Kazuki Fujisaki

Background: Thoracic spine mobility is essential for optimal pitching mechanics and injury prevention in baseball players. While shoulder and hip range of motion (ROM) changes after pitching have been reported, there is a lack of evidence regarding immediate changes in thoracic spine ROM after pitching. Objective: To investigate the immediate effects of repetitive pitching on thoracic spine extension and rotation ROM in high school baseball players and to identify which assessment method is most sensitive to these changes. Design: Randomized controlled trial. Setting: High school baseball fields. Participants: Thirty‐four male high school baseball players were randomly assigned to a pitching group ( n = 17) or a control group ( n = 17). Players with prior elbow surgery or recent injuries were excluded. Interventions: The pitching group performed 100 maximum‐effort fastballs, and the control group rested for an equivalent duration. Main outcome measures: Thoracic kyphosis angle, upper and lower trunk extension ROM, total trunk extension ROM, and six thoracic mobility tests were assessed before and after the intervention. The primary outcome was dominant‐side thoracic rotation ROM measured by the side‐lying rotation test. Results: A significant group × time interaction was observed for dominant‐side rotation in the side‐lying rotation test ( p = .015). Post hoc analysis revealed a significant increase in ROM after pitching in the pitching group (mean difference [pre–post] = −3.4°; p = .004; 95% CI: −5.675 to −1.266). No statistically significant correlation was found between ball velocity and dominant‐side rotation ROM ( r = 0.454, p = .067), although a moderate‐to‐large effect size was observed. Conclusions: Repetitive pitching acutely increases thoracic rotation ROM toward the throwing side in high school baseball players, detectable by the side‐lying rotation test. This test may serve as a practical tool to monitor pitching‐induced mobility changes relevant to performance and injury prevention.

Background In health professions education, fostering proactive learning attitudes is essential, alongside acquiring knowledge and clinical skills. Team-based learning (TBL) has gained attention as a collaborative, learner-centered pedagogy that promotes student engagement and motivation. However, longitudinal evidence regarding its impact on behavioral learning outcomes remains limited. Objective This study aimed to evaluate the effects of TBL on active class attitudes and study time among physical therapy students, compared to regular lectures. Methods A total of 151 third-year students participated in a physical therapy course comprising four regular lectures, followed sequentially by four TBL sessions. Data were collected using questionnaires administered at three time points: before the regular lecture (T1), before the TBL session (T2), and after the TBL session (T3). Outcome measures included Active Class Attitude (ACA) scores and self-reported study time. Results ACA scores increased significantly after the TBL session compared to both T1 and T2. Study time for the target course and for other subjects also increased significantly after TBL. No significant differences were observed among grade point average groups. Conclusion TBL effectively promotes autonomous learning attitudes and enhances study habits, regardless of students’ academic performance. These findings support integrating TBL to foster behavioral engagement in health professions education.

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[Purpose] To clarify the effectiveness of the Copenhagen Adduction Exercise (CAE) for male high school soccer players based on groin pain prevalence and severity. [Participants and Methods] We divided the participants into 2 groups: 205 who performed the exercise (CAE group) and 194 who did not (non-CAE group). For groin pain prevalence, we calculated the injury rate (IR) by dividing the number of injury occurrences by 1,000 player-hours (1,000 ph), and for groin pain severity, we classified the players’ conditions into slight, minimal, mild, moderate, and severe cases. [Results] IR was 0.25/1,000 ph in the CAE group and 0.78/1,000 ph in the non-CAE group, revealing a risk ratio of 0.33. Furthermore, there were significant differences between the groups in the numbers of mild and severe cases. [Conclusion] CAE reduced IR by 30%. In terms of severity, for both minor (slight, minimal and mild) and major (moderate and severe) cases, the numbers were smaller in the CAE group. It was therefore suggested that CAE reduces the prevalence of groin pain overall without regard to its severity levels.

Background: Groin pain is frequently reported by soccer players. A prevention program incorporating the Copenhagen adduction exercise (CAE) has been shown effective in decreasing adductor muscle injury in semi-professional soccer players. However, the effect of such programs on groin pain in high school soccer players is unknown. No reports have examined the effects of combining the CAE with other targeted exercises such as the Nordic hamstrings exercise (NHE). Purpose: To evaluate the preventative effects of exercise on groin pain in high school soccer players in three groups comprising NHE alone, combined NHE and CAE, and a control group. Design: Randomized Controlled Clinical Trial. Methods: A cluster randomized controlled trial spanning 16 weeks was conducted on 202 high school soccer players from seven high schools in a Japanese under 18 Soccer League. Players were allocated to either group A (three schools, 66 players) receiving the CAE alone, or group B (two schools, 73 players) receiving the CAE and NHE, or control group C (two schools, 63 players) who performed their usual training. This study compared the number of injuries, injury rate, and severity of the injury of groin pain in these three groups. Results: The number of players injured was less in group B (4 players) compared to C (18 players), and time-lost to soccer was less in groups A (6 players) and B (3 players) compared to group C (16 players). Injury rates were significantly lower in groups A and B, with the relative risk of injury compared to group C of 0.42 (95% CI 0.19% to 0.90%) in group A and 0.19 (95% CI 0.07 to 0.54) in group B. Conclusion: A 16-week program incorporating the CAE in training sessions in high school soccer players reduced the incidence of groin pain and which may be related to injury severity according to time -lost to soccer, however the combination of both the CAE and NHE may be more effective than the CAE alone. Level of Evidence: 2b

Little is known about the risk factors for developing groin pain in high school soccer players. Therefore, the purpose of the study is to investigate the risk factors for developing inguinal pain in high school soccer players who are undergoing an injury prevention program. A cluster randomized controlled trial was conducted on 202 high school soccer players. Players were allocated to either group A (3 schools, 66 players) receiving the Copenhagen adduction exercise (CAE) alone, or group B (2 schools, 73 players) receiving the CAE and Nordic hamstrings exercise, or group C, the control group without any intervention (2 schools, 63 players). Hip range of motion (ROM) and strength measures were assessed prior to a groin injury prevention program and used in univariate and multivariate analysis to predict development of groin pain. Logistic regression analysis identified that hip abduction ROM and eccentric adductor strength of the dominant leg were factors in the development of groin pain. Increased abduction ROM and decreased eccentric adductor muscle strength of the dominant leg were risk factors for the development of groin pain.