving classroom organization efficiency. At the same time, the article also points out the challenges of current applications, such as infrastructure shortage, insufficient digital literacy of teachers, low algorithm transparency and data ethics concerns. Based on this, this paper proposes a path to promote the deep integration of AI into physical education from four dimensions: system construction, teacher empowerment, technology development and data governance. The study believes that AI will play the role of "intelligent engine" in future college physical education, promoting the transformation of the education paradigm from experience-driven to data-driven.

Konrad Strużek, Kornelia Karamus, Rafał Rejmak et al.

Advances in the understanding of Alzheimer’s disease (AD) pathophysiology, along with the development of neuroimaging and biomarker analysis, have enabled the detection of neurodegenerative changes even before clinical symptoms appear. This article explores the evolution of AD diagnostic criteria, with a particular focus on the pivotal role of cerebrospinal fluid biomarkers (Aβ42, t-tau, p-tau) and brain imaging techniques (MRI, PET). The A/T/N classification system and the concept of compensatory brain mechanisms are also discussed, emphasizing their relevance in early disease detection. The modern diagnostic approach, introduced by the Dubois criteria and further developed by the NIA-AA framework, allows for the identification of AD in its preclinical phase. The presence of biomarker abnormalities in asymptomatic individuals suggests a long latent period and the activation of neuroplastic compensatory processes that may delay symptom onset. The integration of biomarkers has significantly improved diagnostic accuracy, enhanced clinical trial participant selection, and enabled more precise disease monitoring. Despite these advances, effective treatments to halt or reverse disease progression remain elusive, highlighting the urgent need for further research into compensatory mechanisms, individual variability, and early therapeutic strategies.

Gulay Aras Bayram, Gizem Ergezen Sahin, Gizem Yilmaz et al.

Abstract Background With the advancement of technology, it is considered an important step to transfer assessment methods to the virtual environment as it provides individuals with the opportunity for equal feedback, improves test performance and allows for testing with maximum participation. The aim of this study was to evaluate the effects and differences between the classic Wingate Anaerobic Test (WAnT) and a virtual reality-based Wingate Test (VR-WAnT) on the test performance of athletes and to investigate their applicability to athletes. Methods Thirty male athletes aged between 18 and 25 years from professional football teams were included in the study. The athletes’ age, height, weight, total years of sport experience, scores on the system usability scale and satisfaction with the two different testing methods were assessed. A scenario covering all phases of the WAnT and requiring no external cues was prepared by the project team and integrated into the virtual reality headset. Athletes were first assessed using the classic WAnT in a controlled laboratory environment, and two days later the same athletes were assessed using the VR-WAnT in the same environment. Maximum power, minimum power, average power and fatigue index data from the test system were recorded for analysis. Results The results of the study showed no statistically significant differences in maximum power, minimum power, average power and fatigue index values between the two methods (p > 0.05). However, according to the satisfaction measurement, the results of the VR-WAnT were statistically significantly higher compared to the classic WAnT (p = 0.026). Conclusions VR-WAnT may be considered a promising alternative for anaerobic performance testing due to its potential to enhance user experience and satisfaction. It is also believed that the test may offer greater comfort for both practitioner and athletes, while introducing a novel dimension to physiotherapy and rehabilitation assessment processes. Trial registration NCT06661395 (Registration Date: 24 Oct 2024).

D. Thomas, K. A. Erdman, L. M. Burke

Ryan T. Li, Scott R. Kling, Michael J Salata et al.

