Heart rate dynamic during an exercise test in heart failure patients
with different sensibilities of the carvedilol therapy
Carvalho?, Edimar Bocchi and Guilherme Guimaraes
Heart Institute (InCor HCFMUSP)
Some trials suggest that the titration of Carvedilol is based on
rest heart rate from 50 to 60 bpm and a target daily dose of 50
mg/day. Aim: To evaluate the heart rate dynamic in heart failure
patients with different sensibilities of the Carvedilol therapy
during an exercise test.
METHODS Patients were divided into four groups and submitted a treadmill
cardiopulmonary exercise test: heart rate >60 bpm and Carvedilol
60 bpm and Carvedilol >=50 mg/day (19 patients) (non-optimized
low-sensibility); heart rate between 50 and 60 bpm and Carvedilol
>=50 mg/day (16 patients) (optimized); heart rate between 50
and 60 bpm and Carvedilol <50 mg/day (10 patients) (optimized
RESULTS The heart rate peak and the percentage of the peak heart
rate in relation with the maximum heart rate predicted for age during
the cardiopulmonary exercise test were the same between the non-optimized
(128±13, bpm; 74±7%) and non-optimized low-sensibility (136±20,bpm;
78±8%) groups, and between the optimized (105±25, bpm; 60±13%) and
optimized high-sensible (108±16, bpm; 62±8%) groups.
DISCUSSION & CONCLUSION The heart rate dynamic was almost the
same between groups with rest heart rate <60 bpm and between
groups >60 bpm, independently of the Carvedilol dose. Based on
these findings, we propose a new method to titrate carvedilol therapy
by the cardiopulmonary exercise test.
KEY WORDS heart rate, exercise, carvedilol
rate dynamics in heart transplantation patients during a treadmill
cardiopulmonary exercise test: A pilot study
Carvalho?, Lucas Pascoalino, Edimar Bocchi and Guilherme Guimaraes
Heart Institute (InCor HCFMUSP)
One way of defining an individual’s maximum heart rate to be expected
given their age is by the formula (220-age), but the reinnervation
seen in patients who have received heart transplants makes for different
calculations from patients who have suffered heart failure. The
purpose of this study is to evaluate heart rate dynamics (basal,
peak and percentage of predicted heart rate for age) in heart transplant
patients compared to optimized beta-blocked heart failure patients
during a treadmill cardiopulmonary exercise test.
METHODS Twenty two (81% male, 46 ± 12 years) sedentary heart failure
patients and 15 (47% male, 44 ± 13 years) sedentary heart transplant
patients performed a treadmill cardiopulmonary exercise test between
10 am and 3 pm. Heart failure optimization was considered 50 mg/day
or more of carvedilol, with a resting heart rate of between 50 and
RESULTS Basal heart rate was lower in heart failure patients (58
± 5 bpm) compared to heart transplant patients (93 ± 11 bpm; p <
0.0001). Similarly, the peak heart rate (percentage of the maximum
predicted for age) was lower in heart failure patients (60 ± 13%)
compared to heart transplant patients (80 ± 12; p < 0.0001).
Maximum respiratory exchange ratio did not differ between the groups
(1.05 ± 0.06 in heart failure patients and 1.11 ± 0.1 in heart transplant
patients; p = 0.08). Moreover, the heart rate reserve between heart
failure (49 ± 22) and heart transplantation (46 ± 16%) was not different
(p = 0.644).
DISCUSSION & CONCLUSION No patient reached the maximum heart
rate predicted for their age during a treadmill cardiopulmonary
exercise test. The heart rate reserve was similar between groups.
A heart rate increase in heart transplant patients during cardiopulmonary
exercise test of more than 80% of the maximum age-adjusted value
should be considered an effort near the maximum.
KEY WORDS Heart Transplantation, heart rate, exercise
of the London Chest Activity of Daily Living scale (LCADL) in heart
Carvalho 2?, Rachel Garrod 3, Edimar Bocchi 2, Fabio Pitta 1 and
Guilherme Guimaraes 2
1 Departamento de Fisioterapia, Universidade Estadual de Londrina,
Brazil, 2 Heart Institute (InCor HCFMUSP), 3 School of Physiotherapy,
Faculty of Health and Social Sciences, St. George’s University of
London and Kingston University, London, United Kingdom.
The Minnesota Living with Heart Failure Questionnaire (MLHFQ) is
a well validated commonly used tool to assess quality of life in
people with heart failure. However, the tool lacks specific information
concerning breathlessness during daily activities. The London Chest
Activity of Daily Living scale (LCADL) is a tool initially validated
to measure breathlessness during daily activities in patients with
severe Chronic Obstructive Pulmonary Disease. However, since this
tool is not specific to patients with COPD and due to the lack of
current tools to properly assess activities of daily living in patients
with heart failure, the LCADL could also be applied in this population
in order to provide important information concerning their breathlessness
and functional activity. The evaluation of these outcomes may enable
the development of further intervention strategies to address breathlessness
during activities of daily living in this rather disabled population.
METHODS Forty-seven heart failure patients (57% males, 50±9 years,
left ventricle ejection fraction 29±6% and New York Heart Association
(NYHA) functional class I-III) were included in this study. Firstly,
all subjects performed a cardiopulmonary exercise test to determinate
objectively the exercise capacity. Then, patients responded to the
LCADL and the MLHFQ, instructed by the same investigator. The LCADL’s
retest was applied one week later. An analysis of the LCADL scores
stratified by the patients’ functional limitation according to the
NYHA classification was performed.
RESULTs The MLHFQ was highly correlated with LCADL. MLHFQ and LCADL
were also highly correlated with exercise capacity variables. there
was statistically significant difference in the LCADL scores between
NYHA functional classes I and II, as well as classes I and III,
but not between classes II and III. Despite of this, LCADL total
score (r=0.68), and sub-scores self care (r=0.65), domestic (r=0.69),
physical (r=0.67) and leisure (r=0.60) correlated with NYHA functional
class (p<0.0001 for all). The LCADL was strongly reproducible
in all domains. Total score showed a Cronbach’s alpha of 0.99, ri
of 0.98 (0.92 to 0.97 of CI); self-care domain showed a Cronbach’s
alpha of 0.97, ri of 0.95 (0.92 to 0.97 of CI); domestic domain
showed a Cronbach’s alpha of 0.99, ri of 0.97 (0.95 to 0.98 of CI);
physical domain showed a Cronbach’s alpha of 0.96, ri of 0.91 (0.85
to 0.95 of CI); leisure domain showed a Cronbach’s alpha of 0.98,
ri of 0.96 (00.93 to 0.97 of CI)
DISCUSSION & CONCLUSION The LCADL showed to be a valid and reproducible
measurement of dyspnea during daily activities in heart failure
patients. This scale could be an additional important tool for the
assessment of patients’ dyspnea sensation during activities of daily
living and to discriminate/categorize patients with different functional
KEY WORDS lcadl, heart failure, daily activities, quality of life
and clinical significance of aortic root dilatation in highly-trained
De Blasiis 1 ?, Fernando M. Di Paolo 1, Filippo M. Quattrini 1,
Cataldo Pisicchio 1, Emanuele Guerra 1, Barbara Di Giacinto 1, Roberto
Ciardo 1, Stefano Caselli 1, Maurizio Casasco 2 and Antonio Pelliccia
1Institute of Sport Medicine and Science, Italian National Olympic
Committee. Rome, Italy, 2Italian Sport Medicine Federation
Few data are available addressing the impact of athletic training
on aortic root size. We have investigated the distribution, determinants
and clinical significance of aortic root dimension in a large population
of highly-trained competitive athletes.
METHODS Echocardiographic aortic root dimensions were assessed in
2,317 athletes free of cardiovascular disease, aged 24.8 ± 6.1 (9-59)
years, 56% male, engaged in 28 sports disciplines including participation
in Olympic Games and World Championships.
RESULTS In males, aortic root was 32.2 ± 2.7 mm (range 23-44); 95th
percentile, 37 mm, and in females was 27.5 ± 2.6 mm (20-36); 95th
percentile, 32 mm. Aortic root was <40 mm in 2,300 athletes (99%),
and > 40 mm in only 17 (1%), all males. In this subset, aortic
dimension increased over a 8 ± 5 year follow-up (40.9 ± 1.3 to 42.9
± 3.6 mm; p <0.01), including 3 former athletes in whom aorta
became dilated (to 50 mm, 50 mm and 48 mm) after 15-17 year follow-up,
in the absence of symptoms or evidence of systemic disease. Multiple
regression and covariance analysis showed aortic dimension was largely
explained by body surface area, LV mass and age (R2= 0.61), with
sports participation having lower effect.
DISCUSSION & CONCLUSION Dilatation of the aortic root ( >40
mm) is rare in highly-trained athletes, and is not a feature of
physiologic athlete’s heart. Longitudinal assessment of athletes
with aortic root >40 mm showed further dimensional increase,
which occasionally was marked, underscoring the importance of close
clinical surveillance to reduce the risk associated with accelerated
KEY WORDS aortic root dimension, athlete’s heart, echocardiography
presentation of bicuspid aortic valve in 169 sportsmen
Loschiavo?, Serena Bria, Massimiliano Bianco, Teresina Vessella,
Federica Gentili, Vincenzo Palmieri and Paolo Zeppilli
Sports Medicine School, Catholic University of Sacred Heart, Rome,
Bicuspid aortic valve (BAV) is the most common congenital cardiac
anomaly (1-2%) in the general population. Aims of our study were:
1) to evaluate the different patterns of presentation of BAV; 2)
to compare different BAV morphological phenotypes.
METHODS Since 1986 to 2009, 169 sportsmen with BAV (mean age 22±10.4,
range 7-67 years), were evaluated for different reasons in our Institution.
Each subject underwent a thorough cardiological evaluation comprehensive
of clinical examination, resting and exercise ECG, echocardiogram,
24h-Holter monitoring and, when indicated, magnetic resonance imaging
of the heart and/or angio-CT of coronary arteries.
RESULTS BAV was associated with cardiac pathologies/abnormalities
in 46/169 (27%) sportsmen. After excluding subjects with significant
cardiac pathologies (10 cases), aged <12 or >50 years (8 cases),
the remaining 151 were classified in 4 groups: group 0, (22 cases,
14.6%) with an “almost normal valve”; group 1, (94 subjects, 62.2%)
with regurgitation; group 2, (16 cases, 10.6%) with stenosis; group
3, (19 subjects, 12.6%) with isolated aortic dilation. Moreover,
taking into account BAV morphology, 109 cases (72.2%) showed antero-posteriorly
(AP) and 42 (27.8%) latero-laterally (LL) oriented cusps. Sportsmen
with AP-BAV showed larger aortic diameter (34.7±5.9 vs 31.7±6.1)
and a greater proneness to progressive dilation during follow-up
(+0.04±0.08 vs +0.02±0.05 mm/year).
DISCUSSION & CONCLUSION As other cardiac pathologies/abnormalities
are frequently observed in sportsmen with BAV, a thorough cardiological
investigation must always be carried out. Several patterns of BAV
presentation exist, possibly with different outcome. Valve morphology,
finally, seems to be a predictive factor for its prognosis.
KEY WORDS Bicuspid aortic valve, sportsmen, echocardiogram, morphological
phenotypes, aortic diameter, progressive dilation.
fixation of lateral end clavicle fractures in cyclists
Adeel Akhtar?, Paul Jenkins and Christopher Michael Robinson
Shoulder Injury Clinic, Royal Infirmary of Edinburgh, United Kingdom
The aim of our study was to determine the outcomes following open
reduction and internal fixation of acute displaced lateral end clavicle
fractures in cyclists.
METHODS A prospective study was conducted over a 27 month period
from January 2007 to April 2009. We adopted a standard protocol
of treating all acute lateral end clavicle fractures in cyclists
by open reduction and internal fixation with 2 endobuttons attached
with 6 ply orthocord suture in a pulley configuration through bone
tunnels in the clavicle and coracoid. We reviewed these patients
at 3, 6 and 12 months after surgery, with sequential radiographs
and evaluation of functional outcomes.
RESULTS A total of 16 patients were included in the study. The mean
age was 38 years with a range from 16 to 57. At one year follow
up the median Constant score was 93 points, the median DASH score
was 5 points, the mean forward flexion was 180º, mean abduction
was 180º°and the mean external rotation was 110º. 13 patients returned
to cycling within 6 months after the operation. 2 patients had complications
in the form of fibrous non-union and capsulitis which responded
to distension arthrography. There were no re-operations.
DISCUSSION & CONCLUSION We describe a novel method of operative
fixation of lateral end clavicle fractures which produces good functional
and radiological results, with a relatively low rate of operative
complications. We recommend this technique for the displaced lateral
end clavicle fractures in cyclists.
KEY WORDS lateral end clavicle fractures, cyclists, endobutton fixation
following midshaft clavicle fracture in cyclists
Adeel Akhtar? and Christopher Michael Robinson
Shoulder Injury Clinic, Royal Infirmary of Edinburgh, United Kingdom.
The aim of our study was to determine the incidence of pseudo-winging
after midshaft clavicle fracture and correlate it with the functional
outcomes in cyclists.
METHODS A prospective study was conducted between September 2008
and April 2009. Scapulothoracic movement was recorded for all the
patients with clavicle fracture after union and reviewed by 2 blind
observers. The functional outcomes were assessed by using validated
Disabilities of the Arm, Shoulder and Hand questionnaire.
RESULTS There were 36 patients (33 males and 3 females) with mean
age of 29 years. All patients had a pain free full range of motion
of their shoulder girdle. 25 patients (70%) had non-operative treatment
of their clavicle fracture which resulted in malunion. 15 patients
(60%) had scapular prominence and 15 patients (60%) had pseudo-winging
in the non-operative group. 8(53%) patients had mild, 8(53%) had
moderate and 1(6%) had severe pseudo-winging. 11 patients had primary
operative treatment of their clavicle fractures. 2 patients (18%)
had scapular prominence and 3(27%) had pseudo-winging in the operative
group. The median DASH score was 2.5 with a range from 0-66 for
the patients with pseudo-winging and 2.5 with a range from 0-34
for the patients without pseudo-winging.
DISCUSSION & CONCLUSION We concluded that there was a high incidence
(60%) of pseudo-winging after non-operative treatment of midshaft
clavicle fractures in cyclists. There was no statistically significant
difference in the incidence of pseudo-winging between the operative
and non-operative groups. There was also no correlation between
the pseudo-winging and the functional outcomes.
