UNASSIGNED: The primary goal of this study is to evaluate the relationship between Body Mass Index (BMI) and muscle atrophy in individuals with rotator cuff tears.
UNASSIGNED: This study consists of patients with rotator cuff tears identified by MRI from two independent cohorts, the Rotator Cuff Outcomes Workgroup (ROW) and the Multicenter Orthopaedic Outcomes Network (MOON). Presence of atrophy (yes/no) and severity of atrophy (as an ordinal variable) were assessed on MRI by expert physicians. We used multivariable regression models to evaluate the relationship between BMI and muscle atrophy while adjusting for age and sex in each study, conducted sensitivity analyses for full-thickness tear and combined results using inverse variance-weighted meta-analysis.
UNASSIGNED: A total of 539 patients (MOON=395, ROW=144) from the combined cohorts had MRI data available on muscle atrophy. Among these patients, 246 (46%) had atrophy of at least one of the muscles of the rotator cuff and 282 (52%) had full-thickness tears. In meta-analysis across both cohorts, each 5 kg/m2 increase in BMI was associated with a 21% (aOR=1.21, 95% CI=1.02, 1.43) increased odds of having muscle atrophy among individuals with any tear size, and 36% (aOR=1.36, 95% CI=1.01-1.81) increased odds among individuals with full-thickness tear.
UNASSIGNED: Higher BMI was associated with significantly higher odds of muscle atrophy in patiens with rotator cuff tears. More study is needed to unders1tand why and how this relationship exists, as well as whether interventions to reduce BMI may help improve outcomes for these patients.
UNASSIGNED: III.

Rehabilitative practice is often criticised for being non-individualised, monotonous and not well aligned with foundational principles that drive continued physiological adaptation(s). However, our understanding of neuromuscular physiology is rapidly increasing and the way we programme rehabilitation is improving. This viewpoint highlights some of the potential considerations around why the adaptations achieved during rehabilitation programmes may be suboptimal. We provide basic, clinician-focused discussion about potential confounding physiological factors, and put forward several exercise-based programming recommendations and novel approaches to consider in contemporary rehabilitative practice. Specifically, we outline several potential mechanisms contributing to poor muscle activation and function that might be present following musculoskeletal injury. However, clinicians require strategies capable of attenuating these impairments to restore proper function. Therefore, we also provide an overview of recommended strength and conditioning guidelines, and novel strategies (such as external pacing and electrical stimulation techniques) that clinicians can consider to potentially improve the efficacy of musculoskeletal rehabilitation.

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OBJECTIVE: To evaluate the effect of a gluteal activation warm-up on the performance of an explosive exercise (the high hang pull (HHP)).
METHODS: Seventeen professional rugby union players performed one set of three HHPs (with 80% of their one repetition maximum load) following both a control and activation warm-up. Peak electrical activity of the gluteus maximus and medius was quantified using electromyography (EMG). In addition, the kinematics and kinetics of nine players was also recorded using force plate and motion capture technology. These data were analysed using a previously described musculoskeletal model of the right lower limb in order to provide estimates of the muscular force expressed during the movement.
RESULTS: The mean peak EMG activity of the gluteus maximus was significantly lower following the activation warm-up as compared with the control (p<0.05, effect size d=0.30). There were no significant differences in the mean peak estimated forces in gluteus maximus and medius, the quadriceps or hamstrings (p=0.053), although there was a trend towards increased force in gluteus maximus and hamstrings following the activation warm-up. There were no differences between the ground reaction forces following the two warm-ups.
CONCLUSIONS: This study suggests that a gluteal activation warm-up may facilitate recruitment of the gluteal musculature by potentiating the glutes in such a way that a smaller neural drive evokes the same or greater force production during movement. This could in turn potentially improve movement quality.

OBJECTIVE: Surface electromyography (sEMG) is a commonly used technique to investigate muscle activation and fatigue, which is non-invasive and can allow for continuous measurement. Systematic research on the use of sEMG in the sporting environment has been on-going for many years and predominantly based on cycling and rowing activities. To date there have been no reviews assessing the validity and reliability in sEMG exclusively in running activities specifically during on-field testing. The purpose of this review is to evaluate the use of sEMG in the practical context and whether this be translated to on-field testing.
METHODS: Electronic literature searches were performed using the Cochrane Library, PUBMED, CINAHL and PeDro without restrictions on the study date to identify the relevant current English language literature.
RESULTS: 10 studies were relevant after title and content review. All the studies identified were all level three evidence based. The general trends of the sEMG activity appear to correlate with running velocity and muscle fatigue seems almost always the consequence of prolonged, dynamic activity. However, these changes are not consistently measured or statistically significant throughout the studies raising the question of the accuracy and reliability when analysing sEMG measurements and making assumptions about the cause of fatigue.
CONCLUSIONS: An agreed consensus when measuring and analysing sEMG data during running activities particularly in field testing with the most appropriate study design and reliable methodology is yet to be determined and further studies are required.

