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This review aims to synthesize current knowledge on the incidence, characteristics and management of wounds and injuries among professional ice hockey athletes, with the specific focus on the emerging population of Chinese female players. An extensive literature search was conducted across several databases to gather data on injury patterns and wounds, causes, severity and prevention strategies in ice hockey. Special attention was given to studies involving female athletes and unique challenges faced by players in developing regions like China. The review also examined the impact of training modalities, protective equipment and medical interventions on injury rates. The findings reveal a significant seasonal fluctuation in wound incidence, with marked reduction following the preseason period. This trend underscores the effectiveness of adjusted training programmes and essential role of medical teams in injury prevention and rehabilitation. Analysis did not show significant difference in wound rates between technical and physical training sessions, suggesting that injuries are pervasive risk across all training activities. Skating, collisions and inadequate warm-ups were identified as the leading causes of wounds, highlighting areas for targeted preventive measures. The distribution of wounds across various body regions pointed to knee, lower back and wrist as the most vulnerable sites, necessitating focused protection and training adjustments. Ice hockey, particularly among female athletes in China, presents complex injury landscape characterized by the wide range of wounds. The study emphasizes the necessity of comprehensive, multidisciplinary approach to injury prevention that includes training modifications, enhanced protective gear and strategic medical oversight. By addressing the specific causes and patterns of injuries identified, stakeholders can better protect athletes from the inherent risks of the sport, promote safer play and extend career longevity.

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Poor supervision, impaired exercise adherence, and low compliance with exercise regimens result in inconsistent effects regarding exercise interventions. A supervised-walk training regimen (9 km/week) may have a positive effect on functional recovery in female total knee arthroplasty (TKA). This study aimed to evaluate the effect of a supervised walking regimen on lower limb muscle strength, functional fitness, and patient-reported outcomes in female TKA. Twenty-eight female TKA were allocated into a control (CON) (n = 14) or walk training (WT) (n = 14) group. WT on treadmills was initiated 12 weeks after TKA. All patients were examined for lower muscle strength (including extension and flexion of hip and knee), physical function (including a 6-min walk test, 8-foot up-and-go test, and 30-s chair stand test), and Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire. Knee flexor (WT: CON; 64.4 ± 4.1 nm/kg: 43.7±3.3 nm/kg; p = 0.001; effect size: 5.62) and extensor strengths (WT: CON; 73.1 ± 7.5 nm/kg: 48.2 ± 2.4 nm/kg; p = 0.001; effect size: 4.47) statistically increased in the WT group compared to the CON group. The 6-min walk test (from 341.3 ± 20.5 m to 405.5 ± 30.7 m; p = 0.001; effect size: 2.46) and 8-foot up-and-go test (from 9.5 ± 0.7 s to 8.3 ± 0.7 s; p = 0.002; effect size: 1.71) tests also showed significant improvements in the WT group in the follow-up compared to the baseline. An increase in quality of life score according to the KOOS questionnaire (WT: CON; 91.0 ± 2.8: 68.1 ± 5.8; p = 0.001; effect size: 5.02) was noted in the WT group compared to the CON group in the follow-up. WT facilitated improvements in knee muscle strength and functional outcomes in TKA patients.

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OBJECTIVES: The primary objective was to compare hip and knee isometric muscle strength between individuals with a first-time acute lateral ankle sprain and controls. A secondary objective was to investigate hip and knee isometric muscle strength three months post-injury. DESIGN: Cross-sectional and prospective follow-up components. SETTING: Laboratory environment. PARTICIPANTS: Forty-two participants (21 acute lateral ankle sprain and 21 controls) matched for age, sex, physical activity and leg dominance participated. MAIN OUTCOME MEASURES: Hip and knee isometric muscle torque was assessed using a rigidly fixated hand-held dynamometer. Testing in acute lateral ankle sprain participants was performed within four weeks of injury and three months post-injury. Controls were tested at one timepoint. RESULTS: There were no differences in hip or knee isometric muscle torque between acute lateral ankle sprain and control participants (mean differences <0.08). Hip and knee isometric muscle torque in acute ankle sprain participants did not differ between baseline and three months post-injury testing (mean difference <0.06). CONCLUSIONS: Proximal lower limb isometric strength is not impaired within the first three months of sustaining a first-time lateral ankle sprain injury. This implies that hip and knee isometric strength deficits in individuals with CAI may occur at some later stage.

