Italian Journal of Sports rehabilitation and Posturology

2436 – 2451

Authors: Nikola Aksović, Ljubinko Jovanović, Bojan Bjelica, Milan Zelenović, Rosario D’Onofrio

The primary goal of teaching physical education is to increase the fund of motor knowledge, habits and skills. Regardless of the recognized importance of the subject, in most countries in the world the number of classes is constantly declining, and there are certain financial problems in the implementation of teaching, which affects the quality and manner of curricula. The aim of this review is to show the importance and role of methodological and organizational forms of work in physical education classes as well as to show and strengthen the role of teachers in the process of programming, planning, implementation and evaluation of physical education classes. Reduced physical activity of students, which reached only 20% of active time, led to the appearance of various forms of work that raised the value of active time in class over 50% (additional exercise), 61% (polygon and station), while the form of circular training very little time used for preparation, that is, 90% of the time remains for work. The wave and the beginning are the organizational forms of work that are mostly applied in Serbia. Thus, it can be concluded that the methodological and organizational forms of work have led to positive transformations of students, primarily in the field of motor skills.

2465 - 2494

Authors: Jan van de Rakt, Steve McCarthy-Grunwald

Introduction. The reality for the individual that has suffer from an stroke is visible in the text that an person with an severe stroke say: “ Brilliant that I can move and managed my shoulder and elbow and have less difficulties with the ADL and no pain, but at the end of the arm is my hand and that is purpose of al that shoulder movement to bring my affected hand in an position that I can use him .” I was silent. He was right , I wasn’t capable to get an good hand-function . He was able to pick up something and open his hand but only with mass flexion and mass extension . And often when he don’t look to his hand was the object gone ! The therapy remain on that level but when stop an while, he experience what he loss in an short time and his motivation was present again . Still it is never the treatment goal to hold that level!! After the treatment of the flexor attitude and movement synergy, now there is more dissociation possible and that can be through recovery but also through an good treatment. But that means don’t stop, go one with dissociation, also with the hand to get the highest possible level! Design . The science has much efforts in the developmental of robotic and F.E.S. stimulation techniques but still today it isn’t clear that this has the answer for the recovery of the arm and especially the hand and it isn’t also clear or this is an better way to get more function in the hand. But obvious there is much more possible to get an better arm-hand function by using this inventions, but than for all stroke survivors with arm and hand function decrease. An eclectic approach will use everything to get an better result but always with an good base of science and with the training and motoric learning rules in the head. To get an result in the damaged brain must have an amount of intensity to get the brain working on his plasticity. The question remain that we not know how much plasticity an damaged brain has and obvious that is different for every stroke survivor. Conclusion. Therefore therapist try everything what you think can help but also science keep on searching !! And this can also be done in the chronic stage of this disease. In this part also “manipulation techniques to get the diagonals make an better “communication” between them and the muscle pattern and create better keypoint. Often that manipulation is tone inhibition and hands-on technique to use that inhibition for an better facilitation and working on better movements also in direct relation with the A.D.L. Technique that often have great impact in the subacute and chronic phase.

2335 – 2348

Authors: Nikola Aksović, Filip Milanović, Bojan Bjelica, Dejan Nikolić, Nemanja Jovanović, Rosario D’Onofrio

Wheelchair basketball (WB) is a variation of basketball and is played by people with various physical disabilities that are characterized by chronic or severe conditions that limit the ability to use the lower limbs to play basketball in running. The present study is a review study that presents the critical points of existing knowledge about a theoretical approach to the topic of "wheelchair basketball". The aim of this study was to provide an analysis and overview of WB. WB game rules are different compared to running basketball game rules due to the manner of moving, type of faults, and functional classification of players on the court. The basic equipment for the game is wheelchairs and therefore special attention is paid to them and they developed as the sport developed. Each competitor, depending on the degree of disability, has a certain number of points, and the international classification range is from 1.0 to 4.5 points. In conclusion, WB is an intermittent team game for people with physical impairments characterized by chronic or serious conditions limiting their ability to use lower limbs to play running basketball. Therefore, the recommendation to future researchers is to do more research on Paralympic sports, and thus WB, which is one of the most interesting and demanding sports for people with disabilities.