Context: Wearable performance devices and sensors are becoming more readily available to the general population and athletic teams. Advances in technology have allowed individual endurance athletes, sports teams, and physicians to monitor functional movements, workloads, and biometric markers to maximize performance and minimize injury. Movement sensors include pedometers, accelerometers/gyroscopes, and global positioning satellite (GPS) devices. Physiologic sensors include heart rate monitors, sleep monitors, temperature sensors, and integrated sensors. The purpose of this review is to familiarize health care professionals and team physicians with the various available types of wearable sensors, discuss their current utilization, and present future applications in sports medicine. Evidence Acquisition: Data were obtained from peer-reviewed literature through a search of the PubMed database. Included studies searched development, outcomes, and validation of wearable performance devices such as GPS, accelerometers, and physiologic monitors in sports. Study Design: Clinical review. Level of Evidence: Level 4. Results: Wearable sensors provide a method of monitoring real-time physiologic and movement parameters during training and competitive sports. These parameters can be used to detect position-specific patterns in movement, design more efficient sports-specific training programs for performance optimization, and screen for potential causes of injury. More recent advances in movement sensors have improved accuracy in detecting high-acceleration movements during competitive sports. Conclusion: Wearable devices are valuable instruments for the improvement of sports performance. Evidence for use of these devices in professional sports is still limited. Future developments are needed to establish training protocols using data from wearable devices.

Jodie G. Dakic, Jean Hay-Smith, Kuan-Yin Lin et al.

Abstract Background Women participate in sport at lower rates than men, and face unique challenges to participation. One in three women across all sports experience pelvic floor (PF) symptoms such as urinary incontinence during training/competition. There is a dearth of qualitative literature on women’s experiences of playing sport/exercising with PF symptoms. The purpose of this study was to explore the lived experience of symptomatic women within sports/exercise settings and the impact of PF symptoms on sports/exercise participation using in-depth semi-structured interviews. Results Twenty-three women (age 26–61 years) who had experienced a breadth of PF symptom type, severity and bother during sport/exercise participated in one–one interviews. Women played a variety of sports and levels of participation. Qualitative content analysis was applied leading to identification of four main themes: (1) I can’t exercise the way I would like to (2) it affects my emotional and social well-being, (3) where I exercise affects my experience and (4) there is so much planning to be able to exercise. Women reported extensive impact on their ability to participate in their preferred type, intensity and frequency of exercise. Women experienced judgement from others, anger, fear of symptoms becoming known and isolation from teams/group exercise settings as a consequence of symptoms. Meticulous and restrictive coping strategies were needed to limit symptom provocation during exercise, including limiting fluid intake and careful consideration of clothing/containment options. Conclusion Experiencing PF symptoms during sport/exercise caused considerable limitation to participation. Generation of negative emotions and pain-staking coping strategies to avoid symptoms, limited the social and mental health benefits typically associated with sport/exercise in symptomatic women. The culture of the sporting environment influenced whether women continued or ceased exercising. In order to promote women’s participation in sport, co-designed strategies for (1) screening and management of PF symptoms and (2) promotion of a supportive and inclusive culture within sports/exercise settings are needed.

Mizuki Yamada, Mizuki Yamada, Hyunjun Gam et al.

Testosterone replacement therapy (TRT) in transgender men (TM) results in side effects such as elevated triglycerides and increased arterial stiffness. Exercise may be useful to ameliorate such effects, but no studies have examined the effects of acute aerobic exercise in TM. This study aimed to investigate the effects of acute aerobic exercise on arterial stiffness in TM. Thirty-six participants were included, comprising 12 TM (duration of TRT: 57.4 ± 30.3 months), 12 males and 12 females. All participants performed acute aerobic exercise on a treadmill at 50% heart rate reserve for 30 min. Arterial stiffness as measured by brachial-ankle pulse wave velocity (baPWV) was measured before exercise (Pre), 30 min after exercise (Post30), and 60 min after exercise (Post60). Serum sex hormone levels, and serum lipid profile were determined only before exercise. Serum low-density lipoprotein cholesterol (LDL-C) levels before exercise were significantly higher in TM than in males or females (males: p < 0.01; females: p < 0.05). At all points, baPWV in TM was significantly higher than in females (p < 0.05) and significantly lower than in males (p < 0.05). However, when comparing changes in baPWV over time in each group, significant decreases in Post30 and Post60 were seen in males compared to Pre (both p < 0.05), but no significant change after aerobic exercise was seen in TM or females. These results suggest that acute aerobic exercise yield different effects in TM than in males, but is unlikely to reduce arterial stiffness in TM receiving TRT.

