During the coronavirus desease 2019 (COVID-19) pandemic, athletes must be able to adapt to new habits, such as: social restriction, change of competition schedule, and sending back home. This situation has led to an 18.2% increase in sleep disturbances. This study aimed to look at the sleep duration of adolescent athletes during the COVID-19 pandemic and its impact on athlete’s health conditions. A total of 126 adolescent athletes from 15 sports were recruited in this cross-sectional study. Adequate sleep duration was assessed according to the American Academy of Sleep Medicine criteria. Data on health conditions, medical history, injury history, were taken using a questionnaire. Behavioral assessment was assessed through the strengths and difficulties questionnaire. About 80.2% of adolescent athletes had insufficient sleep, and there was a significant relationship between sleep duration and disease incidence with a relative risk (RR) of 3.31 (1.32-8.28) 95% convidence interval (CI). There was no significant relationship between adequate sleep duration and health conditions (p>0.05). Things that may be the cause of sleep disturbances; use of electronic devices (37.6%), environmental conditions (53.4%), and worry (9%). In the end, this indicates adolescent athletes face difficulties in achieving adequate sleep duration during this pandemic and a continuous surveillance system is needed to monitor athletes outside the dormitory.

Ankle sprains can occur in all athletes. The injuries are often considered minor but can occur repeatedly which can cause chronic complications. This evidence-based case report aims to determine the prognosis of recurrent ankle sprains resulting from returning to exercise too early. This report uses two databases for evidence collection, namely PubMed and Cochrane. Of the four articles, it was found that recurrent ankle sprains incidence rate was 33%, and neuromuscular training significantly reduced ankle sprain recurrence rates with relative risk 0.63 (95 % CI: 0.34-0.99) and hazard ratio 0.18 (95 % CI: 0.07-0.43). The healing time to the pre-injury state reached 93.8 ± 1.2 days for conventional therapy and 97.6 ± 1.5 days for a surgical procedure, and the time to return to exercise was 46.6 (95 % CI:15.4-70) days for conventional treatment and 55.2 ± 15.8 (95 % CI: 41.7 ± 9.8) days for surgical procedure. Using an ankle brace can help in healing and preventing recurrent injuries. Future more, proper handling and education about injuries and when is the optimal time to return to exercise can prevent relapse. Keywords: ankle sprain, return to sports, recurrence injury.   Prognosis Kekambuhan Cedera Sprain Pergelangan Kaki Olahragawan Setelah Kembali Berolahraga Lebih Awal Abstrak Cedera sprain pergelangan kaki dapat terjadi pada semua atlet. Cedera tersebut sering dianggap ringan namun jika terjadi berulang dapat menyebabkan komplikasi kronik. Laporan kasus berbasis bukti ini bertujuan untuk mengetahui prognosis kejadian berulang cedera sprain pergelangan kaki akibat kembali berolahraga terlalu awal. Dua basis data digunakan dalam pengumpulan bukti, yakni PubMed dan Cochrane. Dari empat artikel didapati cedera sprain pergelangan kaki dapat terjadi berulang dengan incidence rate 33% dan menyatakan neuromuscular training secara signifikan mengurangi tingkat kekambuhan sprain pergelangan kaki dengan relative risk 0.63 (95% CI: 0.34-0.99) dan hazard ratio 0.18 (95% CI: 0.07-0.43). Waktu penyembuhan ke keadaan sebelum cedera 93.8±1.2 hari untuk terapi konvensional, 97.6±1.5 hari untuk tindakan operatif, waktu kembali berolahraga adalah 46.6 (95% CI:15.4-70) hari untuk tindakan konvensional dan 55.2 ± 15.8 (95 % CI: 41.7 ± 9.8) hari untuk tindakan operasi. Penggunaan penyangga pergelangan kaki dapat membantu proses penyembuhan dan pencegahan cedera berulang. Oleh karena itu penanganan dan edukasi yang tepat mengenai cedera dan menetapkan waktu yang tepat untuk kembali berolahraga dapat mencegah kekambuhan. Kata kunci: cedera pergelangan kaki, kembali berolahraga, cedera berulang.