KEY WORDS Midshaft clavicle fracture, pseudo-winging, cyclists
muscle belly tenderness: diagnostic value for supraspinatus pathology
Carlos Paredes? and Randolph Molo
St Luke’s Medical Center / Institute of Orthopedics & Sports
Medicine/ Quezon City, Philippines
This study aims to determine the usefulness of supraspinatus muscle
belly tenderness (SMBT) upon palpation in determining supraspinatus
METHODS Twenty five patients who presented with shoulder pain were
included in the study. They provided a history of their present
illness and underwent focused physical examination of the shoulder
(palpation of the supraspinatus belly and tendon, Empty can test
and Drop arm test) prior to undergoing MRI. Results were organized
into group 1 (supraspinatus tendinosis/tendinitis) and group 2 (supraspinatus
tears) which was further divided into group 2A (partial thickness
tears) and group 2B (full thickness tears). Diagnostic values were
determined for each test in each group as well as in combination.
RESULTS SMBT showed a high specificity (100%) in diagnosing supraspinatus
pathology. In group 2, SMBT exhibited a good specificity (80%) but
only had a 50% sensitivity. SMBT was also noted to be better in
determining partial thickness tears (sensitivity 80% / specificity
80%) rather than full thickness tears (sensitivity 20% / specificity
65%). SMBT likewise showed the highest post test probability (73%)
and likelihood ratio in the group 2A. With regards to combination
of SMBT with the other test, it showed improvement in its diagnostic
value with the highest being in the group of supraspinatus tears
and the subgroup of partial thickness tears.
DISCUSSION & CONCLUSION SMBT on palpation provides a simple,
inexpensive, non-invasive confirmatory tool for supraspinatus pathology.
It is also of particular value in detecting partial thickness supraspinatus
tears especially if combined with the other special tests.
KEY WORDS Supraspinatus muscle belly, palpation, diagnostic value,
bankart repair and capsular shift for traumatic anterior shoulder
Moebius, Konstantinos Natsis?, Christos Lyrtzis, Trifon Totlis and
Interbalkan Medical Center, Thessaloniki, Greece
Most studies on arthroscopic treatment of anterior – inferior glenohumeral
instability are focused on the repair of lesions of the anterior
– inferior aspect of the labrum (Bankart lesions). Arthroscopic
treatment of anterior shoulder instability is reported less successful
than open techniques with failure rates up to 50%. This study demonstrates
that anterior – inferior instability is associated with multiple
lesions and the treatment of all these lesions can increase success
METHODS The study group consisted of 96 patients who had a mean
age of 27 years (range, 15 to 60 years) at the time of the operation.
There were 74 athletes, 30 patients with more than five dislocations
and 7 patients had a little bony fracture. All shoulders underwent
arthroscopic capsulolabral repair with suture anchors. Additionally,
27 plications with sutures, 45 capsular shifts,16 closures of the
rotator cuff interval and 8 rotator cuff repairs were performed.
RESULTS At a mean of 16 months postoperatively occurred two traumatic
redislocations. In the athletes group 57/74 (77%) returned to the
preinjury and 12/74 (16,2%) to lower sports level, while 5/74 (6,8%)
gave up sport activities.
DISCUSSION & CONCLUSION Arthroscopic treatment of anterior shoulder
instability has evolved tremendously over the last decade. However,
the variety of the available arthroscopic instruments and techniques
shows the complexity of the intra-articular tissue fixation, which
includes anchor placement, suture passing, and knot tying. We believe
that the improved rate of success is the result of repair not only
of the anterior – inferior (Bankart) lesion, but also (where necessary)
of associated lesions and especially of the significant volume decrease
of the capsule.
KEY WORDS shoulder instability, bankart lesion, arthroscopic repair,
strength and activity of deltoid muscle during specific exercises
in impingement syndrome
Ikiz 1 and Filiz Can 2 ?1
Cankaya Hospital / Orthopaedics and Traumatology Department / Ankara,
Turkiye, 2 Hacettepe University / School of Physical Therapy and
Rehabilitation / Ankara, Turkiye
Deltoid muscle plays an important role in normal shoulder function
as well as scapular rotators. Although there are some studies evaluating
deltoid muscle activity, most of them focused only the middle part.
The aim of this study was to evaluate muscular strength and activity
of deltoid muscle during specific exercises have been using commonly
in rehabilitation of impingement syndrome.
METHODS 20 subjects who were suffering from impingement syndrome
(Grade I and II) and 18 healthy subjects were included in the study.
The study group was consisted of 13 female and 7 male with mean
age of 44.05±8.95 years. The mean age of the control group (13 female
and 5 male) was 41.06±15.01 years. All the subjects have been evaluated
for muscle strength using dynamometer and Cyriax isometric muscle
test. Surface EMG has been used for assessing the muscle activity.
Shoulder ladder, shoulder wheel, isometric and isotonic shoulder
exercises were chosen as specific exercises during EMG measurements.
All the results taken from the measurements in the study group have
been compared with the control group.
RESULTS There was significant difference in dynamometric measurements
of 3 parts of deltoid muscle between the study and the control group.
Dynamometric measurements were lower in the study group than the
control group (p<0.05). Strength of deltoid according to Cyriax
muscle test in the study group significantly decreased (p<0.05).
EMG activities of anterior part in maximum work and power during
isometric flexion exercises have reduced in the study group (t1=-2.388,t2=-2.730,p<0.05).
Power of anterior part in the study group during isotonic flexion
exercises (t=-2.290,p<0.05) and during shoulder ladder exercises
(t=-2.151,p<0.05) was also diminished. EMG activity of middle
part of the deltoid in the study group was decreased only during
isotonic abduction exercises (t=-2.051,p<0.05). However there
was significant difference in maximum work and power of posterior
part between the study and the control group during shoulder wheel
DISCUSSION & CONCLUSION The strength of the deltoid muscle was
diminished in impingement syndrome. The most aggressive exercises
for deltoid muscle were shoulder wheel and shoulder ladder exercises.
Isometric exercises and isotonic exercises below than 90º were the
least loaded exercises. The most influenced part of the deltoid
was the anterior part. These results could be taken consideration
in planning of the exercises regarding of deltoid muscle activity
and loading. It should be keep in mind that shoulder wheel and shoulder
ladder exercises must be used carefully in rehabilitation programme.
KEY WORDS Impingement syndrome, deltoid muscle, muscle strength,
uptake kinetics in swimming: New findings
J. Fernandes 2, Ana Querido 2, Leandro Machado 2, Kari L. Keskinen
1 and J. Paulo Vilas-Boas 2?
1Finnish Society of Sport Sciences, Finland, 2 University of Porto,
Faculty of Sport, CIFI2D, Portugal.
Understanding the principal determinants of oxygen (VO2) uptake
kinetics is fundamental to improve human performance in sport. Indeed,
there are some swimming related studies that focus on the relationship
of the VO2 response at different constant work-rate exercises (e.g.
moderate, heavy and severe intensities) and swimmer’s performance.
For instance, our group observed the existence of a slow component
of the VO2 kinetics, superimposed to its fast phase, during a time
to exhaustion test at the swimming velocity corresponding to VO2max
(TLimvVO2max). It was observed, inclusively, that the VO2 slow component
was one of the major TLimvVO2max determinants. However, it was not
tried to relate the VO2 kinetics parameters with swimming competitive
events. The purpose of this study is to observe if the VO2 kinetics
parameters determined at a TLimvVO2max intensity are related to
the 400m front crawl, a typical aerobic power event.
METHODS Seven high trained front crawl swimmers (17.4±1.4 years
old, 63.5±8.7 kg and 168.8±7.3 cm) performed an individualized intermittent
incremental protocol for vVO2max assessment, with increments of
0.05m/s each 200m stage and, 30s intervals, until exhaustion. VO2
was directly measured using a breath-by-breath portable gas analyzer
(K4b2, Cosmed, Italy) connected to the swimmers by a respiratory
snorkel/valve system. Velocity was controlled using a visual pacer
(TAR.1.1, GBK-electronics, Portugal). VO2max was considered to be
reached according to primary and secondary traditional physiological
criteria and vVO2max was accepted as the velocity correspondent
to the first stage that elicits VO2max. Forty-eight hours later,
subjects swam until exhaustion at their pre-determined velocity,
to assess TLimvVO2max. The VO2 kinetics parameters for each phase
of the VO2 response (td1, tau1, A1, td2, tau2 and A2, i.e., time
delay, time constant and amplitude for the fast and slow component,
respectively) were assessed by mathematical modelling (the cardiodynamic
component was not taken into consideration).
RESULTS Velocity of the 400m front crawl event (1.51±0.07m/s) was
related with A1 (39.4±7.5 ml/kg/min; r=0.79, p=0.04), none existing
other significant relationships: td1 (18.4±9.5s; r=-0.56), tau1
(15.9±4.8s; r=0.15), A2 (5.9±3.4 ml/kg/min; r=-0.12), td2 (104.5±6.5s;
r=0.49) and tau2 (34.7±20.6s). V400 presented also an elevated relationship
with VO2max (63.4±6.7 ml/kg/min; r=0.93, p=0.03) and vVO2max (1.43±0.07m/s;
DISCUSSION & CONCLUSION Higher amplitude of the fast component
of VO2 kinetics seems to be directly related to best performances
in the 400m front crawl event. This result seems to confirm that
VO2max plays a central role among the energy-yielding mechanisms
in middle distance swimming and that aerobic power is important
in swimming performance.
KEY WORDS Swimming, VO2 kinetics, fast component, 400m front crawl
of Coordination assessment in young swimmers: comparison between
breathing and non breathing cycles
J. Fernandes?, Jose L. Constancio, Pedro Figueiredo, António Sampaio,
Pedro Goncalves and Olga Vasconcelos
University of Porto, Faculty of Sport, CIFI2D, Portugal
The index of coordination (IdC) aims to assess the continuity of
swimming propulsion, measuring the inter-arm lag time between propulsive
phases. The three patterns of arm coordination described in the
swimming specialized literature are the catch up (IdC < 0), the
superposition (IdC > 0) and the opposition (IdC = 0) modes. No
IdC related studies were conducted in swimmers during the childhood
period, despite the importance of the development of the coordinative
abilities, namely the bimanual coordination, the movement’s dissociation
and the rhythm, in the “basic training” phase. Knowing that children
are not mini-adults, the purpose of this study was to assess the
IdC in young swimmers, trying to observe differences between breathing
(to their preferential side) and non-breathing cycles.
METHODS Subjects (n = 15; 10.7 ± 0.7 years old; 149.3 ± 7.1 cm height;
41.1 ± 7.5 kg weight and 5.3 ± 2.0 years of training background)
performed 2 x 25 m front crawl at high intensity, with rest intervals
higher than 20 min. Swimmers were monitored by two underwater video
cameras (Sony® DCR-HC42E) in the sagittal and frontal planes. Descriptive
statistics and Wilcoxon test were carried out (a significance level
of p < 0.05 was accepted).
RESULTS The mean ± SD, minimum and maximum values for the IdC taking
into consideration the breathing and non-breathing cycles, were,
respectively, -20.4 ± 3.4 (ranging between -25.8 and -13.6) and
-17.8 ± 1.6 (ranging between -19.8 and -14.5) (with significant
difference between trials, p < 0.01). These IdC values indicate
a preference of the children for the catch up mode, with high lag
times between propulsive arm actions, which is not in accordance
with the literature for adult swimmers performing at high intensities
(values situated between -5 and 0). This fact suggests that our
understanding of the skills in the adulthood period should not just
be scaled down and applied to children. Moreover, it seems that
the process of growth and maturation interfere in our understanding
of the inter-arm coordination phenomenon in swimming.
DISCUSSION & CONCLUSION Complementarily, the higher IdC observed,
when comparing breathing and non-breathing cycles, is justified
by the increasing discontinuity in the arms propulsive actions in
the cycles when the swimmer breathes. In fact, in the literature,
it is considered that the duration of the non-propulsive phases
(entry/catch and recovery) is higher in the breathing cycles, being
also observed an inverse correlation with IdC.
KEY WORDS Swimming, index of coordination, breathing cycles
between anaerobic power and sprint ability in football players
Atakan Yýlmaz?, T. Alper Soydan, Ali Özkan and Ayþe Kin-Isler
Baþkent University, Department of Sport Sciences, Ankara, Turkey
In many sports short bursts of high intensity power production play
a major role in performance especially in team sports like football.
Therefore, anaerobic and sprint performances are very crucial and
fundamental activities for these types of sports. Hence, the purpose
of the present study was to examine the relationship between anaerobic
power and sprint ability in football players.
METHODS Fifteen male football players participated in this study
voluntarily (Mage: 23.06±1.98 yrs, Mheight: 173.52±5.80 cm, MBW:
72.91±9.99kg, Mfat: 10.03±4.82 %). Vertical jump of football players
was determined by squat and counter-movement jump tests and anaerobic
power was calculated by Lewis nomogram. Sprint ability was determined
by 20m sprint test and 12x20m running repeated sprint ability tests.
After repeated sprint ability test, best time, total sprint time
and percentage of decrement were determined and calculated.
RESULTS Pearson Product Moment Correlation analysis indicated significant
correlations between anaerobic power of squat jump and total time
at 0-10m (r= .584; p=.022), 10-20m (r=.708; p=.003), 0-20m (r=.682;
p=.005), performance decrement 10-20m (r=.589; p=.021) and 0-20m
(r=.649; p=.009). In addition anaerobic power of counter-movement
jump was significantly correlated with total time at 10-20m (r=.643;
p=.010), 0-20m (r=.611; p=.016), performance decrement at 0-10m
(r=.644; p=.010), 10-20m (r=.686; p=.005) and 0-20m (r=.750; p=.001).
No significant correlation was observed between anaerobic power
of squat and counter-movement jumps and 20m sprint performance and
the best time performances of running repeated sprint ability tests
DISCUSSION & CONCLUSION As a conclusion it can be said that
anaerobic power but not vertical jump, is highly related with total
time and performance decrement in repeated sprint ability, however
is not related with 20m sprint performance in football players.
Lack of association between anaerobic performance and single sprint
performance indicated that factors other than anaerobic performance
might lead to single sprint performance in this group of football
KEY WORDS anaerobic performance, sprint ability, football players
evaluation of training effects in professional soccer players by
monitoring the changes of VO2max, AnT and creatine kinase
Handziski 5 ?, Metin Dalip 3, Eli Handziska 4, Anastasika Poposka
2, Lidija Poposka 1 Mimoza Milenkova 5 and Maja Nedelkovska 6
1 Clinic of Cardiology, 2 Clinic of Otrhopedic, Medical Faculty,
University of Cirilus and Metodij, Skopje, Republic of Macedonia,
3 Faculty of Physical Education, State Univeristy of Tetovo, Tetovo,
Republic of Macedonia, 4 Institute of Physiology, Medical Faculty,
University of Cirilus and Metodij, Skopje, Republic of Macedonia,
5 PZU KINETICUS - Center of sports medicine and exercise science,
Skopje, Republic of Macedonia, 6 Urgent Surgery Center, Clinic fo
Surgery, Medical Faculty, University of ST.Cirilus and Metodij,
Skopje, Republic of Macedonia
Increasing VO2max during the soccer training process is imperative,
but reaching the highest anaerobic threshold (AnT) is connected
with top level performance. On the other side, some data suggest
that plasma concentrations of creatine kinase (CK) could be a better
indicator of training adaptation than LDH and blood lactates. The
aim of this study is to evaluate the soccer training effects by
monitoring the changes of VO2max, AnT and CK.