Aazad Abbas, Imran Saleh, Graeme Hoit et al.

Objective: Smart insufflation (SI) techniques relying on valve and membrane-free insufflation are increasing in usage. Although considerable literature exists demonstrating the benefits of SI on procedural ease and patient outcomes, there remains a paucity describing the financial impact of these devices. The purpose of this study was to determine the financial and efficiency impact of these devices on the operating room and inpatient wards of a hospital. Methods: A discrete event simulation model representing a typical mid-sized North American hospital comparing SI to traditional insufflation (TI) was generated. The National Surgical Quality Improvement database from 2015 to 2019 was used to populate the model with data supplemented from the literature. Outcomes included length of stay (LOS), duration of surgery (DOS), annual procedure volume, profit, return on investment (ROI), and gross profit margin (GPM). From the literature review, DOS savings were 10–32 minutes/case, while LOS savings were 0–3 days/case. Results: Implementation of an SI led to an increase in annual throughput of 42–346 (4.4%–36.6%) cases for all procedures and 38 to 297 (4.3%–33.3%) cases for complex procedures. LOS was found to be decreased by 175–614 (18.3%–64.2%) days for all procedures and 231 to 614 (35.6%–77.9%) cases for complex procedures with the implementation of an SI. Together, this resulted in an increase in net profit of $104,685 per annum. The ROI of SI over the TI device was >1000%, and the GPM for the TI was 90.0%, while the GPM for the SI was 71.7%. Conclusion: Despite the initial financial investment being greater, the implementation of SI offsets these expenses and yields significant financial benefits. Our study demonstrates the financial benefits of SI over TI and illustrates how granular operational and financial analyses of technologies are essential to aid in sound healthcare procurement decision making.

Yiming Zhang, Nan Ru, Zhaowen Xue et al.

Mitochondrial damage is related to the functional properties of immune cells as well as to tumorigenesis and progression. Nevertheless, there is an absence concerning the systematic evaluation of mitochondria-associated lncRNAs (MALs) in the immune profile and tumor microenvironment of osteosarcoma patients. Based on transcriptomic and clinicopathological data from the TARGET database, MAL-related patterns were ascertained by consistent clustering, and gene set variation analysis of the different patterns was completed. Next, a MAL-derived scoring system was created using Cox and LASSO regression analyses and validated by Kaplan-Meier and ROC curves. The GSEA, ESTIMATE, and CIBERSORT algorithms were utilized to characterize the immune status and underlying biological functions in the different MAL score groups. MAL-derived risk scores were well stabilized and outperformed traditional clinicopathological features to reliably predict 5-year survival in osteosarcoma cohorts. Moreover, patients with increased MAL scores were observed to suffer from poorer prognosis, higher tumor purity, and an immunosuppressive microenvironment. Based on estimated half-maximal inhibitory concentrations, the low-MAL score group benefited more from gemcitabine and docetaxel, and less from thapsigargin and sunitinib compared to the high-MAL score group. Pan-cancer analysis demonstrated that six hub MALs were strongly correlated with clinical outcomes, immune subtypes, and tumor stemness indices in various common cancers. Finally, we verified the expression patterns of hub MALs in osteosarcoma with qRT-PCR. In summary, we identified the crosstalk between prognostic MALs and tumor-infiltrating immune cells in osteosarcoma, providing a potential strategy to ameliorate clinical stratification management.

