Journal of Physical Fitness and Sports Medicine
Official journal of the Japanese Society Physical Fitness and Sports Medicine
PDF Download
Online First
The Journal of Physical Fitness and Sports Medicine (JPFSM)
[Volume 13, Number 4 July 25, 2024] Special Issue
Review
- Received: August 17, 2023 / Accepted: September 11, 2023
Abstract
The purpose of this narrative review is to outline pelvic injuries caused by sports, and to clarify their trends, treatment, and management. We describe the rehabilitation for sports injuries of the pelvis, with a focus on pelvic avulsion injuries and pelvic bone stress fractures. This narrative review of fifteen articles published in the last 10 years (from 2013 to 2023) reveals a dearth of new rehabilitation knowledge regarding sports-induced pelvic injuries.
Review
- Received: August 8, 2023 / Accepted: September 11, 2023
Abstract
This review is based on the literature published between 2000 and 2023 and presents an up-to-date evidence-based discussion of anatomical considerations relevant to the management of pelvic trauma. In addition, it discusses the significance of the pelvic ligaments in stabilizing the pelvic ring and of bone mineral density (BMD) in fragility fracture of the pelvis (FFP), which is becoming increasingly common in today’s aging societies. Following an overview of the anatomy and function of the sacroiliac joint (SIJ), the pubic symphysis, and the surrounding ligaments, the suitability of the widely used Young-Burgess classification of high-energy impact pelvic ring fractures, which emphasizes the role of the ligaments in pelvic ring injuries, is discussed. Based on the current body of knowledge, using 2.5 cm of pubic symphysis diastasis as the determinant for surgical intervention for anterior-posterior compression fracture is questioned, and evaluation under anesthesia and lateral stress radiography for accurate diagnosis and treatment planning is proposed instead. The review underscores the need for further research on how the pelvic ligaments can provide optimal stability in the treatment of various types of pelvic fracture. On the other hand, for fragility fracture of pelvis (FFP) in older adults caused by low-energy trauma, the emphasis is on the fragility of the bones. To better manage FFP, the importance of understanding the distribution of BMD in the pelvis is highlighted. Dual-energy X-ray absorptiometry is a common method for measuring BMD, but it has drawbacks. The advantages of measuring BMD using Hounsfield units on computed tomography scans as an alternative method are discussed. An understanding of these issues may lead to better management of the increasing number of FFP cases in older people with reduced BMD.
Review
- Received: December 11, 2023 / Accepted: February 13, 2024
Abstract
Pelvic fractures, accounting for 2–8% of skeletal injuries, present a significant burden in patients with trauma. High-energy incidents often result in severe pelvic trauma accompanied by comorbidities leading to high mortality rates. Managing these complications adds complexity to the treatment process, particularly in older patients who experience longer recovery times and higher injury severity. To improve the long-term quality of life, a multidisciplinary approach is essential. However, rehabilitation feasibility is influenced by the patient’s condition and pelvic fixation stability, necessitating individualized treatment. This study investigated the rehabilitation status and long-term outcomes of older patients with severe polytrauma and pelvic ring fractures caused by high-energy trauma. The results revealed that 79.2% of the patients achieved full weight-bearing, with a median time of 41.5 days, and eventually 58.3% were discharged home. Complications were observed in 83.3% of the patients, with various challenges affecting successful home discharge. Multidisciplinary rehabilitation programs are promising for optimizing outcomes and facilitating recovery in vulnerable patient populations. Still, larger, more focused studies are needed to gain more comprehensive insights into the treatment and recovery of older patients with pelvic ring fractures and severe polytrauma. Understanding these factors is crucial for guiding clinical decision-making and improving long-term outcomes in this population.
