International Society of Sports Nutrition Position Stand: protein and exercise
R. Jäger, C. Kerksick, B. Campbell
et al.
Position statementThe International Society of Sports Nutrition (ISSN) provides an objective and critical review related to the intake of protein for healthy, exercising individuals. Based on the current available literature, the position of the Society is as follows:1)An acute exercise stimulus, particularly resistance exercise, and protein ingestion both stimulate muscle protein synthesis (MPS) and are synergistic when protein consumption occurs before or after resistance exercise.2)For building muscle mass and for maintaining muscle mass through a positive muscle protein balance, an overall daily protein intake in the range of 1.4–2.0 g protein/kg body weight/day (g/kg/d) is sufficient for most exercising individuals, a value that falls in line within the Acceptable Macronutrient Distribution Range published by the Institute of Medicine for protein.3)There is novel evidence that suggests higher protein intakes (>3.0 g/kg/d) may have positive effects on body composition in resistance-trained individuals (i.e., promote loss of fat mass).4)Recommendations regarding the optimal protein intake per serving for athletes to maximize MPS are mixed and are dependent upon age and recent resistance exercise stimuli. General recommendations are 0.25 g of a high-quality protein per kg of body weight, or an absolute dose of 20–40 g.5)Acute protein doses should strive to contain 700–3000 mg of leucine and/or a higher relative leucine content, in addition to a balanced array of the essential amino acids (EAAs).6)These protein doses should ideally be evenly distributed, every 3–4 h, across the day.7)The optimal time period during which to ingest protein is likely a matter of individual tolerance, since benefits are derived from pre- or post-workout ingestion; however, the anabolic effect of exercise is long-lasting (at least 24 h), but likely diminishes with increasing time post-exercise.8)While it is possible for physically active individuals to obtain their daily protein requirements through the consumption of whole foods, supplementation is a practical way of ensuring intake of adequate protein quality and quantity, while minimizing caloric intake, particularly for athletes who typically complete high volumes of training.9)Rapidly digested proteins that contain high proportions of essential amino acids (EAAs) and adequate leucine, are most effective in stimulating MPS.10)Different types and quality of protein can affect amino acid bioavailability following protein supplementation.11)Athletes should consider focusing on whole food sources of protein that contain all of the EAAs (i.e., it is the EAAs that are required to stimulate MPS).12)Endurance athletes should focus on achieving adequate carbohydrate intake to promote optimal performance; the addition of protein may help to offset muscle damage and promote recovery.13)Pre-sleep casein protein intake (30–40 g) provides increases in overnight MPS and metabolic rate without influencing lipolysis.
Exercise is medicine in oncology: Engaging clinicians to help patients move through cancer
Kathryn H. Schmitz, Anna M. Campbell, M. Stuiver
et al.
Multiple organizations around the world have issued evidence‐based exercise guidance for patients with cancer and cancer survivors. Recently, the American College of Sports Medicine has updated its exercise guidance for cancer prevention as well as for the prevention and treatment of a variety of cancer health‐related outcomes (eg, fatigue, anxiety, depression, function, and quality of life). Despite these guidelines, the majority of people living with and beyond cancer are not regularly physically active. Among the reasons for this is a lack of clarity on the part of those who work in oncology clinical settings of their role in assessing, advising, and referring patients to exercise. The authors propose using the American College of Sports Medicine's Exercise Is Medicine initiative to address this practice gap. The simple proposal is for clinicians to assess, advise, and refer patients to either home‐based or community‐based exercise or for further evaluation and intervention in outpatient rehabilitation. To do this will require care coordination with appropriate professionals as well as change in the behaviors of clinicians, patients, and those who deliver the rehabilitation and exercise programming. Behavior change is one of many challenges to enacting the proposed practice changes. Other implementation challenges include capacity for triage and referral, the need for a program registry, costs and compensation, and workforce development. In conclusion, there is a call to action for key stakeholders to create the infrastructure and cultural adaptations needed so that all people living with and beyond cancer can be as active as is possible for them.
American College of Sports Medicine Position Stand. The recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness, and flexibility in healthy adults.