2384 -2421

Authors: Jan van de Rakt, Steve McCarthy-Grunwald

Introduction To increase the possibilities of the hemiplegic arm is this the way to get out the synergy and exercises to an higher level. The differences are big, high cortical there is an high representation of the hand but on an lower level isn’t that completely changed. Still there are areas in the brain that have an connection with the arm, that we can use to get an optimal result and the best way to integrated the remaining possibilities in the ADL. Still much isn’t clear and the answer is still not there what is necessary to get the affected hand –especially- on an higher level. Design. Every person is different and that asked for an personal treatment still … Once an person after an severe stroke say to me: “ Brilliant that I can move and managed my shoulder and elbow and have less difficulties with the ADL and no pain, but at the end of the arm is my hand and that is purpose of all that shoulder movement to bring my affected hand in an position that I can use him .” I was silent. He was right, I wasn’t capable to get an good hand-function. He was able to pick up something and open his hand but only with mass flexion and mass extension . And often when he don’t look to his hand was the object gone ! The programme from Yekutil is perfect but he couldn’t master the last part because his damage brain wasn’t capable to build an good projection that allow him to work with his hand. Conclusion. The therapy remain on that level but when stop an while, he experience what he loss in an short time and his motivation was present again . Still it is never the treatment-goal to hold that level or ….!! After the treatment of the flexor attitude and movement synergies, now there is more dissociation possible and that can be through recovery but also through an good treatment. But that means don’t stop, going on with dissociation, also with the hand to get the highest possible level!!

2243 -2277

Authors: Jan van de Rakt, Steve McCarthy-Grunwald

Part 1 started with the chains, the base for exercising the arm/hand function. Further we discussed the most affected form after an stroke and what we must do to prevent further loss and build an base to an optimal result. That treatment content: 1) Hold the mobility in all joint. 2) The trophic of the arm /hand must be optimal. 3) Try to reduce the high tone and be aware, that when the head of the humerus shift, that tissue also must change of place. Tone in the pectoralis and latissimus will give an pressure and stretch on the n.medianus, that lies behind the pectoralis and that can damage this nerve. Sometimes the tension on the n.medianus is so high that the nerves lies not behind the m.pectoralis but under or even in front of the muscle 4) Be aware of the low perception and extinction. 5) What does the tone of the back diagonal – to the shoulder blade position. 6) Try to exercise in an closed chain and build up an support function in different position. 7)And try to give stimuli that enter the damage brain, but be careful. The mobility has written down in part 1, but this isn’t only for the individual with an severe stroke but all person after an stroke must have this treatment. Of course will the possibility to make movement on his own, makes this an lot easier, but still asked this for an frequently assessment . Part 2 goes further with the trophic of the hand/arm and shoulder because this is often for many person after an stroke an moment that the recovery stops and an lot of pain will influence the quality of life. When it is possible will active movement be introduced because that is the best way to hold the mobility, prevent trophic problems and get the best result. And we go to train the arm that has no or little function with the chain rules . Citation. Jan van de Rakt , Steve McCarthy-Grunwald; The “Pusher “ syndrome, assessment and treatment. Part 2. - Ita. J. Sports Reh. Po. 2023; 10 (22); 1; 2; 2243 -2277 ; ISSN 2385-1988 [online] ; IBSN 007-11119-55; CGI J OAJI 0,201)]. Published online. Authorship credit: “Criteria authorship scientific article” has been used “Equal Contribution” (EC).

2292 - 2305

Authors: Aleksandar Stamenković, Milan Zelenović, Bojan Bjelica, Danijel Božić, Rosario D’Onofrio

Cilj ovog istraživanja bio je da se na osnovu sistematskog pregleda dosadašnjih istraživanja utvrdi uticaj telesnog sastava džudista na njihovu motoriku. Uzorak ispitanika bile su osobe koje se bave džudoom muškog i ženskog pola, ukupno 458 ispitanika. Kriterijumi za analizu radova bili su sledeći: vremenski period objavljivanja radova 2005 - 2020. godine, da su ispitanici osobe koje se bave džudoom i da je cilj istraživanja povezan sa efektima odnosno uticajem telesne kompozicije sa motoričkim sposobnostima džudo sportista. U konačnu analizu je na osnovu postavljenih kriterijuma ušlo 15 radova koji su obrađeni i prikazani. Obradom dobijenih rezultata može se zaključiti da telesni sastav ima veliki uticaj na motoriku kao i sam performans džudista. Naročito je zapaženo da povećana koncentracija masnog tkiva prouzrokuje smanjenje produktivnosti kod statičke snage, aerobne snage, ravnoteže i fleksibilnosti. Značaj ovog istraživanja je u tome što pruža informacije o uticaju telesnog sastava na motoriku, a samim tim i performans na takmičenjima. Na ovaj način može se doći do poželjne telesne kompozicije džudista u zavisnosti od njihove konstitucije, koja bi im omogućila maksimalnu efikasnost i produktivnost na mečevima i to upravo na račun poboljšanja neophodne motorike.

