The evaluation of neck muscle strength in the professional football and ice hockey athletes
Santana Reičela Dijeva, Sandra Rozenstoka
Underdiagnosis of vascular diseases in physical active patients: does it result from atypical presentation of typical diseases or from atypical diseases of typical presentation?
Pierre Abraham, Simon Lecoq, Antoine Bruneau
Metabolic stress and cardiovascular adaptations following repeated dynamic hiit intervals in skiers
Marcis Jakovics, Inese Pontaga, Edgars Bernans
Evaluation and training of balance performance characteristics in young football players in pre-season
A systematic review of bibliotherapy as emotional support in young athletes
Simona Upīte, Roberts Petrovičs, Nikola Anna Intlere, Jolanta Upīte
Exploring sport coach’s awareness and perceptions of bibliotherapy in enhancing young athletes' mental well-being during training
Roberts Petrovičs, Nikola Anna Intlere, Jolanta Upīte, Simona Upīte
Medicina dello Sport - www.sportsmedicinejournal.com
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The 12th International Baltic Sports Medicine Congress was held on May 16-17, 2025, in Riga, Latvia.
The goal of this congress was to build close cooperation between sports medicine physicians, rehabilitation physicians, cardiologists, traumatologists, radiologists, physiotherapists, family doctors, nutritionists and other specialists involved in the medical care of professional athletes, amateur athletes, child athletes and the general public.
The congress shared the latest scientific achievements and practical approaches in sports medicine, as well as offer a medical exhibition and professional networking.
Among the special guests at our congress were Professor Fabio Pigozzi, President of the International Federation of Sports Medicine, Professor Yannis Pitsiladis, Chairman of the Scientific Committees of FIMS and EFSMA, Professor Agnese Magi, President of the Estonian Sports Medicine Association, and Dr. Paulius Petraitis, President of the Lithuanian Sports Medicine Association, and many others.
12th International Baltic Congress of Sports Medicine
May 16-17, 2025 - Riga, Latvia
Longevity: physical activity, pharmacology, and quality of life
Sandra Rozenstoka
Sports laboratory – FIMS Collaborating centre, Riga, Latvia; Latvian Sports Medicine Association, Riga, Latvia; European Federation of Sports Medicine Association; Public Health Institute, Riga Stradins University, Riga, Latvia
Longevity is a multifactorial phenomenon influenced by genetic, biological, and lifestyle determinants. Among the key contributors, physical activity, pharmacology, and quality of life play central roles. Physical activity is a cornerstone of healthy aging, enhancing cardiorespiratory fitness, muscle mass, cognitive function, and independence across the life course—from growth and development in youth, to maintaining high functional capacity in adulthood, and preventing disability in older age. Despite this, 46% of Europeans never engage in exercise or sport, and population-based studies reveal that 90.0% of Latvian adults and 81.2% of students do not meet World Health Organization recommendations. While only 0.5% of teenage athletes progress to the professional level, diverse forms of sport—including recreational, parasport, and health-oriented activities—contribute to functional resilience and long-term well-being.
Pharmacological innovation and personalized medicine further support longevity through preventive healthcare, targeted therapies, and optimization of physiological responses. Nutritional
interventions, such as dietary restriction, amplify the beneficial effects of exercise, particularly in overweight and older adults. Importantly, interindividual differences in genetics, disease burden, and lifestyle modulate responsiveness to physical activity, underscoring the need for personalized interventions.
The prospective study “The Impact of Exercise Consultation on Athlete Health and Exercise Tolerance” done by Sandra Rozenstoka with involving 1,600 participants (550 female, 1,050 male, aged 12–70 years) demonstrated that individualized sports medicine physician guided exercise programs led to significant improvements within 6–8 months. Male adults reduced body weight and BMI. While all participants enhanced exercise tolerance, and physical working capacity by 0.32–0.46 W/kg (p < 0.05); enhanced cardiovascular functionality with greater cardiac output by 1.6 to 3.6 l/min during exercise (p < 0.05), and enhanced respiratory functionality with higher expired volume by 8.8 l/ min, oxygen uptake by 4.0 ml/kg/min and metabolic equivalent by 1.14 MET during exercise (p < 0.05) as well as faster recovery after exercise.
In conclusion, achieving longevity requires an integrative approach that combines physical activity, pharmacological advances, and quality of life strategies, emphasizing preventive healthcare, tailored nutrition, stress management, sleep hygiene, and strong social connections. Longevity is not only about living longer but also about maintaining health, independence, and fulfilment throughout the lifespan.
High achievement sports genetics and sports medicine
Yannis Pitsiladis
Department of Sports and Health Sciences, Hong Kong Baptist University, Hong Kong SAR, China
Elite sporting performance is a multifactorial trait resulting from complex interactions between polygenic influences and environmental exposures. Heritability estimates from classical twin and family studies consistently demonstrate substantial genetic contributions to key physiological and neurocognitive traits associated with high-level sports performance, including maximum aerobic capacity (heritability >90%), muscle fibre composition (>90%), neuromuscular coordination (>70%), motor learning (>65%), and personality (~50%) cognitive traits (40-70%). While environmental factors such as training volume and quality remain essential, the inter-individual variability in both baseline traits and response to training (trainability) underscores the primacy of genetic predisposition, supporting the view that truly elite athletes are built from individuals born with exceptional genetic potential. While early genomic investigations—including candidate gene and underpowered GWAS studies—yielded limited replicable findings, recent advances in genomic methodology have transformed the field.
