Journal of Functional Morphology and Kinesiology

After spinal cord injury (SCI), multiple adaptations occur that influence metabolic health and life quality. Prolonged sitting and inactivity predispose people with SCI to body composition changes, such as increased visceral adipose tissue (VAT) thickness, which is often associated with impaired glucose tolerance. Our goal is to understand whether VAT is an index of leanness, and, secondarily, whether mobility methods influence glucose tolerance for people living with SCI. A total of 15 people with SCI and 20 people without SCI had fasting oral glucose tolerance tests (OGTT) and VAT thickness (leanness) measured during a single session. Glucose was 51% and 67% greater for individuals with SCI relative to those without SCI after 60 and 120 min of an OGTT (p < 0.001). Glucose area under the curve (AUC) was 28%, 34%, and 60% higher for non-lean people with SCI than lean people with SCI and non-lean and lean people without SCI, respectively (p = 0.05, p = 0.009, p < 0.001). VAT was associated with glucose AUC (R² = 0.23, p = 0.004). Taken together, these findings suggest that leanness, as estimated from VAT, may be an important consideration when developing rehabilitation programs to influence metabolism among people with SCI. Full article

Ankle arthrodesis is a commonly used salvage procedure in the management of post-traumatic ankle fractures, which often result in severe disability and may require the amputation of the distal third of the leg. Successful ankle arthrodesis relies on a thorough assessment of local and systemic risk factors to ensure optimal results. Failure to accurately assess these factors may lead to unsatisfactory results. High-energy trauma causing bone defects and soft tissue necrosis often results in osteomyelitis, a condition that poses a significant threat to the success of the arthrodesis procedure. It is important to apply a standardised surgical protocol to minimise the possibility of superficial and deep infection and limit damage to the neighbouring soft tissues. Therefore, it is critical to undertake surgical lavage and debridement and administer systemic and local antibiotic therapy, along with the use of a spacer, to eradicate infection prior to performing arthrodesis. In this study, we present our experience in the recovery of limbs with post-traumatic complications via tibio-astragalic or tibio-calcaneal arthrodesis using a retrograde intramedullary nail technique. The approach involves a multi-step procedure using a previous antibiotic spacer implant and an autologous bone graft (RIA). This study spanned a period from January 2014 to December 2021 and included 35 patients (12 women and 23 men) with a mean age of 47.8 ± 20.08 years (range: 22–85 years). Among the patients, 18 had osteomyelitis following AO 43 C3 fractures, and 9 of them had previous exposure and bone loss at the time of injury. The remaining cases included 10 patients with AO 44 C fracture outcomes and 7 patients with AO 44 B fracture outcomes. Our results emphasise the importance of the meticulous management of local and systemic risk factors in ankle arthrodesis procedures. The successful eradication of infection and subsequent arthrodesis can be achieved via the implementation of surgical lavage, debridement, and systemic and local antibiotic therapy using spacers. This surgical protocol implemented by us has yielded excellent results, saving affected limbs from post-traumatic complications and avoiding the need for amputation. Our study contributes to the existing knowledge supporting the use of retrograde arthrodesis with intramedullary nails in severe cases where limb salvage is the primary goal. However, further research and long-term follow-up studies are needed to validate these results and evaluate the effectiveness of this technique in a larger patient population. Full article

The aim of this study was to investigate the effects of a tart cherry supplement on recovery from exercise-induced muscle damage. Seventeen recreationally active women (mean age ± SD = 22.2 ± 3.3 years, height = 162.0 ± 6.0 cm, body mass = 65.1 ± 11.1 kg, BMI = 24.7 ± 3.5 kg·m²) supplemented with 1000 mg of concentrated tart cherry or a placebo for eight consecutive days. An overload protocol of 8 sets of 10 repetitions of maximal effort concentric and eccentric muscle actions of the leg extensors at a velocity of 60$°·{\mathrm{s}}^{-1}$ was performed on the fourth day of supplementation. Testing sessions consisted of a muscle function test (MFT) to examine pre- and post-testing peak torque, peak power, total work, time-to-peak torque, mean power, muscle activation of the quadriceps, and muscle soreness at baseline and post-testing at 0 h, 24 h, 48 h, and 72 h. A second trial of testing was repeated two weeks later using the opposite supplement to the one assigned for the first trial. No significant interaction for time × condition × velocity (p = 0.916) and no significant main effect for condition (p = 0.557) were demonstrated for peak torque. However, there were main effects for time and velocity for concentric quadriceps peak torque (p < 0.001). For muscle soreness, there was no two-way interaction for time x condition (p > 0.05) and no main effect for condition (p > 0.05), but there was a main effect for time (p < 0.001). In conclusion, a tart cherry supplement did not attenuate losses in isokinetic muscle peak torque, peak power, total work, time-to-peak torque, muscle soreness, or quadriceps muscle activation. Full article