10 -30

Authors: Ali Rafaqat , Marina Ali, Adila Tahir, Suhail Karim -

The purpose of this study was to provide an overview of studies analyzing the Comparison of sports injuries among school going children according to their gender. Searches for this review were conducted using Web of Science, Scopus, PubMed, ERIC, SPORT Discus and Medline with Full-Text databases, and studies from electronic databases from inception to 27 March 2022 were identified. Out of 799 studies, 09 met the inclusion criteria and were included in the review. A total of nine studies articles were kept, representing the Associative studies that exclusively compared the gender differences in sports-related injuries among school-age children. From the nine studies that were considered, three dealt with men, and six with both men and females student’s sports injuries. Results showed that Both male and female school-aged children who participate in structured sports training have a marked decline in sports-related injuries. The primary conclusions of the research that were part of the evaluation highlighted some important problems relating to sports injuries in young boys and girls. The majority of the papers examined in the review supported the finding that male children experience sports injuries more frequently than female children Ali Rafaqat , Marina Ali, Adila Tahir, Suhail Karim - Comparison of sports injuries among school going children according to their gender. - Ita. J. Sports Reh. Po. 2022; Vol. 9 ; Suppl 1 al n°1 ; 10 – 30 ; IBSN 007- 11119-55; CGI J OAJI 0.201). Published Online. Open Access (OA) publishing- Authorship Credit: “Criteria authorship scientific article” has been used “Equal Contribution” (EC) .

43 -54

Authors: D’Onofrio R. , Lupelli N, Sannicandro I. , Agosti N., Bjelica B., Vettone T., Marino R., Di Sanzo V

ABSTRACT Background. Early sport specialization (ESS) has been theorized to be related to increased risk factors for musculoskeletal injury in young skeletally immature athletes. Objective. The objective of this article is to identify possible correlated pathologies, skeletally immature soccer players, with Early sport specialization (ESS) Methods. To achieve this goal, we conducted a review of articles published in Medline PubMed without time limit. Results. Our review showed three possible correlations in skeletally immature soccer players : a) early sports specialization and overuse injuries, b) early sports specialization and Burnout c) early sports specialization and postural/ dysfunctional frameworks. We can point out that young skeletally immature athletes participating in sports that can be defined as high impact such as soccer and basketball, field hockey, showed a higher prevalence of FAI conflict type Cam. Conclusions. Early sport specialization (ESS) in young soccer players is associated with a clear increase in both the psychological component related to burnout and overuse pathologies with postural/ dysfunctional pictures of soccer technical expressiveness Load analysis and activity diversification can help reduce the risk of sports specialization in young soccer players. Keywords : sport specialization in youth, skeletal immaturity , overuse Injuries in the skeletally immature injuries in young soccer, burnout in sport specialization ABSTRACT Background. Si è teorizzato che una Early sport specialization (ESS) sia collegata ad un aumento dei fattori di rischio di lesioni muscoloscheletriche in giovani atleti scheletricamente immaturi. Obbiettivo. L'obiettivo di questo articolo è quello di identificare eventuali patologie correlabili in calciatori scheletricamente immaturi, con la Early sport specialization (ESS) Metodi. Per raggiungere questo obiettivo, abbiamo condotto una revisione di articoli pubblicati su Medline PubMed senza limiti di tempo. Risultati. La nostra revisione ha evidenziato tre possibili correlazioni in calciatori scheletricamente immaturi : a) precoce specializzazione sportiva e lesioni da overuse, b) precoce specializzazione sportiva e Burnout c) precoce specializzazione sportiva e quadri posturo/disfunzionali. Possiamo sottolineare che giovani atleti scheletricamente immaturi che partecipano a sport definibili ad alto impatto come calcio e basket, hockey, hanno evidenziato una maggiore prevalenza del conflitto FAI tipo Cam. Conclusioni. Early sport specialization (ESS) nei giovani calciatori è associata ad un evidente incremento sia della componente psicologica legata al Burnout sia delle patologie da overuse con quadri posturo/disfunzionali dell’espressività tecnica calcistica . L’analisi del carico e la diversificazione delle attività può contribuire a ridurre il rischio di specializzazione sportiva nel giovane calciatore. Keywords : sport specialization in youth, skeletal immaturity , overuse Injuries in the skeletally immature injuries in young soccer, burnout in sport specialization

2139 - 2156

Authors: Franchini Michela., Denoth Francesca., Salvadori Gioele., Trotta Luca., Santarelli Giovanni.

