Kouki Fukuhara

Background: In exercise testing, the ventilatory threshold 1 (VT1) and ventilatory threshold 2 (VT2) are used in lifestyle-related diseases, cardiac rehabilitation, and athletic training. We investigated a VT2 measuring method using a pulse oximeter. Methods: Thirty-four adults (men: 15; women: 19) performed a bicycle ergometer Ramp Test. VT1 values were determined using expiratory gas data. The bifurcation of the curve obtained by designating the pulse rate (PR) as an independent variable and SpO₂/PR as a dependent variable was calculated using the residual sum of squares and defined as the SpO₂ threshold (ST) (SpO₂-Slope method). A second bifurcation with ST as the origin was further defined (ST2). ST2 validity was assessed by comparing and analyzing the differences and correlations with each VT2 obtained by expiratory gas analysis. Results: The correlation between ST2 determined by the SpO₂-Slope method using PR as an index and VT2 obtained from respiratory gas analysis was significant, showing a positive correlation (r = 0.74~0.92; p < 0.01), with most data points falling within the 1.96 ± SD in the Bland–Altman analysis. Conclusions: ST2 values derived from SpO₂ and pulse rate measurements by pulse oximeter may be a valuable VT2 measuring method.

Background: Foot malalignment can augment the risk of lower-extremity injuries and lead to musculoskeletal disorders. This study aimed to clarify the contribution of rearfoot alignment to plantar pressure distribution and spatiotemporal parameters during gait in healthy adolescent athletes. Methods: This retrospective study included 39 adolescent athletes who were divided into the rearfoot eversion and control groups according to a leg heel angle of 7°. A total of 78 legs were analyzed (45 and 33 legs in the rearfoot eversion [women, 53.3%] and control groups [women, 48.5%], respectively). Gait was assessed using an in-shoe plantar pressure measuring system and a wearable inertial sensor. Results: The foot plantar pressure distribution in the hallux was higher in the rearfoot eversion group than that in the control group (p = 0.034). Spatiotemporal parameters showed that the foot pitch angle at heel strike was significantly larger in the rearfoot eversion group than that in the control group (24.5° vs. 21.7°; p = 0.015). Total sagittal range of motion of the ankle during the stance phase of gait was significantly larger in the rearfoot eversion group than that in the control group (102.5 ± 7.1° vs. 95.6 ± 15.8°; p = 0.020). Logistic regression analysis revealed that plantar pressure at the hallux and medial heel and foot pitch angle at heel strike were significantly associated with rearfoot eversion. Conclusions: Our findings suggest that rearfoot eversion affects the gait patterns of adolescent athletes. Notably, leg heel angle assessment, which is a simple and quick procedure, should be considered as an alternative screening tool for estimating plantar pressure and spatiotemporal gait parameters to prevent sports-related and overuse injuries in adolescent athletes.

We assessed whether the coronavirus disease 2019 (COVID-19) pandemic-related disruptions impacted the physical fitness of adolescent athletes. We reviewed the age-, sex-, and sports category-matched data of 78 adolescent athletes (divided into two groups: 2019 group = 37; 2020 group = 41) from the clinical database and investigated their height, weight, body composition, flexibility muscle strength, and jump height. We also provided questionnaires to the teams’ coaches to collect data on the duration of practice suspension due to the COVID-19 pandemic; the practice hours per week in August 2019, immediately after the suspension ended, and in August 2020; and the guidelines for the players after resuming their practice. For data analyses, we considered p ≤ 0.05 as statistically significant. The strength of knee flexion and extension was significantly lower in the 2020 group than in the 2019 group; there was no difference in the other physical fitness parameters. The practice duration in August 2019 and August 2020 was the same. COVID-19-related interruptions did not alter the athletes’ jump height, upper-limb strength, and flexibility but reduced lower-limb muscle strength. We recommend that basic strength training protocols be followed to prevent sports-related injuries after such unexpected practice interruptions.

Background: Persons with an amputation may have an increased heat strain due to reduced surface area. However, there is limited evidence on the thermoregulatory responses in persons with lower-limb amputation (LLA). Although a previous study reported no difference in their rectal temperatures (Tres) in a hot environment, suggesting compensatory sweating of the intact limb, we examined the thermoregulatory responses of such persons in a hot and humid environment. Objective: To compare the thermoregulatory responses―through changes in Tre, sweat, and oxygen uptake (O₂)―between persons with LLA and able-bodied (AB) individuals, in hot and humid environments. Study design: A nonrandomized control trial. Methods: Nine AB men (AB group) and nine persons with LLA group performed the arm ergometer exercise at 60% peak power output intensity for 60 min in a hot and humid environment, and they were tested before and after performing. The O₂, Tre and skin temperature, and total body sweating, and local sweating during exercise were measured and compared between the groups. Results: The changes in O₂ and Tre after the endurance exercise did not differ between the groups (ΔTre: AB group, 1.1°C ± 0.5°C; LLA group, 1.2°C ±0.3 °C; P = 0.65), whereas the amount of local sweating of the chest (group effect, P < 0.01 by two-way analysis of variance [group × time], the group effect size was medium, η² = 0.10) and dehydration rate (AB group, 1.5% ± 0.5%; LLA group, 2.1% ± 0.5%; P = 0.03) were higher in the LLA than in the AB group. Conclusions: We compared the thermoregulatory responses of persons with LLA with those of AB individuals in hot and humid environments. Core body temperatures of persons with LLAs during endurance exercise were not different from those of AB men even in hot and humid environments. We found compensatory increases in the sweat rate of the chest and increased dehydration rate in persons with LLA. More sweat potentially means that athletes with LLA need to drink more fulids.

Decreased muscle-to-fat mass ratio (MFR) is associated with pediatric nonalcoholic fatty liver disease (NAFLD) and may reduce muscular fitness. Regular exercise in sports clubs has not led to reductions in obesity in children and adolescents; they may have decreased MFR. Decreased MFR could cause reduced muscular fitness, which may put them at risk for NAFLD development. We investigated whether MFR is related to muscular fitness and serum alanine aminotransferase (ALT), to determine whether MFR could be used to screen for NAFLD in children and adolescent boys belonging to sports clubs. Altogether, 113 participants (aged 7–17 years) who underwent body composition, laboratory, and muscular fitness measurements during a medical checkup were divided into tertiles according to their MFR. Lower extremity muscular fitness values were significantly decreased in the lowest MFR tertile (p < 0.001); conversely, serum ALT levels were significantly increased (p < 0.01). Decreased MFR significantly increased the risk of elevated ALT, which requires screening for NAFLD, after adjusting for age, obesity, muscular fitness parameters, and metabolic risk factors (odds ratio = 8.53, 95% confidence interval = 1.60–45.6, p = 0.012). Physical fitness and body composition assessments, focusing on MFR, can be useful in improving performance and screening for NAFLD in children and adolescents exercising in sports clubs.