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There is a significant risk of injury in sports and intense competition due to the demanding physical and psychological requirements. Hamstring strain injuries (HSIs) are the most prevalent type of injury among professional soccer players and are the leading cause of missed days in the sport. These injuries stem from a combination of factors, making it challenging to pinpoint the most crucial risk factors and their interactions, let alone find effective prevention strategies. Recently, there has been growing recognition of the potential of tools provided by artificial intelligence (AI). However, current studies primarily concentrate on enhancing the performance of complex machine learning models, often overlooking their explanatory capabilities. Consequently, medical teams have difficulty interpreting these models and are hesitant to trust them fully. In light of this, there is an increasing need for advanced injury detection and prediction models that can aid doctors in diagnosing or detecting injuries earlier and with greater accuracy. Accordingly, this study aims to identify the biomarkers of muscle injuries in professional soccer players through biomechanical analysis, employing several ML algorithms such as decision tree (DT) methods, discriminant methods, logistic regression, naive Bayes, support vector machine (SVM), K-nearest neighbor (KNN), ensemble methods, boosted and bagged trees, artificial neural networks (ANNs), and XGBoost. In particular, XGBoost is also used to obtain the most important features. The findings highlight that the variables that most effectively differentiate the groups and could serve as reliable predictors for injury prevention are the maximum muscle strength of the hamstrings and the stiffness of the same muscle. With regard to the 35 techniques employed, a precision of up to 78% was achieved with XGBoost, indicating that by considering scientific evidence, suggestions based on various data sources, and expert opinions, it is possible to attain good precision, thus enhancing the reliability of the results for doctors and trainers. Furthermore, the obtained results strongly align with the existing literature, although further specific studies about this sport are necessary to draw a definitive conclusion.

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The strength of cardiorespiratory interactions diminishes with age. Physical exercise can reduce the rate of this trend. Inspiratory muscle training (IMT) is a technique capable of improving cardiorespiratory interactions. This study evaluates the effect of IMT on cardiorespiratory coupling in amateur cyclists. Thirty male young healthy cyclists underwent a sham IMT of very low intensity (SHAM, n = 9), an IMT of moderate intensity at 60% of the maximal inspiratory pressure (MIP60, n = 10) and an IMT of high intensity at the critical inspiratory pressure (CIP, n = 11). Electrocardiogram, non-invasive arterial pressure, and thoracic respiratory movement (RM) were recorded before (PRE) and after (POST) training at rest in supine position (REST) and during active standing (STAND). The beat-to-beat series of heart period (HP) and systolic arterial pressure (SAP) were analyzed with the RM signal via a traditional non-causal approach, such as squared coherence function, and via a causal model-based transfer entropy (TE) approach. Cardiorespiratory coupling was quantified via the HP-RM squared coherence at the respiratory rate (K 2 HP-R M), the unconditioned TE from RM to HP (TER M → HP) and the TE from RM to HP conditioned on SAP (TER M → HP| SAP). In PRE condition we found that STAND led to a decrease of TER M → HP| SAP. After SHAM and CIP training this tendency was confirmed, while MIP60 inverted it by empowering cardiorespiratory coupling. This behavior was observed in presence of unvaried SAP mean and with usual responses of the baroreflex control and HP mean to STAND. TER M → HP and K 2 HP- RM were not able to detect the post-training increase of cardiorespiratory coupling strength during STAND, thus suggesting that conditioning out SAP is important for the assessment of cardiorespiratory interactions. Since the usual response of HP mean, SAP mean and baroreflex sensitivity to postural stressor were observed after MIP60 training, we conclude that the post-training increase of cardiorespiratory coupling during STAND in MIP60 group might be the genuine effect of some rearrangements at the level of central respiratory network and its interactions with sympathetic drive and vagal activity.