S. Whitehead, J. Weakley, Stuart J. Cormack et al.

Netball is the one of the most popular women’s sports in the world. Since gaining professional status in 2008 there has been a rapid growth in research in the applied sports science and medicine of the sport. A scoping review of the area would provide practitioners and researchers with an overview of the current scientific literature to support on-court performance, player welfare and reduce injury. The primary objective was to identify the current research on the applied sports science and medicine of netball. Additionally, the article provides a brief summary of the research in each topic of sports science and medicine in netball and identifies gaps in the current research. Systematic searches of PubMed, SPORTDiscus, MEDLINE and CINAHL were undertaken from earliest record to Dec 2020 and reference lists were manually searched. The PRISMA-ScR protocol was followed. Studies were eligible for inclusion if they investigated netball as a sport or the applied sport science and medicine of netball athletes. 962 studies were identified in the initial search, 150 of which met the inclusion criteria. Injury was the most highly investigated sport science and medicine topic (n = 45), followed by physical qualities (n = 37), match characteristics (n = 24), biomechanics (n = 15), psychology (n = 13), fatigue and recovery (n = 9), training load (n = 4) and nutrition (n = 3). A range of cohorts were used from school to elite and international standards. All cohorts were female netballers, except for one study. A rapid growth in studies over recent years was demonstrated with 65% of studies published in the last decade. There still remains gaps in the literature, with a low evidence base for nutrition, training load and fatigue and recovery. This scoping review summarises the current evidence base and key findings that can be used in practice to enhance the applied sport science and medical support to netball athletes across a range of playing standards, and support the growth of the sport. It is evident that netball as a sport is still under-researched.

Wenzheng Zhang, Ya Zhang, Naixia Hu et al.

This study aimed to explore the potential molecular pathways and targets of Alzheimer's disease leading to osteoporosis using bioinformatics tools. The Alzheimer's and osteoporosis microarray gene expression data were retrieved from the Gene Expression Omnibus, and differentially expressed genes in the blood microenvironment related to Alzheimer's disease and osteoporosis were identified. The intersection of the three datasets (GSE97760, GSE168813, and GSE62402) was used to obtain 21 co-expressed targets in the peripheral blood samples in patients with Alzheimer's disease and osteoporosis. Based on the degree algorithm, the top 10 potential core target genes related to these diseases were identified, which included CLEC4D, PROK2, SIGLEC7, PDGFB, PTCRA, ECH1, etc. Two differentially expressed mRNAs, Prokineticin 2 (PROK2) and three colony-stimulating factor 3 (CSF3), were screened in the GSE62402 dataset associated with osteoporosis. Protein–protein rigid docking with ZDOCK revealed that PROK2 and CSF3 could form a stable protein docking model. The interaction of PROK2 and CSF3, core genes related to osteoporosis inflammation, plays an important role in the mechanism of osteoporosis in patients with Alzheimer's. Therefore, abnormalities or alterations in the inflammatory pathways in the peripheral blood samples of Alzheimer's patients may affect the course of osteoporosis.

Eldra W Daniels, David Cole, Bret Jacobs et al.

Office-based ultrasonography has become increasingly available in many settings, and its use to guide joint and soft tissue injections has increased. Numerous studies have been conducted to evaluate the use of ultrasound-guided injections over traditional landmark-guided injections, with a rapid growth in the literature over the past few years. A comprehensive review of the literature was conducted to demonstrate increased accuracy of ultrasound-guided injections regardless of anatomic location. In the upper extremity, ultrasound-guided injections have been shown to provide superior benefit to landmark-guided injections at the glenohumeral joint, the subacromial space, the biceps tendon sheath, and the joints of the hand and wrist. Ultrasound-guided injections of the acromioclavicular and the elbow joints have not been shown to be more efficacious. In the lower extremity, ultrasound-guided injections at the knee, ankle, and foot have superior efficacy to landmark-guided injections. Conclusive evidence is not available regarding improved efficacy of ultrasound-guided injections of the hip, although landmark-guided injection is performed less commonly at the hip joint. Ultrasound-guided injections are overall more accurate than landmark-guided injections. While current studies indicate that ultrasound guidance improves efficacy and cost-effectiveness of many injections, these studies are limited and more research is needed.

Alexander C. Stahn, Martina Anna Maggioni, Hanns-Christian Gunga et al.