Introduzione. Così come la medicina si sta orientando sempre più verso l’approccio personalizzato, si ritiene che anche in ambito sportivo giovanile debbano essere poste in essere azioni preventive strutturate sulla base del profilo individuale di ciascun atleta, con l’obiettivo di potenziarne le capacità coordinative e condizionali nella fase di preparazione atletica e di limitare il rischio di infortunio. Il progetto VELASCO si configura come uno studio pilota per individuare un set di informazioni minime che risultino rilevanti nella definizione di percorsi di preparazione fisica personalizzati e nel monitoraggio dell’efficacia degli stessi. Metodi. Il progetto ha coinvolto un campione opportunistico di 15 atlete, nate fra il 2008 e il 2009, appartenenti ad una squadra di volley giovanile. Lo studio ha previsto la somministrazione ai genitori delle atlete di un questionario strutturato ad hoc con l’obiettivo di ottenere informazioni preliminari relative ad eventuali perturbazioni dei recettori tonico posturali (podalico, sistema oculare, stomatognatico, vestibolare) e per effettuare una prima anamnesi delle ragazze (dolori ricorrenti, infortuni pregressi, condizioni di fatica muscolare e contratture frequenti), completata successivamente durante la visita posturale. Attraverso il questionario, inoltre, sono state indagate quelle caratteristiche psicologiche ritenute maggiormente correlate con stati muscolo tensivi e la compatibilità delle abitudini alimentari delle ragazze con un quadro di corretto apporto nutrizionale, in accordo con i principi della dieta mediterranea. La composizione corporea delle atlete è stata valutata utilizzando il rapporto fra circonferenza vita ed altezza (WtHR - Waist to Height Ratio). Le atlete sono state sottoposte a 2 valutazioni (baseline e intermedia): alla visita posturale iniziale sono seguite due valutazioni strumentali condotte utilizzando (a) pedana stabilometrica per la valutazione della stabilità posturale, (b) kit per l’esecuzione del protocollo Functional Movement Screen – FMS orientato alla valutazione delle limitazioni funzionali e delle asimmetrie e (c) sistema Optojump per la valutazione delle capacità condizionali e coordinative dell’atleta durante l’esecuzione di un Counter Movement Jump. Risultati. I risultati descritti sono relativi al confronto fra le caratteristiche posturali desunte dalla visita iniziale e dal questionario anamnestico e i valori strumentai rilevati al baseline. La relazione fra WtHR e abitudini alimentari risulta non statisticamente significativa, anche considerando la classe di appartenenza rispetto al valore mediano dell’età. Questo risultato sembra suggerire che le differenze in termini di massa corporea possano dipendere da fattori indipendenti dal corretto intake nutrizionale come, ad esempio, il fisiologico sviluppo della massa muscolare a discapito di quella grassa, correlato al progredire dell’età. In relazione all’identificazione di un profilo posturale specifico, i risultati del progetto VELASCO sembrano confermare la relazione fra alcuni parametri stabilometrici e posturometrici e i paramorfismi relativi al dorso ed evidenziare la presenza di compensi più o meno marcati nell’esecuzione di alcuni movimenti funzionali nelle atlete con paramorfismi rispetto alle altre. In particolare la quota di atlete che presenta perturbazioni ad uno o più recettori del Sistema Tonico Posturale è piuttosto elevata, così come quella delle atlete che manifestano segni paramorfici più o meno marcati, soprattutto relativamente alla riduzione/aumento delle frecce cervicale e lombare (rispettivamente 60% e 56,6%), alla presenza di salienza scoliotica di varia entità (66,7%) e di bascule sia in inclinazione (86,7%) che rotazione (66,7%). La quota complessiva di atlete con evidenti segni di rigidità della catena posteriore è rilevante (60%); altrettanto interessante è la prevalenza di contratture dichiarate dai genitori (46,7%), principalmente a carico della zona lombare e delle spalle. Il 40% delle atlete manifesta anche blocco scapolo omerale compreso fra i 30 e i 40 gradi. Confrontando le evidenze emerse dalla visita con i valori stabilometrici rilevati attraverso l’uso della pedana, si evidenziano alcune relazioni statisticamente significative: (a) tendenza alla maggiore anteriorizzazione del baricentro fra le atlete con marcata rigidità rispetto a quelle con catena posteriore normoestesa, (b) minore lateralizzazione verso destra dell’escursione massima del baricentro (BXmax) e riduzione della varianza di oscillazione sul piano frontale (VarX) nelle atlete che presentano evidenza di salienza scoliotica più o meno marcata. Nelle stesse atlete si rileva anche una tendenza ad una minore velocità di oscillazione (V), variazione della velocità di oscillazione (VARVEL), dimensione dell’area (AR) e della lunghezza del percorso (PR) relativo al gomitolo posturale. L’analisi dell’indice di Romberg posturale, calcolato sia in relazione all’area del gomitolo posturale (AR) che alla lunghezza del percorso (PR), ha mostrato una tendenza più o meno marcata fra le atlete nell’utilizzo della vista per il controllo della postura ortostatica: fra le ragazze che utilizzano lenti correttive e tra quelle con difetti di convergenza o con deficit di propriocezione, la vista sembra influenzare maggiormente la capacità di equilibrio. Conclusioni. Nonostante le limitazioni insite in un progetto pilota non consentano la validazione di questo modello con una sufficiente evidenza statistica, i risultati ottenuti sono comunque già di per sé sufficienti per promuovere una cultura dell’approccio sistemico al giovane atleta.