J. Despres, C. Ewing
Position of the American Dietetic Association, Dietitians of Canada, and the American College of Sports Medicine: Nutrition and athletic performance.
N. Rodriguez, N. DiMarco, Susie Langley
The American Congress of Rehabilitation Medicine Diagnostic Criteria for Mild Traumatic Brain Injury.
N. Silverberg, G. Iverson, Alison M. Cogan
et al.
OBJECTIVE To develop new diagnostic criteria for mild traumatic brain injury (TBI) that are appropriate for use across the lifespan and in sports, civilian trauma, and military settings. DESIGN Rapid evidence reviews on 12 clinical questions and Delphi method for expert consensus. PARTICIPANTS The Mild Traumatic Brain Injury Task Force of the American Congress of Rehabilitation Medicine Brain Injury Special Interest Group convened a Working Group of 17 members and an external interdisciplinary expert panel of 32 clinician-scientists. Public stakeholder feedback was analyzed from 68 individuals and 23 organizations. RESULTS The first two Delphi votes asked the expert panel to rate their agreement with both the diagnostic criteria for mild TBI and the supporting evidence statements. In the first round, 10 of 12 evidence statements reached consensus agreement. Revised evidence statements underwent a second round of expert panel voting, where consensus was achieved for all. For the diagnostic criteria, the final agreement rate, after the third vote, was 90.7%. Public stakeholder feedback was incorporated into the diagnostic criteria revision prior to the third expert panel vote. A terminology question was added to the third round of Delphi voting, where 30 of 32 (93.8%) expert panel members agreed that 'the diagnostic label 'concussion' may be used interchangeably with 'mild TBI' when neuroimaging is normal or not clinically indicated.' CONCLUSIONS New diagnostic criteria for mild TBI were developed through an evidence review and expert consensus process. Having unified diagnostic criteria for mild TBI can improve the quality and consistency of mild TBI research and clinical care.
A novel single-portal arthroscopic technique for the management of pediatric humeral lateral condylar fractures
Mingjing Li, Fan Li, Yushun Fang
et al.
BackgroundSurgical intervention is indicated for significantly displaced lateral humeral condyle fractures (LHCFs) in children. Arthroscopic-assisted closed reduction represents a minimally invasive alternative; however, its widespread adoption has been limited by the technical challenges inherent in both pediatric fracture management and elbow arthroscopy. This study introduces a simplified technique utilizing a single proximal anterolateral portal for arthroscopic-assisted reduction, which has shown promising efficacy and safety.MethodsA retrospective analysis was performed on 18 pediatric patients with LHCFs who underwent arthroscopic-assisted closed reduction via a single proximal anterolateral portal at our institution between March 2024 and February 2025. The cohort included 14 boys and 4 girls, with a mean age of 6.1 ± 1.6 years. The mean interval from injury to surgery was 4.7 ± 2.1 days. Data on fracture classification, operative time, duration of K-wire fixation, and functional outcomes were collected and analyzed.ResultsAll 18 patients successfully underwent the procedure. The mean operative time was 56.9 ± 10.0 min, and K-wires were maintained for a mean of 35 ± 8.5 days. At the final follow-up, no significant differences in the carrying angle were observed between the injured and contralateral limbs. According to the Flynn criteria, 16 cases were rated as excellent and 2 as good. One case of a superficial pin site infection resolved with conservative wound care. No instances of delayed union, nonunion, neurovascular injury, or compartment syndrome were recorded.ConclusionThe single proximal anterolateral portal technique for arthroscopic-assisted reduction of LHCFs facilitates minimally invasive debridement of the fracture site and provides direct visualization of the reduction process. This approach serves as a viable and effective alternative for managing lateral condylar fractures that are not amenable to conventional closed reduction due to severe displacement or a prolonged delay from injury. The technique demonstrates a favorable safety profile, and shows promise for broader clinical adoption pending further validation.
Meta‐analysis prediction intervals are under reported in sport and exercise medicine
D. Borg, F. Impellizzeri, S. J. Borg
et al.