Background The leucine metabolite β-hydroxy-β-methylbutyrate (HMB) is widely used as an ergogenic supplement to increase resistance-training induced gains in fat free mass (FFM) and strength in healthy adults. Recent studies have questioned the effectiveness of HMB, particularly when a high protein diet is habitually consumed. To investigate the additive resistance-training induced effects of HMB and protein in untrained individuals, we conducted a randomized double-blind, placebo-controlled study that compared the effects of combined protein and HMB supplementation to protein supplementation alone on FFM and muscle strength after 12-week resistance training. Methods Sixteen healthy men (22 ± 2 yrs) performed a periodized resistance-training program for twelve weeks (four sessions per week). The program comprised two mesocycles, characterized by a linear periodization and non-linear periodization, respectively, and separated by a 1-week tapering period. All participants received 60 g of whey protein on training days and 30 g of whey protein (WP) on non-training days. Participants were randomly assigned to additionally receive 3 g of calcium HMB (WP + HMB) or a placebo (WP + PLA). Body composition and physical fitness were tested before and after the 12-week training program. Whole-body and arm and leg fat free mass (FFM) were assessed by bioimpedance spectroscopy; upper arm and leg fat free cross sectional areas were also quantified using magnetic resonance imaging (MRI); upper and lower body strength were measured by One-repetition maximum (1-RM) bench press and leg press. Results Whole-body and segmental FFM increased in both groups (P <  0.001). However, gains in leg FFM were higher in WP + HMB vs. WP + PLA (arm FFM: + 6.1% vs. + 9.2%, P = 0.2; leg FFM: + 14.2% vs. + 7.0%, P <  0.01). No change in fat mass was observed (P = 0.59). 1-RM increased in both groups (P <  0.001). Conclusions Combined protein and HMB supplementation resulted in segmental, but not whole-body increases in FFM compared to protein supplementation alone. These findings could explain some of the controversial effects of HMB reported in previous studies and have practical implications for maximizing training-induced gains in FFM and clinical conditions associated with skeletal muscle deconditioning such as aging, sedentary lifestyles, bed rest and spaceflight.

Peter O'Donoghue, Mark Milne

Thirty30 is a shorter format of tennis where games start at 30-30. This means that a greater proportion of points are game points or break points than would be the case in traditional tennis. The purpose of the current paper is to compare the probability of players of different abilities winning games, sets and matches between Thirty30 tennis and traditional tennis. This is done using probabilistic models of each format of tennis. The results show that there is reduced dominance of the serve and a greater probability of upsets in Thirty30 tennis than in traditional tennis. The models are also experimented with, adjusting the probability of winning points where the point is a game point or a break point. The paper shows that such scoreline effects have a greater impact in Thirty30 tennis than they do in traditional tennis. This has implications for player preparation for Thirty30 tennis.

M. Mead, J. Gumucio, T. Awan et al.

Tendinopathy is a major clinical problem in sports medicine and is often difficult to treat. Traditional therapeutic approaches have focused on reducing inflammation, yet research suggests that little to no inflammation is present in the tendons that fail to heal. The purpose of this review was to evaluate the effectiveness of the available treatment options for tendinopathy and to inform best clinical practices. A comprehensive search of electronic databases (PubMed, Google Scholar, and Web of Science) was conducted to identify relevant studies through June 2016. Studies were deemed relevant if they were published in English and contained original research on the management of tendinopathy in humans. Studies varied in methodological quality and were often limited by small sample size and lack of sufficient control groups. Critical evaluation of the literature suggests that physical therapy with or without eccentric exercise should be considered a first‐line treatment. Corticosteroids and non‐steroidal anti‐inflammatory drugs provide short‐term symptomatic relief, but long‐term efficacy has not been demonstrated. Inconsistent results do not support the routine use of prolotherapy, platelet‐rich plasma injections, and topical nitric oxide patches. Operative intervention should be reserved until conservative measures fail or an obvious operative lesion is present. While numerous therapeutic modalities exist for tendinopathy in the athlete, the ideal treatment protocol has not been clearly defined. The development of new targeted therapies for tendinopathy is likely to follow a greater understanding of the cellular and molecular mechanisms that underlie its pathogenesis.