METHODS This study included 30 professional football players from
one of the teams of the first football league. The investigations
were made at three points: in the beginning of the preparation period,
after the preparation period, and after competition period. Each
of the investigations was performed in three phases. The following
parameters had been determined: indirect VO2 max (ml/kg/min) during
a maximal treadmill test; AnT with Conconi treadmill test and plasma
concentrations of CK by DEROM method. Plasma concentrations of CK
were measured before (CK1) and after (CK2) maximal treadmill test.
Exercise induced answer of CK was taking account as a difference
between CK1 and CK2.
RESULTS After the preparation period, there were significant increases
of VO2max. At the end of competition period there were significant
decreases of VO2max, plasma concentrations of CK and exercise induced
CK answer. The AnT was statistically unchanged during the whole
training process. There was significant negative correlation between
VO2max and exercise induced CK answer after the preparation period.
DISCUSSION & CONCLUSION The increase of VO2max after the phase
of preparation, connected with a decrease of exercise induced CK
answer, was a result of an adaptation of muscle cell membrane on
increased volume of training in the phase of preparation. Taking
account the decrease of VO2max at the and of phase of competition,
together with the decrease of plasma concentrations of CK and exercise
induced CK answer on the one side, and unchanged AnT during the
whole training process, on other side, it was indicated that this
soccer training process was ineffective and connected with some
signs of fatigue and disadaptation at the end of the phase of competition.
KEY WORDS soccer players, VO2max, AnT, creatine kinase, training
responses and energy expenditure during water cycling
A. Conceição 3, J. Brito 3, H. Louro 2?, R. Fernandes 2, C. Silva
3?, N. Magalhães 3? and V.M. Reis 1
Department of Sport Sciences, Exercise and Health, University of
Trás-os-Montes and Alto Douro, Portugal, 2 Research Center for Sport,
Health and Human Development (CIDESD), 3 Sports Sciences Research
Laboratory, Sports Sciences School of Rio Maior, Polytechnic Institute
of Santarém, Portugal
Equipment that was used to improve physical fitness on land are
being adapted for water, such as the bicycle. The aim of this study
was to compare the energy cost of submaximal cycling at different
intensities, performed during cycling in an aquatic-specific bike
(CW) and on land stationary bike (CL).
METHODS Fifteen trained male subjects (mean ± SD: age 21.73 ± 2.84
years; weight 70.33 ± 5.33 kg; height 175 ± 06 cm; fat mass percentage
15,09 ± 3.13; VO2máx 50,96 ± 5,51 ml.kg-1.min-1; FC 182,64 ± 12,35
bpm). Each subject completed in a randomized order a 6 min exercise
bout at the cadence of 60, 80 and 100 bpm, either on a CL and a
CW, with 48h separating each exercise bout. Oxygen uptake (VO2),
energy expenditure (EE) and the heart rate (HR) were continuously
collected, respectively, with a portable gas analyzer K4b2 (Cosmed,
Rome, Italy) and by a transmitter unit attached to K4b2. Rest metabolic
rate were measured before each trial. The ANOVA test was used for
repeated measures and Bonferroni post-hoc test as well as the paired
RESULTS The VO2, EE and HR increased with the cadences in both exercises
conditions and were significantly higher (p<0.05) when during
DISCUSSION & CONCLUSION The increased of VO2 and HR in the water
exercise showed a direct relation with the speed of cycling at higher
cadences. In conclusion, different intensities may be used in water
exercises with the advantages of smaller joint overload.
KEY WORDS water cycling, oxygen uptake, heart rate
of different rest intervals during resistance training on growth
hormone, testos-terone and blood lactate
Rahimi, Mohammad Qaderi and Saeed Sadeghi Boroujerdi
Department of Physical Education and Sport Science, Islamic Azad
University Branch Mahabad, Mahabad, Iran
Resistance training stimulates the release of different anabolic
hormones, specially growth hormone (GH) and testosterone (TS) (1,2,4,5).
The acute hormonal responses due to resistance training (RT), reinforces
the access to muscle strength, following the chronic training (3).
Aim of the present study was a comparison among three different
rest intervals on growth hormone (GH), testosterone (TS) and blood
lactate and training volume.
METHODS Therefore ten male athletes (Mean ± SD, age=20.37± 2.24
years, body mass= 65.5 ± 26.70 kg) voluntarily participated in four
sessions with 48 h rest interval who were performing different resistance
trainings (RT). At the first session, one repetition maximum (1RM)
of participants evaluated. The subjects from the second session
up to the fourth, each session, performed four sets of squat and
bench press until exhausted with 85% of 1RM and one of rest intervals
of 60s, 90s and 120s between the sets used randomly and then the
number of repetitions in each set was recorded. Also, there were
taken three blood samples from the subjects before (T0), immediately
after (T1) and 30 min after (T3), to determine the GH, TS and blood
lactate serum concentrations.
RESULTS Based of the results, there wouldn’t observe a significant
difference in GH, TS and blood lactate serum concentrations in T0.
It was observed a significant increment of 64 percent in GH concentration
through using the 60s rest intervals in comparison with 120s rest
between sets in T1. Besides, there was observed a significant increment
of 65 and 67 percent in TS concentration through using the rest
intervals of 90s and 120s compared to the 60s rest interval in T1.
It wasn’t observed a significant difference among the three programs
in lactate concentration. Although, the ability of keeping the repetition
(training volume) by using 90s and 120s rest intervals has been
more than that of 60s, but statistically it wasn’t observed a significant
difference in training volume.
DISCUSSION & CONCLUSION The results of the present study support
rest period in RT sets as an important variable to increase the
anabolic hormone concentrations and it should be mentioned that
60s rest interval has caused more increase in GH concentration compared
with 120s rest. But TS response has been larger in the program with
120s rest interval between sets. In summary, the results of this
investigation indicate that serum GH and TS concentrations were
dependent to the length of the rest interval between sets in heavy
RT program. The primary finding of this study was that the patterns
of GH and TS responses were dramatically different to the length
of rest interval between sets in heavy resistance training. Heavy
resistance training with short (60 s) rest interval between sets
resulted in greater acute GH responses than long (120 s) rest interval
between sets. But acute TS responses after heavy resistance training
with long rest (120 s) showed great increase than heavy resistance
training with short (60 s) rest interval between sets
KEY WORDS Growth hormone, testosterone, resistance training, rest
A new hamstring test for measuring active flexibility before return
to sport after in-jury
Carl 1 ?, Nilsson Johnny 2, Tinmark Frerdik 2 and Thorstensson Alf
1 Department of Molecular Medicine and Surgery, Karolinska Institutet/Stockholm,
Sweden, 2 The Swedish School of Sport and Health Sciences/Stockholm,
Passive flexibility tests are often used for establishing criteria
for safe return to sport after hamstring strains. The aim here is
to introduce an active hamstring flexibility test and to evaluate
its reliability and applicability on injured athletes.
METHODS Eleven healthy subjects (28y) were tested on repeated occasions
and 11 athletes (21y) with MRI-verified acute hamstring strain were
tested when clinical examination revealed no signs of remaining
injury. Flexibility, i.e. highest range of motion of 3 consecutive
trials was calculated from electrogoniometer data during maximal
voluntary and passive hip-flexions in a supine position. A VAS-scale
(0-100) was used to estimate experience of insecurity during active
RESULTS No significant test-retest differences were observed. Intra-class
correlation coefficients ranged 0.89–0.97 and coefficients of variation
1.9-3.2%. Active flexibility was greater (23%) than passive flexibility.
In the athletes, the injured leg showed smaller active, but not
passive, flexibility than the uninjured leg. Average insecurity
estimation was 52 for the injured and 0 for the uninjured leg, respectively.
DISCUSSION & CONCLUSION The new active hamstring test showed
good reliability. Furthermore, it seems to be sensitive enough to
detect differences both in active flexibility and in insecurity
after acute hamstring strains, where the commonly used clinical
examination fails to reveal injury signs. Thus, the active hamstring
test adds discriminative power and could provide useful additional
criteria for minimizing the risk for re-injury upon return to sports
KEY WORDS hamstrings, test, strain, flexibility
of FIFA’S “The 11+” injury prevention program on isokinetic strength
Brito?, Pedro Figueiredo, José Soares and António Rebelo
Centre of Research, Education, Innovation and Intervention in Sport,
Faculty of Sport of the University of Porto, Portugal
This study intended to evaluate whether knee extensor and flexor
muscles strength could be improved in response to an injury prevention
METHODS Twenty players (aged 22.3±4.2 yr) performed the “11+”, an
injury prevention program developed by FIFA’s medical assessment
and research centre. Players trained 3 times per week during 10
weeks. Isokinetic strength was evaluated on knee flexor and extensor
muscles at concentric 60º.s-1, concentric 180º.s-1 and eccentric
30º.s-1 angular velocities. Reciprocal strength differences, and
conventional and functional hamstring:quadriceps peak torque ratios
(H/Q ratio) were considered. Descriptive statistics were calculated
and comparisons between pre- and post-intervention scores were conducted
using paired-sample t-tests. Significance was set at 0.05.
RESULTS Peak torque moments increased for all angular velocities.
Regarding knee extensors strength changes, significant differences
were only found for concentric exertions at 180º.s-1 on the dominant
limb (p=0.05). Major improvements were registered in hamstring concentric
exertions only: dominant limb at 60º.s-1 (p=0.14), non dominant
limb at 60º.s-1 (p<0.001), and non dominant limb at 180º.s-1
(p=0.004). No significant changes were found during eccentric exertions.
Conventional H/Q ratios improved in all velocities, despite reaching
significance at concentric 60º.s-1 (p=0.046) on the non dominant
limb only. No significant differences were found on the functional
DISCUSSION & CONCLUSION The “11+” seems to improve concentric
but not eccentric strength. Reciprocal muscle balance appears not
to change due to the program, but players improved concentric hamstrings
strength, mainly on the non dominant limb. We suggest that higher
training volume and intensity should be considered when performing
the injury prevention program.
KEY WORDS soccer, training, muscle balance, hamstrings
strength evaluation can predict muscle strains in professional soccer
players. A prospective study.
Fousekis 1?, Elias Tsepis 1 and George Vagenas 2
1 Technological Educational Institute (T.E.I.) of Patras/ Department
of Physiotherapy, Egio, Greece, 2 University of Athens/ Department
of Physical Education and Sports Science, Athens, Greece
Soccer players tend to use their preferred lower extremity for most
of the soccer activities and especially for controlling and kicking
the ball. Theoretically, this leads to asymmetrical adaptations
of the musculoskeletal structures and consequently to muscle injuries.
The purpose of this prospective study was to investigate the isokinetic
myodynamic profile at the lower extremities of soccer players and
to establish an association between possible strength asymmetries
with the development of muscle strains.
METHODS One-hundred professional soccer players (age 23.4 years,
weight 73,3, height 177.6) were tested isokinetically for concentric
and eccentric strength of the knee flexors and extensors and of
the ankle dorsal and plantar flexors. Knee flexion and extension
was tested at 60o, 180o and 300 o/sec for the concentric mode of
contraction and at 60o and 180 o/sec for the eccentric. The ankle
joint was tested at 60 o/sec for both the concentric and eccentric
mode of contraction. Identical protocols were applied to both body
sides (left, right). A lower extremity strength asymmetric profile
was then created using selected cut-offs for bilateral strength
differences of 15% or more in a total of 14 measurements (concentric
and eccentric evaluation of knee and ankle joint). Players were
followed prospectively for the next 11 months and 31 strains in
the muscles of their lower extremities were recorded.
RESULTS Soccer players suffer many strength asymmetries at their
lower extremities. These asymmetries were most prevalent in the
eccentric function compared to the concentric (Wilks’Ë=0.70, F=4.75,
P=0.000). Players with concentric asymmetries didn’t not present
significant higher incidence rate of muscle strains compared to
players with no concentric asymmetries (Pearson x2= 0.18, p=0.67,
Odds ratio=0.12). In contrary, the incidence rate of muscle strains
increased significantly in players with pre-season eccentric strength
asymmetries (Pearson X2= 7.78, p=0.005, Odds Ratio= 6.91). Furthermore,
grouping of players according to the number of isokinetic asymmetries
revealed that players with many concentric/eccentric asymmetries
presented also significant high epidemiology in muscle strains (Pearson
DISCUSSION & CONCLUSION The outcome of this study confirms the
hypothesis of asymmetrical myodynamic adaptations of the knee and
ankle joint in soccer players. Our findings clarifies the influence
of bilateral isokinetic strength asymmetries on muscle strain at
the lower extremities of professional soccer players. Isokinetic
evaluation during the pre-season period can predict and thus decrease
the incidence rate of muscle strains in soccer.
KEY WORDS soccer, injury prediction, strength asymmetries
strength profile of quadriceps and hamstrings in elite male volleyball
Dervisevic, Vedran Hadzic, Tine Sattler, Goran Markovic and Matjaz
Edvin Dervieviæ, Faculty of Sports Ljubljana, Department of Sports
Medicine, Ljubljana Slovenia
Knowledge of lower-extremity strength can be used in injury prevention,
conditioning and rehabilitation of volleyball players. The goals
were: (1) to describe the concentric and eccentric quadriceps (Q)
and hamstrings (H) muscle function in volleyball players, (2) to
evaluate the differences in Q and H strength, strength ratios and
bilateral strength asymmetry among age groups, playing positions
and playing levels, (3) to compare bilateral strength asymmetry
in Q and H muscles in two different contraction modes.
METHODS 95 professional male volleyball players were tested on an
isokinetic machine at 60°/sec to assess concentric and eccentric
Q and H strength. We also calculated strength ratios and bilateral
strength asymmetries. MANOVAs indicated significant main effect
of playing level on relative PT (p=0.001) and strength ratios (p<0.05).
RESULTS International-level players had significantly (p<0.05)
higher H strength and dynamic control ratio (DCR) of the right leg
compared to the 1st and/or 2nd national division players. There
were no signs of bilateral strength asymmetry regardless of muscle
group tested and contraction mode.
DISCUSSION & CONCLUSION Our results suggest that right H strength
and DCR could be important for successful volleyball performance.
