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Effects of combined exercise and manual therapy on pain and physical function in overweight older adults with knee osteoarthritis: A randomized controlled trial
Seyed Ehsan Hosseini11. Department of Health Promotion and Rehabilitation, Lithuanian Sports University , LT2026-06-02|page 35-47AbstractBackground: Knee osteoarthritis (KOA) is a prevalent musculoskeletal disorder that leads to pain, reduced mobility, and functional limitations, particularly among overweight older adults. While exercise therapy is widely recommended as a primary non-pharmacological intervention, its effectiveness as a standalone approach may be limited due to increased biomechanical stress in this population.
Objectives: This study aimed to evaluate and compare the effectiveness of exercise therapy alone and a combination of exercise and manual therapy on pain, joint function, range of motion (ROM), and physical performance in overweight older adults with KOA.
Methods: A randomized controlled trial design was employed, involving 40 participants who were randomly allocated (1:1 ratio) using a computer-generated simple randomization sequence. Forty overweight older adults (mean age 58.3 ± 4.9 years; BMI 34.8 ± 3.2 kg/m²) with clinically diagnosed KOA participated in the study. Both groups underwent a 12-session physiotherapy program. Data were collected using the Visual Analog Scale (VAS) for pain, WOMAC for joint function, goniometry for ROM, and the Timed Up and Go (TUG) test for physical performance. Statistical analysis was conducted using JASP, including descriptive statistics, independent-samples t-tests, paired-samples t-tests, repeated-measures ANOVA, and ANCOVA to control for potential confounders.
Results: Both groups demonstrated significant improvements in all outcome measures. Compared with exercise alone, the combined intervention resulted in greater pain reduction (adjusted mean difference = -1.07 points, p < 0.001, η² = 0.52), greater improvement in knee ROM (p < 0.001, η² = 0.61), and better TUG performance (p = 0.001, η² = 0.46). No significant between-group difference was observed for WOMAC scores (p = 0.234, η² = 0.03).
Conclusions: The combination of exercise and manual therapy is more effective than exercise alone in improving pain and physical performance in overweight older adults with KOA. A multimodal physiotherapy approach is recommended to optimize rehabilitation outcomes in this population.
APA Citation StyleHosseini, S. E. (2026). Effects of combined exercise and manual therapy on pain and physical function in overweight older adults with knee osteoarthritis: A randomized controlled trial. Sport, Exercise, and Injury, 35-47. https://doi.org/10.56003/sei.v2i1.716 -
Injury patterns and risk factors in high school futsal: An observational study
Rafif Jendra Atmaja11. State University of Malang , ID2025-06-17|page 1-14AbstractBackground: Sports injuries at an early age are crucial and must be given attention.
Objectives: This study aims to analyze injury patterns, causative factors, and prevention strategies specific to high school futsal players.
Methods: The research method used was descriptive quantitative with a cross-sectional study approach. The population in this study were male students of State Senior High School 1 Ponorogo who participated in class meeting activities, with purposive sampling technique found 24 samples. Data collected by questionnaire included information on the type of injury, location of injury, causative factors, injury treatment and type of rehabilitation.
Results: The results showed that the most common injuries were cuts/abrasions (29%) and bruises (23%), most common in the lower extremities, namely knees (23%) and ankles (20%), the most common cause of injury was physical contact (54%), most injuries occurred during the second half (67%), the most common first aid given was cold compresses (51%) and the most common rehabilitation/therapy was massage (25%) and physiotherapy (21%).
Conclusions: The findings can be concluded that the most dominant type of injury experienced by students is abrasion, especially in the knee area. In addition, the main causative factors of injury are fatigue, infrastructure, and collisions between players. The results of this study indicate the urgency of implementing injury prevention programs and the importance of conducting post-injury rehabilitation, in an effort to minimize the risk of injury to support the sustainability of students' careers in sports.
