Injury and illness in short-course triathletes:A systematic review

Background:Determining the incidence and prevalence of injury and illness in short-course triathletes would improve understanding of their etiologies and therefore assist in the development and implementation of prevention strategies.This study synthesizes the existing evidence on the incidence and prevalence of injury and illness and summarizes reported injury or illness etiology and risk factors affecting short-course triathletes.Methods:This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Studies reporting health problems(injury and illness)in triathletes(all sexes,ages,and experience levels)training and/or competing in short-course distances were included.Six electronic databases(Cochrane Central Register of Controlled Trials,MEDLINE,Embase,APA PsychINFO,Web of Science Core Collection,and SPORTDiscus)were searched.Risk of bias was independently assessed by 2 reviewers using the Newcastle-Ottawa Quality Assessment Scale.Two authors independently completed data extraction.Results:The search yielded 7998 studies,with 42 studies eligible for inclusion.Twenty-three studies investigated injuries,24 studies investigated illnesses,and 5 studies investigated both injuries and illnesses.The injury incidence rate ranged 15.7-24.3 per 1000 athlete exposures,and the illness incidence rate ranged 1.8-13.1 per 1000 athlete days.Injury and illness prevalence ranged between 2%-15%and 6%-84%,respectively.Most injuries reported occurred during running(45%-92%),and the most frequently reported illnesses affected the gastrointestinal(7%-70%),cardiovascular(14%-59%),and respiratory systems(5%-60%).Conclusion:The most frequently reported health problems in short-course triathletes were:overuse and lower limb injuries associated with running;gastrointestinal illnesses and altered cardiac function,primarily attributable to environmental factors;and respiratory illness mostly caused by infection.

Assessing proprioception:A critical review of methods

To control movement,the brain has to integrate proprioceptive information from a variety of mechanoreceptors.The role of proprioception in daily activities,exercise,and sports has been extensively investigated,using different techniques,yet the proprioceptive mechanisms underlying human movement control are still unclear.In the current work we have reviewed understanding of proprioception and the three testing methods:threshold to detection of passive motion,joint position reproduction,and active movement extent discrimination,all of which have been used for assessing proprioception.The origin of the methods,the different testing apparatus,and the procedures and protocols used in each approach are compared and discussed.Recommendations are made for choosing an appropriate technique when assessing proprioceptive mechanisms in different contexts.

Age-related changes in proprioception of the ankle complex across the lifespan

Background:Ankle complex proprioceptive ability,needed in active human movement,may change from childhood to elderly adulthood;however,its development across all life stages has remained unexamined.The aim of the present study was to investigate the across-the-lifespan trend for proprioceptive ability of the ankle complex during active ankle inversion movement.Methods:The right ankles of 118 healthy right-handed participants in 6 groups were assessed:children(6-8 years old),adolescents(13-15 years old),young adults(18-25 years old),middle-aged adults(35-50 years old),old adults(60-74 years old),and very old adults(75-90 years old).While the participants were standing,their ankle complex proprioception was measured using the Active Movement Extent Discrimination Apparatus.Results:There was no significant interaction between the effects of age group and gender on ankle proprioceptive acuity(F(5,106)=0.593,p=0.705,η_p^2=0.027).Simple main effects analysis showed that there was a significant main effect for age group(F(5,106)=22.521,p<0.001,η_p^2=0.515)but no significant main effect for gender(F(1,106)=2.283,p=0.134,η_p^2=0.021)between the female(0.723±0.092,mean±SD)and the male(0.712±0.083)participants.The age-group factor was associated with a significant linear downward trend in scores(F(1,106)=10.584,p=0.002,η_p^2=0.091)and a strong quadratic trend component(F(1,106)=100.701,p<0.001,η_p^2=0.480),producing an asymmetric inverted-U function.Conclusion:The test method of the Active Movement Extent Discrimination Apparatus is sensitive to age differences in ankle complex proprioception.For proprioception of the ankle complex,young adults had significantly better scores than children,adolescents,old adults,and very old adults.The middle-aged group had levels of ankle proprioceptive acuity similar to those of the young adults.The scores for males and females were not significantly different.Examination of the range of the scores in each age group highlights the possible level that ankle complex movement proprioceptive rehabilitation can reach,especially for those 75-90 years of age.

Physiotherapist-led home-based physical activity program versus community group exercise for middle-aged adults: Quasi-experimental comparison

Objectives: Program method, program deliverer and participant preference may be important factors in increasing physical activity adherence and program effectiveness. To investigate this, we compared two physical activity interventions in middle-aged adults. Methods: Using a pragmatic quasi-experimental design, sedentary community dwelling 50 - 65 year olds (n = 2105) were recruited to a non-randomized 6-month community group exercise program (n = 93) or a physiotherapist-led home-based physical activity program (n = 65). The primary outcome was physical activity adherence derived from exercise diaries. Secondary outcomes included the Active Australia Survey, aerobic capacity (step- test), quality of life (SF-12v2), blood pressure, waist circumference, waist-to-hip ratio (WHR) and body mass index. Results: Home-based participants were more likely to be younger, working full-time and not in a relationship (p Thirty-three percent of the group participants attended ≥ 70% of group exercise sessions. Ninety percent of home-based participants received ≥ 4 of the planned 6 telephone support calls. Intention-to-treat analysis found adherence to the physical activity sessions prescribed was the same for both interventions (26% ± 28% vs. 28% ± 35%). Both interventions significantly increased the number of participants achieving self-reported “sufficient” physical activity (p ≤ 0.001) and significantly decreased waist circumference (p < 0.001) and WHR (p 0.05). Conclusion: The physiotherapist- led home-based physical activity program, requiring few resources, appears to have increased the adoption of physical activity and adherence to physical activity program requirements for sedentary middle-aged adults. The home-based program, providing equivalent health benefits to the group exercise program, may be particularly suitable for those not interested in or unable to attend a group exercise program. Clinical Trial Registration number Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN126 1000890932.

Assessing proprioception:What do you really want to know?——Response to Krewer et al.

Dear editor,In their comment,Krewer et al.1argue that before selecting a specific method for assessing proprioception,it is essential to consider which component of proprioception is to be assessed.They also note that there is no single method for assessing all aspects of the various proprioceptive senses,