Descriptive data about Q and H muscle function can be used as guidelines
for coaches and therapists during training and rehabilitation of
male volleyball players
KEY WORDS volleyball, isokinetic strength
values of left ventricular remodelling in elite athletes, as assessed
by three-dimensional echocardiography
Quattrini 1, Stefano Caselli 1, Fernando Di Paolo 1, Cataldo Pisicchio
1, Riccardo Di Pietro 3, Barbara Di Giacinto 1, Elvira De Blasiis
1, Emanuele Guerra 1, Roberto Ciardo 1, Maurizio Casasco 2 and Antonio
1 Institute of Sport Medicine and Science, Italian National Olympic
Committee, Rome, Italy. 2 Italian Federation of Sport Medicine,
3 Sapienza University, Rome, Italy.
Aim of our study was to assess the normal values of left ventricular
(LV) remodelling, as assessed by three-dimensional echocardiography
(3DE) in a large population of elite competitive athletes.
METHODS A study population of 426 elite athletes engaged in different
sports disciplines (41 skill, 100 strength, 127 combined and 158
endurance) and 62 sedentary controls underwent 3DE for assessment
of LV end-diastolic volume (EDV), systolic volume (ESV), mass (LVM),
which were normalized to body surface area, and ejection fraction
RESULTS EDV was larger in athletes engaged in strength (77±14 ml/m2;
p<0.001), combined (77±11 ml/m2; p<0.001) and endurance (91±13
ml/m2; p<0.001), but not in skill (70±11 ml/m2) disciplines compared
to controls (63±11 ml/m2). Also, ESV was larger in strength (29±7
ml/m2; p<0.001), combined (29±6 ml/m2; p<0.001) and endurance
(35±7 ml/m2; p<0.001), but not in skill (26±6 ml/m2) disciplines
compared to controls (23±5 ml/m2). LVM was significantly greater
in strength (78±13 g/m2; p<0.001), combined (79±11 g/m2; p<0.001)
and endurance (91±14 g/m2; p<0.001) but not in skill disciplines
(69±10 g/m2) compared to controls (61±10 g/m2). No significant differences
were identified for EF between skill (63±5%; p<0.001), strength
(63±9%; p<0.001), combined (62±5%; p<0.001), endurance disciplines
(62±5%; p<0.001) and controls ( 63±5%).
DISCUSSION & CONCLUSION LV remodelling as assessed by 3D is
related to type of sport participated, with endurance athletes showing
the most marked increase in EDV, ESV and LV Mass; instead, no significant
LV morphologic changes were observed in skill athletes. Regardless
the extent of LV remodelling, the systolic function remained within
normal limits in all athletes.
KEY WORDS athletes, three-dimensional echocardiography, left venticular
ventricular mechanical systole in elite athletes assessed by 3D
Guerra 1, Stefano Caselli 1, Barbara Di Giacinto 1, Filippo Quattrini
1, Elvira De Blasiis 1, Fernando Di Paolo 1, Cataldo Pisicchio 1,
Roberto Ciardo 1, Maurizio Casasco 2 and Antonio Pelliccia 1
1 Istitute of Sports Medicine and Science, 2 Italian Federation
of Sport Medicine, Roma, Italy
We sought to evaluate left ventricular (LV) systolic time interval
(STI) comparatively in elite athletes and sedentary controls by
3-dimensional echocardiography (3DE).
METHODS 426 athletes, involved in skill (n=41), strength (n=100),
combined (n=127), and endurance (n=158) disciplines and 62 sedentary
controls, matched for age, underwent 3DE examination. By off-line
analysis, LV volume-time curve was generated; time from the beginning
of the QRS complex to the minimum systolic volume was considered
to be the systolic time interval, this interval was also expressed
relatively to the length of the hearth cycle (STI %). The systolic
flow rate (SFR) was calculated as the ratio between stroke volume
and STI .
RESULTS Heart rate was lower in athletes engaged in skill (61±12bpm;
p<0.001), strength (58±10 bpm; p<0.001), combined (57±10 bpm;
p<0.001) and endurance (53±10 bpm; p<0.001) sports compared
to controls (75±12 bpm). LV end-diastolic volume was larger in strength
(150±35 ml; p<0.001), combined (158±29 ml; p<0.001) and endurance
(178±32 ml; p<0.001) but not in skill (127±30 ml; p<0.001)
athletes vs. controls (111±27 ml). The STI % was shorter in athletes
compared to controls (40±5 vs 30±4 p< 0.001); among athletes
the STI % was shorter in skill (31±4 %; p<0.001), strength (31±5
%; p<0.001), combined (31±4 %; p<0.001) and endurance (29±4%;
p<0.001) athletes compared to controls (40±5%. In addition, the
SFR was higher in athletes compared to controls (212±58 ml/s vs
310±75 ml/s, p<0.001); among athletes higher values for SFR were
identified in skill (256±60 ml/s; p<0.001), strength (297±78
ml/s; p<0.001), combined (308±67 ml/s; p<0.001), and endurance
(334±74 ml/s; p<0.001) athletes as opposed to controls (212±58
CONCLUSION Elite athletes show a significant shortening of relative
systolic time interval (STI%) in comparison to sedentary controls,
in association with a significant increase in LV emptying velocity
(SFR). These adaptations may contribute to enhance LV systolic function.
Prevalence and clinical significance of negative T waves in sportsmen:
a retrospective study
Gentili?, Massimiliano Bianco, Vincenzo Palmieri, Serena Bria, Alessandra
Loschiavo, Anna Scardigno, Flaviano Giorgiano and Paolo Zeppilli
Sports Medicine Department - Catholic University, Rome
Trained, healthy athletes frequently show 12-lead-ECG changes (sinus
bradycardia, increased QRS-voltages, etc), generally regarded as
physiological adaptation to athletic conditioning. Despite several
studies, disagreement still exists on determinants and clinical
significance of ventricular repolarization anomalies. METHODS Rest-ECG
of the sportsmen evaluated at our Institution from 1979 to 2009
were analyzed, looking for the presence of negative T-waves >2
mm in depth in at least 3 leads (apart from III, aVR, V1). In selected
cases the presence of conditions potentially responsible for these
anomalies were retrospectively researched by means of clinical history
and instrumental investigations (mainly echocardiography). Sportsmen
with systemic diseases potentially affecting ECG (mainly hypertension),
RESULTS Out of 12.387 sportsmen, only 142 (1.14%) (mean age 28.9±12.5,
range 12-59 years) had negative T-waves at rest-ECG and 134 of them
(94.4%) showed cardiac morpho-functional anomalies at echocardiogram
or other tests, diagnostic or highly suspected for: hypertrophic
cardiomyopathy (HCM, 67.9%), isolated papillary muscles hypertrophy
(6.0%), myocarditis (8.9%), arrhythmogenic right ventricular cardiomyopathy
(ARVC, 8.2%), valvular diseases (2.2%), ischemic cardiomyopathy
(1.5%), abnormal coronary artery origin (0.7%), myocardial bridge
(0.7%), dilated cardiomyopathy (0.7%), long-QT syndrome (0.7%).
Forty-three of these 142 sportsmen (30.3%) had giant (>10 mm)
negative T-waves, associated with certain or highly suspected HCM
(83.7%, 58.3% with apical localization), isolated papillary muscles
hypertrophy (4.6%), myocarditis (6.9%); only 1 case (2.3%, evaluated
in early 80s) showed no significant heart abnormalities.
DISCUSSION & CONCLUSION Negative T-waves on rest-ECG of sportsmen
are rare. When observed, a cardiac morpho-functional abnormality,
sometimes at risk of sudden death, must be carefully ruled out.
KEY WORDS Athlete’s ECG; ventricular repolarization; heart; sudden
rate profile to exercise: Effects of age and exercise training
Gomes Ciolac? and Júlia Maria Greve
Institute of Orthopedics and Traumatology do Hospital das Clínicas
da Faculdade de Medicina da USP / Laboratory of Kinesiology / Sao
Heart rate (HR) dynamic during exercise test has shown to be a non-invasive
tool to assess cardiac autonomic control of the nervous system,
reflecting the interaction of sympathetic and parasympathetic activity.
However, there is litle information about the effects of exercise
training on HR dynamic of healthy women of different age groups.
Our purpose was to analyze the effect of two times-a-week exercise
training program on HR dynamic, as well as to compare this effect
among women of different age groups.
METHODS 117 healthy sedentary women, divided in four groups according
to their age (G1 – n=30, 30.3±6.2 years; G2 – n=37; 44.1±2.5 years;
G3 – n=27; 53.7±3.5 years; G4 – n=20; 66.4±6.9 years), were submitted
to a two times-a-week exercise training program with aerobic (20
minutes at 60-75% of reserve heart rate), whole-body resistance
(2-3 sets of 8-12 repetitions at 60-80% of 1- RM), and stretching
exercise, performed for 12 month. Maximal graded exercise test (GXT)
was performed at baseline and after twelve months of follow-up.
RESULTS Exercise training improved cardiorespiratory fitness in
10.3±5.1% with no significant difference among the four age groups.
Resting and recovery HR were reduced in G1 and G2 (p<0.05), but
not in G3 and G4, after the twelve month of exercise training. Peak
HR did not change significantly in any group after the follow-up.
DISCUSSION & CONCLUSION The results suggest that two times-a-week
multi-component exercise training is enough to improve HR profile
to exercise in young (age < 50 years), suggesting a better interection
of sympathetic and parasympathetic system. However, this improvement
was not observed in older women.
KEY WORDS exercise; cardiorespiratory fitness; heart rate; autonomic
nervous system; aging.
of cerebral haemodynamics at boxers according to duplex scanning
Dekhtiarov 2 and A. Muravskiy 1
1 National Medical Academy of Post-Graduate Education named after
P.L. Shupyk, Kiev, 2 Ukranian Sport Medicine and Physical Exercises
Specialists Association, Kiev, Ukraine
To determine the condition of cerebral haemodynamics at boxers according
to duplex scanning.
METHODS Studied condition of cerebral haemodynamics by duplex scanning
extracranial brachiocephalic vessels and transcranial duplex scanning
of 32 amateur boxers aged 18 to 26 years. Surveyed the boxers were
in the preparatory period. Control group consisted of 30 men aged
18 to 25 years who did not have a history of deferred traumatic
brain injury. The survey was conducted in the unit LOGIO 400 PRO
series General Electric Company on the standard methodology used
in the sensors 11, 8 and 2 MHz in a pulse mode and a color mapping.
For the study of intracranial arteries using three standard access:
transtemporal, transoccipital, transorbital.
RESULTS The increased the velocity of blood flow in the artery cerebri
media met in 11 cases. Angiospasm phenomena occurred in 4 cases,
the trend toward hypertonus was observed in 6 cases. Violations
of venous outflow showed overload transverse sinuses - 6 observations,
cavernous sinuses - 2, basal veins - 1. In 13 cases out of 32 haemodynamic
pattern in the studied group of patients characterized by signs
angiodistonia. In the control group from 2 people signs of angiodystonia
DISCUSSION & CONCLUSION Haemodynamic disorders among boxers
have been characterized signs of angiodystonia (40,6%), increased
the velocity of blood flow to arteria cerebri media (34,4%), acceleration
of venous outflow (28,1%), which is required in some cases the appointment
of drugs improving cerebral circulation.
KEY WORDS cerebral haemodynamics, traumatic brain injury, boxing,
adaptation of articular cartilage to different physical exercises
Ozgur Celik 1?, Yasar Salci 1, Feza Korkusuz 1 and Aydiner Kalaci
1 Middle East Technical University/Physical Education and Sports
Department/Ankara-Turkey, 2 Mustafa Kemal University/ School of
Medicine, Orthopedics & Traumatology/Hatay-Turkey
The objective of the present study was to investigate deformational
behavior and functional adaptation of articular cartilage by the
changes of serum level of Cartilage Oligomeric Matrix Protein (COMP)
during a 30-min exercise after 12-weeks of regular high impact,
impact or non-impact exercise.
METHODS Blood samples were drawn from 44 healthy sedentary males
immediately before and after and 0.5 h after a 30-min walking exercise
on a motor-driven treadmill at 5 km/h speed. Serum COMP concentrations
were determined using a commercial enzyme-linked immunosorbent assay
(AnaMar Medical, Goteborg, Sweden). After first measurements participants
were randomly and equally assigned to high impact (running, n=11),
impact (cycling, n=11), non-impact (swimming, n=11) and control
groups (n=11). All exercise groups participated in sessions of 40
minutes per day, 3 days per week for 12 weeks. Exercise sessions
were determined according to the ACSMs’ guidelines. Participants
in running and cycling groups partake sessions in the human performance
laboratory one by one, while swimming group perform exercise sessions
in indoor swimming pool. Throughout the 12-week period, the control
group was told not to participate in any organized or structured
exercise and continue their daily life activities. At the end of
the 12-weeks intervention period, post tests were applied. The data
were analyzed with separate 4x2 (groups and time) mixed repeated-measures
ANOVA design for each phase of blood sampling. Bonferroni-adjusted
paired-samples t-tests were employed for post-hoc analyses. The
level of statistical significance was accepted as p<0.05.
RESULTS Mean values of serum COMP levels at pre-test measurements
for recovery, fatigue and regeneration phases were 10.06±2.05, 11.45±2.58
and 10.24±1.83 U/I respectively. Serum COMP levels at post test
measurements were 9.60±1.95, 11.21±2.36, 10.16±1.93 U/I for each
phases. Multivariate tests indicate a significant fatigue or resting
effect on serum COMP concentration in all experimental and control
groups at pre and post tests. Therefore, pair wise comparisons were
conducted in order to assess which means differ from each other.
Results indicated significant differences in post test measurements
among phases of cycling, swimming and control groups except running
DISCUSSION & CONCLUSION 30 minutes moderate walking activity
has little influence on the increase serum COMP concentrations of
young sedentary men. However, 12 weeks regular weight-bearing high
impact physical exercise (running) decrease the deformational effect
of walking activity by functional adaptation of articular cartilage
to specific environmental requirements.
KEY WORDS COMP, fitness, knee joint, deformation
of anaerobic training on blood nitric oxide and haematological parameters
Turgay 2, A. Cecen Aksu 3? and A. R. Sisman 1
1 Dokuz Eylul University, Medical Faculty, Biochemistry Department,
Izmir, Turkey, 2 Ege University Physical Education and Sports Department,
Izmir, Turkey, 3 Sports Medicine Private Practice, Izmir, Turkey
Nitric oxide (NO) is a vasodilator and an antioxidant gas. Although
the synthesis of NO has been attributed exclusively to the vascular
endothelium, it has been demonstrated that red blood cells (RBCs)
express the endothelial nitric oxide synthase enzyme isoform (eNOS).
In addition, RBCs have been assumed to metabolize large quantities
of NO due to hemoglobin (Hb). The aim of our study is to investigate
the effects of anaerobic (judo) training on serum NO levels and
METHODS 18 Turkish national female judoists (aged 17.9 „b 0.8 yr)
participated in our study. In the 19 week period prior to the competitive
season, once at the start and once at the end, main haematological
parameters (haemogram, serum ferritine, iron, etc), NO and some
biochemical parameters were analyzed in fasting blood.