The aim of this study was to identify the relationship between dry-land and in-water strength with performance and kinematic variables in short-distance, middle-distance, and repeated sprint swimming. Fifteen competitive swimmers applied a bench press exercise to measure maximum strength (MS), maximum power (P), strength corresponding to P (F@P), maximum velocity (MV), and velocity corresponding to P (V@P) using F–V and P–V relationships. On a following day, swimmers performed a 10 s tethered swimming sprint (TF), and impulse was measured (IMP). On three separate days, swimmers performed (i) 50 and 100 m, (ii) 200 and 400 m, and (iii) 4 × 50 m front crawl sprint tests. Performance time (T), arm stroke rate (SR), arm stroke length (SL), and arm stroke index (SI) were calculated in all tests. Performance in short- and middle-distance tests and in 4 × 50 m training sets were related to dry-land MS, P, TF, and IMP (r = 0.51–0.83; p < 0.05). MS, P, and TF were related to SR in 50 m and SI in 50 and 100 m (r = 0.55–0.71; p < 0.05). A combination of dry-land P and in-water TF variables explains 80% of the 50 m performance time variation. Bench press power and tethered swimming force correlate with performance in short- and middle-distance tests and repeated sprint swimming. Full article

The purpose of this study was to compare external workloads between collegiate men’s (MLAX) and women’s lacrosse (WLAX) matches and examine positional differences across the season. Athletes (MLAX: n = 10; WLAX: n = 13) wore a global positional system device during all matches. External load metrics included in the analysis were total distance (TD), sprint distance (SD), accelerations (>3 m/s²), sprint efforts, player load per minute (PL/min), top speed, and distances spent in various speed zones. WLAX had higher TD (p = 0.001), SD (p < 0.001), distances in SZs 2–5 (p < 0.001), PL (p < 0.001), and sprint efforts (p < 0.001) compared to MLAX. However, MLAX performed more acceleration (p < 0.001) and deceleration (p < 0.001) efforts. WLAX midfielders (M) and defenders (D) reached higher top speeds and performed more accelerations than attackers (p < 0.001). Midfielders covered the greatest distance at high speeds (p = 0.011) and the smallest distance at low speeds (<0.001) for WLAX. For MLAX, midfielders performed the highest SDs, top speeds, accelerations, decelerations, and distances in higher speed zones (p < 0.001) compared to attackers and defenders. Results indicate that there are significant gender and positional differences in external workload demands during match play, specifically for volume- and intensity-derived workload parameters, between men’s and women’s lacrosse. Therefore, sports performance coaches should create gender- and position-specific conditioning programs to prepare athletes for match demands. Full article

Participation in empowering physical activities may increase self-efficacy and facilitate long-term engagement. This explanatory sequential mixed-methods study examined the relationship between physical activity empowerment, exercise self-efficacy, and engagement. Midwestern women (N = 147) aged 18–65, 90% white, completed an online cross-sectional survey that captured exercise engagement and self-efficacy for exercise. Participants entered up to five types of physical activities and ranked them from most to least empowering. Physical activities were coded by training type for statistical comparisons using independent t-tests. After survey completion, seventeen women completed a 30 min, 8-question semi-structured interview. Women ranked resistance training as the most empowering physical activity type (38%), followed by running (14%). Total and moderate-to-vigorous physical activity and self-efficacy for exercise scores did not vary between women empowered by cardiorespiratory or resistance training (i.e., total physical activity t(136) = 1.13, p = 0.11; moderate-to-vigorous physical activity t(136) = 2.42, p = 0.06; and self-efficacy for exercise t(136) = 0.66, p = 0.07). Themes identified from the interviews included: (1) women’s physical activity participation barriers are gender-centric, (2) physical activity participation benefits extend beyond physical health, (3) some exercise types are more empowering than others, and (4) empowerment and enjoyment are closely related. Exploring empowerment in exercise may reveal mechanisms to facilitate exercise self-efficacy and engagement in physical activity. Full article

