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(1) Background: Osteoarthritis (OA) is a serious chronic disease mostly affecting the knee joint. Despite the many efforts for developing strategies to predict and control Knee Osteoarthritis (KOA), the disease is on the rise. This paper describes the process for the creation of a simulation model, the Dynamic Knee Osteoarthritis Simulation (DYNAMIKOS) model, that captures the complex interrelationships of the risk factors for the development of KOA; (2) Methods: The DYNAMIKOS model will be based on the System Dynamics approach. The first step will be to develop a Causal Loop Diagram (CLD) model for the risk factors involved incorporating a series of Group Modeling Building (GMB) workshops with experts and stakeholders. Using data from a representative sample of KOA patients, the statistical approaches Exploratory Factor Analysis, Confirmatory Factor Analysis, and Structural Equation Modeling (SEM) will be carried out. (3) Results: This study will develop a simulation System Dynamics model for the risk factors of KOA based on the results of CLD and SEM; (4) Conclusions: The proposed DYNAMIKOS model could be used for effectively analyzing the complex interrelationships among the multiple factors that constitute the spread of KOA. In this way, plausible prevention strategies could be implemented for effectively managing and leading the potential eradication of KOA. [ABSTRACT FROM AUTHOR]

It is essential for physical sports therapists to use reliable field-based tests to identify potential injury risk factors in athletes. The purpose of this study was to compare the inter- and intra-rater reliability of experienced and novice raters during use of the Landing Error Scoring System (LESS) in a field-based examination of professional football athletes. Thirty-seven male football athletes underwent pre-season LESS assessment. Two raters independently evaluated the recorded landing techniques at two separate intervals, two months apart, following the LESS standard protocol. Inter-and intra-rater values were calculated for the LESS total scores and individual scoring items. The overall LESS scores had excellent intra-rater reliability values for both the experienced (interclass correlation coefficient (ICC) = 0.95, 95% CI, 0.89–0.97; p < 0.001) and novice rater (ICC = 0.95, 95% CI, 0.90–0.97; p < 0.001), and very good to excellent inter-rater values for the first (ICC = 0.90, 95% CI, 0.77–0.95; p < 0.001) and second (ICC = 0.86, 95% CI, 0.71–0.93; p < 0.001) evaluation. Most of the individual scoring items ranged from moderate to perfect agreement. In conclusion, sports physical therapists, regardless of experience, can reliably use the LESS's total score, through video analysis of the regime. Individual scoring items can inform clinicians about impairments in the landing mechanism but data should be interpreted cautiously. [ABSTRACT FROM AUTHOR]

Background/Objectives: Given the complex nature of Anterior Cruciate Ligament (ACL) injury, it is important to analyze its etiology with suitable approaches in order to formulate intervention strategies for effective prevention. The present study employs system thinking techniques to develop a Causal Loop Diagram (CLD) Model for investigating the risk factors for ACL Injury (CLD-ACLI), through a Group Model Building approach. Methods: A two-stage procedure was applied involving a comprehensive literature review followed by several systems thinking group-modeling co-creation workshops with stakeholders. Results: Based on input from experts and stakeholders, combined with the latest scientific findings, the derived CLD-ACLI model revealed a series of interesting complex nonlinear interrelationships causal loops between the likelihood of ACL injury and the number of risk factors. Particularly, the interaction among institutional, psychological, neurocognitive, neuromuscular, malalignment factors, and trauma history seem to affect neuromuscular control, which subsequently may alter the biomechanics of landing, predisposing the ACL to injury. Further, according to the proposed CLD-ACLI model, the risk for injury may increase further if specific environmental and anatomical factors affect the shear forces imposed on the ACL. Conclusions: The proposed CLD-ACLI model constitutes a rigorous useful conceptual presentation agreed upon among experts on the dynamic interactions among potential intrinsic and extrinsic risk factors for ACL injury. The presented causal loop model constitutes a vital step for developing a validated quantitative system dynamics simulation model for evaluating ACL injury-prevention strategies prior to implementation. [ABSTRACT FROM AUTHOR]

There is a gap in the literature regarding the complex interrelationships among hamstring injury (HI) risk factors. System dynamics (SD) modeling is considered an appropriate approach for understanding the complex etiology of HI for effective injury prevention. This study adopted the SD method and developed a causal loop model (CLD) to elucidate the intricate relationships among HI risk factors. This is performed by combining literature evidence and insights from expert stakeholders through a group model building (GMB) approach. The GMB methodology facilitated the identification of sixty-five critical factors influencing the HI risk, revealing the dynamic interplay between factors. Stakeholder engagement underscored the importance of previous injury characteristics (level of influence of previous injury, severity of previous injury, quality and size of scar tissue) and the quality of rehabilitation. HI-CLD revealed that many factors had indirect effects on HI risk. The HI-causal loop model establishes a foundation for a future stock and flow quantitative SD model aiming to advance HI prevention strategies through an interdisciplinary collaborative effort. These findings underscore the complexity of HI prevention, necessitating a holistic approach that integrates the views of diverse professional expertise. Appropriate inter-professional collaboration and continuous athlete screening are important for effective injury prevention strategies. [ABSTRACT FROM AUTHOR]

