Carbohydrate ingestion during exercise has been extensively investigated to enhance exercise performance, particularly during prolonged exercise (>2 h) when endogenous carbohydrate is limited. The pertinent benefit of carbohydrate ingestion is that it delays the depletion of vital energy source for exercise, hence delaying fatigue. Athletes have often been advised to drink or rehydrate (replace body fluid loss) to ensure sufficient energy source and to avoid dehydration during exercise Nevertheless, the ability for athletes to rehydrate in a real race setting, maybe challenging due to fluid availability and the nature of the event, such as during a running event. As an alternative to drinking, carbohydrate mouth rinsing has resulted in enhanced prolonged exercise performance. The underlying mechanism responsible for this improvement has been associated with the activation of the oral receptor that is related to reward and behavioural centre of the brain that contributed to enhancing exercise performance. Numerous studies have examined factors that influence the effectiveness of carbohydrate mouth rinsing. While these studies have presented convincing evidence to support their hypothesis, future studies are required to provide new insight into the effectiveness of carbohydrate mouth rinsing on exercise performance. These questions include how the environmental condition and dehydration level may influence the effectiveness of carbohydrate mouth rinsing on endurance exercise performance.

Background: It is considered that the implementation of nutrition care process (NCP) leads to more efficient and effective care, as well as enhancing the roles of dietetics and nutrition professionals in the clinical setting. However, little is known about the NCP being implemented in the sports nutrition setting to deliver nutrition care, especially in meal planning. Therefore, this study aims to identify the process that sports nutritionists (SNs) practice in meal planning to plan meals for athletes and identify the application of NCP. Methods: In-depth interviews, using semi-structured interview questions, were conducted with SNs employed at the National Sports Institute of Malaysia. Five SNs who managed different types of sports were recruited. The interviews were audio-recorded and transcribed verbatim. Data were entered into ATLAS.ti 8 and analysed using thematic analysis. Results: The following processes were identified: (i) collecting pertinent data, (ii) analysing the collected data, (iii) determining nutrition prescriptions, (iv) formulating goals and determining actions, (v) implementing actions and recommendations and (vi) monitoring. Conclusions: This study identified six general processes practiced by SNs in meal planning that comprised the NCP's interrelated steps, except nutrition diagnosis statement from the nutrition diagnosis step of the NCP. A comprehensive process and workflow can help sports dietitians or nutritionists to develop individualised meal plans that can improve athletes' nutritional status, adherence, health and sports performance.

Introduction: The aim of this study was to investigate physiological changes of heart rate (HR), rating of perceived exertion (RPE) and vertical jump (VJ) height responses during a Youth Soccer Match Simulation (YSMS90). Materials and Methods: Twenty (n = 20) male academy soccer players (age:17 ± 2 years, height: 1.69 ± 0.6, weight: 67.9 ± 6 kg) volunteered for this study. In a repeated measures study design, each participant completed the 90 min of soccer match simulation. Heart rate, subjective RPE and VJ were recorded every 5 min throughout the simulation. Results: The mean HR, RPE and VJ height during the YSMS90 were 147 ± 19 beats/min, 16 ± 1 and 34 ± 4 cm, respectively. There was a significant increase of HR and RPE throughout the YSMS90. The VJ performance reduced during the second half of the simulation. Conclusions: The findings from this study suggest that YSMS90 elicited similar physiological responses to soccer match play and may justify the use of YSMS90 for replicating the demands of youth soccer as an ecologically valid soccer match play simulation.