Prediction intervals are a useful measure of uncertainty for meta‐analyses that capture the likely effect size of a new (similar) study based on the included studies. In comparison, confidence intervals reflect the uncertainty around the point estimate but provide an incomplete summary of the underlying heterogeneity in the meta‐analysis. This study aimed to estimate (i) the proportion of meta‐analysis studies that report a prediction interval in sports medicine; and (ii) the proportion of studies with a discrepancy between the reported confidence interval and a calculated prediction interval.
The effects of muscle fatigue on shoulder proprioception and forehand stroke accuracy in Chinese elite table tennis athletes
Zhenlei Chen, Tianshu Zhao, Youqing Shen
et al.
Abstract This study explores the relationship between shoulder proprioception and landing point accuracy in Chinese elite table tennis athletes, particularly under fatigue conditions. A total of 19 male athletes participated, with their shoulder proprioception tested using an ISOMED 2000 isokinetic muscle tester. The tester measured proprioception acuity in both pre-fatigue and post-fatigue conditions, alongside performance in a hitting task assessed with a high-speed serve machine. Results indicated a significant correlation between proprioception and stroke performance, especially in internal and external rotation directions (p < 0.01). After fatigue, proprioception in both the racket-holding and non-racket-holding hands significantly decreased in internal and external rotations (p < 0.01 for both hands), with no significant change in vertical extension (VE). Additionally, the performance of the hitting task after fatigue significantly declined in the racket-holding hand (p < 0.01). These findings suggest that shoulder proprioception plays a crucial role in stroke accuracy and fatigue recovery, providing valuable insights for training, rehabilitation, and performance optimization in table tennis.
First international consensus statement on sports psychiatry
M. Claussen, Alan Currie, Eugene Koh Boon Yau
et al.
Sports psychiatry is a young field of medicine and psychiatry that focuses on mental health among athletes, and sports and exercise within psychiatry and mental disorders. However, the development of sports psychiatry and its fields of activity vary from region to region and are not uniform yet. Sports psychiatry and the role of sports psychiatrists have also already been discussed in the field of sports and exercise medicine, and within medical teams in competitive and elite sports. A uniform definition on sports psychiatry, its fields of activity, sports psychiatrist, and the essential knowledge, skills, and abilities (plus attitudes, eKSA+A) of the sports psychiatrist were developed as part of an International Society for Sports Psychiatry (ISSP) Summit, as well as First International Consensus Statement on Sports Psychiatry. Three fields of activity can be distinguished within sports psychiatry: (i) mental health and disorders in competitive and elite sports, (ii) sports and exercise in prevention of and treatment for mental disorders, and (iii) mental health and sport‐specific mental disorders in recreational sports. Each of these fields have its own eKSA+A. The definitions on sports psychiatry and sports psychiatrists, as well as the framework of eKSA+A in the different fields of activity of sports psychiatrists will help to unify and standardize the future development of sports psychiatry, establish a standard of service within sports psychiatry and together with the neighboring disciplines, and should be included into current, and future sports psychiatry education and training.
Autoimmune pancreatitis - role of intestinal microbiota in pathogenesis. Review of the literature
Katarzyna Wiejak, Katarzyna Schok, Jakub Jasek
Introduction: Autoimmune pancreatitis is a type of chronic autoimmune inflammation that can be divided into two types. Type 1 is a clinical manifestation of IgG4-mediated disease, while type 2 may coexist with inflammatory bowel diseases.
Objective: The aim of the study is to review the literature on the role of the intestinal microbiota in the pathogenesis of autoimmune pancreatitis.
Methods: A literature review was conducted on databases such as PubMed and Google Scholar using the terms: ”autoimmune pancreatits”, “intestinal dysbiosis”, “intestinal microbiome”, and “pathogenesis”.
Conclusions: The intestinal microbiota has an impact on the development of autoimmune pancreatitis, but it is not the main pathogenic factor, but rather a risk factor.
Desarrollo de la habilidad auto-ejercitación en la Educación Física, con utilización de guías de estudio/Developing the self-exercise skill in physical education by using study guides
Miguel Ángel Inguanzo Marrero, Janet Otero Brande
Introducción: El uso de estrategias didácticas en la Educación Física ha cobrado vigencia, especialmente en las últimas décadas, en un mundo en el que todo está regido por las tecnologías, y está de moda hacer deportes al reconocer la importancia que ofrece para la salud, tanto mental como general.
