Wingate Institute

(1) Achilles tendon rupture is one of the most severe lower-limb injuries, frequently occurring during movements involving maximal dorsiflexion with the knee at near-full extension. Preventive strategies are crucial, particularly for athletes engaged in high-risk sports such as basketball. (2) In this work, we examined the effect of a novel Achilles brace on Achilles tendon loading during concentric and eccentric mechanisms associated with tendon rupture. (3) Twenty-eight young basketball players performed tests under two conditions: with the adaptive brace and without it (control). Participants were divided into two groups (n = 14 in both). The first group assessed concentric Achilles loading by performing three plantar-flexor strength tests in three different joint configurations: maximal dorsiflexion with the knee flexed (FKF); injury mechanism position-full plantar flexion with the knee extended (FKE); and neutral ankle position with the knee extended (NKE). The number of maximal heel-raise repetitions performed before onset of fatigue was recorded. The second group assessed eccentric tendon loading by performing single-leg forced maximal-velocity dorsiflexion with the knee extended. In all tests, the time between maximal plantar flexion and maximal dorsiflexion, as well as the ankle range of motion, was analyzed using 2D video. Paired t-tests were used to compare braced and control conditions. In all tests, the ankle range of motion (ROM) did not differ significantly between brace and control conditions. Wearing the brace significantly improved plantar-flexor muscle strength only in the FKE test (31 ± 1.3 repetitions with brace vs. 21 ± 1.3 in control, p < 0.05). No significant differences were found for the FKF (27 ± 1.3 vs. 25 ± 1.3) or NKE (25 ± 1.3 vs. 24 ± 1.3) positions. During drop eccentric loading, wearing the brace resulted in a significantly slower transition time from plantar flexion to dorsiflexion (460 ± 60 ms with brace vs. 320 ± 30 ms in control, p < 0.001). (4) In brief, the novel Achilles brace was found to significantly reduces Achilles tendon load during both concentric and eccentric activities, but only in high-risk joint positions. These findings suggest that the brace provides mechanical protection, and may reduce the risk of Achilles tendon rupture, in athletes exposed to high tendon stress.

Background: Intrinsic capacity (IC) is a novel concept for healthy ageing, introduced by the WHO less than 10 years ago. Although the theoretical framework of the IC consists of five fundamental domains: vitality, locomotion, cognition, sensory, and psychological, there is variance in the tests that are used to assess them. Purpose: To quantitatively assess the IC of older healthy adults, based on the WHO ICOPE recommendation, see: https://apps.who.int/iris/bitstream/handle/10665/326843/WHOFWC-ALC-19.1-eng.pdf?sequence=17&amp;isAllowed=y. We aimed to establish a composite score that could identify the points of functional decline among the healthy older population and identify possible correlations between the five subdomains. Method: Participants: 50 community-dwelling, aged 65+, fluent in the Lithuanian language, with no symptomatic diseases, metabolic disorders, or orthopaedic issues. Tests: Vitality – Mini Nutritional Assessment, handgrip strength, Multidimensional Fatigue Inventory, body mass index, blood tests for haemoglobin, albumin, white blood cells, C-RP. Cognitive – Montreal Cognitive Assessment (MoCA). Locomotion – Short Physical Performance Battery (SPPB) – balance, gait speed, and chair rise tests. Psychological – Geriatric Depression Scale (GDS-15). Sensory – hearing and vision subjective reports. Scoring: The score for each domain was calculated as the points obtained were divided by the maximum possible scores. The global IC score is the sum of all sub-domains and is expected to range between 0 (declining capacity in all sub-domains) and 5 (no impairments in any of the sub-domains). Results: Thirty-nine participants completed all measures (23 women, mean age 72.08 ± 4.54 years). Mean composite score of IC is 3.964 ± 0.408 (range 2.695–4.617) with a proportional distribution. Subdomains Scores: Vitality = 0.795 ± 0.122 (0.455–1.00), Cognitive = 0.692 ± 0.121 (0.250–0.750), Locomotion = 0.902 ± 0.103 (0.667–1.00), Psychological = 0.936 ± 0.159 (0.250–1.00), Sensory = 0.639 ± 0.142 (0.333–1.00). Significant correlations were detected between Vitaliy and Locomotion (r = 0.590, p &lt; 0.001), Vitality and Cognitive (r = 0.492, p &lt; 0.001), and Locomotion and Cognitive (r = 0.325, p &lt; 0.05). The balance test and the nutrition questionnaire had a ceiling effect, and all participants received the maximal score. Conclusion: A lower composite IC score may reflect declining reserves even among healthy older adults. A more sensitive balance test and comprehensive nutritional assessment would enhance diagnostic accuracy and evaluation capabilities. This method should also be tested with less healthy cohorts.