RESULTS After training, no significant changes occurred in serum
NO levels (which decreased % 10.6), significant decreases were determined
in blood RBC, Hematocrit (Hct), trombosit, serum iron, creatinine
and globuline levels (P<0.05), significant increases were established
in blood Hb, ferritine, transaminases (aspartate amino transaminase
and alanine amino transaminase activities). However, after the training,
significant negative relationships were established between NO and
urea levels and transaminases used as predictors of overtraining.
Insignificant negative relationships were found between NO and difference
values between two measurements of RBC, Hct and Hb before and after
DISCUSSION & CONCLUSION The reason of negative effects established
on blood NO levels and main haematological parameters may be in
part the anaerobic nature of intensive judo training.
KEY WORDS Nitric oxide, Hematological parameters, Judo training.
effect of aquatic aerobic training on the quality of life on Multiple
Soltani 4 ?, Seyed Mahmood Hejazi 1, Abbas Noorian 1, Ahmad Zendedel
2 and Marzih Ashkanifar 3
1 Assistant professor of Iran Mashhad Azad University, 2 Assistant
professor of Iran Nishabour Azad University, 3 Biologist of Iran
Mashhad , 4 An academic member of Iran Mashhad Azad university and
also an Academic member of university young researchers club
MS is a central nervous system disease with various physical and
mental symptoms, such as physical disability, movement depauperation,
walking disorders, and decrease in quality of life(QOL). Studies
on MS patients began in 1868 by Sharcot. In a research which was
done on 112 M.S patients by Koudouni and Orologaes (2004) the finding
showed a relative improvement in (QOL) of M.S patients after 8 week
of aerobic training. Purpose study the effect of an aquatic exercise
for 8 weeks, on the improvement QOL of female MS patients.
METHODS From 100 MS patients, 25 people on the basis of illness
degree and age range were selected randomly. with EDSS 1-4 with
average illness time of (4 1) and age rang of (20-50) years. They
were divided in two groups. Experimental group 15 people and controlled
group 10 people. The experimental group participated in the exercise
for 8 weeks, each week three sessions with intensity of 40-50 percent
of the maximum heart-beat rate. The QOL was measured by FAMS. Version
2 questionnaire in experimental and controlled groups before and
after exercise. The gathering data were analyzed by using descriptive
statistic and dependent sample t- test.
RESULTS The research has shown that after 8 weeks, in the experimental
group the QOL was meaning fully improved(P<0/01).
DISCUSSION & CONCLUSION Considering the results of this research,
which has caused in an improvement in the QOL MS patients with low
EDSS, so it seems necessary to apply an aquatic exercise for such
patients. Therefore, it is recommended these exercises to be used
by specialists as a supplementary remedy beside medical treatments
for MS patients
KEYWORDS Multiple sclerosis- - aquatic exercise - quality of life
simple and complex reaction times in female compared to male boxers
Bianco 3?, Matteo Feri 3, Carmela Fabiano 3, Sofia Tavella 2, Umberto
Manili 2, Maurizio Casasco 1, Marcello Faina 2 and Paolo Zeppilli
1 Italian Sports Medicine Federation, Rome, Italy, 2 Sports Medicine
and Science Institute, National Italian Olympic Committee, Rome,
Italy, 3 Sports Medicine Department, Catholic University, Rome,
Cognitive performance can be easily evaluated, nowadays, by means
of computerized neuropsychological (NP) tests, but no research used
this tool to investigate female boxers. Aim of the study is to compare
baseline cognitive performance in female to male amateur boxers.
METHODS Study population was composed of a group of 28 female amateur
boxers, with no history of head concussions (except boxing). A group
of 56 male boxers, matched for age, employment and competitive level
to female athletes formed the control group. Each boxer was requested
to: a) fulfill a questionnaire collecting demographic data, level
of education, occupational status, boxing record and number of head
concussions during boxing; b) undergo a baseline computerized NP
test (CogSport) measuring simple and complex reaction times (RT).
RESULTS Female were significantly (p<0.0001) lighter than male
boxers (56.0+/-7.0 vs 73.1+/-9.8 kg). No significant differences
at NP testing scores were observed between groups. Male boxers showed
a significantly longer simple-RT at the end than the beginning of
the NP test (0.247+/-0.007 vs 0.243+/-0.007 s, p=0.02), however
with a significant lower rate of mistakes (0.7+/-1.6 vs 2.0+/-3.1%,
p = 0.005), observed also in the female group (0.5+/-1.1 vs 2.2+/-3.0%,
p=0.005). No boxing activity parameter (fighting record, number
of knock-outs, etc.) correlated with NP scores.
DISCUSSION & CONCLUSION Women’s Olympic style boxers show no
or minimal differences in baseline cognitive performance in respect
to male amateur boxers. This study confirms that women’s boxing
seems to be as safe as male boxing in respect to cognitive performance.
KEY WORDS concussion; mild traumatic brain injury; contact sports;
analysis and functional deficiencies in elite soccer players with
chronic ankle instability
Türk? and Bülent Bayraktar
Istanbul University Department of Sports Medicine, Istanbul, Turkey
Among all sports-related injuries, ankle injuries have a high risk
for both recurrence and sequela. Instability being the most frequent
and serious sequela is developed in approximately 30-40% of the
patients, can be resistant to conservative managements and became
permanent. It was conceived that; if the differences associated
with chronic ankle instabilities can be demonstrated, pathophysiological
basics of the condition will be comprehensible.
METHODS 157 soccer players, aged between 13-18 years, were recruited
for the study. Among these players, chronic ankle instability was
diagnosed in 22 players (14%), fifteen of these being eligible for
the study. Eighteen healthy soccer players randomized for control
group. The groups were evaluated by 3D computerized walking analysis
for temporo-spatial, kinematic and kinetic assesments in both sagital
and transverse plane. For functional deficiencies; “Functional Ankle
Disability Index” were performed (FADI and FADI-S). Statistical
analysis was performed for assesment of the data.
RESULTS All cases were classified into two groups; group1 for instability
cases and group2 for control group. The groups were similar in respect
to average age, height and weight. There were a statistical significant
difference between the groups in FADI and FADI-S results for both
extremities (<0.05). Although temporo-spatial parameteres and
physical findings were similar in two groups, gait analysis demonstrated
arthrokinetic changes in cases with chronic ankle instabilities.
DISCUSSION & CONCLUSION The studies on chronic ankle instability
are generally either not discriminated the two major factors (functional
and mechanical ankle instability) which are appreciated as two different
entities for instability, or evaluated separately as a single factor.
In the following report, functional disability diagnosed with FADI
and FADI-S was considerably more severe in unstable cases. More
over, unstable cases had hazardous changes for recurrance in movement
pattern during walking analysis.
KEY WORDS soccer, chronic ankle instability, gait analysis, FADI
effect of aerobic and anaerobic functional fatigue protocols on
ground reaction force components during jump landing movement
M. R.1, Hovanloo, F.2, Sadeghi, H. 3 and Abbasi, A.4
1 Master of science, Corrective Exercise & Sport Injury, 2 Assistant
of professor, Faculty of Physical Education & Sport Sciences,
Shahid Beheshti University, 3 Associate Professor, Faculty of Physical
Education & Sport Sciences, Tarbiat Moallem University of Tehran,
4 Master of Science, Sport Biomechanics
In most tasks, most of the loss of force occurs because of the changes
within the muscle or central nervous system and or both of them.
There appears to be a relationship between altered neuromuscular
control and muscle fatigue. The purpose of this study was to examine
the effect of aerobic and anaerobic functional fatigue protocols
(AAFFP) on dynamic postural stability in nonelite young soccer players.
METHODS Twelve male young soccer players who were playing in league
one (Tehran) (age: 17.42 ± 0.51 y, weight: 67.65 ± 6.58 kg, height:
173.33 ± 3.09 cm) that all of them was health participated in this
study. Before beginning the fatigue protocol, dynamic posture stability
index (DPSI) evaluated following single leg jump-landing movement
(athletic task that resulting injury) with sampling frequency of
200-HZ in 3 second recording. Stability indices analyzed in mediallateral
(MLSI), anterior-posterior (APSI) and vertical (VSI) direction.
Immediately following fatigue, post testing was performed. The data
was analyzed with analyses of variance (ANOVA) with repeated measures
(p < 0.05).
RESULTS ANOVA revealed significant differences when comparing anaerobic
fatigue pre test and post test values for MLSI, APSI, VSI, DPSI
and RPE. Likewise aerobic fatigue revealed significant differences
pre test and post test values for VSI and DPSI whereas no significant
differences were revealed when comparing the aerobic fatigue protocols
for pre test and post test of MLSI and APSI.
DISCUSSION & CONCLUSION In attention to this fatigue protocols
probably eccentric contraction of hamstring muscles during the late
swing phase to control forward motion of the thigh and leg segments,
is case of altering in hamstring quadriceps muscle strength rate
and decrease lower extremity stability. Also it seems that, subjects
because of deceleration the body‚s downward velocity for decrease
the impact force, altered mechanical mechanism of landing skill.
The results of this investigation suggest that aerobic and anaerobic
functional fatigue protocols, specially aerobic fatigue have effect
in dynamic postural stability. This matter can be used one of the
main factors in determining of injury mechanism (in jumplanding
Key words fatigue, dynamic postural stability, soccer players, jumplanding
in front crawl technique-case of study
A. 1,2, Silva, A. 2,3, Marinho,D. 2,4, Brito, J. 1,2, Costa, A.
2,4 and Louro, H. 1,2
1 Sports Sciences School of Rio Maior, Polytechnic Institute of
Santarém, Portugal, 2 Research Center for Sport, Health and Human
Development (CIDESD), UTAD, Vila Real, Portugal , 3 Department of
C. of Sport, Exercise and Health of University of Trás-os-Montes
and Alto Douro; Vila Real, Portugal. 4 Departament of C. of Sport,
University of Beira Interior, Covilhã, Portugal
The need to develop systems electromiographic (EMG) in quatic environment,
has led several researchers to refine these instruments to ensure
the credibility of the data provided by EMG. The aim of this study
is to characterize the behavior of two muscle muscles involved in
the crawl technique (biceps brachii and triceps brachii) over a
test of 200m crawl.
METHODS A male swimmer trained was subjected to a test consisting
of a maximum voluntary contraction (CVM) of the Biceps Brachii (
BB) and Triceps Brachii (TB) for standardization. A protocol of
4 x 50m with an interval of 15 seconds at a swimming speed of pre-established,
making each part to 95% of transit time for 200m crawl. The EMG
were used with a Wirelless signal of the BB and TB muscles of the
right arm was removed throughout the test and then synchronized
with the video image, and selected 5 cycles of swimming on all identical
RESULTS There is a gradual decrease of its average muscle activity.
The BB was about 43% and TB was 26%. The largest variation on it,
in the case of BB, between the third and fourth route (21%), and
in the case of TB, between the second and third route (14%).
DISCUSSION & CONCLUSION The muscles studied demonstrated changes
in the duration of swim cycles, indicat-ing that, there is a decrease
in muscle activity, this supposed to be due to limitations in production
capacity under swimmer and the characteristics of the art of swimming
which are changing as increasing fatigue.
KEY WORDS electromiography, kinematics analysis, crawl, swimming
for ýnvestigating the use of the arms in fall recovery
Ak 1 and Stephen J. Piazza 2
1 Middle East Technical University/Department of Physical Education
and Sports, Ankara, Turkey, 2 Pennsylvania State University/Kinesiology
Department/State College, PA - USA
Despite extensive preventive efforts, falls continue to be a major
source of morbidity and mortality. Most studies of falling mechanics
have focused on response time, lower limb muscle strength, and leg
muscle activation. Less attention has been given to rotational arm
movements that express angular momentum that would otherwise be
associ-ated with destabilization of the trunk. The purpose of this
ongoing study was to determine how arm rotation is modu-lated during
a fall recovery in response to varied balance perturbations.
METHODS Twelve volunteer participants were initially held in a static
forward-inclined position using a horizontal tether attached to
a waist belt. The subjects were then unexpectedly released from
initial lean angles of 5.5° and 6.5°. They were instructed avoid
taking a step during the fall recovery. Six Eagle motion analysis
cameras were used to track 54 markers placed on the subjects’ bodies
and a Kistler force platform was used to record ground reaction
force. Full-body kinematics and kinetics were computed from marker
and force data using Visual3D software. Custom written MATLAB code
was used to compute the three dimensional angular momentum of the
arms. At this writing, however, we have completed analysis of only
one subject’s fall recoveries.
RESULTS The results for a single subject showed similar angular
momentum patterns for all trials. First, the arms were rapidly raised
away from the body in the frontal plane. This movement was followed
by a rapid rotation of both arms in the clockwise direction (viewed
from the right). The angular momentum of the arms during this phase
appeared to be graded in response to the magnitude of the perturbation.
Peak angular momentum in sagittal plane was found to be approximately
50% greater for and initial body lean of 6.5° than for 5.5°.
DISCUSSION & CONCLUSION We have developed a methodology for
applying a balance perturbation and measur-ing the use of the arms
during fall recovery. Analysis of one subject’s recoveries showed
that the subject seemed to generate more angular momentum with the
arms when a greater perturbation was applied. Processing all trials
would permit statistical tests to confirm if this apparent modulation
of the response of the arms is consistent across the subject population.
Such findings would suggest that arm rotations are calibrated rather
than being a maximal response. This same methodology may be used
to study the maintenance of balance during sporting activities such
as the volleyball spike.
KEY WORDS fall, recovery, arm rotation, tether release, angular
of temporal patterns of behavior of the crawl technique
H. 1,4, Conceição, A. ?1,4 , Matos, T. 1,4, Nilton, J. 2, Franco,
R. 1, Camerino O. 3, Oliveira, C. 2 and Campaniço, J. 2,4
1 Sports Sciences School of Rio Maior, Polytechnic Institute of
Santarém, Portugal, 2 Department of Sport Sciences, Exercise and
Health, University of Trás-os-Montes and Alto Douro, Portugal, 3
University of Leida, Spain, 4 Research Center for Sport, Health
and Human Development (CIDESD), Vila Real, Portugal
With this work we want to check the standards of the crawl technique
from an observational methodology appropriated.The instrument of
observation (Nilton, 2008) was developed Ad Hoc, using the references
of biomechanical models, based on a mixed system of categories and
formats of fields, with particular reference to four criteria that
add in the form of alpha-numeric codes. The results of the quality
of the instrument revealed indices of reliability and high precision.
METHODS We use a sample of six swimmers from Portuguese and international
level as part of the Portuguese national team in swimming. Each
element was subject to the overall swimming crawl technique at a
distance of 25m to achieve maximum speed without a breath. The units
of observation are natural (events and behaviors) and analytical
(of behavior). The detection of temporal patterns by binomial analysis
(Magnusson, 2000) was made by the software 5.0 Theme created by
Magnusson (1996, 2000). The instrument is intended to identify patterns
which are within the critical intervals, allowing examination of
the inter-relationship of temporal events (movement), using the
record of occurrences in the collection of patterns found in data.