Lateral ankle sprains are one of the most frequent athletic injuries in football, causing deficits in balance. Motor Imagery (MI) has been successively included in sports rehabilitation as a complementary therapeutic intervention. The aim of the present study was to explore the effects of MI on static and dynamic balance and on the fear of re-injury in professional football players with Grade II ankle sprains. Fifty-eight participants were randomly allocated into two groups: First—MI group (n = 29) and second—Placebo group (n = 29), and they each received six intervention sessions. The first MI group received MI guidance in addition to the balance training program, while the second Placebo group received only relaxation guidance. One-way ANOVA showed statistically significant results for all variables, both before and 4 weeks after the interventions for both groups. The t-test showed statistically significant differences between the two groups for static balance for the right lower extremity (t = 3.25, S (two-tailed) = 0.002, p < 0.05) and also for heart rate (final value) in all time phases. Further research is needed in order to establish MI interventions in sports trauma recovery using stronger MI treatments in combination with psychophysiological factors associated with sports rehabilitation. [ABSTRACT FROM AUTHOR]

(1) Background: Sarcopenia and chronic pain are prevalent syndromes among older adults that negatively affect their quality of life. The present study aimed to investigate the relationship between chronic pain and sarcopenia among Greek community-dwelling older adults. (2) Methods: Older adults >60 years of age were enrolled in this descriptive, cross-sectional study. Sarcopenia status was assessed according to the EWGSOP2 2019 algorithm. This assessment included the evaluation of muscle strength, body composition and gait speed. Pain location and pain characteristics were assessed using a self-reported questionnaire. Pain severity was assessed via the visual analog scale. The participants were also asked to fill out the SARC-F, the Hospital Anxiety and Depression Scale (HADS) and the Falls Efficacy Scale-International (FES-I) questionnaire. (3) Results: This study included 314 participants with a mean age of 71.3 ± 7.4 years. The prevalence of sarcopenia was 19.4 (n = 61), and 44.26% of the sarcopenic participants recorded chronic pain. Chronic pain was associated with sarcopenia, comorbidities, the number of drugs and HADS. (4) Conclusions: The results demonstrated a high percentage of chronic pain in the sarcopenic population. The results also highlight the importance of the detection of chronic pain in older patients with sarcopenia in order to develop effective preventive and therapeutic strategies. [ABSTRACT FROM AUTHOR]

Context: Instrument-assisted soft tissue mobilization (IASTM), tissue flossing, and kinesiology taping are increasingly popular treatments among athletes for improving functional performance, despite limited evidence for their efficacy. Objective: Previous research regarding the efficacy of soft tissues and neuromuscular techniques on improving functional capacity of shoulder joints in athletes has yielded conflicting results. We examined the immediate and short-term effects of IASTM, flossing, and kinesiology taping on the functional capacities of amateur athletes' shoulders. Design: Randomized controlled study. Setting: Clinical assessment laboratory. Participants: Eighty amateur overhead athletes (mean [SD]: age = 23.03 [1.89]; weight = 78.36 [5.32]; height = 1.77 [.11]). Interventions: We randomly assigned participants to 4 research sub-groups in which they received the following treatments on their dominant shoulders: IASTM (n = 20), flossing (n = 20), both IASTM and flossing (n = 20), and kinesiology tape (n = 20). Nondominant shoulders served as controls. Main Outcome Measure: We evaluated participants—before, immediately after, and 45 minutes after the therapeutic interventions—with the following tests: internal and external shoulder rotation range of motion, isokinetic strength and total work, the functional throwing performance index, and the one-arm seated shot put throw performance. Results: All therapeutic interventions significantly improved the strength and functional performance of the dominant shoulder in comparison with the control (P <.005) immediately after and 45 minutes after the treatment. The IASTM led to significantly greater improvement in shoulder internal rotation than kinesiology taping immediately after (P =.049) and 45 minutes after the treatment (P =.049). We observed no significant differences between the other treatment interventions (P >.05). Conclusion: Findings from the current study support the use of novel soft tissue and neuromuscular techniques for the immediate and short-term improvement of the shoulder functional capacities in amateur overhead athletes. [ABSTRACT FROM AUTHOR]

