PURPOSE: Anterior cruciate ligament (ACL) injuries are the most common in sports and have doubled in the past 20 years. This study aimed to analyze the latest trends and changes in training programs for ACL injury prevention.
METHODS: In this study, literature was searched using academic search sites, such as 'PubMed', 'Google Scholar', and 'Wiley Online Library'. The literature published between 2015 and 2021 was used.
RESULTS: Eleven papers were selected based on the literature selection criteria. Five warm-up exercise papers and six ACL injury prevention training program papers emphasized neuromuscular training.
CONCLUSIONS: The ACL injury prevention program can be applied in warm-up exercises and training programs. It consists of an exercise form that includes multidimensional components such as plyometrics, muscle strength, balance, and agility. The key to the ACL injury prevention program is to reflect multidimensional components in neuromuscular training and to obtain a significant effect, and it is recommended to participate in regular training for 12-18 sessions and at least 6 months. In addition, it is suggested to utilize the ACL injury prevention program presented in this study until an individual study for ACL injury prevention by sports type is conducted.

PURPOSE: Frailty is a geriatric syndrome that impairs the health and quality of life of older adults. While unintended weight loss is known to be a primary risk factor for frailty, obesity has also been closely associated with frailty. Combined exercise is thought to be an effective way of resolving obesity and frailty, but studies demonstrating the effect of combined exercise on obese frailty are lacking. In this review, we seek to understand the relevant mechanisms by exploring prior studies on obese frailty, and provide the implications of appropriate combined exercise interventions for obese frailty.
METHODS: To collect data for this study, we used academic search systems such as Scopus, Google Scholar, PubMed, and Web of Science. The keywords used for the search were a combination of words such as 'obesity', 'frailty', 'combined or multicomponent exercise', and 'older or elderly adults'.
RESULTS: The results from the 16 selected articles confirmed that combined exercise reduces body weight, percentage of body fat, and risk of falls. Moreover, it improves muscle strength, balance, and walking function of the obese frail population.
CONCLUSIONS: As we have confirmed the positive outcomes on the combined exercise for obese frail older adults, an optimal exercise program needs to be presented. Older adults with obesity are recommended to exercise at least 2-3 times a week during the initial period. Further, they should begin with low-intensity walking, full-body exercise, balance, and flexibility exercises, then gradually increase the exercise volume. Moreover, to facilitate the positive outcomes of physical training and to encourage autonomy and enjoyment of exercise among obese frail older adults, a novel method and an individualized scientific exercise program need to be developed.

PURPOSE: Cancer-related cognitive impairment (CRCI) is exposed to cognitive impairments that interfere with their daily lives after a complete recovery. Exercise is one of the effective non-pharmacological treatments to prevent or improve cognitive function decline. This study evaluated the effects of exercise interventions on cognitive function improvement in CRCI breast cancer patients and searched the association of various aspects in which exercise affects cognitive function improvement.
METHODS: PubMed, ScienceDirect, ACS journal, and Google scholar databases from 1 January 2014 to 31 May 2021 were utilized for searching articles related to research purpose. Meta-analysis was conducted with Comprehensive Meta-Analysis 2.0 using the random-effect model.
RESULTS: A meta-analysis of seven studies showed that walking (ES=0.59, p=.000) was the most effective in improving cognitive function, and moderate-intensity (ES=0.60, p=.000) was more effective than moderate-to-high intensity (ES=0.27, p=.007) exercise in CRCI patients with breast cancer. Cognitive function improvement was observed in short-term exercise intervention for four weeks (ES=0.46, p=.038), and after that, it was found that the cognition improvement effect was maintained or improved through long-term (12 or 24 weeks) exercise. Moreover, the cognitive function of CRCI patients with breast cancer improved without supervision during exercise interventions (ES=0.39, p=.001).
CONCLUSIONS: Walking and moderate-intensity exercise can suppress cognitive impairment in CRCI patients with breast cancer. Personalized exercise prescription through short-term and long-term exercise periods can alleviate cognitive decline and improve the cognitive function of CRCI breast cancer patients. Exercise interventions without supervision also show a positive influence on cognitive function improvement.