Regular Article
- Received: December 11, 2023 / Accepted: February 13, 2024
Abstract
Pelvic fractures, accounting for 2–8% of skeletal injuries, present a significant burden in patients with trauma. High-energy incidents often result in severe pelvic trauma accompanied by comorbidities leading to high mortality rates. Managing these complications adds complexity to the treatment process, particularly in older patients who experience longer recovery times and higher injury severity. To improve the long-term quality of life, a multidisciplinary approach is essential. However, rehabilitation feasibility is influenced by the patient’s condition and pelvic fixation stability, necessitating individualized treatment. This study investigated the rehabilitation status and long-term outcomes of older patients with severe polytrauma and pelvic ring fractures caused by high-energy trauma. The results revealed that 79.2% of the patients achieved full weight-bearing, with a median time of 41.5 days, and eventually 58.3% were discharged home. Complications were observed in 83.3% of the patients, with various challenges affecting successful home discharge. Multidisciplinary rehabilitation programs are promising for optimizing outcomes and facilitating recovery in vulnerable patient populations. Still, larger, more focused studies are needed to gain more comprehensive insights into the treatment and recovery of older patients with pelvic ring fractures and severe polytrauma. Understanding these factors is crucial for guiding clinical decision-making and improving long-term outcomes in this population.
Review
- Received: April 30, 2024 / Accepted: May 13, 2024
Abstract
Rehabilitation protocols for treating pelvic fractures lack uniformity due to variations among patients, injury mechanisms, and fracture types. The incidence of pelvic fragility fractures in the elderly has risen in recent years, prompting discussions on treatment strategies, including conservative approaches. This article aims to conduct a literature review of rehabilitation practices following pelvic fractures reported up to September 2023, to elucidate the current state of the field. We conducted a search on PubMed for literature published prior to September 2023. No systematic selection was applied to articles published thereafter. The search criteria excluded non-English publications, case reports, pediatric fractures, and studies where the primary outcome did not focus on clinical aspects of pelvic fractures. We included a total of 201 papers, narrowing it down to 35 through title and abstract screening. This article described loading protocols, sexual dysfunction, mental dysfunction, surgical techniques and methods of functional assessment. Rehabilitation policies vary, often determined on a case-by-case basis, specifically by individual surgeons or treatment centers. No unified protocols exist at present, but future research will hopefully lead to significant progress.
[Volume 13, Number 5 September 25, 2024]
Short Review Article
- Received: November 27, 2023 / Accepted: January 23, 2024
Abstract
About half of young Japanese women have a cold constitution, which heightens susceptibility to cold syndrome. In recent years, new findings on the physiological features of a cold constitution have increased. Cold constitution lowers the quality of daily life, so coldness and the related complaints need to be alleviated. Single dynamic exercise transiently relieves coldness via the warm-up effect. Exercise training decreases sensitivity to cold under normal temperature conditions and enhances peripheral cutaneous vasodilatory responses in young women with a cold constitution. This review provides an overview of the physiological characteristics of women’s cold constitution and the acute and chronic effects of physical exercise as a countermeasure.
Regular Article
- Received: August 4, 2023 / Accepted: February 7, 2024
Abstract
This study examined the effects of distractions on ratings of perceived exertion (RPE) and affective responses during acute high intensity cycling exercises. Eighteen young males (age: 22.2±1.7 years) visited the laboratory on four sessions. Participants performed three experimental trials following an incremental maximal test. During the three trials, participants performed cycling exercises at 70% VO2max for 20 min under three conditions: control, active distraction, and involuntary distraction. The participants rated their overall and peripheral RPE at 5 min intervals during the 20 min cycling period. Participants’ affective responses were assessed before and after cycling including positive engagement (PE), negative affect (N-affect), and tranquility. There were no significant differences in RPEs among the three conditions. For affective responses, a significant main effect of condition was seen only for N-affect. This study suggested that active and involuntary distractions do not influence perceived exertion when participants perform 20-min vigorous-intensity exercises. One possible reason for the result is that inadequate method used as active distraction. Further research is required to examine the appropriate methods that promote distraction from bodily sensations during high-intensity exercise.
Regular Article
- Received: November 16, 2023 / Accepted: February 16, 2024
Abstract
Early cardiopulmonary resuscitation (CPR) intervention is critical for saving individuals experiencing sudden cardiac arrest. Manikins are considered useful for CPR training, but their level of realism is low, given the visible structural differences in the chests of biological men and women. However, to our knowledge, no study has examined whether a patient’s sex has an impact on the performance of chest compression. Therefore, this study aimed to investigate the quality of chest compressions in female patients, in relation to the rescuers’ posture. This single-center cross-sectional study was conducted from July to October 2023 on 34 healthcare professional university students. Two postures for chest compression were analyzed: 1) kneeling beside the patient’s chest (conventional compression) and 2) straddling the patient (straddle compression). The mean age of the 34 participants (18 men and 16 women) was 21.2±0.6 years. Significant differences were found in mean compression depth (p = 0.005) and appropriate compression ratio (p = 0.013) between the conventional and straddle compression but not in other parameters. In conclusion, the rescuers’ posture during chest compression in female patients affects the compression depth and depth ratio. The straddle compression may facilitate the provision of well-balanced compressions of appropriate depth and depth ratio. These findings can be applied to CPR training and provide guidance for administering chest compressions to female patients.
