To return to being physically active, COVID-19 survivors need a guide to safely return to exercise. The most common symptoms reported in COVID-19 survivors were fatigue and breathlessness. It is crucial to rule out severe complications post-acute COVID-19 such as myocarditis, pulmonary embolism, pulmonary fibrosis and deep vein thrombosis before exercise. In this study, we proposed a self-guide assessment to safely return to exercise using post-COVID-19 Physical Activity Readiness Questionnaire and discussed on COVID-19 survivor-graded exercise programme. The key points highlighted during graded exercise programme are (1) individualisation, (2) monitoring for red flag symptoms (chest pain, breathlessness at rest or minimal exertion, palpitation, chest tightness and severe calf pain), (3) step down 1 stage if feels extreme fatigue on exercise, (4) start slow and progress slow with the exercise and (5) if in doubt, to refer yourself out to health professionals. These steps will encourage COVID-19 survivors to continue being active. It will also ease the healthcare burden by reducing the number of referrals of pre-participation health evaluation for mild symptoms or asymptomatic COVID-19 survivor patients to return to exercise.

Introduction: Sports nutrition is essential to improve exercise performance and maintain healthy body composition. However, the knowledge of balanced nutrition often being neglected by student-athletes and coaches. Aims: This study aimed to investigate sports nutrition knowledge across gender and level of participation. Materials and Methods: The participants were 178 university student-athletes (96 males and 82 females) actively competing in various individual and team sports. The student-athletes completed a sports nutrition knowledge survey to determine the adequate score (mean >75%). Results: The overall sports nutrition knowledge was inadequate (61.6% ± 13.1%), specifically only 29 student-athletes who obtained >75% or higher. Male student-athletes score slightly higher than females (62.4% vs 61.6% score), respectively. However, there is no significant difference between gender and level of participation (P > 0.05). There was no significant difference between the level of participation (P > 0.05). Conclusions: There was inadequate sports nutritional knowledge among student-athletes regardless of gender and level of participation. The intervention to enhance sports nutritional knowledge and a balanced diet is important for health and optimal athletic performance. Future studies are needed to examine athletes' behaviour and nutritional intake before training or competition.

Background: Coaching effectiveness leads to successful athletes, including athlete's development and performance, positive psychological progress and athlete outcomes. The coach–athlete relationship referred to all the conditions where the feelings, thoughts and behaviours of coach and athlete are mutually and casually related to each other. While, anxiety is an experience of an unpleasant athlete's psychological and physiological feeling. However, the existing literature on the influence of coaching effectiveness and the coach–athlete relationship does not investigate specifically competitive anxiety. Aims and Objectives: This current study aims to investigated athletes' perception of coaching effectiveness, coach–athletes' relationship and competitive anxiety experience of the athletes. Methods: One hundred and fifty-two (n = 152) athletes from various team sports completed a questionnaire pack assessing the study variables. The coaching effectiveness scale, coach–athlete relationship questionnaire and competitive state anxiety inventory-2 were used as an instrument for this study. Results: Results revealed that there were significant correlations between all the factors of coaching effectiveness and all the factors of the coach–athlete relationship. However, the anxiety assessment indicated a positive, negative significant correlation with the factors of coaching effectiveness and factors of the coach–athlete relationship. Further, there were no significant differences among all the factors of coaching effectiveness between genders except 'technique effectiveness'. Next, there were no significant differences in the coach–athlete relationship between genders except for 'commitment'. However, results revealed that there were significant differences in anxiety assessment except 'cognitive anxiety' between genders. Conclusion: The competitive anxiety experience of athletes the performance of the athletes is based on how effective their coaches to influence the athletes and how they work together. Thus, do coaching effectiveness and coach–athlete relationship stand out as the fundamental factors in issues of athlete's anxiety? It might be yes as the effectiveness of the coach and relationship with the athletes is the main causes that determine the enthusiasm of a team and the athlete's confidence.

Background: There were limited studies on the prevalence of injuries and illnesses among ultramarathoners. Aim and Objectives: This was a retrospective study to describe the injuries and illnesses seen during Four Feather Ultra Marathon 2020, Sabah, held from 29^th February 2020 to 1^st March 2020, for future preparation of medical team standby. Methods: All ultramarathoners who reported to the medical camp or on site with medical complains, and musculoskeletal complains were included in the study pools. There were 6 medical camp sites; KM10, KM19, KM36, KM51, KM62 and KM90. Results: The incidence of injury was 504 per 1000 athletes, 478 per 1000 km run, and 401.4 per 1000 h run. There was no severe injury or medical illness that require urgent referral to a hospital. For minor injuries and illnesses, 54.3 % due to medical conditions, 39.8% due to musculoskeletal injuries and 5.9% due to skin conditions. For heat-related illness, 31.5% were heat cramps and 15.7% were heat exhaustion. 50KM category runners have the highest percentage of heat-related illness (78.3%) followed by 90km category (11.7%) and 20km category (10%). 74.2% (n = 89) of heat-related illness occurred at KM 19, 20% (n=24) occurred at KM 37, 2.5% (n = 3) at KM 50, and 3.3% (n = 4) at KM 70. Conclusion: It is important to identify the early signs of severe heat-related illness. Thus, pre-planning medical standby is crucial to alert all medical staff during the event regarding symptoms and signs of heat-related illnesses during the event.