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BACKGROUND: A few studies have reported on how to predict increased dynamic knee valgus angle (KVA), a risk factor for second anterior cruciate ligament (ACL) injury after ACL reconstruction. This study aimed to identify the factors with the potential to predict the KVA during single-leg hop landing. METHODS: Using three-dimensional motion analysis systems, knee motion during a single-leg hop landing task was measured in 22 patients who had undergone ACL reconstruction at 8-10 months postoperatively. The KVA at initial contact (IC) and maximum KVA during the 40-ms period after IC were calculated using the point cluster technique; correlations between the KVA and other factors were assessed. We performed multiple regression analysis to determine whether KVA could be predicted by these parameters. RESULTS: The KVA was significantly negatively correlated with the static femorotibial angle (FTA; P < 0.01) and patient height (P < 0.01). It was positively correlated with the body mass index (P < 0.05). Multiple regression analysis showed that a small FTA could predict the KVA at IC (ß: 0.52, 95% confidence interval (CI): 2.24-(-0.42); P < 0.01). The maximum KVA during the 40-ms period after IC was associated with the FTA (ß: 0.46, 95% CI: 2.22-(-0.26); P = 0.02) and height (ß: 0.40, 95% CI: 0.59-(-0.02); P = 0.04). CONCLUSION: At 8-10 months after ACL reconstruction, the KVA was significantly correlated with the FTA, with reduced FTA being associated with an increased dynamic KVA during single-leg hop landing. The measurement of anatomical parameters may aid in predicting the second ACL injury risk after reconstruction.

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BACKGROUND: Only limited data are available regarding postural stability between anterior cruciate ligament (ACL)-injured patients with medial meniscus (MM) tear and those with lateral meniscus (LM) tear. The purpose of this study was to compare preoperative postural stability for both involved and uninvolved knees in ACL rupture combined with MM and LM tears. It was hypothesized that there would be a significant difference in postural stability between these two groups. METHODS: Ninety-three ACL-injured patients (53 combined with MM tears vs. 40 combined with LM tears) were included. Static and dynamic postural stability were evaluated with the overall stability index (OSI), anterior-posterior stability index (APSI), and medial-lateral stability index (MLSI) using stabilometry. Knee muscle strength was evaluated using an isokinetic testing device. RESULTS: In the static postural stability test, none of the stability indices showed significant differences between the two groups for both knees (p > 0.05). In the dynamic postural stability test for involved side knees, the OSI and APSI were significantly higher in the LM tear group compared to the MM tear group (OSI: 2.0 ± 0.8 vs. 1.6 ± 0.5, p = 0.001; APSI: 1.5 ± 0.6 vs. 1.3 ± 0.5, p = 0.023), but not the MLSI (p > 0.05). In the static and dynamic postural stability tests in each group, there were no significant differences between the involved and uninvolved side knees (p > 0.05). There was no significant difference in the knee muscle strength between the two groups (p > 0.05). All postural stability showed no significant correlation with knee muscle strength (p > 0.05). CONCLUSION: Dynamic postural stability was poorer in patients with ACL rupture combined with LM tear than in those with MM tear. Therefore, close monitoring for postural stability would be necessary during preoperative and postoperative rehabilitation, especially for patients with ACL rupture combined with LM tear. LEVEL OF EVIDENCE: LEVEL III.

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Previous studies have found an inverse relation between serum concentrations of interleukin (IL)-6 and physical performance in seniors, however this was limited to higher functioning older adults with low to moderate levels of inflammation. We explored the consistency of this association in a cohort of mobility limited older adults with chronic low-grade inflammation. This study included 289 participants (≥ 70 years old) with IL-6 level between 2.5 and 30 pg/mL and a walking speed < 1.0 m/sec from the ENRGISE Pilot study. Physical performance was assessed using the short physical performance battery (SPPB), usual gait speed over 400 m, grip strength, and knee extensor and flexor strength measured by isokinetic dynamometry at 60 and 180°/sec. There was a significant inverse correlation between log IL-6 and knee extensor strength at 60°/sec (r= -0.20, p = 0.002), at 180°/sec (r = -0.14, p = 0.037), and knee flexor strength at 60°/sec (r = -0.15, p = 0.021). After adjustment for potential confounders, the values of knee extensor strength at 60°/sec showed a trend toward a progressive reduction across IL-6 tertiles as IL-6 levels increased (p = 0.024). No significant association was found between IL-6 and other objectively measured physical performance. The findings were generally of smaller magnitude and less consistent than previously reported, which suggests that the associations are attenuated in those with both elevated inflammation and mobility limitations. These results have implications for planning and interpreting future intervention studies in older adults with low-grade inflammation and mobility limitations.