[Volume 14, Number 1 January 25, 2025]
Regular Article
- Received: October 4, 2023 / Accepted: February 28, 2024
Abstract
Arm-cranking exercises combined with electrical muscle stimulation (EMS) of the lower limbs at maximum intensity enhance vascular endothelial function. To bring this procedure into clinical application, we examined the effects of acute arm-cranking exercise combined with lower-extremity EMS at different intensities on vascular endothelial function. The study included eight healthy adult males. After resting in the supine position, arm-cranking exercises were performed at an intensity of 50% VO2 max for 20 min, and the lower limb received EMS under three trials: maximum intensity trial (A+100%EMS trial), 50% intensity trial (A+50%EMS trial), and 25% intensity trial (A+25%EMS trial). Flow-mediated dilation (FMD), which reflects vascular endothelial function, was measured before and after the procedure, and the normalized FMD (nFMD) was calculated. The mean nFMD before and 30 min after the exercise was 0.8±0.3 and 2.3±1.8, respectively, in the A+100%EMS trial and 0.9±0.4 and 1.4±1.0, respectively, in the A+50%EMS trial, indicating a significant increase after exercise under both trials. No changes were observed in the A+25%EMS trial. The combination of arm-cranking exercise and 50% intensity EMS appears to be a clinically applicable program for improving vascular endothelial function, even with reduced exercise intensity.
Short Communication
- Received: February 1, 2024 / Accepted: April 1, 2024
Abstract
Weight loss reduces visceral fat and improves glucose tolerance. Our previous study found that weight loss from 3 consecutive days of fasting led to deteriorated glucose tolerance, but it is not clear whether this was due either to the physiological stress associated with consecutive fasting or that fasting itself. This study aimed to compare the effects of repetitive or consecutive fasting on intra-abdominal fat mass and glucose tolerance in rats fed a high-fat diet. After 2 weeks of high-fat diet feeding, male Wistar rats were divided into three groups matched for body weight: one group continued to receive the high-fat diet ad libitum for 2 weeks (control, CON); the second group fasted for the last 3 days (consecutive fasting, CF); and the third group repeated 1-day fasting three times with a 6-day ad libitum feeding interval (repetitive fasting, RF). Compared with the CON group, the intra-abdominal fat mass was significantly lower in the CF group after the intervention period, and there was a tendency for lower values in the RF group. During the oral glucose tolerance test, plasma glucose level was significantly higher in both fasting groups compared with the CON group, while that in the CF group was significantly higher than that in the RF group. Compared with the CON group, the CF group had significantly lower plasma insulin level, with a tendency for lower levels in the RF group. These findings suggest that even when fasting days are dispersed over multiple occasions, insulin secretion capacity may decrease in a similar manner to consecutive fasting, leading to a deterioration in glucose tolerance.
Regular Article
- Received: December 26, 2023 / Accepted: April 23, 2024
Abstract
The mitochondria are highly plastic organelles. Exercise training alters mitochondrial dynamics (mitochondrial fission and fusion) in skeletal muscles and improves overall mitochondrial function by altering mitochondrial morphology and forming new networks. However, changes in mitochondrial dynamics over time during exercise have not previously been observed. In the present study, we examined the changes in mitochondrial fission and fusion protein expression in rats over four weeks of endurance swimming training. The expression of the GTPase protein dynamin-related protein 1 (Drp1), a mitochondrial fission protein, increased during the early phase of the training period. In contrast, the expression of optic atrophy type 1 (OPA1), a mitochondrial fusion protein, was increased in the late phase of the training period. These data suggest that mitochondrial fission was increased in the early phase, and mitochondrial fusion was initiated partially in the late phase, of the training period. In conclusion, mitochondrial dynamics may be modulated depending on the phase of muscular adaptation to exercise training. This modulation contributes to enhanced mitochondrial function in skeletal muscle.