2170 -2201

Authors: Jan van de Rakt, Steve McCarthy-Grunwald

Part 1 gives us insight in the Pat. Davies Approach and the surprising reaction of so many person with an severe pusher syndrome after an stroke. That there must be an deficit in the brain is clear and that deficit has also an strong effect on the perception of the body scheme. There are investigators that point this as the ultimate personnel neglect on “spine” level !! The reaction describe in part 1, when we try to set this person in the right “symmetry” is very clear that there must be an strong reaction of the damaged brain, that this isn’t his truth. On the other hand is the brain capable to interpreted stimuli from the affected side, but not on his end of his capacity. Working with an back splint is the answer and that must done much more! Walking without is possible but asked so much from the person that we can place the question : Is he/she learning ? !! In this part, we exercise and learn of buildup, more confidence though increasing the power in the affected side by task specific resistance therapy. So many times therapist try to step as soon as possible over on walking without an back splint and then often the tone of hamstrings increased through the static reaction and makes, that the therapist must set an step back to start again with back splint. Make the back splint an fast part of the treatment and there are option to use the wall or even new approach with weight decrease on the sealing in combination with the splint and the wall. We start this part with the transfers, that will be an problem for an long time because this asked so much from the person with an pusher syndrome. But never make the mistake an use an apparatus that has an negative influence on the body perception, because you are learning the wrong attitude. Citation. Jan van de Rakt , Steve McCarthy-Grunwald; The “Pusher “ syndrome, assessment and treatment. Part 2. - Ita. J. Sports Reh. Po. 2022; 9 (21); 3; 4; 2170 -2201 ; ISSN 2385-1988 [online] ; IBSN 007-11119-55; CGI J OAJI 0,101)]. Published online. Authorship credit : “Criteria authorship scientific article” has been used “Equal Contribution” (EC). Correspondence for author: Jan van de Rakt e mail : jan@vanderakt.nl

2211 - 2224

Authors: Ljubica Milanović , Bojan Bjelica , Borislav Cicović , Dušan Đorđević

Fizička aktivnost predstavlja efikasnio sredstvo za poboljšanje tjelesnog sastava žena i muškaraca. Primjena dijetalnog režima ishrane, smanjenje dnevnog kalorijskog unosa i povećanje fizičke aktivnosti, imaju važnu ulogu u ovom procesu. U radu je primjenjen metod introspekcije, izvojeni su radovi čija su istraživanja bila usko vezana sa problematikom rada. Srednji ili visoki intenzitet predstavlja efektivan način za redukciju tjelesnih masti kod populacije muškaraca i žena, međutim, rezultati mogu oscilovati najpre zbog vrste i trajanja aktivnosti, ali najviše zbog uzorka ispitanika, budući da kod fizički neaktivne populacije može doći do kontraindikacija. Program koji je pogodan primjeniti za fizički neaktivne osobe jeste umjereni intenzitet i individualno dozirano opterećenje u skladu sa njihovim mogućnostima.