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Physical Exercise in Sports Sciences and Rehabilitation: Physiology, Clinical Applications and Real Practice

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A special issue of Applied Sciences (ISSN 2076-3417). This special issue belongs to the section "Applied Biosciences and Bioengineering".

Deadline for manuscript submissions: closed (20 July 2022) | Viewed by 48888

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Prof. Dr. Alessandro de Sire

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Guest Editor

Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", 88100 Catanzaro, Italy
Interests: rehabilitation; physical exercise; osteoporosis; sarcopenia; osteoarthritis; sports medicine; pain management; fractures; musculoskeletal disorders
Special Issues, Collections and Topics in MDPI journals

Prof. Ozden Ozyemisci Taskiran

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Guest Editor

Department of Physical Medicine and Rehabilitation, Koç University School of Medicine, Istanbul, Turkey
Interests: rehabilitation; physical exercise; spinal deformities; osteoarthritis; ultrasound; pediatrics; cardiopulmonary rehabilitation; sports medicine; COVID-19

Special Issue Information

Dear Colleagues,

Physical exercise is the main tool available to rehabilitation and sports medicine, consisting in the prescription of muscle contractions and body movements to improve functioning and to help subjects in responding to the needs of daily life. Several exercise interventions have been proven to improve the general health, wellbeing, and quality of life in subjects at risk of or suffering from medical conditions, injuries, and disabilities. In this scenario, ongoing research is investigating the role of exercise in subcellular, molecular, and chemical processes, with a high interest in physiology by recent literature. A subject-tailored physical exercise aimed at recovering/improving mobility, muscle strength, and performance is crucial both in patients with musculoskeletal disorders (e.g., affecting joints, ligaments, muscles, nerves, and tendons) and in sports athletes.

Therefore, in the present Special Issue, we aim at presenting evidence on the key role that physical exercise might play for the wellbeing of the general population, for the rehabilitation of chronic medical conditions, and for achieving a peak performance in elite sports professionals.

Prof. Alessandro de Sire
Prof. Ozden Ozyemisci Taskiran
Guest Editors

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Keywords

rehabilitation
sports
physical exercise
musculoskeletal rehabilitation
muscle strength
physical performance

Published Papers (12 papers)

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Editorial

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4 pages, 208 KiB

Open AccessEditorial

Physical Exercise in Sports Sciences and Rehabilitation: Physiology, Clinical Applications and Real Practice

by Alessandro de Sire and Ozden Ozyemisci Taskiran

Appl. Sci. 2023, 13(8), 4868; https://0-doi-org.brum.beds.ac.uk/10.3390/app13084868 - 13 Apr 2023

Viewed by 949

Abstract

Physical exercise has long been recognized as a cornerstone of health promotion, disease prevention, and rehabilitation [...] Full article

(This article belongs to the Special Issue Physical Exercise in Sports Sciences and Rehabilitation: Physiology, Clinical Applications and Real Practice)

Research

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9 pages, 1750 KiB

Open AccessArticle

Effects of a 6-Minute Fast-Walking Protocol on Changes in Muscle Activity in Individuals with Flatfoot

by Chu-Yuan Chiang, Kuang-Wei Lin, Hui-Min Lee, Shun-Hwa Wei and Li-Wei Chou

Appl. Sci. 2022, 12(4), 2207; https://0-doi-org.brum.beds.ac.uk/10.3390/app12042207 - 20 Feb 2022

Cited by 2 | Viewed by 1447

Abstract

Flatfoot causes abnormal biomechanics in the lower extremity, resulting in discomfort and excessive burden on lower extremity muscles during functional tasks, and it potentially leads to associated syndromes in the lower extremity. The aim of this study was to investigate how a demanding, repetitive task affects the muscle strength, activities, and fatigue of the lower extremities during function tasks. Nineteen individuals with flexible flatfoot (10M9F, age: 24.74 ± 2.68 years) and fifteen non-flatfoot participants (6M9F, age: 24.47 ± 3.74) took part in this study. All participants performed maximal voluntary isometric contraction and functional tasks, including walking and single-leg standing tests before and immediately after a 6-min fast-walking protocol. A surface electromyography system was used to collect muscle activation data. Our results showed that, after 6 min of fast walking, peroneus longus activity increased only in the non-flatfoot group, and gastrocnemius activity increased in the flexible flatfoot group. In the flexible flatfoot group, greater recruitment in abductor halluces and greater fatigue in the tibialis anterior was observed. Individuals with flexible flatfoot showed altered muscle activation pattern after 6-min fast walking. These findings can provide an evidence-based explanation of associated syndromes in flatfoot populations and lead to potential intervention strategies in the future. Full article