Background: A number of injury prevention programmes have been introduced in soccer. However, the familiarity and utility of these programmes by coaches in Malaysia is yet to be determined. Aim and Objectives: This study aimed to record the knowledge, attitude and practice of injury prevention exercise programmes (IPEPs), specifically the FIFA 11+, amongst coaches of elite league teams in Malaysia. Materials and Methods: Active coaches from four elite soccer leagues (Super League, Premier League, President's Cup and Youth Cup) in Malaysia were invited to participate. Thirty-three (n = 33) responses were returned. Results: Most respondents (87.9%) agree that soccer players are at high risk of lower-limb injury, and that it could have adverse effects on teams' and players' performances, careers and quality of life. More than two-thirds (71.9%) of respondents were optimistic about lower-limb soccer injury prophylaxis, however, familiarity toward the FIFA 11+ was considerably low, thus its practice is relatively low. Most respondents familiar to the programme believe that improvements could be introduced to suit their teams better or develop an own version of the FIFA 11+ specifically tailored for their teams. Having the need for equipment and lack of supervision may hinder IPEP maintenance in a team. Conclusion: Injury prevention programmes need early implementation and progressive variation for ongoing practice. Clearly, no IPEP may serve as the perfect 'one-programme-fits-all' injury prevention measure. This study may provide some insight for practitioners and soccer club organizers to develop future IPEPs and exercise better programme delivery amongst professional soccer teams.

Background: Knee injuries are the most common injury among Malaysian elite athletes. However, an injury profile of elite soccer players in Malaysia is yet to be determined. Aim and Objectives: This study was conducted to determine the injury characteristics among elite, male U19 and U22 soccer players. Materials and Methods: Four teams were observed throughout the 2018/2019 season, where a total of 111 players were documented in accordance with the Federation International de Football Association Medical and Research Centre accord to determine the incidence, class, severity and causation of injuries among elite, male U19 and U22 soccer players. Results: From a total of 111 players (U19: n = 58; U22: n = 53) during the 2018–2019 season, a sum of 64 injuries were reported to the team physicians of the participating teams in the current study, representing an estimated 0.58 injuries per player throughout a single season. From the total number of injuries, 57.8% (n = 37) injuries were registered to the U22 age group, whereas 42.2% (n = 27) were reported in the U19 Age Group. When factoring in the number of players in each respective age group, the number of injuries among the U22 age group was higher than the U19 age group (0.72 vs. 0.47 injuries/player/season). Conclusion: Most soccer injuries reported were lower limb injuries, newly sustained and required up to 14 days of treatment before returning to full participation in the competition. Match-play injuries appeared to be more common than training injuries, with the ankle and knee joints being the most common injury locations. Sprains and ligamentous damage were the most common injury class sustained by players.

Background: Lower limb musculoskeletal profiling is important in pre-competition medical assessment (PCMA) as it helps to identify musculoskeletal pathologies that need rehabilitation and risk factors for injury that need specific prevention programme. However, a normative value is needed to identify which is normal or pathological. Our objective in this study is to establish a normative value for football-specific adaptation of lower limb musculoskeletal examination among Malaysian professional footballers. Materials and Methods: This is a prospective cross-sectional examining 83 Malaysian footballers from a single club during PCMA from 17 January 2022 to 17 February 2022. We included anthropometric assessments using body impedance analysis, objective lower limb muscle strength assessments using handheld dynamometer, range of motion and objective dynamic balance test using the Biodex system. Results: The mean age of our study was 20.3 ± 3 years. Goalkeepers and defenders have a higher body mass index and a higher skeletal muscle mass. Strikers and midfielders have a higher quadriceps and hamstring strength. Non-dominant leg has a better overall stability and anterior posterior stability index compared to dominant leg. Defender has a better overall stability. Sixty-six footballers (80%) have at least 1 low Add: Abd ratio of less than 0.9, which requires preventive programme for groin injury. Conclusion: This study demonstrates a position-specific adaptation in different positions in football.