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Chronic effects of inspiratory muscle training (IMT) on autonomic function and baroreflex regulation are poorly studied. This study aims at evaluating chronic effects of different IMT intensities on cardiovascular control in amateur cyclists. A longitudinal, randomized, controlled blind study was performed on 30 recreational male cyclists undergoing IMT for 11 wk. Participants were randomly allocated into sham-trained group (SHAM, n = 9), trained group at 60% of the maximal inspiratory pressure (MIP60, n = 10), and trained group at critical inspiratory pressure (CIP, n = 11). Electrocardiogram, finger arterial pressure, and respiratory movements were recorded before (PRE) and after (POST) training at rest in supine position (REST) and during active standing (STAND). From the beat-to-beat series of heart period (HP) and systolic arterial pressure (SAP), we computed time domain markers, frequency domain indexes in the low frequency (0.04-0.15 Hz) and high frequency (HF, 0.15-0.4 Hz) bands, an entropy-based complexity index (CI), and baroreflex markers estimated from spontaneous HP-SAP sequences. Compared with SHAM, the positive effect of MIP60 over the HP series led to the HF power increase during REST (PRE: 521.2 ± 447.5 ms2; POST: 1,161 ± 878.9 ms2) and the CI rise during STAND (PRE: 0.82 ± 0.18; POST: 0.97 ± 0.13). Conversely, the negative effect of CIP took the form of the decreased HP mean during STAND (PRE: 791 ± 71 ms; POST: 737 ± 95 ms). No effect of IMT was visible over SAP and baroreflex markers. These findings suggest that moderate-intensity IMT might be beneficial when the goal is to limit cardiac sympathetic hyperactivity at REST and/or in response to STAND.

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BACKGROUND: Neutrophil gelatinase-associated lipocalin (NGAL) is a glycoprotein released during early phases of a postischemic kidney in response to kidney injury, inflammation, and oxidative stress. It can be detected in urine after 2 hours of an ischemic event. The aim was to measure and to correlate the level of urine NGAL (uNGAL) with urea, creatinine, and glomerular filtration rate (GFR) of endurance cycling athletes (n = 19) and physically active individuals (control, n = 17). METHODS: Quantification of urea and creatinine were performed by dry chemical method, and GFR was calculated using the modification of diet in renal disease formula, according to Brazilian Society of Nephrology. uNGAL analyses were performed by enzyme linked immunoabsorbent assay. Analyses were performed 48 hours after exercises. RESULTS: uNGAL (in ng/mL) levels, expressed as median, minimum, and maximum, in cyclist group, 387.7 (109.7-1691.0), was significantly higher than that observed in control (physically active) group, 141.5 (4.8-657.0), (P < .05). No significant correlations were observed between uNGAL and creatinine, urea, or GFR (P > .05). CONCLUSIONS: Results have pointed to increased uNGAL levels in endurance cycling athletes. Increase of uNGAL in absence of clinical signs or alterations in creatinine, urea, or GFR might suggest that there is metabolic adaptation to endurance exercise, or possibly predisposition to acute kidney injury over time.

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Abstract The aim of this study was to compare the maximum oxygen consumption (VO2max) between road cyclists with and without risk for eating disorders. The sample was composed of 43 cyclists aged 18-25 years, participants of the road cycling championship of the State of Pernambuco. VO2max was measured by a computerized metabolic analyzer during an incremental test in cycleergometer. The initial test load was 50 W, with increments of 25 W every minute until volitional exhaustion or inability to maintain the current load. To evaluate disordered eating behaviors (DEB), the Eating Attitudes Test was used (EAT-26). Univariate analysis of covariance (ANCOVA) was used to compare the VO2max between cyclists with (EAT-26 ≥ 21) and without (EAT-26 < 21) risk for eating disorders. The findings showed statistically significant VO2max difference between cyclists with and without risk to eating disorders (F (2,41)=28.44; p=0.01), indicating moderate effect size (d = 0.6). It was concluded that DEB was related to cyclists with lower VO2max.