[Volume 14, Number 2 March 25, 2025]
Regular Article
- Received: January 15, 2024 / Accepted: April 24, 2024
Abstract
Glucose has been reported to reduce the expression of L-type amino acid transporter 1 (LAT1) protein in C2C12 myocytes. We therefore hypothesized that increased dietary carbohydrate and energy intake would reduce LAT1 protein expression in rodent skeletal muscle. Here, we tested this hypothesis. In Experiment 1 to examine the effects of dietary carbohydrate intake, male Sprague Dawley (SD) rats were divided into low-carbohydrate (low-CHO) and high-carbohydrate (high-CHO) diet groups. Each group was fed a low-CHO (20% carbohydrate) or high-CHO (70% carbohydrate) diet, respectively. Total energy intakes of both groups were matched by pair feeding. In Experiment 2 to examine the effects of dietary energy intake, rats were divided into low-Energy diet (fed 68% of ad libitum energy intake) and high-Energy diet (ad libitum) groups. After 7 days of dietary manipulation, the lower leg muscles on one side were percutaneously stimulated and subjected to one acute bout of resistance exercise. The contralateral leg muscle served as an internal control. We collected gastrocnemius muscle 6 h after contraction. In both Experiments 1 and 2, when results were analyzed by two-way analysis of variance, no main effect of diet on LAT1 protein concentration was observed. There was also no main effect of resistance exercise, or no interaction between diet and exercise. These results do not support our hypothesis that increased dietary carbohydrate and energy intake reduce LAT1 protein expression in rodent skeletal muscle. Furthermore, diet may not affect the effects of resistance exercise on LAT1 protein expression.
Regular Article
- Received: January 26, 2024 / Accepted: April 24, 2024
Abstract
This study aimed to prospectively record the occurrence of adverse events and near-misses during sports in middle-aged and older adults who voluntarily engaged in sports in the community and to clarify the frequency and characteristics of such events. The participants comprised 14 groups (14 sports) of middle-aged and older adults who voluntarily played sports in Sakae Ward, Yokohama. The follow-up period was 14 months (November 1, 2022, to December 31, 2023). Representatives of the target groups reported once a month to Sakae Ward via postcards regarding the status of their activities and the occurrence of adverse events and near-misses. The survey items included the age of the main participants in each group, number of activities during the month, duration of each activity, number of participants per activity, adverse events, and near-misses during sports. During the 14-month observation, eight adverse events and two near-misses were reported in the 14 groups, mainly comprising middle-aged and older adults. Of the eight adverse events, four were falls, all occurring in those aged ≥70 years and triggered by environmental problems. In this study, there were only two near-misses compared to eight adverse events, suggesting that the participants may have been unaware of near-misses. Therefore, even for sports played by groups of residents, it is important to identify risks by assessing health conditions prior to exercise and to implement initiatives to foster safety awareness among participants, such as hazard prediction training.
Regular Article
- Received: January 15, 2024 / Accepted: May 8, 2024
Abstract
Sleep and nutrition play a crucial role for athletes, contributing to the quality of recovery, optimization of performance, as well as the preservation of health and injury prevention. This study aimed to explore the potential relationships between sleep quality, nutritional status, and dietary habits among Moroccan male professional footballs players during the competitive period, while examining the influence of sleep quality on nutritional behaviors. Methods: This descriptive research included 49 professional male football players. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI) to differentiate “good sleep” and “poor sleep” groups. Dietary intake was collected using the 24-hour recall and analyzed by validated nutritional software to obtain data on energy intake and dietary frequency.The results reveal that 36 participants are classified as having "Good Sleep" and 13 as "Poor Sleep quality." With a significant difference (4.0 ± 0.2 vs. 6.9 ± 0.9, p < 0.001), consecutively. The correlation study between the (PSQI score) and nutritional status variables has revealed significant associations: a negative correlation with total energy intake (TEI) (r = -0.687, p < 0.01), carbohydrates intake (CHO g/kg BM) (r = -0.499, p < 0.01); and well as (CHO%) and (PRO%) ratios (r = -0.294, p < 0.05), (r = -0.292, p < 0.05) consecutively. On the other side, the PSQI demonstrates a positive correlation with the (FAT%) and Fats and butter. Conclusions These results suggest an association between sleep quality and dietary intake, indicating a potential influence of sleep quality on dietary choices.