Introduction: The shoulder is at high risk of injury, particularly in throwing activities such as basketball. ]Aims: The objective of this study was to determine the prevalence and patterns of shoulder pain amongst Malaysian men's wheelchair basketball (WCBB) players. Furthermore, factors that are associated with shoulder pain were investigated. Materials and Methods: Eleven national WCBB players participated in this study. All players completed the clinical research forms which collected socio-demographic information, WCBB participation and history of shoulder pain. Assessments of shoulders range of motion, isometric muscle strengths and clinical shoulder tests were performed on all players. Results: The prevalence of shoulder pain amongst Malaysian WCBB players was 36.4%. Players with current shoulder pain had significantly higher Performance Corrected Wheelchair User's Shoulder Pain Index (PC-WUSPI) scores (13.8 vs. 3.3, P = 0.02) and a greater number of positive shoulder clinical tests (3.5 vs. 1.0, P = 0.04) than players without pain. Players with shoulder pain are frequently diagnosed with rotator cuff injuries, particularly involving the supraspinatus and subscapularis muscles. A significant moderately strong positive correlation between PC-WUSPI score and number of positive clinical shoulder tests was found (r = 0.71; P = 0.01). Conclusions: Prevalence and patterns of shoulder pain amongst Malaysian men's WCBB players are comparable to previous studies. A strong association between PC-WUSPI score and number of positive clinical shoulder tests suggests a potential role of regular PC-WUSPI assessment for early detection of shoulder problems amongst players.

Background: Soccer is regarded as the most popular sports in the world, with millions of people are actively involved in the game. Being a contact sports in nature, soccer players are susceptible to various kinds of injuries such as lower extremities muscle injury. In addition to those familiar injuries that soccer players sustain during the game, traumatic brain injury is also a possibility. Head impacts in soccer could be a result of head-to-head impact with an opponent player, head-to-elbow impact, an impact with the goal post, impact with the ground, as well as an impact with the soccer ball, which occurs during a heading manoeuvre. Soccer allows the players to use their head to hit the ball to pass it to a teammate, or even perform heading to score goal. Although soccer heading is perceived as less harmful as compared to head impacts with other hard objects, many studies have shown compelling evidence that this repetitive heading might harm the brain, thereby leading to traumatic brain injury. Protective headgears designed, especially for soccer players have been commercially available in the market for some years. Objective: This article investigates the effectiveness of two padding foams by means of heading experiment. Methodology: An anthropometric test device known as Hybrid III head and neck dummy instrumented with an inertial sensor that consists of a triaxial accelerometer and gyroscope installed at the centre of gravity of the head was used in the experiment. A soccer ball launching machine was used to propel the ball at several inbound velocities. Peak linear acceleration and peak rotational acceleration (PRA) were recorded, and the head injury criterion (HIC) and the rotational injury criterion (RIC) were calculated. Results: Poron X-ray diffraction (XRD) foam was found to provide the best protection in both linear and rotational components. However, for protection against HIC, it is evident from the findings that both foams were very effective at lower inbound ball velocity and became drastically ineffective as the inbound velocity increases up to 22 m/s (i.e. equal to 79.2 km/h). This could be attributed to the foam being completely compressed by the high-velocity ball impacting it. The same situation is seen for RIC, however with less significant decline in protective performance. Conclusion: Overall, it can be concluded that the Poron XRD foam could be a better foam to be used in soccer headgear as compared to the yoga mat foam.

Tumoural calcinosis is a rare entity commonly caused by hyperphosphatemia due to bone mineral disease, hyperparathyroidism of chronic renal failure. However, our case demonstrated a normo-phosphatemic tumoural calcinosis post-COVID-19. This is a 36-year-old with a multiple history of soft-tissue calcification presented with acute onset severe right shoulder pain associated with anterior shoulder swelling at day 20 post-COVID-19. The clinical examination reveals anterior shoulder swelling at bicipital groove with severe restriction of range of motion due to pain. Ultrasound revealed an initial solid mass arising from the sheath of long head of biceps tendon which turns into cystic mass at week 4 of the disease. Computed tomography scan demonstrate sedimentation sign. His blood parameters revealed normo-calcemic, normo-phosphatemic bone profile, normal renal function and no sign suggestive of rheumatological disease. He was started on short course on non-steroidal anti-inflammatory drugs (NSAIDs) for 3 week and does not require surgical intervention. His symptoms completely resolved after 4 weeks with persistent shoulder swelling. He was started with prophylaxis low phosphate diet to prevent future recurrence. Our case demonstrates that conservative management using the short course of NSAIDs can be beneficial in treating primary normophosphatemic tumoural calcinosis.