Resumo O objetivo da pesquisa foi comparar o consumo máximo de oxigênio (VO2máx) entre ciclistas de estrada com e sem risco para o desencadeamento de transtornos alimentares. A amostra foi composta por 43 ciclistas com idade entre 18 e 25 anos, participantes do campeonato pernambucano de ciclismo de estrada. O VO2máx foi mensurado por um analisador metabólico computadorizado no decorrer de um teste incremental realizado em cicloergômetro. A carga inicial do teste foi 50 W, com incrementos de 25 W a cada minuto até atingir a exaustão voluntária ou impossibilidade de manter a carga atual. Para avaliar os comportamentos de risco para os transtornos alimentares (CRTA) foi utilizado o Eating Attitudes Test (EAT-26). Conduziu-se a análise univariada de covariância (ANCOVA) para comparar o VO2máx entre ciclistas com (EAT-26≥21) e sem riscos (EAT-26<21) para os transtornos alimentares. Os achados revelaram diferença estatisticamente significante do VO2máx entre ciclistas com e sem risco para os transtornos alimentares (F(2,41)=28,44; p=0,01), indicando moderado tamanho do efeito (d=0,6). Concluiu-se que os CRTA estiveram relacionados aos ciclistas com menor VO2máx.

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Muchas veces se interpreta que entre los odontólogos y los deportistas media sólo un protector bucal. Hoy se considera que la odontología es tan importante como la nutrición y la psicología, las cuales integran el equipo médico de entidades deportivas, sobre todo en los ámbitos de alto rendimiento y profesionalismo. La odontología que se practica a los deportistas no difiere de la que se presta a cualquier otro paciente. Las prácticas odontológicas dependen, en todo caso, de las características propias de esa población, las que determinan una atención diferenciada o adaptada. Nuestra tarea abarca la prevención, el diagnóstico y el tratamiento de las distintas patologías y lesiones. La actuación en el área de la atención primaria de la salud nos conecta con deportistas, lo cual aporta experiencias que guían nuestras acciones. En cuanto a los protectores bucales, necesarios en los deportes de contacto, existen diferentes tipos, espesores y características que se adaptan al deporte en cuestión y a la edad de quien lo practica; y también existen diferentes procedimientos para su confección. Por todo esto, debemos apuntar a que los pacientes acudan a nosotros, en lugar de adquirir directamente en los comercios los dispositivos que pueden no ser apropiados.

Many times, it is believed that a mouthguard is all thatseparates athletes from dentists. Dentistry is nowadays consideredto play an important role in medical support of high performance sport teams as well as nutrition or psychologyand more so in professional practice. Dental care providedto athletes is obviously not different from that performed inregular patients.The difference is given by the distinctive features presentedby them, which will require treatment adapted to their specialneeds. As dentists, we also know that our work includesprevention, diagnosis and subsequent treatment of differentlesions and pathologies. Since our field of action is withinprimary health care, an initial consultation with the athletewill provide the information that will guide our counseling, treatment, and regular controls. Regarding physical contact sports where a mouthguard might be indicated, differenttypes, thicknesses and materials are available as well as different processing techniques. All of these possibilities can beused to motivate athletes for dental consultation leading themto avoid standard devices that are sold in sport stores.

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BACKGROUND AND OBJECTIVE: Early sport practice prevents development of diseases in children/adolescents, but still unclear its effect over health in adulthood. Therefore, the purpose of this study was to analyze the association between sport practice in early life and chronic diseases in adulthood. MATERIALS AND METHODS: A retrospective population-based survey carried out in eight Brazilian cities with adults of both genders. Throughout a multistage random process 2720 adults (1096 male and 1624 female) were selected and interviewed. Type 2 diabetes mellitus and arterial hypertension were assessed in a face-to-face interview through a self-report, which was necessarily based on previous medical diagnosis. Early sport practice was assessed in childhood (7-10 years old) and adolescence (11-17 years old). Current physical activity and body mass index were assessed in adulthood throughout a face-to-face interview. RESULTS: Type 2 diabetes mellitus and arterial hypertension were identified in 8.1% (95% CI, 7.1-9.2) and 23.5% (95% CI, 21.9-25.1) of the sample, respectively. Early sport practice during childhood and adolescence was associated with lower occurrence of arterial hypertension (OR, 0.49; 95% CI, 0.33-0.73) and type 2 diabetes (OR, 0.46; 95% CI, 0.24-0.88) in adulthood. CONCLUSIONS: Independently of obesity and current physical activity, early sport practice in early life was positively associated with lower occurrence of chronic diseases in adulthood.