(This article belongs to the Special Issue Physical Exercise in Sports Sciences and Rehabilitation: Physiology, Clinical Applications and Real Practice)

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14 pages, 2783 KiB

Open AccessArticle

Development and Trial of a Prototype Device for Sensorimotor Therapy in Patients with Distal Radius Fractures

by Daichi Narita, Toyohiro Hamaguchi and Hiromi Nakamura-Thomas

Appl. Sci. 2022, 12(4), 1967; https://0-doi-org.brum.beds.ac.uk/10.3390/app12041967 - 14 Feb 2022

Cited by 1 | Viewed by 1617

Abstract

This study examined the clinical feasibility of a prototype device (development name: Ghost) for facilitating range of motion (RoM) recovery in the acute phase in patients with distal radius fractures (DRF). The Ghost device involves the administration of a combination of vibratory and visual stimuli. We divided the patients into the Ghost (n = 10) and control group (n = 4; tendon vibration only) groups. The experimental interventions were administered between the day after surgery and day 7 postoperatively. Traditional hand therapy was provided to both groups once daily from day 7 until day 84 postoperatively and once a week from day 84 until the end of the intervention period. Because vibratory stimulation makes the patient focus on wrist flexion, the primary outcome was the arc of wrist flexion-extension on the injured side, which was measured on days 7, 14, 28, 42, 56, 70, and 84. Analysis of covariance was applied using a bootstrap method to evaluate changes over time and compare them between the groups. Analyses was performed after stratification by age and body mass index. Both interventions improved RoM over time in patients with DRF. Results showed that Ghost has greater efficacy for improving wrist RoM in DRF patients than vibration alone. Treatment with Ghost can result in good RoM improvement during the acute phase of DRF in young patients and those with and normal or low body mass index. Further study is needed to verify our findings and assess the extent of RoM recovery. Full article

(This article belongs to the Special Issue Physical Exercise in Sports Sciences and Rehabilitation: Physiology, Clinical Applications and Real Practice)

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16 pages, 1259 KiB

Open AccessArticle

Assessment of Lumbar Extensor Muscles in the Context of Trunk Function, a Pilot Study in Healthy Individuals

by Daniela Vlažná, Peter Krkoška, Matyáš Kuhn, Filip Dosbaba, Ladislav Batalik, Eva Vlčková, Stanislav Voháňka and Blanka Adamová

Appl. Sci. 2021, 11(20), 9518; https://0-doi-org.brum.beds.ac.uk/10.3390/app11209518 - 13 Oct 2021

Cited by 7 | Viewed by 3548

Abstract

A comprehensive assessment of trunk function, including the lumbar extensor muscles, appears to be important in various conditions affecting axial musculature. This pilot cross-sectional observational study aimed to define a battery of tests that comprehensively assess trunk muscle function (strength and muscular endurance). Sixty subjects without low back pain (LBP) underwent measurement of isometric lower back extensor strength using a hand-held dynamometer (HHD) in three positions; measurement of respiratory muscle strength; and Biering-Sørensen, prone-plank, and side-bridge tests. The repeatability, short-term and long-term reliability using the HHD device in different postural positions was confirmed. The greatest isometric lower back extensor strength was generated in the sitting position by male subjects. Time of effort in the Biering-Sørensen test was longer in women and older subgroups than in men and younger individuals, although this was not the case for the other two muscular endurance tests. This pilot monitoring of trunk muscle strength and endurance in healthy volunteers may lead to a better understanding of trunk muscle function. Based on this methodological background, the authors aim to use the defined battery of tests in their further studies in a group of patients with LBP and certain neuromuscular diseases to verify its usefulness in clinical practice. Full article