PURPOSE: This study evaluates the differences in the expression of genes frequently analyzed in the field of exercise science between the skeletal muscle tissue and various cell types that comprise the skeletal muscle tissue.
METHODS: We summarized the genes and proteins expressed in the skeletal muscle that were published in “Exercise Science” journal from 2015 to present. Thereafter, we selected 15 genes and proteins that were the most analyzed genes and proteins in the skeletal muscle. These genes and proteins were horizontally compared for expression differences in skeletal muscle components and cultured cells based on NCBI Gene Expression Omnibus DataSets.
RESULTS: The most analyzed genes (encoding analyzed proteins) in skeletal muscle tissues in “Exercise Science” were PPARGC1A, PPARD, MTOR, MAP1LC3A, MAP1LC3B, PRKAA1, AKT1, SLC2A4, MAPK1, COX4I1, MAPK14, MEF2A, MAPK8, RPS6KB1, and SOD1. Among them, PPARGC1A, AKT1, SLC2A4, MAPK1, and COX4I1 were specifically expressed in the skeletal muscle. However, expression of other genes was found to be significantly affected in other cell types of the skeletal muscle tissue.
CONCLUSIONS: Genes such as PPARGC1A, which are specifically expressed in the skeletal muscle, may be analyzed without pretreating (such as perfusion) the skeletal muscle tissue. However, expression of other genes may depend on the skeletal muscle cell type. Thus, in such instances, pretreatment, such as perfusion and isolation, should be considered.

PURPOSE: The primary objective of this study was to investigate the effects of local cold and heat stimuli on cutaneous thermal sensitivity and inter-threshold zone at rest and during exercise.
METHODS: Cutaneous warm and cold thresholds were measured on two body regions (forehead and hand) in three types of local thermal stress environments (neutral, heat, cold) using a method of limit in sixteen young, healthy male subjects (25.44±2.28 years) at rest and during exercise.
RESULTS: The results showed that the thermal inter-threshold zone was wider on the hand than on the forehead under thermal stress conditions at rest and during exercise. The thermal inter-threshold zone on both body regions widened with exercise (p<.05). Exercise significantly blunted both the warm and cold sensitivity in the forehead (p<.05), but only cold sensitivity in the hand (p<.05). Moreover, the thermal inter-threshold zone on both the forehead and hand became significantly wider when heat or cold stress was applied to the local body region (p<.001). In the forehead, warm and cold sensitivity were significantly blunted in both heat and cold stress environments (p<.05), whereas in the hard they were significantly blunted only in the heat stress environment (p<.01).
CONCLUSIONS: In conclusion, the present study showed that the forehead is more sensitive to both warm and cold stimuli than the hand, regardless of thermal stress or exercise. Furthermore, the thermal inter-threshold zone on both the forehead and the hand widened with exercise and local thermal stimuli.

PURPOSE: Leukocyte telomere length (LTL) is a potential indicator of cellular senescence. However, its relationship with the type and volume of regular exercise is unclear. Therefore, we investigated the effects of the type and volume of long-term regular exercise on the LTL in middle-aged men (N=109, mean age=44.7±4.1 years [range: 40-56 years]).
METHODS: For all participants, the volume of physical activity (PA) was evaluated using a self-report questionnaire, and blood samples were collected simultaneously. We cross-sectionally examined the associations among the type and volume of PA, LTL, telomerase activity (TA), mitochondrial DNA copy number (mtDNA), and body composition in three groups: 1) bodybuilders (BBs) with at least 5 years of athletic experience (n=36, mean age: 42.3±3.3 years [40-51 years]), 2) cyclists (CCs) with an athletic career similar to that of the BBs (n=37, mean age: 45.4±4.4 years [range: 40-53 years]), and 3) healthy ordinary people (CON; n=36, mean age: 46.3±3.3 years [range: 40-56 years]).
RESULTS: The LTL showed a significant positive correlation with the volume of PA (r=.285, p=.003), regardless of the type of PA. Furthermore, the LTLs were longer in the BB (p=.007) and CC (p=.003) groups (who performed moderate-to-vigorous PA for 150 minutes or more per week) than in the CON group. Conversely, the TA was significantly higher in the BB group (p=.009) than in the CON group; however, it only tended to be high in the CC group (p=.115). There were no intergroup differences in both the mtDNA (p=.127) and 8-hydroxydeoxyguanosine (p=.289) levels.
CONCLUSIONS: The TA was found to increase, and thus prevent telomere loss, in middle-aged men who performed PA of moderate-to-vigorous intensity, regardless of the PA type.