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A acupuntura vem se destacando cada vez mais como técnica de diagnóstico e tratamento na medicina esportiva equina. O fato de ser uma técnica não invasiva, de baixo custo, que proporciona boa analgesia e eventualmente melhora de performance, a coloca como uma das técnicas mais promissoras dentro da medicina esportiva equina. Além disso, o número de profissionais interessados, instituições de ensino e pesquisas vem crescendo de forma significativa, o que favorece ainda mais o seu desenvolvimento e aplicabilidade dentro da área de medicina equina. O objetivo desta revisão é discutir o uso da acupuntura na medicina esportiva equina como mais uma ferramenta terapêutica e propedêutica que visa melhorar o desempenho dos animais atletas.

The equine acupuncture has been highlighted even more as diagnostic and treatment technique inthe equine sport medicine. The fact of been a non invasive technique, of low cost, with good analgesia and evenperformance improvement has bring it as one of the most promising technique in equine medicine and rehabilitation ..Despite this, the number of interested professionals, schools and research has increased in a significant way,which helps more the development and applicability into the equine medicine. The objective of this revision is to discuss the use of Acupuncture in the equine sport medicine as one more therapeutic and propaedeutic tool,which aim is to improve the performance of the athletic animais.

La acupuntura ha ido aumentando cada vez más como el diagnóstico y el tratamiento técnico en medicina deportiva equina. AI ser una técnica no invasiva, de bajo coste, proporcionando una buena analgesia y,finalmente, mejora el rendimiento, Ia lista como una de Ias técnicas más prometedoras en medicina deportivaequina. Por otra parte, el número de profesionales interesados, instituciones educativas y de investigación haaumentado de manera significativa, 10que favorece aún más su desarrollo y aplicación en el área de Ia medicinaequina. EI objetivo de esta revisión es discutir el uso de Ia acupuntura en Ia medicina deportiva equina como una herramienta terapéutica y pedagógica que tiene como objetivo mejorar los atletas de rendimiento animal.

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A acupuntura vem se destacando cada vez mais como técnica de diagnóstico e tratamento na medicina esportiva equina. O fato de ser uma técnica não invasiva, de baixo custo, que proporciona boa analgesia e eventualmente melhora de performance, a coloca como uma das técnicas mais promissoras dentro da medicina esportiva equina. Além disso, o número de profissionais interessados, instituições de ensino e pesquisas vem crescendo de forma significativa, o que favorece ainda mais o seu desenvolvimento e aplicabilidade dentro da área de medicina equina. O objetivo desta revisão é discutir o uso da acupuntura na medicina esportiva equina como mais uma ferramenta terapêutica e propedêutica que visa melhorar o desempenho dos animais atletas. (AU)

The equine acupuncture has been highlighted even more as diagnostic and treatment technique inthe equine sport medicine. The fact of been a non invasive technique, of low cost, with good analgesia and evenperformance improvement has bring it as one of the most promising technique in equine medicine and rehabilitation ..Despite this, the number of interested professionals, schools and research has increased in a significant way,which helps more the development and applicability into the equine medicine. The objective of this revision is to discuss the use of Acupuncture in the equine sport medicine as one more therapeutic and propaedeutic tool,which aim is to improve the performance of the athletic animais.(AU)