High levels of kinesiophobia (fear of movement/reinjury) have been related to reinjury and adverse injury rehabilitation outcomes in athletes. To examine the extent to which pain vigilance, memory of injury-related pain, and current injury-related pain were associated with kinesiophobia, a cross-sectional study was conducted with 172 current and former athletes from Iran (n = 113) and the United States (n = 59) who reported having experienced a serious injury that affected their participation or performance in sport. Questionnaires were administered to participants via an online survey platform. Hierarchical multiple regression analysis revealed that pain vigilance and memory of pain were positively associated with kinesiophobia, with the full model accounting for 31% of the variance in kinesiophobia scores. The findings suggest that excessive attention to pain-related stimuli and memory of pain for an injury that occurred an average of four years earlier may contribute to the experience of fear of movement and reinjury in current and former athletes. Full article

Attentional resources are a cornerstone of both cognitive and academic performance. The purpose of this study was to analyse the effect of high-intensity interval training (HIIT) sessions on selective attention and visuoperceptual ability in young students. A total of 134 students (12.83 ± 1.23 years) joined this study. They were randomly assigned to a control group (CG) (n = 67), which watched a documentary, or an experimental group (EG) (n = 67), which performed 16 min of HIIT. Attention and visuoperceptual ability were assessed through the Perception of Similarities and Differences test (Caras-R test). A repeated-measures two-way ANOVA analysis was conducted. The CG showed an increased number of errors compared to the EG (p < 0.001) and showed a lower Impulsivity Control Index (p < 0.001) after the investigation. The EG, meanwhile, showed an increased number of hits (p < 0.001), Impulsivity Control Index (p < 0.001), and attentional efficacy (p < 0.001). In addition, the EG showed a decreased number of errors (p < 0.001) and omissions (p < 0.01). In conclusion, 16 min of HIIT was time-effective in improving selective attention and visuoperceptual ability in young students. These results show the importance of physical exercise and the promotion of physical activity breaks during the academic day to improve learning processes. Full article

Little is known about the differences in vertical jump biomechanics executed on rigid (RJS) and sand (SJS) surfaces in female indoor and beach volleyball players. Eleven young female beach volleyball players with a combined indoor and beach volleyball sport background performed squat jumps, countermovement jumps with and without an arm swing, and drop jumps from 40 cm on a RJS (force plate) and SJS (sand pit attached to the force plate). The results of the 2 (surface) × 4 (vertical jump test) repeated-measure ANOVA revealed a significant (p < 0.05) main effect of the surface and the vertical jump test on the jump height and time to achieve peak vertical body center of mass velocity. A significant (p < 0.05) main effect of the test, but not of the surface (p > 0.05), was observed for the other examined biomechanical parameters. The only significant (p < 0.05) jump height gain difference between RJS and SJS was observed for the utilization of the stretch-shortening cycle, which was higher in SJS (15.4%) compared to RJS (7.5%). In conclusion, as the testing was conducted during the beach volleyball competitive season, the examined female players showed adaptations relating the effective utilization of the pre-stretch and enhanced stability during the execution of the vertical jump tests on a SJS compared to RJS. Full article

This study examined the effects of joint angle (JA) on maximal voluntary isometric contraction (MVIC) and neuromuscular responses following fatiguing tasks anchored to RPE. Nine men (mean ± SD: age = 20.7 ± 1.2 yrs) performed forearm flexion MVICs at elbow JAs of 75° and 125° before and after sustained, isometric forearm flexion tasks to failure at fatiguing joint angles (FJA) of 75° and 125° anchored to RPE = 8. The amplitude and frequency of the electromyographic and mechanomyographic signals were recorded. Neuromuscular efficiency was calculated by dividing normalized torque by normalized electromyographic amplitude. A dependent t-test was used to assess the mean difference for time to task failure (TTF) between FJA. Repeated measure ANOVAs were used to assess mean differences for pre-test to post-test MVIC and neuromuscular responses. There was no significant difference between FJA for TTF (p = 0.223). The MVIC (collapsed across FJA and MVIC JA) decreased from pre-test to post-test (51.1 ± 5.0 vs. 45.3 ± 5.6 Nm, p < 0.001). Normalized neuromuscular parameters remained unchanged (p > 0.05). The FJA resulted in similar torque and neuromuscular responses, and the decreases in MVIC were not tracked by changes in the neuromuscular parameters. Thus, the neuromuscular parameters were not sensitive to fatigue, and pre-test to post-test measures may be compared between different FJA. Full article