PURPOSE: Body composition is strongly associated with cardiometabolic risk factors, and accurate measurement of body composition is vital for the management of chronic diseases. In this study, we assessed whether major factors such as urination, aerobic exercise, food, and water consumption had significant effects on body composition by segmental bioelectrical impedance analysis (BIA).
METHODS: To achieve the goal of this study, research was conducted on 32 healthy young males (n=18) and females (n=14). All participants underwent body composition analysis in four different conditions (both pre- and post-urination, moderate-intensity aerobic exercise for 30 minutes, immediately after food and water consumption, 30, 60, and 120 minutes after each treatment), and segmental BIA was performed using Inbody720.
RESULTS: We found that after urination, body weight, skeletal muscle mass, and basal metabolic rate (BMR) significantly decreased. However, water intake significantly increased body weight, body fat mass, and body fat percentage. Furthermore, an acute 30-minutes aerobic exercise significantly decreased body weight, fat mass, and fat percentage, and increased skeletal muscle mass and BMR. In addition, impedance decreased immediately and increased 120 minutes after the acute aerobic exercise. Finally, food ingestion significantly increased the body weight, skeletal muscle mass, and BMR.
CONCLUSIONS: Our study suggests that variables such as urination, exercise, food consumption, and water intake should be considered to accurately assess body composition.

PURPOSE: This study aimed to examine changes in pulmonary function induced by an internal nasal dilator (IND) and to determine whether an IND enhances exercise performance.
METHODS: Young, healthy men (n=13) were randomly assigned either an IND or control (CON) session to perform a pulmonary function test (PFT). All participants then completed treadmill exercise tests that consisted of maximal and submaximal running with or without an IND.
RESULTS: Some variables of PFTs were increased in men that used INDs compared to those in the CON group (p<.05, respectively). There was a significant difference between sessions in energy cost during the running test (65% VO2max) (p<.05). In the IND group, respiratory muscle fatigue during exercise was lower, and relaxation of respiratory muscles after exercise was faster, as compared with the CON group (p<.05).
CONCLUSIONS: IND may contribute to improvements in pulmonary function. Furthermore, INDs may reduce energy costs and respiratory muscle fatigue during submaximal exercise by maintaining nasal breathing and facilitating respiratory muscle relaxation after maximal exercise tests.

PURPOSE: Arterial stiffness is an independent risk factor for cardiovascular disease and inversely associated with flexibility. Self-myofascial release (SMR) using a foam roller is a popular intervention to improve flexibility, restore the muscles, fascia, tendons, and ligaments, and regain soft-tissue extensibility. This study aimed to investigate whether a single bout of SMR has a beneficial effect on arterial stiffness and the function of the autonomic nervous system and the relationships among these variables in young and middle-aged women by age.
METHODS: Ten healthy young (23.20±0.59 years) and 10 middle-aged women (44.50±0.91 years) completed an instructed SMR using a foam roller. Brachial-ankle pulse wave velocity (baPWV), augmentation index (AIx), trunk flexibility, shoulder flexibility, heart rate variability, including standard deviation of normal R-R intervals (SDNN), and the root mean square of the standard deviation of the time between heartbeats (RMSSD) were measured before and after one 30-minutes bout of SMR.
RESULTS: After one bout of SMR, trunk and shoulder flexibility increased in both groups of women, while AIx decreased significantly (from 6.9±2.9 to -1.9±4.6%, p=.0072, young women group; from 22.1±3.4 to 14.7±1.7%, p=.0049, middle-aged women group). However, the baPWV, RMSSD, and SDNN did not change. In the analysis of correlations between all measured variables, changes in AIx showed negative correlations with flexibility and SDNN.
CONCLUSIONS: This study suggests that one bout of SMR using a foam roller positively affected arterial stiffness in women by reducing AIx and improving flexibility.