La acupuntura ha ido aumentando cada vez más como el diagnóstico y el tratamiento técnico en medicina deportiva equina. AI ser una técnica no invasiva, de bajo coste, proporcionando una buena analgesia y,finalmente, mejora el rendimiento, Ia lista como una de Ias técnicas más prometedoras en medicina deportivaequina. Por otra parte, el número de profesionales interesados, instituciones educativas y de investigación haaumentado de manera significativa, 10que favorece aún más su desarrollo y aplicación en el área de Ia medicinaequina. EI objetivo de esta revisión es discutir el uso de Ia acupuntura en Ia medicina deportiva equina como una herramienta terapéutica y pedagógica que tiene como objetivo mejorar los atletas de rendimiento animal.(AU)

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OBJETIVO: Avaliar as técnicas de banda dupla e banda simples para reconstrução anatômica do ligamento cruzado anterior do joelho e comprovar que a técnica de dupla banda, além de fornecer maior estabilidade anterior, também causa menor dor e uma melhor resposta subjetiva do paciente. MÉTODOS: Selecionamos 42 pacientes que foram submetidos à reconstrução do LCA, conforme a técnica de reconstrução anatômica por banda simples com enxerto de tendões flexores com dois túneis ou reconstrução anatômica por banda dupla e quatro túneis com enxerto de tendões dos músculos semitendíneo e gracilis. Todas as fixações foram realizadas com parafusos de interferência. Não houve variação na amostra, avaliou-se no pré-operatório IKDC objetivo, subjetivo, Lysholm e tempo de lesão. Reavaliou-se após seis meses todas as variáveis anteriormente citadas, incluindo o KT-1000 correlacionando o joelho contralateral. RESULTADOS: Não houve diferença significativa entre os dois grupos nas avaliações subjetivas, mas na amplitude de movimento, nas avaliações objetivas, incluindo o KT-1000 (com significância estatística), o grupo da banda simples anatômica obteve melhores resultados. CONCLUSÃO: Nosso estudo demonstra que não obtivemos diferença entre os dois grupos nas avaliações subjetivas, porém nas avaliações objetivas observamos melhores resultados na técnica por banda simples anatômica.

OBJECTIVE: To evaluate the double-band and single-band techniques for anatomical reconstruction of the anterior cruciate ligament of the knee and demonstrate that the double-band technique not only provides greater anterior stability but also causes less pain and a better subjective patient response. METHODS: We selected 42 patients who underwent anterior cruciate ligament reconstruction, by means of either the single-band anatomical reconstruction technique, using flexor tendon grafts with two tunnels, or the double-band anatomical reconstruction technique, using four tunnels and grafts from the semitendinosus and gracilis tendons. All fixations were performed using interference screws. There was no variation in the sample. Before the operation, the objective and subjective IKDC scores, Lysholm score and length of time with the injury were evaluated. All these variables were reassessed six months later, and the KT-1000 correlation with the contralateral knee was also evaluated. RESULTS: There was no significant difference between the two groups in subjective evaluations, but the single-band group showed better results in relation to range of motion and objective evaluations including KT-1000 (with statistical significance). CONCLUSION: Our study demonstrated that there was no difference between the two groups in subjective evaluations, but better results were found using the single-band anatomical technique, in relation to objective evaluations.

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OBJECTIVE: To evaluate the double-band and single-band techniques for anatomical reconstruction of the anterior cruciate ligament of the knee and demonstrate that the double-band technique not only provides greater anterior stability but also causes less pain and a better subjective patient response. METHODS: We selected 42 patients who underwent anterior cruciate ligament reconstruction, by means of either the single-band anatomical reconstruction technique, using flexor tendon grafts with two tunnels, or the double-band anatomical reconstruction technique, using four tunnels and grafts from the semitendinosus and gracilis tendons. All fixations were performed using interference screws. There was no variation in the sample. Before the operation, the objective and subjective IKDC scores, Lysholm score and length of time with the injury were evaluated. All these variables were reassessed six months later, and the KT-1000 correlation with the contralateral knee was also evaluated. RESULTS: There was no significant difference between the two groups in subjective evaluations, but the single-band group showed better results in relation to range of motion and objective evaluations including KT-1000 (with statistical significance). CONCLUSION: Our study demonstrated that there was no difference between the two groups in subjective evaluations, but better results were found using the single-band anatomical technique, in relation to objective evaluations.