Objetivo: Elaborar una estrategia didáctica que contribuya a la formación de la habilidad auto-ejercitación del ejercicio físico, en los estudiantes de la carrera “Medicina Veterinaria”, de la Universidad Agraria de La Habana.
Métodos: Se utilizaron diferentes métodos y técnicas, como la encuesta, la entrevista, así como, el análisis de documentos, la observación a clase y la triangulación metodológica. La muestra estuvo conformada por 77 estudiantes y 15 profesores de Educación Física.
Resultados: La aplicación práctica de la estrategia didáctica, demuestra que, se contribuye a perfeccionar la enseñanza de la Educación Física de los estudiantes, con la utilización de las guías de estudio como herramienta didáctica.
Conclusiones: Se concluye que, la aplicación de la estrategia didáctica mostró evidencias en la formación de la habilidad auto-ejercitación del ejercicio físico, materializadas en el incremento de los niveles de la condición física en el 78,55% de los estudiantes./Introduction: The use of didactic strategies in physical education has gained validity, especially in the last decades, in a world where everything is ruled by technologies, and playing sports is fashionable by recognizing the importance it offers for both mental and general health.
Objective: To elaborate a didactic strategy that contributes to the development of the self-exercise skill for physical exercise in Veterinary Medicine students of the Agrarian University of Havana.
Methods: Different methods and techniques were used, such as the survey, the interview, as well as the analysis of documents, classroom observation and methodological triangulation. The sample consisted of 77 students and 15 physical education teachers.
Results: The practical application of the didactic strategy shows that it contributes to improve teaching physical education to students, with the use of study guides as a didactic tool.
Conclusion: It is concluded that the application of the didactic strategy showed evidences in the formation of the self-exercise skill for physical exercise, materialized in the increase of physical condition levels in 78.55% of the students.
Education (General), Social sciences (General)
Should I Rest or Should I Go Now? A Randomized Cross-Over Trial Comparing Fixed and Self-Selected Rest Durations in High-Intensity Interval Training Cycling Sessions
Eyal Colorni, Evyatar Ohayon, Julie N. Côté
et al.
Abstract Background In high-intensity interval training (HIIT), the rest durations between intervals are commonly prescribed using a fixed approach (e.g., 30 s between intervals). An alternative is the self-selected (SS) approach, in which trainees select their resting durations. Studies comparing the two approaches report mixed results. However, in these studies, trainees in the SS condition rested for as little or as long as they wished, leading to dissimilar total rest durations between conditions. Here, for the first time, we compare the two approaches while controlling for total rest duration. Methods Twenty-four amateur adult male cyclists completed a familiarization session, followed by two counterbalanced cycling HIIT sessions. Each session was composed of nine, 30-s intervals, in which the goal was to accumulate as many watts as possible on an SRM ergometer. In the fixed condition, cyclists rested for 90 s between intervals. In the SS condition, cyclists had 720 s (i.e., 8 × 90 s) of rest to allocate in any way they wished. We measured and compared watts, heart rate, electromyography of the knee flexors and extensors, rating of perceived effort and fatigue, perception of autonomy and enjoyment. Additionally, a subsample of ten cyclists completed a retest of the SS condition. Results With the exception of perception of autonomy, which was higher in the SS condition, outcomes were highly similar in both conditions. For example, the average aggregated differences were: 0.57 (95% CI − 8.94, 10.09) for watts; − 0.85 (95% CI − 2.89, 1.18) for heart rate; and 0.01 (95% CI − 0.29, 0.30) for rating of perceived effort (on a 0–10 scale). Additionally, the retest of the SS condition resulted in a similar rest allocation pattern across the intervals and in similar outcomes. Conclusion Given the similarities in performance, physiological and psychological outcomes between the fixed and SS conditions, both can be equally utilized based on coaches’ and cyclists’ preferences and training goals.
Treatment of avascular necrosis of the humeral head – Postoperative results and a proposed modification of the classification
Jonas Schmalzl, Annika Graf, Michael Kimmeyer
et al.