RESULTS The patterns found in each swimmer is different and each
pattern is adjusted to the particular individual techniques.
DISCUSSION & CONCLUSION The same swimmer can present similar
structures for implementation, representing a behavior pattern.
In all the swimmers were identified more than one standard. However,
it is noteworthy that no swimmer of the sample made the same overall
behavior at any stage observed in the five cycles analyzed.
KEY WORDS Temporal Patterns, Behaviour, Crawl Technique
of anthropometric features and nutritional habits of elite Italian
athletes, selected for participation in the 2008 Bejing Olympic
Di Giacinto 1, Alessio Franco 1, Giovanna Berlutti 1, Loredana Torrisi
1, Claudio Briganti 1, Irene Tamara Pamich 1, Elvira De Blasiis
1, Filippo Maria Quattrini 1, Maurizio Casasco 2 and Antonio Pelliccia
1 Institute of Sport Medicine and Science, Medicine and Nutrition
Department, Rome, Italy, 2 Italian Sport Medicine Federation, Rome,
aim of our study was to characterize a population of elite athletes,
participating at the highest level of competition including the
Olympic Games, with regard to their nutritional habits and body
METHODS 555 elite Italian athletes (340 male and 215 female), selected
for participation in the 2008 Olympic Games were included in this
analysis. Athletes aged 14 to 45 years, and were engaged in 25 different
sport disciplines. Anthropometric characteristics, nutritional habits
and dietary intakes were assessed; specifically, height, weight,
body mass index (BMI), fat mass and fat-free mass (by skin folds)
were measured. Moreover, a nutritional survey was performed by expert
dieticians to evaluate daily energy intake (DEI), total proteins
and proteins per kilogram of body-weight, lipids, carbohydrates,
C-vitamin and iron.
RESULTS mean values ± standard deviations for male and female athletes
were respectively: age 27±6 and 25±6 years, weight 80±12.8 and 62±12.9
kg, height 181±10.5 and 168±8.7 cm, BMI 24.3±2.9 and 21.8±2.8 kg/m2,
fat mass 13±4.8% and 20.5±5.6%. The nutritional survey showed, in
male and female athletes, respectively, DEI 3066±630 and 2373±449
kcal/day; proteins 18.6±3.4% and 18.6±3.2%; proteins for kg of body
weight 1.8±0.4 and 1.8±0.3 g/kg; carbohydrates 49±6.4% and 49.3±6.7%;
lipids 32.3±5% 32.4±5.7%; C-vitamins 133±78.9 and 136±75.0; iron
16.3±4.3 and 13.4±3.6 mg.
DISCUSSION & CONCLUSION Italian elite athletes appear to be
in the upper range for height respect to the mean of Italian population;
their fat mass is very low and, consequently, their fat-free mass
is increased, as an expression of enhanced muscular structure. Indeed,
nutritional habits are considered appropriate to their caloric expenditure,
following the pattern of the “Mediterranean Diet” as recommended
by the World Health Organization.
KEY WORDS athletes, anthropometric characteristics, nutritional
comparison of some bone and calcium metabolism indices in active
and non active menopause women
Reza Ramezan Pour 1?, Mohammad Reza Hamedini 3 and Fatemeh Vaeznia
1 Islamic Azad University- Mashhad Branch, 2 Islamic Azad University-Behshar
Branch, 3 Sabzevar University, Tehran, Iran
The purpose of this study was to compare some bone and Calsium metabolism
in active and non active Menopause women(MW). Calcium and Phosphorus
of Urinary and serum, special bone Alkaline Phosphatase as a bone
construction index and Resisting Acid Phosphatase to Tartarate as
a bone absorbtion Index and Parathyroid hormone(PaH) and Calcitonine
hormone(CH) for comparison of Calcium and bone metabolism were all
considered in two groups.
METHODS Twenty eight MW (14 active and 14 nonactive) with the some
traits from those who were clients to a sport club in Sabsevar were
used to from the two treatment groups. Measures: Height, weight,
PWC ,VO2Max ,WHR.BMI, BP and RHR of the subjects were determined.
Subjects had similar nutritional program and didn’t use any drugs.
Prior to breakfast morning urine test up to 80 cc and blood sample
from brachialis vein up to 10 ml were gathered from the subjects.
Comparison of two groups and pearson’s correlation test was used
to determine the relationship between the indices.
RESULTS 1- Serum calcium rate, serum PaH and bone AP in active MW
were significantly lower than non active women, and CH rate in active
MW was significantly higher than non active one (p<0.05). 2-
Between urine calcium, serum and urine Phosphorus ,between Resisting
Acid Phosphatase to serum Tartarate and between Calcium ration to
urine creatinin in active MW with non active women no significant
difference was observed.
DISCUSSION & CONCLUSION It seems that prolonged regular physical
activity can affect calcium and bone metabolism indices in MW and
prevent degeneration of bone tissue by decreased bone regeneration
and also obviate bone tissue from calcium and mineral empaiying
through decreased PaH and increased CH.
KEY WORDS Calcium and bone metabolism. serum and Urinary Phosphorus.
Alkaline Phosphatase. Acid Phos-phatase. Parathyroid and Calcitonine
hormones. active and non active Menopause women.
strength balances of the ankle and regional bone mineral density
of tibia in medial tibial stress syndrome patients
Yuksel?, Cengizhan Ozgurbuz, Metin Ergun, Nevzad Denerel and Cetin
Ege University Medicine Faculty /Sports Medicine Department, Ýzmir,
Medial tibial stress syndrome (MTSS) is one of the most common causes
of exercise related leg pain. Our knowledge about the pathophysiologic
mechanism and the specific pathologic lesion of MTSS is limited.
The primary purpose of this study was to evaluate possible disbalances
of muscle forces acting on the ankle, which might play a role in
pathopysiology of MTSS. Also this study aimed to evaluate possible
changes in tibial regional bone mine-ral density (BMD) at acute
phase, which was shown to decrease after 5 months of duration of
METHODS Fifteen MTSS patients (mean duration of MTSS was 8 (3-24)
weeks ) were compared with 13 control subjects. Mean age and body
mass index of patients were 21 ± 2.8 years and 22,2 ± 2.8 kg/m².
Mean age and body mass index of controls were 23.2 ± 3.1 years and
21.7 ± 2.9 kg/m². All subjects filled in a questionnaire about nutrition
and exercise habits. Ankle plantarflexion, dorsiflexion, eversion
and inversion concentric forces were evaluated using an isokinetic
dynamometer. Standard lomber and femur BMD measurements were taken.
The BMD of three regions from both tibias’ was measured, too.
RESULTS Mean and peak eversion torques of MTSS group at 30°/sec
velocity were significantly higher than controls (mean: 21.9 ±6.4;
18.3 ±6.1 Nm (p<0.05), peak: 23.4 ±6.4; 19.3 ±5,0 Nm (p<0.05)).
Mean inversion torque/mean eversion torque ratio of MTSS group at
30°/sec velocity was significantly lower than controls (0.97 ±0.22;
1.23 ±0.46, p<0.05). Mean eversion torque of MTSS group at 120°/sec
velocity were significantly higher than controls (14.0 ±3.6; 11.7
±3.8 Nm, p<0.05). Tibial regional bone mineral density showed
no significant difference between groups. Lomber T-score was significantly
higher in control group (p<0.05).
DISCUSSION & CONCLUSION Decreased Inversion/eversion ratio because
of increased eversion torque might be a predisposing factor of MTSS.
BMD of the tibia at the pain side doesn’t seem to be affected.
KEY WORDS medial tibial stress syndome, isokinetic strength, bone
mineral density, eversion, inversion
evaluation of ýnterventions based on transtheoretical model in adoption
and maintenance of physical activity
Ay 1? and Ayla Bayýk Temel 2
1 Celal Bayar Universty Health Services Vocational School, Manisa,
Turkey, 2 Ege Universty, School of Nursing, Department of Public
Health Nursing, Ýzmir, Turkey
This study evaluates the effect of informing and counseling interventions
carried out by researchers to improve the exercise behavior in adults,
based on transtheoretical model.
METHODS The study design is a quasi-experimental interventional
study, which was conducted in a single group with pre-test and post-test
follow-up design. The data on individual socio-demographics, the
stages of change in the context of Transtheoretical Model, process
of change, self-efficacy, decisional balance, was collected by questionnaires
before interventions (pre-test). Thereafter, the individual counseling
was given to the participants. The follow-up evaluation continued
at the first, third, and sixth months.
RESULTS The mean age of the participants was 38.17± 8.22. The difference
between the stages of change determined at four different time points
was highly statistically significant (p<0.0001). There is a significant
difference in mean of the general scores of stages of change scale
between pre-intervention and last intervention time (p<0.0001).
There was a statistically significant in the self-efficacy difference
between pre-intervention and last intervention time (p<0.0001).
The mean scores of decisional balance was increased in the pros
dimension and decreased in cons dimension after information and
counseling interventions (p<0.0001). The analyses of the relation
between the mean scores of the stages of change, process of change,
decisional balance and self-efficacy was correlated statistically
significantly ( p<0.0001).
DISCUSSION & CONCLUSION As a result the group in general progressed
in the stages of change. As a result, in the 64% of the participants
progressed in the stages of change whereas there was no change in
the 25% and 11% regressed in the stages of change. In conclusion,
the evaluation of Transtheotetical Model based interventions for
physical exercise behavioral improvement demonstrated that the nursing
interventions is effective and beneficial to adapt positive behaviors
in regular exercise behavior.
KEY WORDS Transtheoretical Model, Stage of Change, Process of Change,
Individualized Counseling, Intervention, Exercise.
target consideration sport influence on the selector of bloody factors
among male fast students.
Rasoli 1 and Jafar Barghi Mogadam 2
1 Azarbaijan rejional electric company sport manajer & physical
education P.H.D student&Staff member of Ahar Azad University-Tabriz-Iran,
2 Staff member of Tabriz Azad University& physical education
In random; 2007 a research design with general target consideration
sport influence on the selector of bloody factors (Triglyceride;
Cholesterol; LDL & HDL Lipoproteins) was performed among male
fast students in Islamic Azad University; Tabriz; with special targets.
METHODS To survey sport effect on the amount of blood Triglyceride;
Blood Cholesterol; HDL Lipoproteins and LDL Lipoproteins among male
fast students in Islamic Azad University; Tabriz. One hundred ten
male fast students of Azad University selected by random which have
been stood in two groups of fifty five people by chance. From all
selectmen were cupped amount of 5 cc blood in every process before
and after Ramadan. During lent month (Ramadan) for experimental
groups were given sport activities such as Cooper Testing three
times a week. The variations of bloody factors in the first or second
test were compared in statistic method (T test) and these are following
RESULTS The meaningful variations in balance of Triglyceride and
LDL & HDL Lipoproteins between experimental groups weren’t observed.
The meaningful relation between sport exercises and reduction of
measure of Blood Cholesterol in experimental groups were observed.
DISCUSSION & CONCLUSION fast people can continue their sport
activities without any worried. This work not only makes negative
variations from blood fast but also it will reduce the measure of
their blood Cholesterol; to; and keeps it in normal limit. And consequently
this work prevents from illnesses such as: Intensification Blood
fats; Atherosclerosis; and some infraction.
KEY WORDS Triglyceride, cholesterol, lipoproteins ldl & hdl,
vitamin C supplementation, exercise-induced lipid peroxidation and
Babak Nakhostin-Roohi 4, Farhad Rahmani-Nia 3 , Parvin Babaei 2
and Shahab Bohlooli 1
1 Ardabil University of Medical Sciences, Iran, 2 Cellular and Molecular
Research Center, Guilan University of Medical Sciences, Iran, 3
Exercise Physiology Department of Guilan University, Iran, 4 Islamic
Azad University Ardabil Branch, Iran
The purpose of this study was to evaluate the effect of acute supplementation
with vitamin C on exercise induced lipid peroxidation, muscle damage
METHODS Sixteen healthy untrained male participated in a 30 min
exercise at 75% VO2max. Subjects were randomly assigned to one of
the two groups: placebo (P) and vitamin C (VC: 500 mg vitamin C).
Blood samples were obtained prior to supplementation (baseline),
2hrs after the supplementation (immediately pre-exercise), immediately,
2hrs and 24hrs post-exercise. Plasma levels of vitamin C, total
antioxidant capacity (TAC), creatine kinase (CK), malondialdehyde
(MDA), total leukocytes, neutrophils, lymphocytes, interleukin-6
(IL-6), CRP and cortisol were measured.
RESULTS With supplementation, plasma vitamin C concentration increased
significantly only in the VC (P<0.05). TAC decreased significantly
in P group, 2hrs and 24hrs after exercise (P<0.05). Although
MDA levels were similar between groups at the baseline, it increased
significantly after exercise only in the P group (P<0.05). CK
increased immediately and 2hrs after exercise in both groups and
24hrs after exercise only in placebo group compared with pre-exercise
(P<0.05). Markers of inflammation (total leukocytes, neutrophils
and IL-6) and muscle damage (CK) were increased significantly in
response to the exercise in both groups (P<0.05).
DISCUSSION & CONCLUSION VC supplementation prevented exercise-induced
lipid peroxidation and muscle damage but had no effect on inflammatory
KEY WORDS supplementation, exercise, vitamin C, inflammation
profiles and cognitive function at high altitude
Bjursten 2?, Per Ederoth 1, Engilbert Sigurdsson 5, Magnus Gottfredsson
4, Ingvar Syk 7, Orri Einarsson 6 and Thomas Gudbjartsson 3
1 Department of Anesthesiology and Intensive Care, and 2 Department
of Cardiothoracic Surgery, Department of Clinical Sciences, Lund
University, Sweden, 3 Department of Cardiothoracic Surgery, and
4 Department of Infectious Diseases, and 5 Department of Psychiatry,
Landspitali University Hospital, Faculty of Medicine, University
of Iceland, 6 Department of Radiology, Akureyri Hospital, Iceland,
7 Department of Surgery, Department of Clinical Sciences, Malmö,
Lund University, Sweden
Exposure to high-altitude can lead to Acute Mountain Sickness (AMS)
and High-Altitude Cerebral Edema (HACE). In this study we investigated
the effect of high-altitude on neurocognitive function and S100B-release.
Increased S100B-release has been hypothesized to be a sign of loss
of integrity in the Blood-Brain-Barrier (BBB).