(This article belongs to the Special Issue Physical Exercise in Sports Sciences and Rehabilitation: Physiology, Clinical Applications and Real Practice)

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10 pages, 402 KiB

Open AccessFeature PaperArticle

Intra-Articular Hybrid Hyaluronic Acid Injection Treatment in Overweight Patients with Knee Osteoarthritis: A Single-Center, Open-Label, Prospective Study

by Dalila Scaturro, Fabio Vitagliani, Pietro Terrana, Daniele Cuntrera, Vincenzo Falco, Sofia Tomasello and Giulia Letizia Mauro

Appl. Sci. 2021, 11(18), 8711; https://0-doi-org.brum.beds.ac.uk/10.3390/app11188711 - 18 Sep 2021

Cited by 11 | Viewed by 2446

Abstract

Background: A BMI > 25 is the most decisive, albeit modifiable, risk factor for knee osteoarthritis (KOA). This study aimed at assessing the efficacy of intra-articular injections of hybrid hyaluronic acid (HA) complexes (Sinovial^® H-L) for the treatment of KOA in overweight patients in terms of disease severity, cardiocirculatory capacity, and quality of life. Materials: In this single-site, open-label, prospective trial, 37 patients with symptomatic knee OA were assessed at baseline and 3 months after ultrasound-guided intra-articular injection of hybrid HA complexes (Sinovial^® H-L). Results: Primary variables displaying a statistically significant improvement after treatment were pain (VAS), disease severity (WOMAC), and cardiopulmonary capacity (6 min walk test). Among secondary variables, quality of life (SF-12) improved significantly, as did analgesic intake for pain control. No statistically significant difference was observed in body fat and muscle mass percentage measured by bioelectrical impedance analysis. Conclusions: Intra-articular hybrid HA injections are significantly effective in improving OA-related disease severity, cardiopulmonary function, and analgesic intake. This supports the role of hybrid HA viscosupplementation as a nonpharmacological treatment to relieve pain, reduce disability, improve quality of life, and limit the risk of polypharmacy in overweight patients with knee OA. Full article

(This article belongs to the Special Issue Physical Exercise in Sports Sciences and Rehabilitation: Physiology, Clinical Applications and Real Practice)

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11 pages, 263 KiB

Open AccessArticle

Possibilities of Using Phyto-Preparations to Increase the Adaptive Capabilities of the Organism of Test Animals in Swimming

by Mariusz Ozimek, Victoria Zaborova, Oxana Zolnikova, Natiya Dzhakhaya, Elena Bueverova, Alla Sedova, Vitaly Rybakov, Irina Ostrovskaya, Yulia Gaverova, Konstantin Gurevich, Vladimir Malakhovskiy, Łukasz Rydzik and Tadeusz Ambroży

Appl. Sci. 2021, 11(14), 6412; https://0-doi-org.brum.beds.ac.uk/10.3390/app11146412 - 12 Jul 2021

Cited by 1 | Viewed by 1626

Abstract

Background: To study the possibilities of using phytopreparations to increase the adaptive capabilities of the animals on which the experiments were conducted in swimming. Methods: 100 mongrel male rats were divided into 5 groups of 20 animals in each one. For 30 days running, the animals were immersed for 10 min in a bath with water at a temperature of +4 °C. In addition to cold exposure, the animals of the first three groups were injected per os with stress protectors 30 min before the immersion in water. The rats of the first group received an inhibitor of the enzyme gamma-butyrobetaine hydroxylase, the second group was given an extract of Eleutherococcus, and the third group took an extract of Ligusticum wallichii. As a placebo, to control the effect of the stress protectors, the rats of the fourth group were injected per os with 0.9% NaCl solution, and the animals in the fifth group were not given any drugs. On days 1, 4 and 30 of the experiment, five randomly selected animals from each group were decapitated, the heart and liver were removed, and the activity of tissue enzymes—superoxide dismutase (SOD), glutathione peroxidase (GPO), alanine aminotransferase (ALT), and aspartate aminotransferase (AST)—was analyzed. Results: The animals in the control group displayed a decrease in the activity of most of the studied enzymes, increasing from the 1st to the 30th day of the experiment. The NaCl solution had practically no effect on the analyzed parameters. Against the use of the enzyme gamma-butyrobetaine hydroxylase inhibitor, the activity of the enzymes did not change as compared with the pre-intervention level. On the first day of ingestion, the effects of the Ligusticum wallichii extract were similar to those of the enzyme gamma-butyrobetaine hydroxylase inhibitor. On the 30th day of ingestion, the effects of the Eleutherococcus extract were practically indistinguishable from those of the enzyme gamma-butyrobetaine hydroxylase inhibitor. Conclusions: The data obtained suggest the presence of cytoprotective effects in the two phytopreparations that are similar to the enzyme gamma-butyrobetaine hydroxylase inhibitor. In this case, the effect of the extract of Ligusticum wallichii is more pronounced under the acute stress conditions, and the extract of Eleutherococcus, under the chronic stress conditions. Full article

(This article belongs to the Special Issue Physical Exercise in Sports Sciences and Rehabilitation: Physiology, Clinical Applications and Real Practice)

12 pages, 1485 KiB

Open AccessArticle

Efficacy of an Acupressure Mat in Association with Therapeutic Exercise in the Management of Chronic Low Back Pain: A Prospective Randomized Controlled Study

by Antonio Frizziero, Paolo Finotti, Cinzia La Scala, Giovanni Morone, Giovanni Piran and Stefano Masiero

Appl. Sci. 2021, 11(11), 5211; https://0-doi-org.brum.beds.ac.uk/10.3390/app11115211 - 04 Jun 2021

Cited by 1 | Viewed by 14977

Abstract

(1) Background: Acupressure is a noninvasive, low-cost technique that makes use of physical pressure on specific points using a finger or a device and shows positive effects on chronic pain as an adjunctive method to the rehabilitation exercises. The study’s aim was to evaluate the therapeutic efficacy on pain, disability, and life quality of an acupressure mat associated with a rehabilitation program in patients with chronic low back pain. (2) Methods: All participants underwent a specific rehabilitation program, initially with 10 supervised exercise sessions, then as home exercise for 6 months. The subjects in the experimental group (EG) were additionally provided with an acupressure mat and used it for 60 min per day. (3) Results: 44 patients (31 females) were equally divided among the treatment groups. A significant time interaction was found in both groups for McGill Pain Questionnaire, Oswestry Disability Index, and EuroQol-5D, and only in the EG for Visual Analog Scale. (4) Conclusions: The acupressure mat is simple and provides an additional benefit for patients in relieving pain and improving function and quality of life, especially in the medium-to-long term. Full article

(This article belongs to the Special Issue Physical Exercise in Sports Sciences and Rehabilitation: Physiology, Clinical Applications and Real Practice)

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9 pages, 800 KiB

Open AccessArticle

Anterior Cruciate Ligament Injury Prevention Exercises: Could a Neuromuscular Warm-Up Improve Muscle Pre-Activation before a Soccer Game? A Proof-of-Principle Study on Professional Football Players

by Alessandro de Sire, Andrea Demeco, Nicola Marotta, Lucrezia Moggio, Arrigo Palumbo, Teresa Iona and Antonio Ammendolia

Appl. Sci. 2021, 11(11), 4958; https://0-doi-org.brum.beds.ac.uk/10.3390/app11114958 - 27 May 2021

Cited by 26 | Viewed by 7845

Abstract

Neuromuscular warm-up has been shown to decrease the risk of anterior cruciate ligament (ACL) injury improving muscular firing patterns. All preventive training programs described in the literature have a duration of several weeks. To date, no studies have explored the immediate effect of a neuromuscular warm-up exercise on pre-activation time of the knee stabilizer muscles. Thus, this proof-of-principle study aimed at evaluating the acute effects of a neuromuscular warm-up exercises on the electromyographic activation of knee stabilizer muscles’ activation pattern. We included 11 professional football players, mean aged 23.2 ± 4.5 years, from a Southern Italy football team. All of them underwent a standard warm-up exercise protocol at the first day of the evaluation. At 1 week, they underwent a structured neuromuscular warm-up exercise protocol. We assessed as outcome measure the pre-activation time (ms) of rectus femoris (RF), vastus medialis (VM), biceps femoris (BF), and medial hamstrings (MH) upon landing. Outcomes were assessed before and after the standard warm-up and neuromuscular warm-up. Pre-activation time of RF, VM, BF and MH significantly improved only after neuromuscular warm-up (p < 0.05); moreover, there was a significant (p < 0.05) between-group difference in pre-activation time of all muscles after the neuromuscular warm-up compared with the standard warm-up. These findings suggested that physical exercise consisting of a structured injury prevention neuromuscular warm-up might have an immediate effect in improving the activation time of the knee stabilizer muscles, thus potentially reducing the risk of ACL injury. Full article

(This article belongs to the Special Issue Physical Exercise in Sports Sciences and Rehabilitation: Physiology, Clinical Applications and Real Practice)

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9 pages, 1220 KiB

Open AccessFeature PaperArticle

Effectiveness of Combined Treatment Using Physical Exercise and Ultrasound-Guided Radiofrequency Ablation of Genicular Nerves in Patients with Knee Osteoarthritis

by Alessandro de Sire, Lorenzo Lippi, Claudio Curci, Dario Calafiore, Carlo Cisari, Antonio Ammendolia and Marco Invernizzi

Appl. Sci. 2021, 11(10), 4338; https://0-doi-org.brum.beds.ac.uk/10.3390/app11104338 - 11 May 2021

Cited by 15 | Viewed by 2322

Abstract

Radiofrequency (RF) is a mini-invasive neuromodulation intervention that is commonly used in chronic pain conditions including general musculoskeletal pain related to several diseases, including knee osteoarthritis (KOA). However, to date, few studies investigated synergistic therapeutic approaches combining RF with rehabilitative physical exercise protocols in KOA patients. This prospective cohort study aimed at assessing the short-term effects on pain in KOA patients of a multimodal intervention consisting of ultrasound (US)-guided RF geniculate ablation and concomitant rehabilitative physical exercise. We included grade III KOA patients with knee pain (Numerical Pain Rating Scale, NPRS >4) not responsive to conventional treatments. They underwent a combined intervention including US-guided RF geniculate ablation and a 2-week physical exercise program. At the baseline (T0) and 1 month after (T1) we assessed: NPRS, Knee Injury and Osteoarthritis Outcome Scale (KOOS), quality of life, exercise adherence, and safety. All the 47 KOA patients enrolled (68.8 ± 13.7 years old) showed a reduction of pain (NPRS: 7.48 ± 1.74; 3.63 ± 1.68; p < 0.001). In addition, there was a significant improvement (p < 0.05) also in the other functioning and HRQoL outcomes. Adherence to the exercise program was over 80% in more than half (28) of the patients. No major adverse events were reported. These findings suggested that US-guided RF ablation of genicular nerves combined with rehabilitative exercise therapy might be considered a safe and effective approach in the complex management of KOA patients. Full article

(This article belongs to the Special Issue Physical Exercise in Sports Sciences and Rehabilitation: Physiology, Clinical Applications and Real Practice)

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9 pages, 847 KiB

Open AccessArticle

The Relationship between Clinical Tests, Ultrasound Findings and Selected Field-Based Wheelchair Skills Tests in a Cohort of Quadriplegic Wheelchair Rugby Athletes: A Pilot Study

by Lucrezia Tognolo, Alfredo Musumeci, Andrea Pignataro, Nicola Petrone, Michael Benazzato, Francesco Bettella, Giuseppe Marcolin, Antonio Paoli and Stefano Masiero

Appl. Sci. 2021, 11(9), 4162; https://0-doi-org.brum.beds.ac.uk/10.3390/app11094162 - 02 May 2021

Cited by 2 | Viewed by 1915

Abstract

Manual wheelchair use may determine shoulder joint overload and rotator cuff injury. Chronic shoulder pathologies can also influence the propulsion ability of wheelchair athletes with spinal cord injury (SCI) during sport activities. However, the relationship between shoulder pathology and wheelchair performances has never been explored. Therefore, the study aimed to investigate the correlation between shoulder pathologic findings with clinical tests and ultrasonography evaluation and the results of wheelchair performance tests. Nineteen quadriplegic wheelchair rugby players were evaluated to investigate the association between clinical and ultrasound shoulder pathologic findings and their correlation with the performance of field-based selected wheelchair skills tests (WSTs). The outcome measures were the International Wheelchair Rugby Classification Score, dominant and non-dominant Physical Examination Shoulder Score, and dominant and non-dominant Ultrasound Shoulder Pathology Rating Scale (USPRS). The WST was measured at the beginning and at one-year follow-up. A statistically significant correlation was found between the time since SCI and dominant USPRS (p < 0.005). The non-dominant USPRS was strongly related to WST at the beginning (p < 0.005) and the end of the study (p < 0.05). Data suggest that the severity of the non-dominant shoulder pathology detected on the ultrasound is related to lower performance on the WST. Chronic manual wheelchair use could be responsible for dominant SCI shoulder joint and rotator cuff muscle damage, while non-dominant USPRS could be related to performance on the WST. Full article

(This article belongs to the Special Issue Physical Exercise in Sports Sciences and Rehabilitation: Physiology, Clinical Applications and Real Practice)

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Review

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15 pages, 1133 KiB

Open AccessReview

From Exercise to Cognitive Performance: Role of Irisin

by Mirko Pesce, Irene La Fratta, Teresa Paolucci, Alfredo Grilli, Antonia Patruno, Francesco Agostini, Andrea Bernetti, Massimiliano Mangone, Marco Paoloni, Marco Invernizzi and Alessandro de Sire

Appl. Sci. 2021, 11(15), 7120; https://0-doi-org.brum.beds.ac.uk/10.3390/app11157120 - 31 Jul 2021

Cited by 8 | Viewed by 3409

Abstract

The beneficial effects of exercise on the brain are well known. In general, exercise offers an effective way to improve cognitive function in all ages, particularly in the elderly, who are considered the most vulnerable to neurodegenerative disorders. In this regard, myokines, hormones secreted by muscle in response to exercise, have recently gained attention as beneficial mediators. Irisin is a novel exercise-induced myokine, that modulates several bodily processes, such as glucose homeostasis, and reduces systemic inflammation. Irisin is cleaved from fibronectin type III domain containing 5 (FNDC5), a transmembrane precursor protein expressed in muscle under the control of peroxisome proliferator-activated receptor-γ coactivator-1α (PGC-1α). The FNDC5/irisin system is also expressed in the hippocampus, where it stimulates the expression of the neurotrophin brain-derived neurotrophic factor in this area that is associated with learning and memory. In this review, we aimed to discuss the role of irisin as a key mediator of the beneficial effects of exercise on synaptic plasticity and memory in the elderly, suggesting its roles within the main promoters of the beneficial effects of exercise on the brain. Full article

(This article belongs to the Special Issue Physical Exercise in Sports Sciences and Rehabilitation: Physiology, Clinical Applications and Real Practice)

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Other

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20 pages, 553 KiB

Open AccessSystematic Review

Motor Imagery and Sport Performance: A Systematic Review on the PETTLEP Model

by Giovanni Morone, Sheida Ghanbari Ghooshchy, Claudia Pulcini, Emanuele Spangu, Pierluigi Zoccolotti, Marialuisa Martelli, Grazia Fernanda Spitoni, Valentina Russo, Irene Ciancarelli, Stefano Paolucci and Marco Iosa

Appl. Sci. 2022, 12(19), 9753; https://0-doi-org.brum.beds.ac.uk/10.3390/app12199753 - 28 Sep 2022

Cited by 5 | Viewed by 4927

Abstract

The aim of this review is to critically analyze the evidence provided throughout the years regarding the application of motor imagery (MI) in sport performance, focusing on the PETTLEP approach. Among the different MI approaches, in fact, the PETTLEP model takes into account many different domains for increasing the performance of athletes. These domains include physical features, the environment, task-related aspects, timing, learning, emotion, and perspective. Full article

(This article belongs to the Special Issue Physical Exercise in Sports Sciences and Rehabilitation: Physiology, Clinical Applications and Real Practice)

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