Abstract Background Avascular necrosis of the humeral head after proximal humeral fracture i.e. type 1 fracture sequelae (FS) according to the Boileau classification is a rare, often painful condition and treatment still remains a challenge. This study evaluates the treatment of FS type 1 with anatomic and reverse shoulder arthroplasty and a new subclassification is proposed. Methods This single-center, retrospective, comparative study, included all consecutive patients with a proximal humeral FS type 1 treated surgically in a four-year period. All patients were classified according to the proposed 3 different subtypes. Constant score (CS), Quick DASH score, subjective shoulder value (SSV) as well as revision and complication rate were analyzed. In the preoperative radiographs the acromio-humeral interval (AHI) and greater tuberosity resorption were examined. Results Of 27 with a FS type 1, 17 patients (63%) with a mean age of 64 ± 11 years were available for follow-up at 24 ± 10 months. 7 patients were treated with anatomic and 10 with reverse shoulder arthroplasty. CS improved significantly from 16 ± 7 points to 61 ± 19 points (p < 0.0001). At final follow-up the mean Quick DASH Score was 21 ± 21 and the mean SSV was 73 ± 21 points. The mean preoperative AHI was 9 ± 3 mm, however, 8 cases presented an AHI < 7 mm. 4 cases had complete greater tuberosity resorption. The complication and revision rate was 19%; implant survival was 88%. Conclusion By using the adequate surgical technique good clinical short-term results with a relatively low complication rate can be achieved in FS type 1. The Boileau classification should be extended for fracture sequelae type 1 and the general recommendation for treatment with hemiarthroplasty or total shoulder arthroplasty has to be relativized. Special attention should be paid to a decreased AHI and/or resorption of the greater tuberosity as indirect signs for dysfunction of the rotator cuff. To facilitate the choice of the adequate prosthetic treatment method the suggested subclassification system should be applied.
Diseases of the musculoskeletal system
Peculiarities of neuroendocrine and metabolic effects of sulfate-chloride sodium-magnesium mineral waters "Myroslava" and "Khrystyna" of Truskavets’ spa in healthy female rats
Myroslava Hrytsak, Dariya Popovych, Nataliya Badiuk
et al.
Background. Earlier we found that the newly created sulfate-chloride sodium-magnesium drinking mineral waters of Truskavets’ spa have similar neuroendocrine and metabolic effects on healthy old female rats significantly different from daily water. The aim of this study is to elucidate the effects of these mineral waters on the neuroendocrine status and metabolism of these animals. Materials and Methods. Experiment was performed on 50 healthy female Wistar rats. Animals of the first group remained intact, using tap water from drinking ad libitum. Rats of the control group for 6 days injected a tap water through the tube at a dose of 1,5 mL/100 g of body mass. The rats of the main groups received the water "Myroslava" and "Khrystyna". The day after the completion of the drinking course in all rats, at first, assessed the state of autonomous regulation by parameters of the HRV. The plasma levels of the hormones of adaptation were determined: corticosterone, triiodothyronine and testosterone (by the ELISA) as well as electrolytes: calcium, magnesium, phosphates, chloride, sodium and potassium; nitric metabolites: creatinine, urea, uric acid, medium molecular polypeptides, bilirubin; lipid peroxidation products and antioxidant enzymes, as well as cholesterol, amylase and glucose. Most of the listed parameters of metabolism were also determined in daily urine. In the adrenals the thickness of glomerular, fascicular, reticular and medullar zones was measured. Results. To identify exactly those parameters, the set of which all four groups of animals differ significantly from each other, the information field of the registered parameters was subjected to discriminant analysis. The program included in the model 8 endocrine and 16 metabolic parameters, information about which is condensed into three roots. The first root reflects directly the SOD and corticosterone and inversely the reticular zone as well as plasma uric acid and glucose. The second root contains information about Nap/Kp ratio, natrihistia, amylasemia, magnesiumuria as well as inversely about kaliemia. The third root reflects directly the triiodothyronine, parathyroid activity, plasma Ca, natriuria and chloriduria as well as urine malondyaldehide. Inversely displays the root information about the testosterone, Ku/Nau ratio, glomerular zone, plasma katalase and Na as well as uricosuria and amylasuria. In the information space of the three discriminant roots, all four groups are quite clearly distinguished. Classification accuracy is 94% (three errors). Conclusion. The newly created sulfate-chloride sodium-magnesium drinking mineral waters of Truskavets resort have specific endocrine and metabolic effects on healthy old female rats with weekly use. This provides a basis for preclinical studies.