Pendahuluan: Cedera sprain pergelangan kaki merupakan cedera yang sering terjadi pada aktivitas olahraga dengan angka kejadian mencapai 40%. Penatalaksanaan utama adalah dengan melakukan manajemen konservatif berupa RICE dan latihan penguatan. Namun, seiring perkembangan banyak dokter dan atlet menggunakan analgesik dan anti inflamasi sebagai pengobatan terhadap persepsi nyeri dan pembengkakan. Artikel ini bertujuan untuk menemukan evidence base medicine terbaru tentang penggunaan analgesik dan anti inflamasi yang relevan pada cedera sprain pergelangan kaki. Metode: Studi dilakukan dengan penelusuran literatur dengan menggunakan pendekatan Evidence Base Medicine. Penelusuran literatur pada 2 basis data digital PubMed dan Cochrane berdasarkan Prisma Flow Chart dan kriteria inklusi dan eksklusi. Tidak dilakukan analisis statistik pada studi ini. Hasil: Penelusuran diperoleh enam studi yang terdiri dari lima studi systematic review yang membahas tentang penggunaan NSAID, Opioid, Acetaminophen, dan Cox-inhibitor pada pasien cedera ankle sprain. Penggunaan NSAID sedikit bermakna dibandingkan dengan penggunaan plasebo dan tidak ada perbedaan bermakna antara penggunaan NSAID dengan analgesik golongan lain. Penggunaan topikal memiliki efektifitas yang dirasa lebih baik dibandingkan dengan penggunaan oral NSAID. Kesimpulan: Penggunaan analgesik dalam kasus cedera sprain pergelangan kaki masih memerlukan penelitian lebih lanjut dengan pertimbangan utama berdasarkan persepsi nyeri pasien. Terapi konservatif merupakan pendekatan utama.

The increase of inflammatory biomarkers due to decompression dive is one of the factors that could cause decompression sickness (DCS), one of them is tumor necrosis alpha (TNFα). According to the preconditioning theory, exercise before dive can reduce amount of gas bubble to prevent DCS. This study aimed to prove that exercise before diving can prevent increase of TNFα. This study employed quasi-experimental design with trained male divers. The subject divided into two groups, treatment and control. The treatment group got submaximal exercise with 70% heart rate intensity, using cycle ergometer with young men's Christian association (YMCA) procedure modify by Guritno, 24 hours before decompression dive 280 kPa bottom time 80 minute with US-NAVY table, whereas the control group only do decompression dive. TNFα expression was checked three times, at beginning of study, before dive and after dive. In treatment group there was insignificant decrease TNFα, from 7.06±1.85pg./ml to 6.75±1.81pg./ml, whereas the control group showed a significant increased TNFα, from 8.22 (1.45 to 13.11)pg./ml to 8.39 (1.73 to 12.18)pg/ml, and significant difference was found between the mean difference for two groups p<0.05. It can be concluded that acute submaximal exercise prevents an increase of TNFα after single dive decompression to prevent possibility occurring DCS).

During the COVID-19 pandemic, The Centers for Disease Control and Prevention CDC, stated that obesity prevalence increased by 52%. In Indonesia, the prevalence of obesity is 21.8%. Obesity triggers an increase in pro-inflammatory cytokines, which induces chronic inflammation both locally and systemically, which can cause health problems, such as cardiovascular disease, diabetes mellitus, metabolite syndrome, and an increased risk of infection. One of the components of obesity management is increasing physical activity. One of the domains of physical activity is exercise. Exercise with the appropriate frequency, duration, intensity, type, and periodization can influence cytokine modulation so that it can reduce systemic inflammation and increase physical fitness. This evidence-based case report (EBCR) aims to determine the type of exercise periodization in obesity management and its effect on health-related fitness. The process of searching for literature on EBCR uses the PRISMA method on 3 databases, namely: PubMed, EBSCOhost, and ProQuest. From the search results, it was found that the combination of endurance and strength training exercises with linear periodization 3 times a week, was found to be better in improving fitness in obese people. Linear periodization increases cardiopulmonary fitness with a relative mean difference of 17.8(0.3 to 35.3) %, maximal strength with 1 RM bench press and 1 RM leg press test also increased, and also reduce body fat percentage about 2.1(-4.8 to 0.5) %. Thus, the combination of strength and cardiorespiratory exercise with linear periodization gives a positive response to the components of health-related fitness in obese people.