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Objective The aim of this study is to compare the isokinetic knee muscles peak torque measurements and proprioception between the affected and intact limbs of patients with stroke, in addition to finding the correlation between knee muscles strength and lower limb function. Methods Twelve patients with stroke (mean age 64.33 ± 6.140 years), with 3 to 7 months poststroke who can walk 25 feet independently without using or using assistive devices and full passive range of motion were included in the study. Biodex isokinetic dynamometer was used for measuring isokinetic strength at 90°/s, 120°/s, and 150°/s and isometric strength at 60°/s in both flexors and extensors of the knee, whereas proprioception was measured at 45°/s knee flexion, all for affected and intact limbs. Functional measurements were assessed using the Fugl-Meyer Assessment for Lower Limb scale and Barthel Index (BI). Results The differences shown were found to be statistically significant between affected and intact limbs in isokinetic 90°/s flexion ( p = 0.005), extension ( p = 0.0013), and isometric at 60°/s flexion ( p < 0.0001) knee muscle strengths and also the proprioception ( p = 0.05). Significant positive correlation was found between isokinetic affected side knee flexion at 90°/s ( r = 0.903) with BI ( r = 0.704). Conclusion There is a significant difference in peak torque measurements between affected and normal lower limbs of poststroke patients, as well as a significant correlation between the knee strength and lower limb functions. Furthermore, it can also be concluded that the differences in knee proprioception between the affected and intact limbs were shown to be significant.

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Leg dominance has been reported as one potential risk factor for lower-limb injuries in recreational downhill skiers. The current study proposed and tested two possible mechanisms for a leg dominance effect on skiing injuries-imbalance of the knee muscle strength and bilateral asymmetry in sensorimotor control. We hypothesized that the knee muscle strength (Hypothesis 1; H1) or postural control (Hypothesis 2; H2) would be affected by leg dominance. Fifteen well-experienced recreational downhill skiers (aged 24.3 ± 3.2 years) participated in this study. Isometric knee flexor/extensor muscle strength was tested using a dynamometer. Postural control was explored by using a kinematic principal component analysis (PCA) to determine the coordination structure and control of three-dimensional unipedal balancing movements while wearing ski equipment on firm and soft standing surfaces. Only H2 was supported when balancing on the firm surface, revealing that when shifting body weight over the nondominant leg, skiers significantly changed the coordination structure (p < 0.006) and the control (p < 0.004) of the lifted-leg movements. Based on the current findings, bilateral asymmetry in sensorimotor control rather than asymmetry in strength seems a more likely mechanism for the previously reported effect of leg dominance on lower-limb injury risk in recreational downhill skiers.

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Objective To compare the knee function recovery at different times of returning to sport after anterior cruciate ligament reconstruction(ACLR) among elite athletes using knee isokinetic muscle strength test and various hop test.Methods Forty-one elite athletes(14 males,27 females,mean age 22.6 ± 4.1 years) undergoing ACLR between January 2013 and September 2014 were chosen from the database of the National Institute of Sports Medicine and Shanghai Huashan Hospital.Rehabilitation was performed using the same protocol by professional physiotherapists and trainers,who recorded the time of returning to sport of each athlete.One week prior to the scheduled return,bilateral knee isokinetic muscle strength test(test value:peak torque;angle velocity:60°/s,180°/s;motion:flexion,extension) and four hop tests(single hop for distance,side-to-side hop,up-down hop and 8 hop) were applied with the limb symmetry index(LSI) calculated.The athletes were then grouped by their returntime referring to surgery into the premature group(6～8 months),timely return group(9～12 months) and delayed group(over 12 months).The tests results were recorded and compared among the three groups.Results Fourteen athletes were selected into the premature group,with 19 in the timely group and 8 in the delayed group.The average LSI of 60°/s flexion peak torque of the premature group (87.4％ ± 7.5％) was significantly lower than the timely group(95.8％ ± 6.6％) and the delayed group(96.0％ ± 2.4％) (P＜0.01).Significant differences were observed between the premature group and delayed group regarding the 60° extension peak torque(85.8％ ± 9.4％ and 94.8％ ± 4.8％,P＜0.05),180°/s flexion peak torque(90.7％ ± 8.7％ and 101.4％ ± 6.8％,P＜0.05),and 180°/s extension peak torque (90.6％ ± 5.2％ and 97.8％ ± 5.6％,P＜0.05).The average LSL of the premature group at single hop for distance,side-to-side hop and up-down hop(93.A％ ± 8.5％,84.7％ ± 7.3％ and 112.5％ ± 5.7％) was significantly lower than that of the timely group(95.7％ ± 6.0％,104.2％ ± 4.3％ and 105.3％ ± 7.9％) and the delayed group regarding(98.1％ ± 1.9％,104.7％ ± 4.0％ and 106.3％ ± 7.4％) (P＜0.01 for all).The relative peak torque of 60°/s extension of the premature group(2.48 ± 0.58 Nm/kg) was significantly lower than the delayed group(3.21 ± 0.51 Nm/kg) (P＜0.01).Conclusions For elite athletes,returning to sport within 9 months after ACLR results in insufficient restoration of the knee function.Delayed return to sport doesn't improve the outcomes of hop tests,but can enhance the maximum extension torque peak,which needs further study.