Introduction: The achievement of an Olympic gold medal in 2016 by a Southeast Asian (SEA) swimmer invigorated Malaysian swim authorities to increase investment in the sport. However, Malaysian swimming performance declined during the 2019 SEA Games, intensifying the urgency to identify events that have the highest potential for Malaysian swimmers to achieve a podium finish by comparing international swimming records of previous SEA (SG), Asian (AG) and Commonwealth (CG) games, and also world records with those recorded during the 2021 Malaysia Open which involved swimmers from the Malaysian national team. Methods: Primary data from the Malaysia Open were converted into swim points according to FINA's formula and compared with SG, AG, CG and world records dated up to 25 August 2021 (including records set during the Tokyo Olympics) using a spreadsheet programme. Results: Analyses (n = 80 male and 79 female records) revealed that: (i) Malaysian male swimmers were strongest in the middle-distance freestyle and backstroke events, while female swimmers were best in the short- and middle-distance breaststroke events; (ii) overall Malaysian swimmers' swim points were 30 years behind current world standards; (iii) current male and female national team swimmers have a possibility of undergoing successful participation experience in 30% and 60% of international-level events, respectively and (iv) swimmers from Singapore and Vietnam won most of the medals offered at SG, while China, Japan and South Korea are the main winners at AG. Conclusion: Malaysian swim authorities should focus on developing swimmers for endurance events and events that do not require an endowment of significant physical size, and on training female swim talent to win at international-level swim competitions. In addition, new training technology needs to be incorporated as this has been found to be indispensable.

Introduction: Quadriceps weakness and extension deficit of the knee following anterior cruciate ligament (ACL) reconstruction (ACLR) can threaten rehabilitation, and isometric quadriceps exercise is the usual prescription. However, the outcome depends more on the individual's re-learning process. Identification of this lacuna and focussed attention to the isometric strength of quadriceps are lacking in the current practice, and developing a tool can lead to optimal outcomes in ACLR. The objective of this study was to assess the role of 'isometric quadriceps pressure difference' (IQPD) in regaining quadriceps strength following the ACLR using a simple tool. Patients and Methods: Eight patients who underwent post-operative ACL rehabilitation between March 2016 and May 2018 were analysed retrospectively. A 'progressive isometric training protocol (PITP)' based on IQPD was prescribed along with the standard protocol. Data were collected from the case records of the patients. IQPD, thigh muscle girth and heel height difference (HHD) were noted pre-operatively, immediately following surgery and 3 months post-operatively. A non-parametric test was used to compare the outcomes before and after surgery. Results: Based on the analysis, the inclusion of IQPD-based PITP in regaining the terminal extension had a significant statistical difference in the IQPD, HHD and girth (p < 0.007, p < 0.005 and p = 0.027, respectively). Conclusion: IQPD can be a simple, cost-effective strategy to identify subtle quadriceps weakness. Further, PITP can improve the isometric quadriceps strength in the acute post-operative period and reduce the incidence of knee extension deficit in post-ACLR.

Introduction: During the swim meet, race analysis is a common practice to provide insight into each event. This case study explores the variables of swimming performance using the video analysis method. Purpose: To determine the best indicator from a set of swim variables (digitised from video) for competitive swim races by one Malaysian freestyle swimmer in preparation for the Tokyo Olympic Games 2020. Methods: Race video footage was analysed retrospectively to determine the key parameter for each event distance. The following variables were calculated: start time, end time (ET), turn time (TT), stroke count, stroke length, stroke rate, average velocity (AV) and stroke index. Differences were subsequently assessed among the parameters within the same event style. Results: The results from the correlation test between the eight digitised variables and final time (FT) showed that for both 200 and 400 m events the variables AV (respectively, r = −0.96 and r = −0.94) and TT (respectively, r = 0.89 and r = 0.83) were significantly correlated. In addition, for the 200 m events, the ET also significantly correlated (r = −0.94) with FT. Conclusion: This swimmer and over this period of Olympic qualifiers competitions, AV and TT were the best indicators for swim performance. Regarding the 200 m events, the end (sprint) time may also be an indicator.

Background: There are various attempts to replicate the demands of soccer match-play, simulating the irregular pattern of locomotion based on motion analysis of actual soccer match-play, using either treadmill or underground protocols. Aims: The aim of this preliminary study was to investigate whether the modified treadmill versus overground soccer-specific simulation replicated the physiological effects of match-play. Methods: Six healthy (n = 6) recreationally soccer-trained male players (age, 24 ± 2 years; height, 173 ± 7 cm and body mass, 76 ± 6 kg) participated in this repeated measure design study. During the testing session, each player completed a 45-min treadmill and overground-simulated match-play involving the same average running velocity. Heart rate and rating of perceived exertion (RPE) were recorded every 5 min throughout the simulation. Results: The physiological responses in the overground simulation (heart rate 169 ± 9 beats.min⁻¹; RPE 14 ± 1) were significantly greater than the treadmill simulation (heart rate 145 ± 12 beats.min⁻¹; RPE 12 ± 1). Conclusions: The heart rate and RPE response in the overground simulation was consistent with soccer players during actual match-play. The treadmill simulation, however, demonstrated a lesser physiological response compared to that as observed during match-play likely due to the exclusion of utility movements and high accelerations and deceleration.