The enhanced paper grip test (EGPT) quantitatively assesses lower limb strength. EGPT assesses the hallux grip force by reacting a pulling force derived from a card, being positioned underneath the participant's hallux. This study aimed to investigate the repeatability and clinical applicability of the EPGT for assessing foot muscle strength. EPGT force was measured using a dynamometer. The reliability of the measurement of EPGT force was assessed by having two examiners performing the test on the same group of healthy adults. Clinical applicability was assessed in community-dwelling adults of both genders. EPGT force was recorded for both feet using the same standardised protocol for all participants. Regarding reliability, 20 healthy adults aged 23.04±5.5 years participated in the present study. The EGPT demonstrated good to excellent test-retest (ICC1,2 0.8 to 0.86) and interrater reliability (ICC1,2 0.82 to 0.88). A convenience sample of 15 community-dwelling adults (71.6±7.8 years, 68.5% women) was recruited for clinical applicability testing. All participants performed the test with mean score 15±5.7 N. EPGT is a reliable measurement of the hallux grip force strength and can be used for clinical and research purposes. [ABSTRACT FROM AUTHOR]

Acute lateral ankle sprain is one of the most common musculoskeletal injury in football causing deficits in balance. Motor Imagery (MI) has been progressively included in sports rehabilitation as an adjunct therapeutic modality either for injury management or sports performance (e.g. fear of re-injury). The aim of the present study was to investigate the effects of MI on balance and on the fear of re-injury in professional football players with ankle sprain Grade II. Fifty-eight professional football players participated in the study. Athletes were in the return to play period, and they were randomly divided into 2 groups: 1st MI group (n = 29) and 2nd -- Placebo group (n = 29). Both groups received the same balance training program. Athletes in the 1st -- MI group received a standardized recorded content of MI instructions in addition to the balance training program, while athletes in the 2nd -- Placebo group received only relaxation instructions. Static balance was evaluated with the Single Leg Stance Test (SLST) by the portable KForce Plates, dynamic balance was evaluated with the Y Balance Test (YBT), the fear of re-injury was assessed using the Causes of Re-injury Worry Questionnaire (CR-IWQ), the ability of MI with the use of the Greek version of the Vividness of Movement Imagery Qusetionnaire-2 (VMIQ-2-GR) and the responses of the Autonomic Nervous System through the Oxygen saturation (SPO2) and the heart rate. Results indicated a statistically significant improvement for the YBT (p < 0.001) between the 2 groups while there were no statistically significant differences on the other variables. Despite the MI group did not show statistically significant results, there was an improvement in all main outcome measures post intervention. Further research is recommended in order to explore the MI interventions in combination with psychophysiological factors associated with sports rehabilitation and performance. [ABSTRACT FROM AUTHOR]

Therapeutic exercise is integral to the comprehensive rehabilitation of patients with cardiovascular disease and, as such, is recommended by the American Heart Association as a valuable and effective treatment method for such patients. The type of exercise applied to these patients is aerobic and resistance exercise with mild intensities and loads to avoid overloading the cardiovascular system. Blood flow restriction exercise is a novel exercise modality in clinical settings that has in many studies a similar effect on muscle hypertrophy, strength, and cardiovascular response to training at a 70% strength level without blood flow restriction. Since this exercise mode does not require high-intensity loads, it can be a safe method for improving muscle strength, cardiovascular endurance, and functionality in cardiovascular patients. Given that, the objective of this review is to assess and summarize existing evidence for the use of blood flow restriction in cardiovascular patients. A scoping review of existing clinical trials was conducted. Eleven studies were examined that suggested the use of blood flow restrictions in cardiovascular patients to achieve improvements in muscle strength, functionality, and cardiovascular parameters such as blood pressure decrease. [ABSTRACT FROM AUTHOR]

Acute noncontact Lower Extremity (LE) injuries constitute a significant problem in team sports. Despite extensive research, current knowledge on the risk factors of LE injuries is limited to static simplistic models of instantaneous cause and effect relationships ignoring the time dimension and the embedded complexity of LE injuries. Even though complex systems approaches have been used in various cases to improve policy and intervention effectiveness, there is limited research on predicting and managing LE injuries. This creates an opportunity to fill the gap in the current literature by applying the System Dynamics (SD) methodology to model LE injuries. The proposed approach allows for synthesizing risk factors and examining their interaction. This paper makes the first step towards such an approach by developing a causal loop model revealing the etiology of LE injuries. A causal loop model for LE injuries is developed via an extensive literature review and brainstorming with experts. In contrast to the traditional static approaches, the proposed model reveals some of the complexity and nonlinear relationships of the various sports injury risk factors. The derived causal loop model may then be used to quantify these interactions and develop a simulation model. This will be achieved by operationalizing and incorporating the main risk factors that impact LE injuries in an integrated sports injury prediction model. In this way, plausible strategies for preventing LE injuries can be tested prior implementation and thereby achieve optimization of intervention programs. [ABSTRACT FROM AUTHOR]