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Physical therapists and osteopaths want to know the quantitative force transmitted in the tissues during resistance exercise and also the relationship between tissue strength and the specific type of resistance exercise of the skeletal muscles. This paper uses the strain energy function for large deformations associated with the active and passive response of transversely isotropic skeletal muscle tissue to evaluate muscle strength and force transmitted in tissues during resistance exercises for the quadriceps muscle at the knee during isometric training exercise at different knee angles in vivo. It is found that after an exercise program, the muscle stiffness is halved when the bending angle of the knee increases from 50° to 100°. The muscle strength generated is marginally greater at 100° than at 50°. The stress transmitted in the lateral direction for 100° bending is double that for 50°.

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[Purpose] From the viewpoint of prevention of knee osteoarthritis, the aim of this study was to verify how muscle strength and joint laxity are related to knee osteoarthritis. [Subjects and Methods] The study subjects consisted of 90 community-dwelling elderly people aged more than 60 years (22 males, 68 females). Femorotibial angle alignment, knee joint laxity, knee extensors and flexor muscle strengths were measured in all subjects. In addition, the subjects were divided into four groups based on the presence of laxity and knee joint deformation, and the muscle strength values were compared. [Results] There was no significant difference in knee extensor muscle strength among the four groups. However, there was significant weakness of the knee flexor muscle in the group with deformation and laxity was compared with the group without deformation and laxity. [Conclusion] Decreased knee flexor muscle strengths may be involved in knee joint deformation. The importance of muscle strength balance was also considered.

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To investigated whether an acute hypoxic stimulus affects muscle strength development assessed by isokinetic dynamometry during maximal knee extension. A total of 15 healthy young men participated in this study (61.9 ± 6.1 kg; 1.72 ± 0.08 m; 20.9 ± 2.6 years). We evaluated knee extension and flexion isokinetic dynamometer performance in normoxic and hypoxic conditions. The analyzed parameters, for concentric contraction, were peak torque and total work measured at 1.05 and 5.23 rad/s; and fatigue index measured at 5.23 rad/s. During isokinetic testing, heart rate and oxygen saturation (SpO2) were monitored. Hypoxic conditions (3,600 m) were simulated, via a mixing chamber, with the dilution being constantly controlled by a PO2 probe. Test reproducibility results (test-retest) for all isokinetic knee parameters were classified as moderate to almost perfect (ICC = 0.694 to 0.932). SpO2 was 88.4 ± 3.4% in the hypoxic condition and 97.1 ± 0.7% in the normoxic condition (p = 0.000, effect size = 0.87). Heart rate was not significantly different between normoxic and hypoxic conditions at the end of the test. There were no significant differences in isokinetic variables evaluated for the extensor and flexor muscles at concentric contraction between the normoxic and hypoxic conditions. Our findings indicate that reduced arterial oxygenation per se has no effect on the muscular isokinetic strength of the knee extensors.

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The purpose of this study was to clarify physical characteristics related to low back pain (LBP) in collegiate track and field athletes. We particularly focused on the nature of the track and field. The subjects were 21 male collegiate track and field athletes including only sprinters, hurdlers, long jumpers and triple jumpers. The examined parameters were physical characteristics, isokinetic flexor and extensor strength in the knee and trunk regions. The evaluation of LBP was estimated by a questionnaire test and orthopedic surgeons' diagnosis. According to these evaluations, we divided all track and field athletes into two groups ; LBP group (n＝11, 52.4%) and no LBP group (n＝10, 47.6%). As a result, a take-off leg of knee flexor/extensor strength ratio in the LBP group was significantly lower than that in the no LBP group (<i>P</i>＜0.05). The LBP group showed a significant difference between a take-off leg and a lead leg in knee flexor strength compared with the no LBP group (<i>P</i>＜0.05). The LBP group has been short engaged in the track and field than the no LBP group (<i>P</i>＜0.05). In the trunk flexor and extensor strength, there was no significant difference between the LBP and the no LBP group in this study. These results suggest that the imbalanced knee muscle strength may be one of some factors related to chronic low back pain in collegiate track and field athletes.