[Volume 14, Number 3 May 25, 2025]
Regular Article
- Received: January 12, 2024 / Accepted: May 8, 2024
Abstract
Lower baseline neurocognitive ability could be a risk factor for anterior cruciate ligament (ACL) injuries. We investigated the effects of high-intensity exercise (HIE) on neurocognitive function in athletes, and if any changes in neurocognitive function after the HIE had effects on an unanticipated cutting motion. Fourteen collegiate female athletes performed a bicycle ergometer HIE exercise at 80% of their heart rate reserve. Neurocognitive function was evaluated by the Stroop Interference Test (SIT) pre- and post-HIE. Biomechanical variables were captured using a motion analysis system while participants performed side-step cutting tasks in anticipated and unanticipated conditions. Participants were divided into two groups according to the changes of SIT scores after HIE: increased performers (IP; n = 7) and decreased performers (DP; n = 7). The average SIT score of the IP group significantly increased, while that of the DP group significantly decreased after the HIE (Paired t-test, P < 0.001). The main effect of the HIE using repeated-measures ANOVA, was a significant decrease in peak knee valgus moment (pre: anticipated-condition − 0.1 ± 0.1Nm/kg, unanticipated 0.0 ± 0.2Nm/kg; post: anticipated 0.0 ± 0.1Nm/kg, unanticipated 0.1 ± 0.2Nm/kg, P = 0.024) and peak ground reaction force (pre: anticipated 3.3 ± 2.1%BW, unanticipated 3.8 ± 2.1%BW; post: anticipated 3.1 ± 3.4%BW, unanticipated 3.6 ± 3.6%BW, P = 0.035) only in the IP group. The athletes with improved neurocognitive functions had decreased the biomechanical ACL injury risk factors during the side-step cuttings. Improving neurocognitive function may contribute to ACL injury prevention.
Short Communication
- Received: February 5, 2024 / Accepted: May 9, 2024
Abstract
This study aimed to investigate the differences in exercise load due to variations in lower limb weight during stair ascent and descent. The study involved 10 healthy adult men and women without respiratory or circulatory diseases (five men and five women). Using a respiratory gas analysis device, the participants performed stair climbing under three conditions: 1) full weight, 2) half (partial) weight-bearing, and 3) non-weight-bearing. The maximum oxygen uptake during stair climbing was defined as the peak oxygen uptake. Additionally, the time required for ascent and descent was measured using a stopwatch, and heart rate and perceived fatigue at the end were assessed using the Borg scale. Peak oxygen uptake and Borg scale scores significantly increased during ascent and descent under the non-weight-bearing condition compared to those under the full weight-bearing and half-weight-bearing conditions. The required time was significantly extended under the half-weight-bearing and non-weight-bearing conditions compared to that under the full-weight-bearing condition. Therefore, when stair ascent and descent are necessary during a period requiring the use of both crutches, it is considered desirable to perform them only after at least half-weight-bearing condition or more is permitted, as this approach results in a considerable reduction in load.
Regular Article
- Received: March 4, 2024 / Accepted: May 23, 2024
Abstract
This study assessed the effects of a rugby-specific concussion awareness program on improving the recognition of relevant symptoms and knowledge of concussion in male collegiate rugby union players. Thirty-one collegiate rugby union players from Japan were offered a concussion awareness program; they responded to a questionnaire assessing symptom recognition and knowledge of concussion three times (before, immediately after, and four weeks after the implementation of the program). Immediately after the program, the recognition score of suspected concussion symptoms was higher compared with before and four weeks later, when it was still higher than before but not statistically significant. In addition, more players selected the correct answers about rugby-specific concussion topics after the program. Our findings suggest that while concussion awareness is expected to improve immediately, this effect was not maintained after four weeks. Therefore, concussion awareness opportunities should be scheduled regularly, such as at the start of each season, before the beginning of the competition season, and when new players join the team.