Whole-Body EMS Superimposed Walking and Nordic Walking on a Treadmill—Determination of Exercise Intensity to Conventional Exercise
Ronald Verch, Josephine Stoll, Miralem Hadzic
et al.
Electrical muscle stimulation (EMS) is an increasingly popular training method and has become the focus of research in recent years. New EMS devices offer a wide range of mobile applications for whole-body EMS (WB-EMS) training, e.g., the intensification of dynamic low-intensity endurance exercises through WB-EMS. The present study aimed to determine the differences in exercise intensity between WB-EMS-superimposed and conventional walking (EMS-CW), and CON and WB-EMS-superimposed Nordic walking (WB-EMS-NW) during a treadmill test. Eleven participants (52.0 ± years; 85.9 ± 7.4 kg, 182 ± 6 cm, BMI 25.9 ± 2.2 kg/m2) performed a 10 min treadmill test at a given velocity (6.5 km/h) in four different test situations, walking (W) and Nordic walking (NW) in both conventional and WB-EMS superimposed. Oxygen uptake in absolute (VO2) and relative to body weight (rel. VO2), lactate, and the rate of perceived exertion (RPE) were measured before and after the test. WB-EMS intensity was adjusted individually according to the feedback of the participant. The descriptive statistics were given in mean ± SD. For the statistical analyses, one-factorial ANOVA for repeated measures and two-factorial ANOVA [factors include EMS, W/NW, and factor combination (EMS*W/NW)] were performed (α = 0.05). Significant effects were found for EMS and W/NW factors for the outcome variables VO2 (EMS: p = 0.006, r = 0.736; W/NW: p < 0.001, r = 0.870), relative VO2 (EMS: p < 0.001, r = 0.850; W/NW: p < 0.001, r = 0.937), and lactate (EMS: p = 0.003, r = 0.771; w/NW: p = 0.003, r = 0.764) and both the factors produced higher results. However, the difference in VO2 and relative VO2 is within the range of biological variability of ± 12%. The factor combination EMS*W/NW is statistically non-significant for all three variables. WB-EMS resulted in the higher RPE values (p = 0.035, r = 0.613), RPE differences for W/NW and EMS*W/NW were not significant. The current study results indicate that WB-EMS influences the parameters of exercise intensity. The impact on exercise intensity and the clinical relevance of WB-EMS-superimposed walking (WB-EMS-W) exercise is questionable because of the marginal differences in the outcome variables.
Self-esteem, anxiety and coping strategies to manage stress in ice hockey
Adriana Kaplánová
Background: Sweating, increased heart rate, fidgeting, worrying thoughts and fear of failure are typical symptoms of an inability to manage stress in an important moment of match. Thus, there is well-founded need for psychological training that can help ice hockey players to control their emotions in stressful situations. Objective: Because of a lack of research monitoring mental skills of ice hockey players, the aim of the study is to investigate the relationship between self-esteem, anxiety of ice hockey players and their coping strategies to manage stress. Methods: The study sample consisted of 40 male ice hockey players with age of 21.67 ± 1.94 years. The level of self-esteem was evaluated by the Rosenberg Self-Esteem Scale RSES, anxiety was measured by the Sport Anxiety Scale SAS-2, and coping strategies to manage stress were assessed by the Athletic Coping Skills Inventory ACSI-28. The study used the correlational research design with Spearman correlation coefficient. Results: We found that coping strategies to manage stress have significant relationship with at least one anxiety construct of the ice hockey players, namely coping with adversity, coachability, concentration, goal setting and mental preparation, peaking under pressure and freedom from worry. We also found that coping strategies to manage stress have significant relationship with the self-esteem of ice hockey players, namely coping with adversity, concentration and freedom from worry. Conclusion: Our research showed that the level of coping strategies to manage stress varies according to the level of self-esteem and the level of the anxiety. It seems that reduced anxiety and increased self-esteem can lead to better stress management and optimal competition performance.