METHODS Seven healthy volunteers trekked to Capanna Regina Margherita
(4554 meters above sea level) in the Monte Rosa Massif. During ascent
and descent, five test events were undertaken, where participants
performed neurocognitive testing, Lake Louise-scoring (LLS) and
blood was drawn for measurements of S100B
RESULTS The S100B levels increased 42-122% from baseline, and mean
LLS increased from 0.57 to 2.57. A significant correlation was observed
between both S100B levels and LLS, and between S100B and some neurocognitive
DISCUSSION & CONCLUSION The study indicates that S100B can be
released by a mild hypoxia in the setting of AMS. Moreover, an observed
correlation between S100B and a lower score on neurocognitive tests
suggests that the pathogenetic mechanisms may be associated. The
study demonstrates that cognitive function can be adversely affected
by symptoms of AMS.
of perceived exertion in cycle ergometer: Effect of maximal capacity
Kasýmay 1?, Barýþ Çakýr 1, Ömer Utku Erzengin 2 and Hýzýr Kurtel
1 Marmara University School of Medicine, Departments of Sports Physiology,
2 TUBITAK-MAM / Istanbul, Türkiye
Perceived exertion is described as “the subjective intensity of
effort, strain, discomfort, and/or fatigue” that is experienced
during the physical exercise. Rating of perceived exertion (RPE)
is a widely accepted tool in the estimation of exercise intensity
and in prescription of exercise. It has been previously shown that
RPE have positive associations with physiological variables, such
as heart rate and oxygen utilization.The aim of our study was to
evaluate the physiological responses to exercise intensities determined
by heart rate reserve (HRR) method and to detect whether perceived
exercise intensity can be affected by individuals fitness level.
METHODS Twenty sedentary participants of both sexes aged 20 to 41
(mean 26.9) participated. Rating of perceived exertion (RPE) scores
were collected at different percentages of subjects’ HRRs during
graded exercise test on a cycle ergometer. Following the test, subjects
were divided into two groups according to their maximal O2 uptakes
(VO2max) as high (MET>=10; n=9), and low MET groups (MET<10;
n=11). After 48 hours, participants performed the steady state exercise
test at a perceived exertion level of 13-14. For regression analysis
the mean values for intercepts, slopes, and Pearson r correlations
RESULTS In all HRR levels low MET group had significantly lower
MET values (p<0.01-0.001). Perceived exertion was significantly
higher in low MET group compared to high MET group during graded
exercise test. In steady state cycling test, low MET group exercised
at higher relative VO2 values compared to high MET group (p<0.05-0.001).
The groups cycled at similar HRR percentages to a given RPE score.
DISCUSSION & CONCLUSION Our results demonstrate that exercise
intensity can be prescribed in individuals with different VO2max
levels by HRR percentages or by RPE scale methods considering the
fact that individual oxygen consumptions may differ. In conclusion,
the guidance of perceptual indices for prescription of exercise
intensity has positive associations with physiological variables,
and can be used in the estimation of exercise intensity and in the
prescription of exercise. Our results suggest that when exercise
prescription is organized according to HRR method in sedentary individuals
with different fitness levels, exercise intensity may be perceived
similar despite different oxygen consumptions. High and low MET
groups cycled at similar HRR percentages to a given RPE score. Moreover,
exercise intensity of the groups having different maximal oxygen
consumption levels could be prescribed either by HRR percentages
or by RPE scale methods considering the fact that individual oxygen
consumptions during exertion may differ.
KEY WORDS rating of perceived exertion (RPE), Borg scale, cycle
ergometer, steady state exercise, VO2max differences, heart rate
The association between physical fitness and ventilatory efficiency
in major depressive disorder: A potential adjunct for risk stratification?
Donath Lars 2?, Puta Christian 2, Boettger Silke 1, Mueller Hans
Josef 2, Wetzig Franziska 1, Baer Karl-Juergen 1 and Gabriel Holger
1 University hospital of Jena, Departments of Psychiatry and Psychotherapy,
Jena, Germany, 2 University of Jena, Departement of sports medicine,
Cardiopulmonal exercise testing (CPET) provides eligible information
regarding ventilatory abnormality in chronic heart failure (CHF)
but in major depressive disorder (MDD) such data remain unavailable.
Ventilatory efficiency measurements offer insights into ventilatory
and metabolic dysfunction and is commonly used to stratify cardiac
risk. Thus, the current study was conducted to estimate and classify
ventilatory inefficiency and its relationship to physical fitness
in MDD. Secondary, we evaluated ventilatory and metabolic demands
at the ventilatory anaerobic threshold (AT).
METHODS A single exhaustive incremental exercise test was completed
by 15 female pair matched major depressive patients. AT was assessed
as submaximal ventilatory threshold according to Beaver and colleagues.
VE/VCO2 slope was fitted via linear regression to the relationship
of ventilation and carbon dioxide production until peak exercise.
Furthermore, peak exercise data were also assessed in order to quantify
ventilatory demands and objective exhaustion levels.
RESULTS In depressive disorder AT appeared at high significant lower
relative work rates (0,48±0,14 vs. 0,67±0,21 W•kg-1, p<0,01)
than in healthy controls. We found a conspicuous ventilatory abnormality
with augmented VE/VCO2 slopes in depressive disorder. Three out
of 15 achieved critical ventilatory class (VC)-III (36,0-44,9) and
8 out of 15 achieved VC-II (30,0-35,9; figure 2). We interestingly
revealed a strong correlation between physical fitness and ventilatory
DISCUSSION & CONCLUSION CPET measures are beneficial to estimate
ventilatory efficiency and maximal and submaximal physical fitness
in MDD. But further investigations are needed to verify if the ventilatory
classification system is also appropriate to stratify risk levels
in depressive disorder.
KEY WORDS exercise testing, ventilatory inefficiency, VE/VCO2 slopes,
ventilatory threshold, individual anaerobic threshold, exercise
treatment, cardiac risk
of body composition and hydration status in cadet super leage wrestlers
(14- 17 years)
Demirkan 1?, Mitat Koz 1, Cengiz Arslan 2 and Gülfem Ersöz 1
1 Ankara University, Physical Education and Sports School, 2 Inönü
University, Physical Education and Sports School, Ankara, Turkey
In sports based on weight categories such as wrestling, many athletes
are exposed to rapid weight loss applications to compete in the
categories they want. However, acute weight loss is thought to affect
performance and health negatively. This study aims to determine
the cadet super league wrestlers’ body composition and hydration
levels and to investigate how this affects performance.
METHODS Measurements were accomplished on the first day of work,
which is the seventeenth day before competition, third day before
weigh in, before weigh in and immediately before the competition.
During these study periods, body weight, skinfold and urine specific
gravity (Usg) were measured and, scoring was done according to competition
RESULTS Body weight and hydration levels didn’t change significantly
until the third day of event weight (P> 0.05). A significat level
weight loss (% 3.9 ± 2,7) and an increase in Usg level (1.024- 1.028
g/cm³) were determined in the last three days before weigh in. However,
no significant change in Usg values (P> 0.05) was observed after
weigh in until the match, although a significant weight gain (P<
0.05) was observed. Furthermore, no significant level correlation
has been found (P> 0.01) between the positive points obtained
at the end of the competition and changes in body weight and hydration
DISCUSSION & CONCLUSION Consequently, it can be said that there
are a rapid weight loss and dehydration in cadet wrestlers just
before the weigh in and there is a rapid weight gain after weigh
in until the competition; however, it doesn’t improve the hydration
status, so the wrestlers compete dehidrated; however, this doesn’t
lead to a meaningful change on the wrestlers’ match result.
KEY WORDS cadet wrestlers, hydration, urine specific gravity, body
back pain in elite track and field male and female athletes
Tsitas?, Nikolaos Malliaropoulos and Olga Kiritsi
National Track and Field Center, Sports Medicine Clinic, S.E.G/A.S.,
Low back pain is a common complaint in general adult population
with disc herniation being the underlying reason most of the times.
The aim of this study is to investigate and compare the cause of
low back pain (LBP) in elite track and field (T&F) male and
METHODS Retrospective cohort study of SEGAS clinic LBP reports compiled
by certified physicians between 1998 and 2008. The participants
were 18 to 26 year-old male and female elite T&F athletes with
LBP. The main outcome measure was an analysis of MRI findings, classified
by anatomic location and event category (throwers, jumpers, sprinters,
runners and decathlon athletes).
RESULTS One hundred fifty six athletes (65 female, 91 male) were
included in the study, all presenting with LBP. MRI reports revealed
abnormal findings in 122 athletes (48 female, 74 male) and were
normal in 34 athletes (17 male, 17 female). When evaluating all
events concurrently disc herniation was the most common cause in
both males and females, followed in decreasing order by disc degeneration,
disc bulging, spondylolysis, grade I facet degeneration and muscle
strain. Significant gender difference in MRI findings (p < 0.05)
was seen for three event categories. Disc herniation was more common
in female throwers but in males it was more often reported in jumpers
and sprinters. Degenerated disc was most commonly seen in male sprinters
and in female throwers and jumpers. Facet degeneration was encountered
mostly in female sprinters and male jumpers. Finally spondylolysis
was mainly seen in female sprinters but evenly spread among male
sprinters, jumpers and throwers.
DISCUSSION & CONCLUSION When evaluating all event categories
concurrently our data suggest very little difference in MRI findings
between elite T&F men and women. However, when assessing each
category separately significant gender difference exists.
KEY WORDS low back pain, track and field, male, female
lateral release for clinical and radiographic tilt of the patella
Konstantinos Natsis?, Ulf Moebius, Nikolaos Anastasopoulos, Christos
Lyrtzis, Trifon Totlis and Konstantinos Vlasis
Interbalkan Medical Center, Thessaloniki, Greece
The purpose of the present study was to evaluate the results of
lateral retinacular release, in the treatment of patients suffering
from pain, due to chondromalacia of the patella.
METHODS 107 athletes, 62 women and 45 men, who suffered, in the
last 6 years (2003-2008), from patellofemoral pain syndrome, were
included in the study. The criteria for inclusion were the presence
of complaints of patellofemoral pain, with no predominant instability,
clinical signs pointing to lateral retinacular tightness and radiological
evidence of lateral patellar tilt. In 21 athletes the symptoms were
bilaterally. All patients had a positive Clark test, while 32/107
(32,1%) knees had joint swelling. We performed a radiological examination
in all patients. At operation all patients were subjected to a comprehensive
arthroscopic examination of the knee joint. In 95/107 (88,8%) knees
we cut arthroscopically the lateral patellar retinaculum. Any cartilaginous
lesions of the patella were classified according to Ficat. Patellar
debridement was performed in all cases except from 12/107 (11,21%)
knees with 1st degree lesions. The patients began isometric exercises
of the quadriceps muscle from the 1st day postoperatively. They
followed a program for strengthening of the vastus medialis muscle.
RESULTS All patients were relieved from the pain. The 105/107 (98,13%)
patients continued sports, while the 2/107 (1,87%) patients who
gave up sports, had taken their decision preoperatively. In 2/107
(1,872%) patients there was a postoperative hematoma in the lateral
surface of the knee and in 1 case (0,93%) there was an infection
required re operation.
DISCUSSION & CONCLUSION The data indicated that significantly
better results can be achieved in patients who have positive clinical
signs pointing to patella tightness, well localized parapatellar
tenderness and positive medial patellar glide test. Poorer results
are to be expected in cases with severe chondral lesions.
KEY WORDS Patellofemoral pain, lateral patellar tilt, arthroscopic
outcome of an ACL reconstruction using biodegradable interference
screws and a sophisticated graft tension system
Natsis?, Ulf Moebius, Trifon Totlis, Christos Lyrtzis and
Interbalkan Medical Center, Thessaloniki, Greece
The purpose of this study is to report the preliminary postoperative
clinical results after arthroscopic ACL reconstruction with quadrupled
hamstring autograft, fixed with biodegradable interference screws,
endopearl in the femoral tunnel and using a new tensioner for graft
METHODS Between May 2003 and May 2007, we performed an endoscopic
ACL reconstruction with a quadrupled hamstring autograft in 121
patients. The graft was fixed with a biodegradable interference
screw and endopearl in order to enhance the mechanical stability
in the femoral tunnel. The tibial side of the graft was fixed by
a conical biodegradable interference screw and a washer screw as
back-up fixation after tensioning each tendon by different tension.
Postoperatively the patients were permitted an accelerated rehabilitation
program, without a motion limiting brace. At least 2 years postoperatively
(24 – 48months) x-rays, Lachmann’s Test, Pivot shift and mean anterior
translation of the tibial head, measured by the Rolimeter (side
– to – side difference) was evaluated. The average follow-up was
RESULTS Radiological findings showed an average of 22% increase
in the tibial tunnel diameter. Postoperative complications were
four excessive haematomas and three infections, both treated by
DISCUSSION & CONCLUSION Arthroscopic ACL reconstruction with
quadrupled hamstring autograft, fixed with biodegradable interference
screws and tensioning the two grafts separately, provides excellent
ligament stability and permits an early accelerated rehabilitation.
There was an increase in the tibial tunnel diameter but there were
no effects on the clinical results.
KEY WORDS ACL reconstruction, hamstring’s autograft, medial portal
placement, graft tension
study of static lower extremity alignment in female athletes with
Daneshmandi and Farzaneh Saki
Guilan University, Iran
Rupture of the ACL is a serious, common and costly sport injury
in world. Each year an estimated more than 250000 ACL injury occur
in USA. Females are 2 to 8 times more likely to sustain ACL rupture
than their male counterparts. It appears several intrinsic and extrinsic
risk factors associated with ACL injury. The study of three important
malalignment risk factor as pronation, tibial torsion and Q angle
in tear of ACL in professional female athletes.
METHODS Twenty ACL – injured female (age 24.90 ± 5.75 yr, height
167.05 ± 6.58 cm, mass 60.88 ± 5.58 and athletic experience 7.70
± 4.41 yr) and 20 non-injured female (age 24.80 ± 5.59 yr, height
166.15 ± 6.39 cm, mass 60.20 ± 6.08 and athletic experience 7.00
±3 .69 yr) were matched by age, sport and limb participated in this
study. Navicular drop, tibial torsion and Q angle was measured in
both limbs. Mechanism of injury was noncontact in about 90% cases.
RESULTS In 17 cases (85%) a medial meniscus injury was reported.
The finding showed significant difference between pronation and
tibial torsion in groups (p<.05). There is no significant difference
in Q angle between groups (p<.05). Also there are no significant
difference in lower extremity alignment between injured and non-injured
limb of ACL injured group.
DISCUSSION & CONCLUSION Therefore identifying of the biomechanical
risk factors and screening athletes with hyperpronation and internal
tibial torsion that may predispose them the ACL to excessive injury
is important also apply corrective and prevention program from coaches
KEY WORDS malalignment, female athletes, ACL injury, pronation,
internal tibial torsion
association between tibial slope, isokinetic knee strength and anterior
cruciate ligament injury risk in soccer players
Þenýþýk 2?, Metin Ergün 2, Emin Taþkýran 1, Cengizhan Özgürbüz 2
and Çetin Ýþlegen 2
1 Ege University School of Medicine, Department of Orthopedics And
Traumatology, Izmir, Turkey, 2 Ege University School of Medicine,
Department of Sports Medicine, Izmir, Turkey
The purpose of this study was to examine the influence of tibial
slope and isokinetic strength of knee extensor and flexor muscle
groups on anterior cruciate ligament (ACL) injury risk.