This study aimed to compare the effects of two 8-week in-season strength-training programs on handball players’ physical and technical parameters. Thirty-six male athletes were randomly separated into three groups: a control group (n = 12), a plyometric training group (PG, n = 12), and an eccentric-overload training group (EG, n = 12). The PG and EG performed upper- and lower-limb plyometric or eccentric-overload exercises, respectively, three times per week. Control groups performed regular handball training. The athletes were assessed for counter movement jump (CMJ) and Abalakov vertical jump (ABK) height, 15 m linear sprint time, handball-throwing speed (i.e., penalty throw; 3-step running throw; jump throw), and cardiorespiratory endurance through the 20 m shuttle-run test. Heart rate and blood lactate were measured at the end of the endurance test. No baseline differences were noted for dependent variables between groups. The session rating of perceived exertion was similar between the intervention groups (PG = 361 ± 12.2 AU; EG = 370 ± 13.3 AU). The ANOVA revealed significant (p < 0.05; Δ = 5–9%; effect size (ES) = 0.45–1.96). Similar improvements for experimental groups compared to the control group for CMJ, ABK jump, penalty throw, 3-step running throw, and jump throw. However, interventions did not affect 15 m, cardiorespiratory endurance, nor heart rate or blood lactate after the endurance test. In conclusion, an 8-week handball intervention by performing plyometric or eccentric-overload training in-season improves the physical and technical parameters of male players when compared to regular handball practice. Full article

Exercise confers a multitude of benefits with limited adverse side effects, making it a powerful “medication” for a plethora of diseases. In people living with uncontrolled glucose levels, exercise can be an effective “medication” to assist in the management of hyperglycemia. We sought to survey healthcare providers (physicians and physical therapists) to determine the current state of exercise recommendation for people with glucose control issues. Healthcare providers were surveyed from six academic medical centers in the Midwest to determine the recommended exercise parameters (type, frequency, duration, intensity, and timing) for patients with glucose control issues. Data from 209 practitioners who completed the survey were used for analysis. Chi-square tests were used to determine differences in exercise recommendations between physical therapists (PTs) and physicians (MD/DOs). PTs and MD/DOs recommended similar exercise parameters. Of all respondents, 78.9% recommended exercise to patients with glucose control issues. Respondents who considered themselves to be active exercisers were more likely to recommend exercise than those who were not exercisers. Only 6.1% of all respondents recommended post-meal exercise. Healthcare providers overwhelmingly recommended exercise for people with glucose control issues, but the “timing” is not congruent with best practice recommendations. Full article

The transversus abdominis (TrA) is a core muscle that contributes to functional mobility and lumbar stability. This study aimed to compare the changes in TrA thickness during different Pilates exercises, and to identify the exercise that elicited the greatest TrA activation. Forty-four healthy women were divided into two groups: young (25–35 years old) and middle-aged (36–55 years old). TrA thickness was assessed by ultrasound while the participants performed five Pilates exercises: basic position, hundred, hip roll, side plank, and dead bug. A repeated measures analysis of variance revealed that the dead bug exercise induced a significantly higher increase in TrA thickness (relative to rest) than the other exercises (p < 0.05). The young group also showed a significantly higher overall TrA thickness than the middle-aged group (p < 0.05). The findings suggest that the dead bug exercise is the most effective for enhancing TrA activation among the Pilates exercises tested. The basic position and the hundred exercises can be used as warm-up exercises before performing more challenging exercises such as the hip roll, the side plank, and the dead bug. The sequence of exercises can be similar for both young and middle-aged women. Full article

The purpose of this study was to examine sex differences in resting metabolic rate (RMR) and associations between measured RMR and body composition parameters in athletes. One-hundred and ninety collegiate men (n = 98; age: 20.1 ± 1.6 yr.; body mass: 92.7 ± 17.5 kg; height: 181.6 ± 6.2 cm, body mass index: 28.0 ± 4.7 kg/m²) and women (n = 92; age: 19.4 ± 1.1 yr.; body mass: 65.2 ± 11.0 kg; height: 168.0 ± 6.6 cm, body mass index: 23.0 ± 3.6 kg/m²) athletes volunteered to participate in this study. Athletes completed a body composition assessment using air displacement plethysmography and RMR using indirect calorimetry. Assessments were completed in a fasted state and after refraining from intense physical activity > 24 h prior to testing. Data were collected during the 2016–2019 seasons. Men had a higher RMR compared to women (2595 ± 433 vs. 1709 ± 308 kcals; p < 0.001); however, when adjusted for body mass (p = 0.064) and fat-free mass (p = 0.084), the observed differences were not significant. Height, body mass, body mass index, fat-free mass, and fat mass were positively associated with RMR in both men and women athletes (r = 0.4–0.8; p < 0.001). Body mass (men: β = 0.784; women: β = 0.832)) was the strongest predictor of RMR. Men athletes have a higher absolute RMR compared to their women counterparts, which is influenced by greater body mass and fat-free mass. Body mass is the strongest predictor of RMR in both men and women athletes. Full article