Gut microbiota: implications for sports and exercise medicine
Owen Cronin, O. O’Sullivan, W. Barton
et al.
38 sitasi
en
Biology, Medicine
A risk assessment model for chronic ankle instability: indications for early surgical treatment? An observational prospective cohort – study protocol
Gwendolyn Vuurberg, Lauren M. Wink, Leendert Blankevoort
et al.
Abstract Background Chronic ankle instability (CAI) is a common result of an ankle sprain. Even though early surgical treatment yields the best results, overall only professional athletes are eligible for acute surgical stabilization. Treating all patients with early surgical stabilization leads to a high amount of unnecessary invasive interventions, as not all patients progress to CAI. If patients at risk of developing CAI can be identified, treatment policies may be applied more effectively and efficiently. The purpose of this study is to develop a risk assessment model to identify patients at risk for CAI that should receive early surgical treatment. Methods In this observational prospective cohort, all patients aged sixteen years and older, reporting at the emergency department of one of the participating hospitals after sustaining a lateral ankle sprain, and filled out 1 out of 3 follow-up questionnaires and the 1 year follow-up are included. A lateral and anteroposterior radiograph is made. Patients are excluded if a fracture or other pathology is present. The included patients receive four questionnaires, including questions focusing on the sprain, treatment and complaints, the Foot and Ankle Outcome Score and the Cumberland Ankle Instability Tool. A total of eleven radiographic variables are assessed for inter- and intra-observer reliability. Additionally, four factors extracted from the questionnaires, will be evaluated for correlation with CAI. Significantly correlating factors (e.a. risk factors) will be implemented in a risk assessment model. For the final model, based on sixteen variables with a minimum of 20 events per variable and a prevalence of 30–40% after an initial sprain, a sample size of 2370 patients is needed to perform both internal and external model validation. Discussion This study will develop the first large scale model for the risk at CAI after an ankle sprain combining radiographic and patient characteristics. With this risk assessment model, patients at risk for CAI may be identified and properly informed on the treatment options. Patients identified as being at risk, may receive more adequate follow-up and become eligible for early surgical stabilization. This prevents patients from experiencing unnecessary long-lasting complaints, increasing the success rate of conservative and surgical treatment. Trial registration Retrospectively registered: NCT02955485 [Registration date: 3–11-2016]. NTR6139 [Registration date: 3–1-2017].
Diseases of the musculoskeletal system
Does Performance of Speed-Accuracy Movements Depend on Gender and the Left or the Right Hand?
Kristina Motiejūnaitė, Dalia Mickevičienė, Albertas Skurvydas
et al.
The aim of the study was to establish the differences in men and women’s performance of speed-accuracy movements with their left (LH) and right (RH) hands. The research participants were 24 healthy right-handed subjects: 12 males (aged 20.8 ± 1.1 years) and 12 females (aged 21.4 ± 1.0 years). The research was carried out in the Laboratory of Human Motor Control at the Lithuanian Academy of Physical Education (LAPE) applying the analyzer of dynamic parameters of human leg and arm movement (DPA-1; Patent No. 5251; 2005 08 25), which is used for the qualitative estimation of the dynamic parameters of one arm and leg target movement, two arms and legs coordinated and independent target movements, when the resistance power and target are coded with different programmable parameters. The task was performed with the right and then with the left hand (50 repetitions with each hand). The subjects had two tasks: a) to react as quickly as possible (simple task); b) to react as quickly as possible and to hit the target on a computer screen quickly and accurately (complicated task). We registered the maximal and mean movement speed, reaction time, movement trajectory and intraindividual variability of the right and the left hands. Conclusions. There was no significant difference in accuracy between female and male subjects, thought female subjects performed speed-accuracy task more slowly than men. Both males and females performed the speed-accuracy task with their right hand faster and more accurately than with their left hand. Performing movements with different hands the indices of reaction time did not differ significantly. Both males and females performed movements with their right and left hands with the same intraindividual variability.
Keywords: movement control, reaction time, speed-accuracy task, right and left hand, gender.