The prevalence of depressive symptoms post cardiac surgery remains high even 1 year after the operation. However, the relationship between postsurgery long-term depression and physical activity is not well understood. The purpose of our study was to investigate the relationship between depression and physical activity levels in patients during an 18-month follow-up period post cardiac surgery. Fifty-seven patients with 82.5% men and an average age of 60.3 years were followed up for 18 months in the study. Depression was assessed using the Center for Epidemiologic Studies Depression scale. Physical activity levels were measured using the International Physical Activity Questionnaire at 18 months. The most common procedures were cardiac bypass (49.1%) and valve replacement (35.1%). Compared with preoperative levels (14.4 ± 1.5), depression scores were significantly increased immediately post surgery (21.0 ± 1.3, P = .002), decreased at 10 days post discharge (14.4 ± 1.2, P < .001), and increased again at 18 months post discharge (19.0 ± 1.1, P = .01). Physical activity levels, measured using the International Physical Activity Questionnaire, were inversely associated with depression scores. Participation in cardiac rehabilitation did not show a significant relationship with depression scores. Patients with higher International Physical Activity Questionnaire scores had lower Center for Epidemiologic Studies Depression scores, highlighting the potential benefits of physical activity in managing postoperative depression. These findings underscore the importance of promoting physical activity as a potential intervention to improve mental health in patients who had undergone cardiac surgery.

BackgroundPatients commonly seek outpatient physical therapy services for musculoskeletal disorders. Understanding these patient groups in Israel provides valuable insights into the healthcare system. We aimed to investigate physician referral patterns for physical therapy across different age and sex groups, focusing on neck and low back pain. Additionally, we sought to explore the therapeutic interventions provided by physical therapists for these conditions.MethodsFor this retrospective, cross-sectional study we utilized data from a national health maintenance organization covering > 4 million people at 100 physical therapy outpatient clinics. We measured the prevalence rates of physicians’ referral patterns for neck and low back pain according to age and sex, as well as therapeutic interventions prescribed by physical therapists. We used Z-tests to assess the differences in prevalence rates between women and men within the same age group. Logistic regression analyses were used to evaluate the likelihood of patients of a specific age group being referred to physical therapy compared with the total sample. We analyzed prevalence rates of different treatment protocols used by physical therapists according to these referrals.ResultsOverall, 1,593,592 physician referrals for physical therapy were made over 6 years for all musculoskeletal conditions. Of those, 32.4% were for spine disorders, with 21.2% for low back pain and 11.1% for neck pain, mostly chronic (80.6% and 72.7%, respectively). Women were more likely than men to be referred for both low back pain (odds ratio = 1.36, 95% confidence interval = 1.34–1.38, p < 0.001) and neck pain (1.40, 1.37–1.43, p < 0.001). All referral rates increased with age. The most common treatment provided by physical therapists for neck and low back pain was education and advice for an active lifestyle.ConclusionsThis study provides comprehensive data that highlight significant trends related to age, acuteness, and sex. Chronic low back and neck pain are the predominant reasons for physical therapy referrals, particularly among women and older adults. Physician referrals for neck and low back pain aligned with the epidemiology of such conditions in the Israeli population, underscoring the need for targeted rehabilitation strategies, early intervention programs, and effective healthcare service planning.

BackgroundInflammatory bowel disease (IBD) causes fatigue, pain, and fecal urgency/incontinence symptoms. Identifying symptom profile subgroups and related psychological correlates might enable earlier intervention and more effective tailored treatment pathways.MethodsThis study was nested within a randomized controlled trial of a digital symptom intervention for people with IBD (n = 780). Latent profile analysis was conducted on pre-randomization baseline measures of fatigue, pain, and fecal incontinence. Multinominal logistic regression examined associations between profile membership and clinical, demographic and psychological factors.ResultsLatent profile analysis determined a three-profile model: Moderate (50%), High (40%), and Severe symptoms (10%). Diagnosis and fecal calprotectin were not associated with profile membership, but female gender, comorbidity, time since diagnosis, and irritable bowel syndrome (IBS)-type symptoms were associated with High and Severe symptoms profiles. Depression, anxiety, negative symptom perceptions, all-or-nothing and avoidance behaviors significantly increased the relative risk of High and Severe symptoms profile membership.ConclusionsMany participants experienced symptoms even when deemed to be in clinical remission. After controlling for clinical, inflammatory, and demographic factors, the relative risk of High or Severe symptom profile membership was associated with potentially modifiable cognitive behavioral factors. These factors were also associated with IBS-type symptoms. Recognizing the potential impact of cognitive behavioral factors in exacerbating symptoms can lead to earlier identification of patients who require support and allows treatment plans to be tailored more precisely. The findings from this study promote a more integrated approach to IBD management, combining medical treatment with cognitive behavioral interventions to enhance patient care and improve outcomes.