APA Citation StyleAtmaja, R. J. (2025). Injury patterns and risk factors in high school futsal: An observational study. Sport, Exercise, and Injury, 1-14. https://doi.org/10.56003/sei.v1i1.513 -
Eccentric hamstring strength and asymmetry in female handball athletes: A descriptive study
Alvito Dandy Putra Sanjaya1, Awang Firmansyah2, Aziz Abdul Hakim3, Panji Bana41. Universitas Negeri Surabaya , ID2. Universitas Negeri Surabaya , ID3. Universitas Negeri Surabaya , ID4. Universitas Negeri Surabaya , ID2025-06-17|page 60-69AbstractBackground: Handball is a competitive sport that requires high physical strength and muscle endurance. The game requires a balance of muscle strength to support athletes in performing movements such as sprints, jumps, and fast movement maneuvers. Lack of flexibility and high hamstring muscle asymmetry values are risk factors for injury to handball athletes.
Objectives: This study aims to determine the eccentric strength and hamstring muscle asymmetry in female handball athletes in Surabaya City.
Methods: The study subjects were 13 female handball athletes from Surabaya aged 18-23 years with regional-level competition experience and no lower extremity injuries. The instrument in this study is Nordbord by Vald Performance; Nordbord is a portable rapid assessment tool that can analyze large groups, providing information about the exact functional strength parameters quickly and efficiently. This study used a quantitative descriptive method to analyze hamstring muscle strength and asymmetry data.
Results: Indicated the athletes had an average (body mass of 59.30 ± 10.94 kg and height of 164.80 ± 6.80 cm). The overall eccentric hamstring strength was 88.1% of the expected norm, with right and left maximum forces averaging 230.70 ± 48.80 N and 233.61 ± 50.15 N, respectively. The average asymmetry between legs was -1.44 ± 9.14%, suggesting relatively balanced muscle strength.
Conclusions: The study concluded that hamstring eccentric strength in both legs should be improved by approximately 11.9% while maintaining the current low asymmetry levels to support muscle balance. Targeted training interventions are recommended to increase hamstring strength and minimize asymmetry, enhancing performance and reducing injury risk in female handball athletes.
APA Citation StyleSanjaya, A. D. P. , Firmansyah, A. , Hakim, A. A. , & Bana, P. (2025). Eccentric hamstring strength and asymmetry in female handball athletes: A descriptive study. Sport, Exercise, and Injury, 60-69. https://doi.org/10.56003/sei.v1i1.553 -
The effects of the FIFA 11+ program on lower limb functional outcomes: A systematic review
Yulingga Nanda Hanief1, Italo Sannicandro2, Raja Mohammed Firhad Raja Azidin31. State University of Malang , ID2. Clinical and Experimental Medicine Department, University of Foggia , IT3. Faculty of Sports Science and Recreation, Universiti Teknologi MARA , MY2025-12-30|page 122-138AbstractBackground: The FIFA 11+ program has been proven effective in preventing soccer injuries, but evidence regarding its impact on lower extremity functional outcomes is still scattered and reported heterogeneously.
Objectives: This systematic review aims to synthesize evidence regarding the effects of the FIFA 11+ program on lower extremity functional outcomes—including ROM, knee extension, internal and external hip rotation, and hamstring muscle strength—in athletes.
Methods: This systematic review was prospectively registered in PROSPERO (CRD420251147261) and conducted in accordance with PRISMA 2020 guidelines. A total of 14 studies involving athletes or physically active individuals met the inclusion criteria. Functional outcomes were measured using various instruments, primarily an isokinetic dynamometer for muscle strength and a goniometer for ROM measurement. The methodological quality of the studies was assessed using the Newcastle–Ottawa Scale. Due to substantial heterogeneity in study design, measurement instruments, intervention protocols, and reporting formats, a quantitative meta-analysis was not performed, and the data were synthesized using a qualitative narrative approach.
Results: Most studies (approximately 70–80%) reported an increase in hamstring muscle strength after the FIFA 11+ intervention, particularly in concentric and eccentric isokinetic measurements. Improvements in ROM and functional outcomes of the knee and hip were also reported, although results varied between studies. Evidence related to knee extension and hip rotation shows lower consistency compared to hamstring strength.
Conclusions: The FIFA 11+ program shows potential functional benefits beyond injury prevention, particularly in improving hamstring muscle strength and several aspects of joint mobility.APA Citation StyleHanief, Y. N. , Sannicandro, I. , & Azidin, R. M. F. R. (2025). The effects of the FIFA 11+ program on lower limb functional outcomes: A systematic review. Sport, Exercise, and Injury, 122-138. https://doi.org/10.56003/sei.v1i2.670
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