A pivotal example is the multi-phase, multi-ethnic GWAS conducted in my laboratory (Wang et al., Biol Sport 2025;42:141-59), which robustly identified and validated genomic loci associated with sprint and power performance across discovery, replication, and functional validation phases. This landmark study represents a critical inflection point in sports genomics, demonstrating that rigorous, powered designs can uncover biologically and clinically meaningful insights into performance predisposition.
As sports medicine has entered the era of precision health, the need to act boldly has never been
more urgent. Inspired by the rapid scientific mobilization during the Covid-19 pandemic, there is now a compelling case to launch a global “Human Genome and Phenome Project” – an integrated effort combining high-resolution genomic sequencing with comprehensive phenotypic, behavioural, and environmental data. Such an initiative would not only advance our understanding of elite performance but also pave the way for personalized interventions in training, injury prevention, and recovery.
This vision calls for large-scale collaboration across countries, disciplines, and institutions —to move beyond fragmented research and build a unified, data-rich foundation for the future of sports medicine and beyond. High-performance athletes can no longer be viewed through a one-size-fitsall lens. To truly unlock human potential, there is a need to “think big”, act collectively, and embrace a long-term commitment to integrative, personalized science.
Physical activity in obesity
Katarzyna Szmigielska
Department of Sports Medicine, Medical University of Lodz,
Poland
Obesity is a chronic complex disease defined by excessive fat deposits that can impair health. In clinical practice, the body fatness is usually estimated by BMI. For adults, WHO defines obesity when BMI is greater than or equal to 30 kg/m2 and overweight when BMI is greater than or equal to 25 kg/m2 Obesity can lead to increased risk of type 2 diabetes coronary artery disease; heart failure and it increases the risk of certain cancers.
The basis of obesity treatment is to achieve a negative energy balance through dietary recommendations, physical activity, behavioral modifications, and pharmacotherapy. Regardless of weight loss, exercise has been shown to reduce several risk factors associated with obesity such as blood pressure, glycemic intolerance disorders, lipid disorders. Regular physical activity leads to many health benefits like reduction in the amount of fat tissue, reduction in the size of adipocytes, increase in sensitivity of adipose tissue to lipolytic factors.
Lifestyle interventions for weight loss that combine reductions in energy intake with increases in energy expenditure through physical activity often result in an initial 5%-10% reduction in body weight. A review of weight loss interventions found that programs which combined diet and exercise resulted in a 20% greater weight loss versus diet restriction alone. It has been shown that the resting metabolic rate in physically active people is 5-20% higher compared to people who lead a sedentary lifestyle.
In the treatment of obesity, both endurance and resistance training are recommended. Endurance training increases the aerobic capacity of muscles, i.e., it increases the ability to oxidize fats during physical exercise and, consequently, the effectiveness of fat burning. Resistance training alone does not result in clinically significant weight loss. Cycling, swimming, water gymnastics are re-
commended forms of physical activity that do not overload the musculoskeletal system. Marching or running, the simplest and most accessible form of movement, are not the most recommended forms of activity for obese people because it can lead to possible overloads. Energy requirements of physical exertion are mainly covered by the oxidation of fats and carbohydrates. The higher exercise intensity the higher proportion of carbohydrates in meeting energy demand so the intensity of physical activity recommended for obese people should by moderate. There is a dose-response relationship between physical activity levels and the magnitude of weight loss. The ACSM’s position stand on physical activity and weight loss concluded that more 150 min per week of physical activity results in modest weight loss of ~2–3 kg, and between 225–420 min per week of physical activity results in a 5 kg to 7.5 kg weight loss.
Physical exercise is beneficial in combination with dietary restriction, as long as it is not lower than the resting metabolic rate. Physical activity appears also necessary for most individuals to prevent weight regain. Studies support the value of ~200–300 min/week of physical activity during weight maintenance to reduce weight regain after weight loss.
Sports medicine guidelines – Croatian Sports Medicine Society
Vladimir Ivančev 1, Davor Plavec 2
1University of Split, Split, Croatia; 2Prima Nova, Zagreb, Croatia; JJ Strossmayer University of Osijek, Croatia
Objectives. Regarding International Sports Federations healthcare criteria and actual Sports Act in Croatia it was necessary for us to create framework in our daily sports medicine healthcare. In 2019, at the initiative of Croatian Sports Medicine Society, athletes are included in National Healthcare Plan and Program as a population that requires special and specific healthcare. This was the first national official document that recognized athletes as specific population, and that was not intended for competitive athletes only but also for recreational and exercise health related population.
Materials and methods. Three types of laws and official documents were studied: the Sports Act; laws on healthcare and health insurance; and the Health Care Regulations for Athletes issued by international sports federations. All of these official documents were examined in light of the doctrine, scientific facts, and professional principles of the medical profession. Discussion and writing of this Guidelines including, besides sports medicine specialists, many other sports related specialists such as cardiologists, orthopaedics, clinical physiologists, etc.
Results. A review of the laws and regulations revealed a range of legal and bureaucratic inconsistencies that hinder or complicate the effective implementation of health protection measures for athletes. Such questionable regulations are impossible in practice and often significantly deviate from scientifically based facts and the established standards of the medical profession. Based on contemporary literature, these guidelines consider the main points of clinical examination, diagnostical procedures, relative and absolute contraindication,
organisation of medical service in local community and clubs, medical duties and equipment in sports competitions.
Conclusions. Through the development of these guidelines, we aim to initiate changes in legal and other official documents, all based on facts. While respecting existing regulations, scientifically and professionally grounded multidisciplinary medical teams will prepare a working draft of the Guidelines, which will be presented to the relevant ministries, with the goal of making a joint contribution to improving health care for all those who engage in sports or exercise daily.
Leisure-time physical activity in Latvian inhabitants: preliminary data
1University of Latvia, Riga, Latvia; 2Longenesis Ltd, Riga, Latvia
Objectives. In line with Latvia’s Public Health Guidelines, there is a recognized need for focused interventions to enhance health literacy. This study examined health literacy and leisure-time physical activity across diverse demographic groups.
Materials and methods. A population-based cross-sectional survey was carried out using a random sample of Latvian residents. Data were gathered on socio-demographic characteristics, as well as on stress levels, dietary habits, physical activity, and sleep quality. Descriptive and univariate statistical methods were applied to assess leisure-time physical activity differences across socio-economic groups.
Results. The study included 1133 participants from different Latvian regions (mean age 51.0, Standard deviation, SD 18.5, 44.2% men, 38.5% of participants with secondary professional education). No significant gender differences were found in overall self-evaluated physical activity. However, men reported more time spent on high-intensity activity (mean = 3.6, SD 5.7 in men vs. 3.1,5.8 SD hours/week in women, p < 0.01) and muscle strengthening (mean = 1.2, SD 3.4, and mean 0.6, SD 2.4 hours/week, for men and women, respectively). Age negatively correlated with hours spent on moderate and high-intensity physical (p < 0.01), with younger individuals being more active. However, the correlation in both cases was weak. Moderate activity was reported by 50.9% of those with secondary and 51.3% in those with higher education, but only 36.3% in the primary education group, where
low activity levels dominated (50.0%) (p = 0.02). Participants with higher education reported more hours/week of moderate physical activity (mean = 7.6, SD 9.1 compared to the less than 7 hours/ week in the groups with primary and secondary education), while time spent on high-intensity activity and muscle strengthening did not differ significantly by the levels of education (p Physical activity levels were higher among younger and more educated participants. Therefore, targeted interventions are needed for older and less-educated population groups p = 0.37 and p = 0.11, respectively).
Conclusions. Physical activity levels were higher among younger and more educated participants. Therefore, targeted interventions are needed for older and less-educated population groups.
New Croatian bylaw for athletes preparticipation examinations
Davor Plavec 1, Vladimir Ivančev 2
1Prima Nova, Zagreb; JJ Strossmayer University of Osijek, Croatia; 2University of Split, Split, Croatia
Objectives. The new sports law (2023) prescribed the need for the bylaw describing the extent and periodicals for preparticipation examination in athletes. Croatian Association of Sports Medicine (CASM) together with other professionals was included in the creation of this bylaw. It is our intent to present the current state of preparticipation in Croatia.
Materials and methods. Current literature was studied and different solutions were discussed between members of the CASM and in between members of the Ministry of Health working group that included also other professionals (sports cardiologists, paediatricians, pulmonologists, members of the Croatian Olympic Committee health commission, etc.) until the consensus was reached. At the end general public consultations were done through the web platform and the final text was reached.
Results. We will present the final state of this new bylaw and what we expect from its application. Every athlete in Croatia would have the obligation to pass this preparticipation examination at least once a year.
Conclusions. We expect that this bylaw would significantly increase the safe of our athletes during training sessions and competitions.
Breathing techniques for stress reduction and cognitive function improvement in the adolescent athlete population
1Riga Stradins University, Riga, Latvia; 2Aston University United Kingdom
Objectives. Breathing techniques in adolescent sports have been in use for a while now. Despite showing efficacy in reducing stress and improving several cognitive function parameters, the use of these techniques imposes several challenges. Some of the challenges involve lack of continuous interest because of the breathing techniques often being quite monotonous. Being able to integrate breathing techniques of various different kinds might add to the variability and increase the chances of continuous engagement. The goal of this research is to determine and summarize what breathing techniques are used in the adolescent athlete population in general.
Materials and methods. A scoping review was conducted in eight databases (Science Direct; Scopus; Cochrane; ProQuest; PsycINFO; Google Scholar; The Web of Science; and EBSCOhost Complete) covering period from January 2000 to December 2023 to discover the prevalence of the use of breathing techniques in the adolescent athlete population. The search was conducted particularly for 14 -17 years athletes, which is an age range often corresponding to youth league.
Results. Five studies were found on breathing techniques used in the adolescent athlete population. The techniques used encompasses Heart Rate variability biofeedback, Yogic Breathing techniques, Slow-paced breathing and relaxation breathing. The included studies show a great variability in study design as well as a lot of heterogeneity in the study populations which makes the comparison difficult.
Conclusions. Although breathing techniques for adolescent athletes are not used as commonly as in the adult sports, they have potential to provide meaningful benefits for stress reduction and the enhancement of cognitive function, similarly as it has been shown for adults. More studies with similar study designs and homogeneous populations are necessary in order to compare and determine the most efficient techniques.
The evaluation of neck muscle strength in the professional football and ice hockey athletes
Santana Reičela Dijeva
1 ,
2
Sandra Rozenstoka
1Riga Stradins University; 2Sports laboratory – FIMS Collaborating centre, Riga, Latvia; Latvian Sports Medicine Association, Riga, Latvia; European Federation of Sports Medicine Association; Public Health Institute, Riga Stradins University, Riga, Latvia
Objectives. The cervical spine and neck muscles are subject to sport-specific stress in contact sports such as football and ice hockey. According to the 2020 European Society of Cardiology guidelines, football is classified as a high dynamic and moderate static load sport (Class III-B), while ice hockey is classified as a high dynamic and static load sport (Class III-C). Neck muscle strength capabilities play a crucial role in stabilizing the head during sport-specific movements, during collisions with an opponent, and may reduce the risk of sports injuries. The aim of the study was to compare neck muscle strength between professional football players, ice hockey players, and a control group of physically active people.
Materials and methods. This is a pilot study for a larger European Union Recovery and Resilience Mechanism Plan and state budget-funded science excellence project within RSU and RSU with LSPA external consolidation No. 5.2.1.1.i.0/2/24/I/ CFLA/005 Scientist grant “The impact of sport type on neck functional abilities, movement stereotypes and health risks in sports and para sports” No. RSUZG-2024/1-0016 and was conducted at the Sports Laboratory - FIMS CCSM, using its equipment. Eighteen professional international-level adult male football (F) and hockey (IH) players and control group physically active individuals (CG) were tested with anthropometry, training program assessment and helmet-based isometric dynamometry in a sitting position to reduce the involvement of other body muscles and statistical analysis of the
data was also performed. Ethics approval No. E-3 obtained from the Ethics Committee of the Latvian Sports Medicine Association.
Results. Anthropometry showed statistically significant differences in weight (including BMI): F 77.0 ± 2.5 kg vs. IH 87.6 ± 3.6 kg and CG 87.0 ± 5.2 kg (p < 0.05). All participants had been involved in their sport for 14–20 years: F and IH had a regular training program 6 days a week, 1-2 times a day, 90 minutes; CG 3 days a week, 90 minutes. Statistically significantly greater strength was demonstrated in IH flexion 24.6 ± 1.3 kg (also in lateral flexions), compared to F 19.3 ± 1.2 kg and CG 22.8 ± 0.8 kg (p < 0.05), there was no difference between H and CG (p>0.05). F showed similar strength in neck flexors and extensors, IH had stronger flexors, but CG had stronger extensors with a significant difference with F and IH (p<0.05). Lateral flexors were similar in each group (p>0.05), but with a significant difference between F, IH and CG groups (p<0.05).
Conclusions. Sport-specific training programs influence neck muscle strength abilities. Of the sports studied, hockey players showed the greatest sport-specific effect and greater strength abilities in flexion and lateral flexion, while soccer players showed the lowest strength in all directions.
Underdiagnosis of vascular diseases in physical active patients: does it result from atypical presentation of typical diseases or from atypical diseases of typical presentation?
Pierre Abraham, Simon Lecoq, Antoine Bruneau
Sports medicine, University Hospital in Angers, France
Since vascular diseases are expected to occur preferentially in the elderly, vascular diseases in physically active patients are frequently underdiagnosed or is suffering prolonged diagnostic erring. Further in elderly physically active patients, the simultaneous presence of co-morbid conditions may question the responsibility of the various potential causes in the symptoms. The presentation will review upper limb and lower limb exercise-induced or exercised-revealed vascular diseases. It will underline that sports physician should be aware of clinical signs and complains that should lead to suspect a vascular origin to exercise-induced symptoms but also of recent developments in diagnostic vascular investigations during exercise.
Metabolic stress and cardiovascular adaptations following repeated dynamic hiit intervals in skiers
Marcis Jakovics, Inese Pontaga, Edgars Bernans
Riga Stradins University, Riga, Latvia
Objectives. Analyze metabolic stress response as blood lactate level after dynamic intervals of “2x up to 10”. Investigate participants ability to subjectively manage load and induced stress. Determine the ability of the subjects to maintain and improve work capacity, to maintain constant power as a criterion. Develop recommendations for coaches regarding the selection of training protocol.
Materials and methods. Anthropometry, Ergometry, Gas exchange analysis, Blood lactate analysis, Pulsometry, Mathematical statistics. Four female (age 18±2 years; VO2max: 51.2±2.2 ml/kg/min, weight: 63.18±3.58 kg) and six male (age 17±1.67 years; VO2max: 58.57±2.81 ml/kg/ min, weight: 74.76±3.63kg) skiers participated in this study (approved by LSPA Ethical committee (3/51813)). For two weeks every participant performs interval training according to the dynamic high-intensity interval training protocol “2x to 10min”. A standardized 20min warm-up with a heart rate of 120 x/min is performed before. A maximal oxygen consumption load is used in the 2 intervals until failure. The time spent at the load is recorded. Rest ratio 1:2. The participant is invited to the next training session in 2 days for 2 weeks. After two weeks another maximal oxygen consumption test is performed.
Results. To assess the metabolic stress imposed by the interval sessions, we analyzed post-exercise blood lactate concentrations. The mean lactate concentration per session ranged from 11.8 to 13.0 mmol/L. The Friedman test (p=0.265) found no significant differences across sessions, and Wilcoxon signed-rank tests between consecutive ses-
sions also showed no significant pairwise changes (all p>0.1). These results statistically support that athletes experienced consistently high metabolic stress throughout, with no dips in effort, despite the subjective nature of session termination. Athletes demonstrated a marked improvement in their capacity to sustain high-intensity exercise. The mean time to failure on Day 1 was 357.1±53.1 sec, which increased to 535.0±87.2 sec by Day 6 – an absolute gain of 177.9 sec, representing a 49.8% improvement (p=0.013). Analysis of heart rate data across six consecutive training days revealed a significant reduction in cardiovascular strain over time. The percentage of interval duration spent above 90% of each athlete’s individual HRmax declined from a mean of 87.6% on Day 1 to 80.1% on Day 6 (p=0.002)
Conclusions. Allowing athletes to subjectively determine the point of exhaustion during intervals still resulted in consistently high metabolic stress, as evidenced by elevated blood lactate levels. The dynamic HIIT protocol (“2× up to 10min”) appears to be a promising strategy for tapering before a major event. This approach not only maintains physiological intensity but also enhances work capacity at VO₂max and may support weight management. These results indicate a clear cardiovascular adaptation: athletes were able to sustain longer high-intensity efforts while spending relatively less time in extreme heart rate zones. This reflects improved cardiovascular efficiency and tolerance to high-intensity interval stress over the short-term training cycle. Further research is needed to confirm its effects on VO₂max and broader performance outcomes.
Evaluation and training of balance performance characteristics in young football players in preseason
Riga Stradins University Latvian Academy of Sport Education, Riga, Latvia
Balance performance, especially in unipedal stance, is crucial when performing football-specific technical skills, as high-intensity and explosive actions like sprints, jumps, accelerations, and decelerations during changes of direction. Additionally, better balance performance reduces the number of falls and injuries.
Objectives. The objective of our study was to evaluate static and dynamic balance characteristics, their determining factors, and balance trainability in young male football players.
Materials and methods. 19 male footballers (age 15.3±0.9 years, training experience in football 8.1±2.6 years, Tanner stage 3– 4) had 8.4±2.1 training hours in five sessions weekly. The static and dynamic balance were evaluated using a stabilometric platform. To measure a static balance, players were instructed to maintain a balanced unipedal stance for 30 seconds with eyes open, but for dynamic balance - in an unipedal stance for 30 seconds on a movable balance platform. The range of movements (ROM) was measured using a goniometer.
Results. Adolescent football players in static balance did not differ significantly when standing on the dominant (D) and nondominant (N) legs (p≥0.092). Dynamic balance was the norm for non-athletes but low for football players: total stability index (TSI)2.04±0.66, total trunk deviation (TTD) angle 3.4°±2.4° standing on the D leg and TSI 2.00±0.74, TTD angle 3.2°±1.7° N leg (p≥0.260). The peak isometric torques of the ankle plantar and dorsal flexor muscles were higher in the D leg
than in the N (p≤0.018). The ROMs of ankle plantar and dorsal flexion of the D and N legs did not differ significantly (p≥0.08), and their values were within the normal range. Then, the balance and plyometric exercises were incorporated into the regular training sessions twice a week with a duration of 30-35 min, and the tests were repeated after 8 weeks. The static balance side-asymmetry in unipedal stance was observed standing on the D and N legs (p ≤ 0.037), with significant enhancement only in the N leg (p≤0.041). Dynamic balance improved: the TTD angle reduced standing on the D and N legs (p≤0.041). The peak isometric torques of the ankle dorsiflexor and plantar flexor muscles remained higher in the D leg than in the N leg (p≤0.021), and the peak isometric torques of the ankle dorsiflexor muscles increased in both legs (p≤0.001). The passive plantar flexors (PF) ROM was reduced in both ankles (p≤0.008), and the active PF ROM increased only in the D leg (p=0.033).
Conclusions. Eight weeks of balance and plyometric exercises implemented twice a week for 30 minutes led to improved dynamic balance performance, unipedal static balance, ankle dorsal flexor muscle strength, and higher passive stiffness of the ankle joints. The inclusion of additional balance and plyometric exercises twice a week for 30 minutes in the routine training program of adolescent football players is highly recommended to improve dynamic and static balance performance, motor skills and reduce the number of falls.
Enhancing injury prevention in football: a smart socks-based biofeedback system for real-time biomechanical monitoring
Anna Davidoviča 1, Guna Semjonova 1 , Signe Tomsone 1, Aleksejs Kataševs 2 , Aleksandrs Okss 2, Linda Lancere 3 , Lydia Kamynina 3, Andis Bikšāns 3
1Riga Stradins university, Riga, Latvia; 2Riga Technical University, Riga, Latvia; 3Vidzeme University of Applied Sciences, Riga, Latvia
Objectives. Lower limb injuries, particularly in football, remain a significant concern due to their high incidence and impact on player performance and career longevity. This study aims to develop and assess a smart socks-based biofeedback system capable of real-time biomechanical monitoring to mitigate injury risk by providing immediate.
Materials and methods. The proposed system integrates textile-based pressure sensors and inertial measurement units (IMUs) within smart socks to capture biomechanical data during football-related movements. Real-time feedback is delivered via a mixed reality interface, enabling players and coaches to make data-driven adjustments. The system’s validation involves laboratory testing with controlled movement protocols and field-based testing with football players to assess usability, accuracy, and effectiveness.
Results. Preliminary findings indicate that the smart socks system successfully capture foot pressure variations and movement asymmetries with high accuracy. Real-time biofeedback enables athletes to adjust movement mechanics, potentially reducing injury risk factors such as excessive load on the lower extremities. User evaluations highlight the system’s effectiveness in promoting biomechanical awareness and its feasibility for integration into training.
Conclusions. This study demonstrates the potential of smart textile-based biofeedback systems in enhancing injury prevention strategies in football. By providing real-time biomechanical monitoring and mixed reality feedback, the system offers a novel approach to mitigating injury risks and improving training methodologies. Future research will focus on refining sensor accuracy, expanding user trials, and optimizing the integration of biofeedback into professional football training environments.
Dry needling in sports medicine: minimalistic treatment strategy for optimal recovery
Dalius Barkauskas
Hila, Rehabilitation and sports medicine centre, Lithuania
Objectives. This review aims to critically analyse and consolidate current evidence on the scientific principles, clinical applications, and efficacy of dry needling (DN) as a minimalistic intervention strategy within sports medicine. Emphasis is placed on evaluating DN’s role in pain management, enhancement of athletic performance, and acceleration of recovery processes following sports-induced injuries.
Materials and methods. A thorough literature review was undertaken utilizing peer-reviewed publications accessible through major scientific databases, notably PubMed. Inclusion criteria encompassed controlled clinical trials, systematic reviews, meta-analyses, and evidence-based articles published within the preceding decade, explicitly focusing on the neurophysiological mechanisms, clinical effectiveness, and functional outcomes associated with DN in sports-related contexts
Results. Dry needling, clearly delineated from traditional acupuncture, leverages contemporary neurophysiological insights. Its therapeutic efficacy arises from interactions involving peripheral nociceptive modulation via gate control mechanisms and transient receptor potential channel modulation, as well as central analgesic pathways mediated through endogenous opioid systems. Empirical evidence robustly supports DN’s capability to alleviate myofascial pain, mitigate muscle stiffness, deactivate myofascial trigger points, and enhance overall neuromuscular function. Clinical investigations consistently report significant functional enhancements attributable to DN interventions, notably increases in muscle strength, explosive power, joint flexibility, and improvements in
neuromuscular coordination. Specific studies, including those involving elite soccer athletes, have documented enhanced thigh muscle strength and improved hip flexion following DN treatments, alongside measurable increases in vertical jump performance metrics. Furthermore, DN has been demonstrated to effectively mitigate delayed-onset muscle soreness (DOMS) and expedite recovery of muscle tissue integrity subsequent to intensive exercise regimens.
Conclusions. Dry needling represents an evidence-based, minimally invasive, and efficacious therapeutic modality in the management of musculoskeletal disorders within athletic populations. Its demonstrated clinical utility, combined with cost-effectiveness and minimal invasiveness, renders DN particularly suitable for widespread integration into contemporary sports medicine practice. Nonetheless, optimal outcomes are contingent upon practitioners’ advanced anatomical comprehension and specialized procedural competence. Further rigorous randomized controlled trials are imperative to substantiate DN’s sustained therapeutic impacts and to optimize treatment protocols within clinical sports medicine frameworks.
Cognitive and stress-related predictors of athletic excellence
Objectives. This study aimed to identify psychological and cognitive characteristics that differentiate athletes of varying performance levels. The focus was on how stress tolerance, reaction time, and frustration management relate to an athlete’s competitive level (elite, pre-elite, amateur), using validated psychometric measures. Understanding these relationships may contribute to improving athlete selection processes, refining training programs, and enhancing performance prediction models in both team and individual sports.
Materials and methods. The study sample consisted of 181 athletes aged between 16 and 25 (M = 18.9 years), representing a wide range of individual and team sports across different competitive levels (elite, pre-elite, and amateur). Psychometric evaluation was conducted using the Vienna Test System, which included the following measures: 1) Stress Tolerance (capacity to function under pressure), 2) Median Reaction Time under Stress, 3) Performance (Work Ability), 4) Frustration Tolerance (emotional stability under pressure), 5) Simple Reaction Time (cognitive response speed), 6) Motor Reaction Time (psychomotor readiness). Pearson correlation was used to explore relationships between these psychological variables and athletes’ competitive levels.
Results. Key findings revealed several statistically significant relationships. Stress Tolerance was positively correlated with Performance (r=0.341, p<0.001) and negatively with Median Reaction Time (r=–0.501, p<0.001), indicating that athletes with higher stress tolerance and more reflective thinking patterns tend to perform more consistently. Frustration Tolerance was negatively associated
with Performance (r=–0.397, p<0.001), suggesting that highly competitive athletes may experience stronger negative affect in failure contexts. Motor Reaction Time positively correlated with Performance (r=0.232, p=0.002), reinforcing the importance of quick psychomotor responses in high-level sport. Athlete Level correlated negatively with Simple Reaction Time (r=–0.216, p =0.003) and Median Reaction Time (r=–0.161, p=0.030), indicating faster cognitive processing in higher-level athletes. Demographic factors such as age and sport type had weak-to-moderate correlations with psychometric indicators but did not significantly alter core findings.
Conclusions. The results suggest that elite athletes demonstrate high stress tolerance, faster cognitive and motor reactions, and higher mental efficiency under pressure. These psychological traits appear to distinguish them from their pre-elite and amateur peers. The Vienna Test System proves to be a valuable tool for profiling athletes’ cognitive-emotional functioning and can support talent identification, targeted psychological training, and holistic athlete development strategies.
The impact of physical activity on working memory performance in the aging population
Objectives. An essential component of higher cognitive functioning is working memory (WM). It is responsible for the temporary storage and manipulation of information to perform complex cognitive activities such as planning, reasoning, and problem solving. WM performance declines with increasing age. Studies show that physical activities (PA) are positively related to better WM performance in both healthy older adults and in those with mild cognitive impairment or Alzheimer`s disease. The aim of this study was to investigate the relationship between a broader spectrum of PA and WM performance, particularly in the context of aging, by comparing the effects of PA performed over a lifetime to those done in the past year, while controlling for the effects of participants overall level of cognitive functioning.
Materials and methods. The study included 54 participants, aged 56-84 years (M=67.98, SD=6.81, 35.2% male). Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA). PA data were collected using the Motor Reserve Index (MRIq) and Current Physical Activity (CPAq) questionnaires (Pucci, 2024; Pucci et al., 2024). Both were translated into Latvian and piloted (MRIq, N=37, α = 0.806; CPAq, N = 45, α = 0.577). The questionnaires cover activities such as household chores, walking, leisure, sports, caregiving, and work. The MRIq assessed PA since age 18, while the CPAq focused on the past 12 months. WM was measured using the N-Back task in PsychoPy and the Backwards Corsi Block Tapping Test (B-CBTT) in PsyToolkit, with performance assessed by reaction time, accuracy, and WM capacity.
Results. A partial Pearson`s correlation was conducted to examine the relationship between MRIq, CPAq, N-Back and B-CBTT while controlling for MoCA score. Statistically significant correlations regardless of participants MoCA scores were found between the MRIq total score and N-Back reaction times (r(51)=-.297, p=.031), indicating that individuals who were more physically active during their lifetime had faster WM reaction times. However, no significant correlations were found between MRIq, N-Back accuracy, and CBBT scores, nor between CPAq and WM test results. Across the six domains of PA - namely, housework, walking, leisure activities, sports, care activities, and workplace activities – a significant correlation regardless of participants MoCA scores was found in for the MRIq case between caregiving and N-Back reaction times (r(51)=-.328, p=.016), and work-related physical activities and N-Back reaction times (r(51)=-.397, p=.003). These associations suggest that individuals who were more physically active during their lifetime through work or caregiving tended to have faster working memory reaction times. Additionally, a significant correlation was found between CPAq caregiving PA and N-Back accuracy, which was positive (r(51)=.272, p=.049), indicating that the more active the individual, the better their working memory accuracy.
Conclusions. Our results show that greater lifetime PA is associated with faster WM performance in older adults, particularly in caregiving and work-related PA, which are linked to shorter reaction times. Our results also indicate that higher levels of caregiving PA during the past year are associated with better WM accuracy. This may be due to the complexity of work and caregiving environments, which demand attention and quick reactions, enhancing WM speed. The lack of correlations between MRIq, CPAq, and B-CBTT test results could stem from debates on whether the CBBT measures all WM aspects or primarily the visuospatial component. If it`s the latter, PA may influence WM as an integrated system rather than individual components. Limitations should be noted: a small sample size; low internal consistency of the CPAq; and the need for more advanced tools to assess recent PA, as short-term life events may influence responses, unlike long-term PA assessments.
A systematic review of bibliotherapy as emotional support in young athletes
Simona Upīte 1, Roberts Petrovičs 2 , Nikola Anna Intlere 2, Jolanta Upīte 2
1Marupe’s County Sports School, Marupe’s County, Latvia;
2University of Latvia, Riga
Objectives. Mental health cannot be separated from physical health, as evidenced by mental health symptoms and disorders increasing the risk of physical injury and delaying subsequent recovery. Using literature for therapeutic purposes, bibliotherapy has gained recognition as a valuable tool for providing emotional support and insights to various populations, including young athletes. Recent studies highlight its potential in addressing emotional abuse, stress, and anxiety among youth involved in sports. Integrating bibliotherapy into preventive strategies for young athletes can offer a non-invasive, supportive approach to enhancing their emotional well-being. By incorporating bibliotherapy into their preventive plans, young athletes can benefit from a non-invasive, encouraging method to improve their emotional health. Although there is little research on bibliotherapy for young athletes, it is frequently incorporated into youth work and educational environments to promote resilience and emotional development. This review aims to explore the effectiveness of bibliotherapy as a preventive tool for emotional support in young athletes.
Materials and methods. A comprehensive search was conducted across multiple scientific databases, including PubMed, Scopus, and Web of Science. The search yielded a total of 42 articles that met the inclusion criteria based on the keywords: young athletes, emotional support, preventive tool, bibliotherapy.
Results. Young athletes’ anxiety and tension symptoms have been successfully reduced by bibliotherapy. It gives athletes a secure environment in which to examine and communicate their fee-
lings, resulting in increased emotional resilience. Research suggests that bibliotherapy helps lessen the impact of emotional maltreatment that young athletes in non-elite sports endure. There is potential for improving general mental health and well-being by using bibliotherapy as a preventative measure. When incorporated into routine training programs, bibliotherapy sessions can lower burnout rates and create a friendly environment. According to the literature, young athletes may benefit from bibliotherapy in addition to more conventional psychological support techniques.
Conclusions. These findings underscore the potential of bibliotherapy as an effective preventive tool for emotional support in young athletes, warranting further research and implementation in sports settings. It is necessary to implement bibliotherapy for young athletes. This comprehensive research indicates that collaboration with local educators, psychologists, and youth workers could enhance an understanding of bibliotherapy techniques. This could help create tailored programs that address the specific emotional needs of young athletes.
Exploring sport coach’s awareness and perceptions of bibliotherapy in enhancing young athletes’ mental well-being during training
Roberts Petrovičs 1, Nikola Anna Intlere 1, Jolanta Upīte 1, Simona Upīte 2
1University of Latvia, Riga, Latvia; 2Marupe’s County Sports School, Marupe’s County; Riga’s 1st hospital, Riga, Latvia
Objectives. Often, athletes’ physical training and conditioning are prioritized over athletes’ mental health, but it is equally crucial for their overall performance and success. Athletes are just as vulnerable to mental health issues as the general population and potentially even more so due to the unique pressures of their environment. Bibliotherapy, the use of literature to support mental health, has emerged as a potential tool to enhance young athletes’ psychological well-being. Memoirs and biographical films by athletes can motivate children in competitive sports and help them understand sportsmanship. Bibliotherapy can support young athletes in managing emotional challenges and setbacks. Raising awareness among coaches, who are well-suited to be able to check in with young people regularly, and professionals about the benefits of sports literature is crucial. This research aims to assess sports trainers’ awareness and perceptions of bibliotherapy and its viability in supporting young athletes’ mental well-being during training sessions.
Materials and methods. A survey was conducted among 100 sports coaches in Latvia to gather data on their awareness and perceptions of bibliotherapy. The survey included 58 male and 42 female from various sports schools and sports disciplines. The questionnaire comprised sections on knowledge of bibliotherapy, perceived benefits, and willingness to integrate bibliotherapy into training routines. Google Forms was used to facilitate the survey process.
Results. Most sports coaches (n=70) are not aware of the role that bibliotherapy can play in promoting mental resilience in young athletes. Among those who engage with bibliotherapy, 58 coaches have recommended resources like autobiographies and video training materials to help young athletes cope with stress and challenges. A significant majority (n=99) agreed that bibliotherapy could help athletes better understand their emotions and behaviours. Despite this, only 44 respondents devote about 2 hours per month to literature related to sport psychology or personal development. Additionally, 43 respondents, although they read such literature, cannot recommend it to their athletes, while 31 have tried to do so. A substantial number (n=97) believe that bibliotherapy tools could improve athletes’ understanding of psychological resilience and emotional awareness during practice; (n=96) indicated that bibliotherapy could provide valuable support during injuries or performance slumps; (n=82) suggested using bibliotherapy during training to better prepare athletes for competition pressure; (n=93) favoured its use post-training. Finally, 90 respondents expressed a desire for quality bibliotherapy programs in Latvia to support young athletes’ mental and emotional well-being, highlighting a need for more resources and tools for coaches.
Conclusions. The survey reveals a significant gap in awareness among sports coaches regarding the role of bibliotherapy in promoting mental resilience in young athletes. Despite this, there is a notable interest in and use of bibliotherapy resources among coaches who recognize its potential benefits in various sports disciplines. Overall, the findings underscore the need for developing comprehensive bibliotherapy programs and resources in Latvia to support the mental and emotional wellbeing of young athletes.