Professional young athletes should adopt a suitable fluid consumption and hydration program. Previous studies have indicated high prevalence of poor drinking habits and inappropriate hydration status among athletes. PURPOSE: To assess the effectiveness of using smart bottle, which track daily water intake and encourage water consumption on fluid intake and hydration status among young elite athletes at the Academy for Sport Excellence at the Wingate Institute. METHODS: Thirty-seven adolescent athletes (18 females) age 15.8±1.1 years, engaged in volleyball, beach volleyball, and triathlon, participated in the study. Athletes were provided with a smart bottle integrated with smartphone application designed to measure and encourage drinking amounts. The study comprised a three-week duration: in the initial week athletes were instructed to consume fluids only from the provided smart bottle with no measurements or active reminding. In the second week drinking measurement were recorded, finally, in the third week both the smart bottles and the accompanying smartphone application were actively utilized, enable also active drinking reminding. Urine specific gravity (USG) before afternoon training session was measured once a week throughout the study period. RESULTS: In comparing the second and third weeks, average daily drinking amount increased significantly (p<0.001), from 1,288±771 to 2,476±1296 ml. Concurrently, the average USG, decreased significantly (p=0.01), from 1.019±0.01 to 1.012±0.01. Moderate negative correlation (r=-0.496; p<0.01) was demonstrated between drinking amount and USG. The calculated average heat load, from Meteorological Service measurements revealed no significant difference between the second week (24.9±1.9) and the third week (24.6±1.5), with both falling within "moderate heat load" category. CONCLUSIONS: In this study we demonstrated an improvement in water consumption correlated with an enhanced hydration status among adolescent athlete utilizing a smart bottle and integrated with a smartphone drinking application. While these findings suggest immediate benefits, further studies are essential to evaluate the long-term effects of active drinking bottle utilization among young athletes.

When playing basketball, players are required to have high explosive power, which requires the ability to move in efficient, specific, and game-specific movement patterns that combine both horizontal and vertical abilities. Differences have been seen between young male and female basketball players in this measure. The aim of this study was to examine differences in players' unique movements by gender, age, and playing positions using a novel test for basketball players. This study included 232 young basketball players, male and female, from a range of Israeli leagues, who were divided into three categories: under-14, under-16, and under-18. Our findings showed that males presented better results than females in all age categories. Moreover, females in the under-18 category presented better results than those in the under-14 category, but not more than those in the under-16 category. Differences in playing positions were only examined between males and females in the under-18 category, where players begin to specialize in playing positions, and here, guards showed better results than forwards and centers. Our conclusions highlight the importance of including unique, sport-specific tests in talent identification and selection processes, as these tests can provide valuable information about a player's skill set and potential for success. The findings are presented in an achievement table of the expected physical fitness results by age and gender for the benefit of basketball coaches and strength and conditioning coaches when assessing their players.

Individuals with autism spectrum disorder (ASD) are at higher risk for developing common chronic diseases. Engagement in physical activity (PA) can prevent health issues; however, people with ASD are known to engage in lower levels of PA in comparison to their peers. This study evaluated the effect of a long-term, 12-month PA intervention on the fitness and quality of life of adults with ASD. A quantitative approach was implemented to assess participants' fitness, functional ability, quality of life, and participation in a range of PA classes at three different time points. Qualitative data were collected via in-depth, semi-structured interviews with three participants with ASD and three staff members. A total of 34 adults with ASD (mean age 39.76 + 7.27) participated in the quantitative part of the study. Approximately 53% of the participants exhibited perseverance and conducted adequate PA each month. Significant improvements were found in one fitness component and two quality-of-life components. Factors revealed for the program's success were the individuals' free choice of the PA classes and supporting people and a budget that tailored the project. Policymakers who plan health promotion programs for adults with ASD should consider long-term PA programs, with freedom of choice among PA modalities and schedules.

When playing basketball, athletes must optimally perform repeated short sprints with minimal recovery time, requiring both anaerobic and aerobic abilities, including high VO2max.Yet differences have been seen between young male and female basketball players in this measure.The aim of this quantitative study was to examine differences in players' VO2max by gender, age group, and relative age effect (RAE) using the novel Yo-Yo Recovery Test for Basketball Players.The study included 438 young basketball players, male and female, from a range of Israeli leagues, who were divided into three categories: under-14, under-16, and under-18.To assess RAE, the participants in each category were divided into three trimesters of four months, based on their date of birth.The participants' VO2max was assessed using the novel aerobic test.In this study, we hypothesized that male players will exhibit greater aerobic capacity than female players of the same age and that older players will exhibit greater aerobic capacity than younger ones.Our findings supported these hypotheses, as male players presented better physical fitness results than female players in all age categories.Moreover, female players in the under-18 category presented better results than those in the under-14 category, but not more than those in the under-16.Differences in the relative age effect on performance were seen between the genders and within the female participants.While the male participants presented a steady improvement with age, the results of the girls showed a different pattern.The findings are presented in an achievement table that presents the expected physical fitness results by age and gender, for the benefit of basketball coaches and fitness trainers when assessing their players' aerobic capacity.