METHODS A total of 64 elite soccer players and 45 sedentary controls
were enrolled in this study. Radiographic and isokinetic measures
were taken before the start of season. The angle between mid-diaphysis
line of the tibia and between the anterior and posterior edges of
the medial tibial plateau is measured as tibial slope via lateral
graphies. Isokinetic strength of knee extensor and flexor muscle
groups was measured at 60 and 300o/sec through a Cybex 6000 NORM
dynamometer. Individual player exposure and injuries prospectively
recorded during the two and a half year period.
RESULTS In total, 11 non-contact ACL injuries (10 dominant and 1
non-dominat leg, incidence= 0.2/1000 playing hour) had been registered
during the study period. Tibial slope of the injured players in
both dominant and non-dominant legs was higher compared with the
uninjured players. The difference reached significant level only
for the dominant leg (p < 0.001). The tibial slopes of the dominant
legs of the injured players were higher than that of the non-dominant
legs (p = 0.042). Players with a tibial slope over the mean group
value had 5.62 times “Odds Ratio” increased ACL injury risk. Injured
players had higher eccentric quadriceps strength (p = 0.007) and
lower eccentric flexor/extensor ratio (p = 0.031) at 60°/sec in
both dominant and non-dominant legs than uninjured players.
DISCUSSION & CONCLUSION The findings of the study revealed that
higher tibial slope seems to be related to increased ACL injury
risk. In addition, higher eccentric quadriceps strength and lower
eccentric flexor/extensor ratio should also be taken into consideration
as contributing factors.
KEYWORDS tibial slope, knee, isokinetic strength, ACL injury
training responses in young swimmers of different level
Almeida Marinho 1?, Nuno Garrido 2, Tiago Manuel Barbosa 3, Henrique
Neiva 1, Aldo Matos Costa 1, António José Silva 2 and Mário Cardoso
1 Department of Sport Sciences, University of Beira Interior / CIDESD,
Covilhã, Portugal, 2 Department of Sport Sciences, University of
Trás-os-Montes and Alto Douro / CIDESD, Vila Real, Portugal, 3 Department
of Sports Sciences, Polytechnic Institute of Bragança / CIDESD,
Some authors (e.g. Maclaren and Coulson, 1999; Dekerle, 2006) reported
that aerobic training has a positive effect on critical velocity
in swimming. However, it raises the question whereas this effect
is similar among swimmers of different performance level. Therefore,
the purpose of this study was to determine the training responses
in aerobic parameters (critical velocity and critical stroke rate)
in young swimmers of different level during an in-season period
METHODS 3 groups of 6 young swimmers of both gender belonging to
the same swimming club participated in this study. All participants
have been trained by the same coach and for the same club for the
previous two years. Swimmers were divided according to the value
of critical velocity value determined using 50 m and 400 m front
crawl tests. Group 1 comprised of 6 swimmers with the best performance
in the test (high level), group 3 comprised of 6 swimmers with the
lower performance (poor level) and group 2 was the intermediate
group. The evaluations took place in two different moments: beginning
of the in-season and after 12 weeks of training. For each swimmer,
critical velocity and critical stroke rate were determined in both
RESULTS In groups 1 and 2 critical velocity increased between the
first and the second moment (1.15 vs. 1.18 m.s-1; 1.04 vs. 1.07
m.s-1; p<0.05) whereas in group 3 the increase in critical velocity
was not significant (p>0.05). Although critical stroke rate decreased
in the same period for all groups, this decrease was not significant
in none of them.
DISCUSSION & CONCLUSION As expected, critical velocity enhanced
during the training period, suggesting that 12 weeks of swimming
training cause the improvement in the aerobic capacity. The swimmers
were able to perform the same intensity without increasing their
stroke rate to swim at a higher velocity. The combination of stroke
rate with critical velocity could be useful physiological and technical
criteria for coaches for monitoring endurance training in swimmers;
despite more research is needed to understand the effects of training
in different level groups.
KEY WORDS Physiological, aerobic, technique, training, swimming.
Dekerle, J. (2006). The use of critical velocity in swimming. A
place for critical stroke rate? Portuguese Journal of Sport Sciences
Maclaren, D.P. and Coulson, M. (1999). Critical swim speed can be
used to determine changes in training status. In: Biomechanics and
Medicine in Swimming VIII. Eds: Keskinen, K.L., Komi, P.V. and Hollander,
A.P. Jyvaskyla: Grummerus Printing. 227-232.
of biological age in females aged 18-65 based on physical fitness
Ghasemi?, Zainab Rafei, Vahid Zolaktaf and Shirin Davarpanah
University of Isfahan / Faculty of PE and Exercise Sciences/ Isfahan-Iran
Biological age depends on functional capacity of cells, organs,
and the body as a whole. Chronological age is not always an appropriate
marker of biological age, simply because the growth and aging rate
is not the same for different people. This study was designed to
study the rate of biological aging in females according to the level
of their sporting activities. It also provided a good opportunity
to produce an equation to estimate biological age of Iranian women.
METHODS 107 females aged 18 to 65 were recruited for the study.
They belonged to age categories of 18-20, 21-25, 26-30, 31-35, 36-40,
41-45, 46-50, 51-55, 56-60, and 61-65. Each category consisted of
at least 10 volunteers out of 15 females who were requested to participate
in the study. Physical fitness tests included: vertical jump, modified
pull-ups, sit and reach, Ellinois agility test, 30 meter run, 20
meter Shuttle run, sit-ups, and medicine ball throw. Sporting activity
level was determined using a standard scale. The data was statistically
analyzed by Discriminant and Multiple Regression analyses.
RESULTS Data analysis revealed that chronological age had a reverse
relationship with all physical fitness factors. However, the rate
of declination of physical fitness of subjects depended on their
sporting activity level, indicating the higher the sporting activity
the lower the rate of declination (p?0.05). A multiple regression
formula was developed for estimation of biological age in women.
DISCUSSION & CONCLUSION The positive effect of sport on biological
age explored in this study is similar to findings of other researchers
in developed countries. However, our subjects had lower physical
fitness compared to them. This finding is alarming, especially when
considering aerobic fitness. This study could be more reliable,
if the same data are collected from other provinces of the country.
KEY WORDS aging, physical fitness, females, biological age
training restores hemodynamic, hormonal and metabolic profile in
normotensive young women at high familial risk of hypertension
Gomes Ciolac 2?, Edimar Alcides Bocchi 1, Luiz Aparecido Bortolotto
1, Vagner Oliveira Carvalho 3, Júlia Maria Greve 2 and Guilherme
Veiga Guimarães 1
1 Heart Institute do Hospital das Clínicas da Faculdade de Medicina
da USP / Sao Paulo, Brazil, 2 Institute of Orthopedics and Traumatology
do Hospital das Clínicas da Faculdade de Medicina da USP / Laboratory
of Kinesiology / Sao Paulo, Brazil, 3 Instituto da Criança do Hospital
das Clínicas da Faculdade de Medicina da USP / Genetics Unit / Sao
Offspring of essential hypertensive parents are at high risk of
future hypertension and subsequent cardiovascular diseases. However,
the underlying pathophysiology of family cluster hypertension in
women is incompletely understood. Moreover, there is little information
about the effects of exercise training (ET) in this population.
METHODS We studied healthy sedentary young women with two hypertensive
parents (FH++: n=17; 25.1±4.8 years), one hypertensive parent (FH+:
n=18; 24.9±4.1 years), or none hypertensive parent (FH–: n=15; 25.3±3.8
years), to analyze their ambulatorial blood pressure (ABP), carotid-femoral
pulse wave velocity (PWV), and biochemistry (total cholesterol and
fractions, triglycerides, glucose, insulin and insulin sensitivity).
BP, nor-epinephrine (NE), endothelin-1 (ET-1) and nitrite/nitrate
(NOx) were also analyzed during a graded exercise test (GXT). Then,
the FH++ and FH+ women were randomically assigned to a three times-a-week
ET program (FHex) or control group (FHcon), and had their ABPM,
PWV, biochemestry, NE, ET-1 ant NOx levels analyzed after 16 weeks
RESULTS ABP were not different between groups, but PWV was 7.5%
and 12.6% higher in FH++ than FH+ and FH–, respectively, and 4.8%
higher in FH+ than FH– (p<0.01). Insulin and insulin sensitivity
were increased in FH++ and FH+ (p<0.05), and LDL-cholesterol
tended to be higher only in FH++ (p=0.07). FH++ showed higher exercise
diastolic BP than FH– (p<0.01), and increased resting, exercise
and recovery NE and ET-1 levels than FH–. FH+ showed only greater
rest, exercise and recovery NE, exercise EPI, and rest ET-1 (p<0.05).
Rest, exercise and recovery NOx were lower in FH++ and FH+ than
FH– (p<0.01). On the other hand, ET reduced PWV (p<0.01),
insulin (p=0.001), insulin sensitivity (p<0.01), and LDL-cholesterol
(p<0.05), to levels similar to those of FH–. ET also reduced
exercise diastolic BP (p<0.05), rest and exercise NE (p<0.05),
and rest ET-1 (p<0.05). Exercise and recovery NOx was also improved
after ET (p<0.05). There were no significant differences in any
parameter for the FHcon or FH– after the follow-up.
DISCUSSION & CONCLUSION Hemodynamic, metabolic and hormonal
abnormalities typical of hypertension were presented in nonhypertensive
young women offspring of hypertensive parents before any increase
in BP, where the greater abnormalities were observed in women with
a strong family history of hypertension (FH++). On the other hand,
exercise training restores these abnormalities to levels similar
to those of young women without history of hypertension. These results
suggest that exercise training may have a potential role in the
management of an inherited hypertensive disorder.
KEY WORDS hypertension; endothelial function; insulin; sympathetic
activity; exercise; prevention
of haemoglobinopathies in Qatar sportsmen
Claude?, Massimiliano Sala, Hamilton Bruce, Paoloni Justin and Chalabi
Haemoglobinopathies are prevalent in many regions of the world,
with the impact on both health and athletic performance varying
depending on the nature of the abnormality. Extreme exercise may
be hazardous in athletes even with haemoglobinopathy trait. This
study wished to evaluate the prevalence of hemoglobinopathy (homozygous
or heterozygous) in sportsmen in Qatar.
Methods 704 male athletes who underwent medical screening over a
12 month period were included in the study, with all athletes having
a low Mean Cell Volume (MCV) or Mean Cell Haemoglobin (MCH) investigated
with a thallassemia screen and DNA analysis as indicated. Age ranged
from 14 to 36 years old (mean 22.5).
RESULTS Of 104 (14.7%) athletes meeting the criteria for further
investigation, 81 (77.8%) underwent further testing. The prevalence
of thalassaemia trait in this group was found to be 19.7%. Haemoglobinopathies
observed included 8 â-Thalassaemia minor, 8 á-thallassemia minor,
4 sickle cell trait and one Haemoglobin D Los Angeles variation.
Of those found to be positive for thalassaemia, 13 were Qatari (61.9%),
with the remainder being from other Gulf, Asian and African countries.
DISCUSSION & CONCLUSION We conclude that there is a high prevalence
of hemoglobinopathy trait in athletes in this region with low MCV
and MCH, and given the potential implications for health, screening
and counseling to this population is recommended.
KEY WORDS sport, athlete, thallassemia, hemoglobinopathy, blood
of COX-2 inhibitor drug on exercise-induced inflammation and lipid
Khoshkhahesh 2, Marefat Siahkuhian 1 and Babak Nakhostin-Roohi 2
2 Department of Exercise Physiology, University of Mohaghegh-Ardabili,
Ardabil. Iran, 2 Sports Medicine Federation of Islamic Republic
of Iran- Ardabil Branch
The purpose of this study was to examine the effect of acute Celecoxib
administration on exercise-induced inflammation, muscle damage and
lipid peroxidation markers.
METHODS Twenty healthy untrained male (age; 25.5±4.5 yrs, weight;
72.7±7.9 kg, height; 177.3±7.2 cm) were ran-domly assigned to treatment
(T) and placebo (P) groups. Blood samples were taken before, immediately,
3 and 24h after exercise. Subjects ran for 30-min at 75% VO2max
on treadmill. T and P groups consumed 100 mg Celecoxib and pla-cebo
immediately and 12h after the second blood sampling, respectively.
Total leukocyte counts and creatin kinas (CK) activity by Aautoanalyzer,
C-reactive protein (CRP) by Nephelometry and malondealdehyde (MDA)
by HPLC were measured. Data were analyzed using repeated measures
analysis of variance (ANOVA) with Bonferroni correction.
RESULTS Markers of inflammation (total leukocyte and neutrophil
counts) were significantly increased 3h and de-creased 24h after
exercise in both groups (P<0.05). Lymphocyte counts significantly
decreased 3h after exercise (P<0.05), then increased 24h after
exercise only in P group. CRP and CK levels were significantly increased
immedi-ately, 3 and 24h after exercise in two groups (P<0.05),
but no difference between groups. Peak of CK activity was found
24h after exercise only in T group. MDA levels were significantly
increased immediately after exercise in both groups (P<0.05).
There was no difference between two groups, though MDA levels were
higher 24h after exercise in T group.
DISCUSSION & CONCLUSION According to this study, it seems acute
Celecoxib administration has been able to attenuate some markers
of inflammation but not lipid peroxidation.
KEY WORDS Celecoxib- Lipid peroxidation- inflammation- muscle damage
6-week protocol based on exercise and antioxidant supplementation
improved oxida-tive stress in athletes with mental retardation
Javier Ordonez?, Ignacio Rosety, Miguel Angel Rosety, Alejandra
Camacho, Gabriel Fornýeles-Gonzalez, Manuel Rosety and Manuel Rosety-Rodriguez
School of Sport Medicine. University of Cadiz, Spain
Recent studies have reported a high prevalence of obesity and overweight
in handicapped athletes. How-ever, little information is available
in the literature regarding oxidative stress in high-performance
athletes with mental retardation. Mainly if we take into account
high performance, overweight and mental retardation have been associated
to increased oxidative damage that has been finally proposed as
a pathogenic mechanism of atherosclerosis, cell aging, neurodegeneration,
etc. in this population. Further oxidative damage may impair their
physical performance as well as increasing the risk of sports-related
injuries. Accordingly the present study was undertaken to ascertain
the influence of a mixed protocol in plasmatic total peroxide concentration
in athletes with mental retardation.
METHODS Fifty-five high-performance, overweight athletes with mental
retardation volunteered for this study. Fourty were randomly included
in experimental group to perform a 6-week protocol including exercise
(low-moderate intensity aerobic exercise before breakfast 3 times/week,
45-50 minutes) and supplementation (1g ascorbic acid + 400 UI ƒÑ-tocopherol
6 times/week). