Asian Journal of Sports Medicine
Volume:12 Issue: 3, Sep 2021

Context:

 SARS-COV-2 is a coronavirus belonging to the beta-coronavirus group that primarily targets the human respiratory system and causes symptoms similar to those of pneumonia. It should be noted that clinical symptoms of patients with COVID-19 vary in different people. These patients do not only experience respiratory problems. In fact, COVID-19 infection may show a variety of symptoms, including fever, shortness of breath, dry cough, nasal congestion, sore throat, nausea, vomiting, myalgia, arthralgia, fatigue (muscular and mental), joint swelling, headache, diarrhea, as well as some musculoskeletal symptoms. Therefore, the aim of this article was to investigate the major musculoskeletal problems in patients with COVID-19 through a narrative review study.

Evidence Acquisition: 

This study collected the related published studies in the PubMed, ScienceDirect, and Google Scholar sources between 2019 - 2020. The main keywords were COVID-19, coronavirus, and musculoskeletal problems such as muscle fatigue, myalgia, arthralgia, and joint swelling.

 The major musculoskeletal symptoms included muscle fatigue (25.6%), myalgia and arthralgia (15.5%), joint swelling (as reactive arthritis), and such conditions as joint limitations, tendon shortening, and muscle weakness due to prolonged bed rest.

 Our findings revealed that attention to musculoskeletal rehabilitation of patients with COVID-19 is as essential as their respiratory rehabilitation. Besides, it would be effective in reducing the physical complications of hospitalization, returning to independence and functional activities, as well as improving the quality of the patients’ life.
 

 Gyms are among the places where various human infections can spread. One of the most important strategies to prevent infection spread among athletes is the use of strong and effective disinfectants.

 The aim of this study was to evaluate and compare the antiseptic properties of chlorhexidine gluconate and pomegranate peel extract on staphylococcal isolates from sports mats.

 This descriptive-analytical study was performed on 22 Staphylococcus aureus, and Staphylococcus epidermidis isolates from a total of 105 sports mat samples. After identification of multi-drug resistant (MDR) staphylococcal isolates, the antimicrobial effect of chlorhexidine gluconate 20% and pomegranate peel extract was evaluated by broth microdilution according to the instructions of the Clinical and Laboratory Standards Institute.

 Overall, 14 (66.7%) S. aureus and 8 (28.6%) S. epidermidis isolates resistant to azithromycin, linezolid, ciprofloxacin, vancomycin, and aztreonam were reported as MDR strains. The minimum inhibitory concentration (MIC) of chlorhexidine gluconate, which inhibited the growth of 90% of MDR S. aureus isolates was 250 μg/mL, which was 4-fold lower than the MIC of pomegranate peel extract (MIC90 ≥ 500μg/mL) and 2-fold lower against MDR S. epidermidis isolates (MIC90 ≤ 125 μg/mL). The MIC of chlorhexidine gluconate and pomegranate peel extract against S. aureus isolates differed significantly (P = 0.037).

 Compared to pomegranate peel extract, chlorhexidine gluconate has a higher antibacterial effect on MDR staphylococcal isolates from sports mats. Further research is required to verify the efficacy of this biocide for disinfection of gyms and sports clubs.

This study is one of the first to specifically analyze cardiorespiratory fitness and its association with age, weight, height, body fat percentage (BFP), body mass index (BMI), team performance, and player position for a large number of soccer players in an Asian top league.

213 players (age = 25 ± 5 years, height = 181.2 ± 6.8 cm, weight = 76.1 ± 8.1 kg, BFP = 11.3 ± 3.1) affiliated with 16 soccer clubs from Iran’s Premier League (i.e., the highest level of club football in Iran), were tested for maximal aerobic power (VO2 max), first and second ventilatory thresholds (VT1 and VT2), and ventilatory efficiency at rest (VO2 rest). The nonparametric Spearman's correlation test was performed to check for correlations, and the resulting rank correlation coefficients (rs) and probability value (P) are presented.

In terms of mean ± standard deviation, the 213 male players participating in this study have VO2max = 55.3 ± 5.4 mL.kg-1.min-1, VT1 = 57.3 ± 4.2 (% max), VT2 = 92.6 ± 3.4 (% max) and VO2rest = 7.1 ± 1.4 mL.kg-1.min-1. No correlation between VO2max and team performance or BFP was observed. The correlations between VO2max and age (rs= -0.23, P = 10-3), height (rs = -0.34, P ≅ 0), weight (rs = -0.42, P ≅ 0) and BMI (rs = -0.30, P = 10-5) were considered statistically significant. The difference between VO2max of players in different positions was also statistically significant. Goalkeepers possessed the lowest VO2max, with a mean value of 49.8 mL.kg-1.min-1. Defenders had the lowest mean VO2max value players (equal to 54.7 mL.kg-1.min-1) amongst outfield players, and midfielders had the highest mean VO2max (= 56.9 mL.kg-1.min-1). The other indices of cardiorespiratory fitness (VT1, VT2 and VO2rest) had no statistically significant correlation with the physical characteristics of the soccer players, team performance and player position.

The study demonstrates that VT1, VT2, and VO2rest are not distinguishing factors amongst different categories of age, weight, height, team performance, and player position, but VO2max varies with age, weight, height, and BMI. The study also shows that there is a high correlation between the physical demands of player positions during a game and the aerobic capacity of players in those positions, and this must be taken into account in soccer training.

 Several studies have investigated risk factors for injury in different sports. However, little scientific information is available in relation to futsal injuries.

 This study prospectively analyzed the influence of physical fitness parameters on the occurrence of futsal injuries in Iranian national teams.

 Prior to the season, all 55 players of 3 Iranian national futsal teams took part in a series of tests for physical fitness parameters such as cardio-respiratory fitness, muscle strength, body composition, flexibility, agility, and speed. Team physicians recorded all injuries, medical attention, and time loss due to the injury throughout the match and training sessions.

 During 18 months, 54 futsal injuries were sustained by 32 players. Injured players had poorer performance at baseline in agility, speed, and vertical jump than players who did not incur an injury during the season. Lower maximal oxygen uptake (VO2max) values were associated with a higher injury risk. No differences between injured and uninjured players were observed in age, anthropometric data, flexibility, and lower extremity strength.

 Some physical fitness parameters were associated with the risk of injuries in futsal. Therefore, improving physical fitness might help to reduce the number of futsal injuries.

The integrity of the autonomic nervous system (ANS) is essential for keeping physiological processes stable, even under stress. Since there is growing interest in heart rate variability (HRV) analysis for the noninvasive assessment of the ANS in sickle cell anemia (SCA) patients, we studied the behavior of the ANS in the presence of a stressor that simulates daily-life multitasking, the Glittre ADL test (GA-T).

To evaluate the involvement of the ANS using HRV in adults with SCA during the GA-T and to quantify the strength of the correlation of HRV with lung and muscle functions.

In this cross-sectional study, 16 adults with SCA and 12 healthy controls without sickle cell disease underwent HRV assessment during the GA-T, pulmonary function tests (spirometry, diffusing capacity for carbon monoxide (DLCO), and respiratory muscle testing). Peripheral muscle function [handgrip strength (HGS) and quadriceps strength (QS)] were also measured.

Compared to the healthy controls, adults with SCA showed lower HRV, with worse parasympathetic modulation due to reductions in the following indices: the root-mean-square difference of successive normal iRRs (iRR) (RMSSD); the percentage of pairs of consecutive iRRs whose difference is > 50 m (pNN50); the high-frequency component of heart rate variability (HF); and the standard deviation of instantaneous beat-to-beat variability (SD1) (P < 0.001 for all). Compared to healthy controls, individuals with SCA showed greater sympathovagal imbalance (higher ratio between low-frequency and HF components) and lower complexity of the ANS (lower approximate entropy). The GA-T time was correlated with parasympathetic activity indices: RMSSD (rs = -0.650, P < 0.01); pNN50 (rs = -0.932, P < 0.0001), HF (rs = -0.579, P < 0.01), and SD1 (rs = -0.814, P < 0.0001). Correlations between parasympathetic activity indices and DLCO, HGS, and QS measures were also significant.

Adults with SCA have low HRV, with low parasympathetic activity, sympathovagal imbalance, and abnormal ANS complexity. In addition, lower HRV is associated with longer GA-T time, greater impairment of pulmonary diffusion, and greater muscle strength dysfunction.

Myotendinous stiffness is related to the collagen content of the muscle and tendon, and can be estimated during running by changes in vertical stiffness (kvert) and the resulting modifications of the spatiotemporal parameters (on-off ground asymmetry and landing-takeoff asymmetry). Supplementation with amino acids found in collagen, such as proline, glycine, and hydroxyl proline, combined with ascorbic acid, improve collagen synthesis and potentially result in improved mechanical strength and stiffness.

To determine if hydrolyzed collagen (HC) supplementation increases kvert and improves the spatiotemporal parameters during running in recreational triathletes.

Nine active males (weight; 68.4 ± 5.7 kg, height; 171.8 ± 5.4 cm, age; 32.5 ± 4.1 years; Vo2max; 53.15 ± 2.19 mL/kg/min) were randomly distributed into a collagen group (CollG, n = 5) and a control group (CG, n = 4). Participants were supplemented for 4 weeks with 15g HC (CollG) or 15g placebo (CG; maltodextrin), 3 times per week. One hour after supplementation, the participants of both groups were asked to perform four repetitions of short sprints to further stimulate collagen synthesis. The ground reaction forces were recorded during running at 4.44 m s-1, 5.55 m.s-1, and 6.66 m.s-1 for assessment of kvert and the spatiotemporal step parameters.

Both groups increased kvert with speed (4.44 - 6.66 m s-1) from 24.8 ± 2.7 to 53.7 ± 16.5 N/m and from 25.1 to 49.8 N/m in the CollG and CG, respectively (P < 0.0001); however, there were no differences between groups before and after the supplementation period. As a consequence, the spatiotemporal parameters of running were also similar between groups.

Four weeks of HC supplementation does not improve the bouncing mechanism of running in recreational triathletes.

Evaluating concomitant injury in patients with anterior cruciate ligament (ACL) rupture is important for predicting long-term results. Meniscofemoral ligament (MFL) rupture has been observed in patients with anterior cruciate ligament rupture in arthroscopic evaluation for ruptured ACL.

The objective of this study was to investigate the concomitant meniscofemoral ligaments injury in patients with anterior cruciate ligament ruptures via magnetic resonance imaging (MRI).

A total of 200 patients (with ruptured ACL, n = 100; with intact ACL, n = 100) were retrospectively evaluated via MRI. In the group with ruptured ACL; the patients who were diagnosed as having noncontact ACL injuries and had undergone primary ACL reconstructions were included. The control group included 100 patients with suspected ACL rupture (from a similar injury mechanism) and whose MRI revealed an intact ACL. In the group with ruptured ACL, the time from injury to MRI was evaluated. A comparison of the presence of anterior MFL (aMFL) and posterior MFL (pMFL) between the two groups was evaluated.

In the ACL ruptured group, a significantly lower presence of aMFL or pMFL was observed compared to the control group (P = 0.001). The time from injury to MRI was significantly higher in the patients with absent MFL defined in MRI relative to the other groups (P = 0.001).

We observed absence of MFLs (aMFL and pMFL) in a significant majority of patients with ruptured ACLs. Furthermore, we found a significant relationship between the time from injury to MRI and absence of MFL in the ruptured ACL group.