Current recommendations for physical activity in children overlook the critical importance of motor skill acquisition early in life. Instead, they focus on the quantitative aspects of physical activity (eg, accumulate 60 min of daily moderate to vigorous physical activity) and selected health-related components of physical fitness (eg, aerobic fitness, muscular strength, muscular endurance, flexibility and body composition). This focus on exercise quantity in youth may limit considerations of qualitative aspects of programme design which include (1) skill development, (2) socialisation and (3) enjoyment of exercise. The timing of brain development and associated neuroplasticity for motor skill learning makes the preadolescence period a critical time to develop and reinforce fundamental movement skills in boys and girls. Children who do not participate regularly in structured motor skill-enriched activities during physical education classes or diverse youth sports programmes may never reach their genetic potential for motor skill control which underlies sustainable physical fitness later in life. The goals of this review are twofold: (1) challenge current dogma that is currently focused on the quantitative rather than qualitative aspects of physical activity recommendations for youth and (2) synthesise the latest evidence regarding the brain and motor control that will provide the foundation for integrative exercise programming that provide a framework sustainable activity for life.

OBJECTIVE: To assess the time course of changes in rapid muscle force/torque production capacity and neuromuscular activity of lower limb muscles in response to prolonged (∼2 h) match-play tennis under heat stress.
METHODS: The rates of torque development (RTD) and electromyographic activity (EMG; ie, root mean square) rise were recorded from 0 to 30, -50, -100 and -200 ms during brief (3-5 s) explosive maximal isometric voluntary contractions (MVC) of the knee extensors (KE) and plantar flexors (PF), along with the peak RTD within the entirety of the torque-time curve. These values were recorded in 12 male tennis players before (prematch) and after (postmatch, 24 and 48 h) match-play in HOT (∼37°C) and COOL (∼22°C) conditions.
RESULTS: The postmatch core temperature was greater in the HOT (∼39.4°C) vs COOL (∼38.7°C) condition (p<0.05). Reductions in KE RTD occurred within the 0-200 ms epoch after contraction onset postmatch and at 24 h, compared with prematch, independent of environmental conditions (p<0.05). A similar reduction in the KE peak RTD was also observed postmatch relative to prematch (p<0.05). No differences in KE RTD values were observed after normalisation to MVC torque. Furthermore, the rate of KE EMG activity rise remained unchanged. Conversely, the PF contractile RTD and rate of EMG activity rise were unaffected by the exercise or environmental conditions.
CONCLUSIONS: In the KE, a reduction in maximal torque production capacity following prolonged match-play tennis appears to account for the decrease in the rate of torque development, independent of environmental conditions, while remaining unchanged in the PF.

OBJECTIVE: To assess the time course of changes in physical performance in response to match-play tennis under heat stress.
METHODS: Two matches consisting of 20 min of effective playing time (2×10 min segments) were played in COOL (∼102 min; ∼22°C and 70% relative humidity (RH)) and HOT (∼119 min; ∼36°C and 35% RH) environments. Repeated-sprint ability (3×15 m, 15 s rest), 15 m sprint time with a direction change (180°), vertical jump height (squat and countermovement jumps) and leg stiffness (multirebound jumps) were assessed in 12 competitive male players prematch, midmatch and postmatch, and 24 and 48 h after match completion.
RESULTS: During the repeated-sprint ability test, initial (+2.3% and +3.1%) and cumulated sprint (+1.5% and +2.8%) times increased from prematch to midmatch and postmatch, respectively (p<0.001), while the sprint decrement score did not change. Match-play tennis induced a slowing (average of both conditions: +1.1% and +1.3% at midmatch and postmatch time points; p=0.05) of 15 m sprint time with direction change. Compared with prematch, leg stiffness (-6.4% and -6.5%; p<0.001) and squat jump height (-1.5% and -2.4%; p=0.05), but not countermovement jump height (-0.7% and -1.3%; p>0.05), decreased midmatch and postmatch, respectively, regardless of the condition. Complete recovery in all physical performance markers occurred within 24 h.
CONCLUSIONS: In tennis, match-related fatigue is characterised by impaired repeated-sprint ability, explosive power and leg stiffness at midmatch and postmatch, with values restored to prematch baseline 24 h into recovery. In addition, physical performance responses (match and recovery kinetics) are identical when competing in cool and hot environments.

Improving the recovery capabilities of the tennis athlete is receiving more emphasis in the research communities, and also by practitioners (coaches, physical trainers, tennis performance specialists, physical therapists, etc). The purpose of this article was to review areas of recovery to limit the severity of fatigue and/or speed recovery from fatigue. This review will cover four broad recovery techniques commonly used in tennis with the belief that the interventions may improve athlete recovery and therefore improve adaptation and future performance. The four areas covered are: (1) temperature-based interventions, (2) compressive clothing, (3) electronic interventions and (4) nutritional interventions.

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