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INTRODUÇÃO E OBJETIVOS: Vários autores têm investigado a incidência de lesões no futebol, poucos têm-se preocupado com o tempo de afastamento dos atletas ou com os prejuízos financeiros oriundos de tal situação. O objetivo deste estudo foi confrontar, através de um estudo de coorte histórico, o tempo total de afastamento de atletas lesionados com as variáveis: idade, posição dos jogadores e tipo de lesão. MÉTODOS: Foram analisados os jogadores de futebol profissional do Marília Atlético Clube que atuaram no Campeonato Brasileiro de Futebol - Série B, de 2003 a 2005. As informações foram coletadas através do acesso direto aos prontuários médicos e protocolo de coleta de dados, com um período de seguimento de 24 meses, sendo, posteriormente, realizada a análise estatística. RESULTADOS: A idade dos jogadores variou de 18 a 35 anos (24,5 ± 4,4); os jogadores mais freqüentemente lesionados foram: atacantes (36,8 por cento), zagueiros (26,6 por cento), meias (20 por cento), laterais (10 por cento) e goleiros (6,6 por cento); as lesões mais comuns foram: musculares (46,8 por cento), ligamentares (26,6 por cento), ósseas (16,6 por cento) e meniscais (10 por cento); o tempo de afastamento nos atacantes variou de 10 a 240 dias (28 ± 78,3), nos zagueiros de 20 a 120 dias (26,5 ± 33,9), nos meias de 10 a 180 dias (18,5 ± 66,3), nos laterais de 13 a 240 dias (17 ± 129,9) e nos goleiros de 35 a 60 dias (47,5 ± 17,6). CONCLUSÃO: A análise estatística mostrou não haver correlação entre a idade dos jogadores e o tempo total de afastamento dos mesmos (p = 0,31), não houve diferença significativa entre o tempo de afastamento nas diferentes posições dos jogadores dentro de campo (p = 0,49), houve diferença significativa entre o tempo total de afastamento e os diferentes tipos de lesão (p < 0,001) entre as variáveis: lesões meniscais e ósseas, lesões meniscais e musculares, lesões ligamentares e ósseas e, finalmente, lesões ligamentares e/ musculares.

INTRODUCTION AND OBJECTIVES: several authors have investigated the incidence of injuries occurred in outdoor soccer games. However, just a few are concerned about the athletes' healing period or the financial damage due to this no-activity period. The purpose of this study was to assess, through a cohort study, the injured athletes' recovery period, facing it to the variables: age, position in game and injure pattern. METHODS: The medical reports of all professional soccer players of Marília Atlético Clube who were injured during the Brazilian Soccer Championship - 2nd Division, from January/2003 to December/2005 were assessed, with a 24 months follow-up. RESULTS: Athletes' mean age (SD) was 24.5 years (4.4 years); the most frequently injured athletes were: strikers (36.8), center-backs (26.6 percent), center-midfielders (20 percent), side-midfielders (10 percent) and goalkeepers (6.6 percent). The most frequent injuries were: muscular (46.8 percent), ligament (26.6 percent), bone (16.6 percent) and meniscal (10 percent); the strikers have shown a mean recovery period of 28 days (78.3 days), the center-backs 26.5 days (33.9), the center-midfielders 18.5 days (66.3), the side-midfielders 17 days (129.9) and the goalkeepers 47.5 days (17.6). CONCLUSION: Statistical analysis showed that there was no correlation between athletes' age and their healing period (p/ =/ 0.31); there was no statistical difference between the healing period among the five different athletes' positions (p/ =/ 0.49); there was statistical difference between the healing period and the injury pattern (p/

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