[Volume 14, Number 4 July 25, 2025]
Regular Article
- Received: February 20, 2024 / Accepted: June 3, 2024
Abstract
During pregnancy, physiological insulin resistance increases due to endocrine factors secreted by the placenta. Gestational diabetes mellitus is an example of a common complication arising from this phenomenon, for which exercise therapy is used as standard treatment. While the acute effects of static stretching on blood glucose levels are known, the effects of dynamic stretching in a seated or supine position are unclear. This study investigated the effects of dynamic stretching in a seated or supine position on blood glucose levels in young adult women with post-load hyperglycemia wearing a maternity simulation jacket. We included 11 healthy women in the luteal phase of their menstrual cycles with blood glucose levels >140 mg/dL 30 min after glucose loading. Four exercise conditions were established: bed-stretching (BSt) involving dynamic stretching in a seated, supine, or lateral position, standing-stretching (SSt) involving dynamic stretching in a standing position, walking (W) involving treadmill walking at a comfortable speed, and control (C) involving sitting at rest. After fasting for 10–14 h, blood glucose levels were measured using self-monitoring blood glucose at baseline and every 15 min for 120 min thereafter. In the BSt and W conditions, the blood glucose levels, peaks, and area under the curve at 45 and 60 min after glucose loading were significantly lower than those in the C condition. Therefore, dynamic stretching in a seated or supine position suppressed blood glucose level elevation after glucose loading in young adult women with post-load hyperglycemia wearing a maternity simulation jacket.
Short Communication
- Received: May 2, 2024 / Accepted: June 21, 2024
Abstract
Problem addressed: Previous attempts have been made to superimpose ultrasound images (Overlapping Images Method). The merit of this method is that it enables capturing the entire morphology of the muscle and tendon in the longitudinal direction beyond the width of the ultrasound probe. However, the division points between tissues were identified visually, and the reliability of the measurement was not clarified. Experimental approach: This study identified the division points for the overlapping images method using the following two procedures: (1) visual-only identification and (2) a combination of visual and custom-built software-based identification. Finally, the reliability of the measurements for each procedure was examined by estimating the intra- and inter-rater correlation coefficients (ICC 1.1, ICC 2.1). The length of the Achilles tendon, muscle-tendon unit, and gastrocnemius muscle was measured using the overlapping images method for 19 volunteers. Main results and findings: The ICC 1.1 and ICC 2.1 scores for visual identification alone ranged between 0.61–0.91 and 0.70–0.93, respectively. The scores for the combination of visual and software-based identification ranged 0.90–0.99 and 0.58–0.96, respectively. Conclusions: The high intra- and inter-rater reliability in the overlapping images method was demonstrated in almost all measurements of the three tissue lengths and the applicability of overlapping images method was demonstrated. In particular, the intra-rater reliability was better when a combination of visual and custom-built software-based identification was used.
Regular Article
- Received: February 20, 2024 / Accepted: June 26, 2024
Abstract
Triathlon is an endurance sport that requires a high aerobic capacity. Previous studies demonstrated that lower-leg vascular conductance (VC) was associated with maximal oxygen uptake. However, it is unclear whether muscular VC is greater in triathletes versus untrained individuals. To test our hypothesis that VC in skeletal muscle is greater in triathletes relative to untrained peers and is associated with higher aerobic capacity in triathletes, this study investigated 10 male triathletes (21±1 years of age) and 8 untrained men (22±1 years). Triathletes exhibited greater maximal oxygen uptake than their untrained counterparts (61±6 vs. 39±6 mL/kg/min, P < 0.01), as well as lower heart rate (54±7 vs. 65±9 bpm, P < 0.01) and body fat (11±2 vs. 16±6 %, P = 0.03). There were no detectable intergroup differences in systolic (115±8 vs. 117±9 mmHg, P = 0.74), mean (83±6 vs. 86±8 mmHg, P = 0.30), or diastolic (62±6 vs. 65±7 mmHg, P = 0.49) blood pressure. Lower-leg blood flow (4.2±1.3 vs. 2.5±0.9 mL/dL/min, P = 0.01) and VC (0.05±0.01 vs. 0.03±0.01 mL/dL/min/mmHg, P = 0.02) based on venous occlusion plethysmography were greater in triathletes versus untrained men. Maximal oxygen uptake was correlated with lower-leg blood flow (r = 0.70, P < 0.01) and VC (r = 0.69, P < 0.01). These results demonstrate that lower-leg VC is higher in triathletes than in untrained individuals, and it may be associated with higher aerobic capacity in triathletes relative to untrained counterparts.