The depth jump (DJ) is commonly used to evaluate athletic ability, and has further application in rehabilitation and injury prevention. There is limited research exploring sex-based differences in DJ ground reaction force (GRF) measures. This study aimed to evaluate for sex-based differences in DJ GRF measures and determine sample size thresholds for binary classification of sex. Forty-seven participants from mixed-sex samples of NCAA athletes and young adults performed DJs from various drop heights. Force platform dynamometry and 2-dimensional videography were used to estimate GRF measures. Three-way mixed analysis of variance was used to evaluate main effects and interactions. Receiver operating characteristic (ROC) curve analysis was used to evaluate the combined sensitivity and specificity of dependent measures to sex. Results revealed that reactive strength index scores and rebound jump heights were greater in males than females (p < 0.001). Additionally, young adult females showed greater peak force reduction than young adult males (p = 0.002). ROC curve analysis revealed mixed results that appeared to be influenced by population characteristics and drop height. In conclusion, sex-based differences in DJ performance were observed, and the results of this study provide direction for future DJ investigations. Full article

The correct assessment of body composition is essential for an accurate diagnostic evaluation of nutritional status. The body mass index (BMI) is the most widely adopted indicator for evaluating undernutrition, overweight, and obesity, but it is unsuitable for differentiating changes in body composition. In recent times, bioelectrical impedance analyses (BIA) have been proven as a more accurate procedure for the assessment of body composition. Furthermore, the efficiency of bioelectrical impedance vector analyses, as an indicator of nutritional status and hydration, has been demonstrated. By applying a bioimpedance analysis, it is possible to detect fat mass (FM), fat free mass (FFM), phase angle, and body cell mass (BCM). It is important to point out that phase angle and BCM are strongly associated with health status. The aim of this research was to examine body composition and the association between the phase angle and BCM in 87 subjects (14 males and 73 females), aged between 23 and 54 years, with BMIs ranging from 17.0 to 32.0 kg/m², according to sex. The BMI results revealed that the majority of the assessed subjects were within the normal range and had a normal percentage of FM. Our data indicate that a direct relation exists between phase angle and cellular health and that these values increase almost linearly. Consequently, a high phase angle may be related to increased BCM values. Full article

This study investigates the visual activity of fencers in conditions resembling official competitions. Previous research in experimental conditions has shown that experts focus on specific areas of the torso and the armed arm to control movement initiation. Eight right-handed fencers (epee: two males, one female; foil: one male; sabre: two males, two females) participated in a simulated competition, wearing an eye tracker during one bout. The findings showed that the main fixation in foil and sabre is the upper torso, while in epee, it is the lower torso. In epee and sabre, the upper torso is viewed about 50% of the time, with three other areas also observed, while in foil, the fixation is totally directed to the upper torso. Additionally, two new areas of interest were identified: the score machine and an area involving fixations other than the opponent. The study found no direct link between visual activity and performance. The visual search strategy varies among weapons, with foil using a gaze anchor or foveal spot and epee and sabre utilizing a visual pivot due to the discipline’s inherent rules. The study also emphasizes that competition-like conditions can disrupt visual activity with external stimuli, possibly affecting performance. Full article

Telemedicine was shown to be indispensable during the SARS-CoV-2 pandemic to ensure continuity of care for fragile patients. We compared a telerehabilitation program versus an outpatient rehabilitation program in women with breast cancer undergoing quadrantectomy surgery. There were 56 women with breast cancer divided into two groups: the treatment group (TG), made up of 24 patients undergoing a remote rehabilitation project program; and the control group (CG), composed of 32 patients subjected to the same rehabilitation project program in an outpatient setting. At the time of enrollment (T0) and the end of the 8 weeks of treatment (T1), the following questionnaire scores were considered: numerical rating scale (NRS), Disabilities of the Arm, Shoulder and Hand questionnaire (Quick-DASH), Piper fatigue scale (PFS)m and Breast Cancer Therapy Functional Rating Scale (FACT-B). We observed that the CG showed greater improvements than the TG in upper limb function (7.8 ± 4.2 vs. 10.9 ± 4.9; p < 0.05) and quality of life (27.9 ± 7.2 vs. 40.0 ± 3.3; p < 0.05). No difference in efficacy between the two groups was observed for pain (2.2 ± 0.6 vs. 2.3 ± 0.9; p = 0.64) and fatigue (3.2 ± 1.1 vs. 3.2 ± 0.6; p = 0.66). Telerehabilitation is a valid tool in the management of women with breast cancer in the postoperative phase. However, face-to-face rehabilitation treatment may be preferred because it is more effective as it allows the construction of a specific, personalized, and targeted rehabilitation program. Full article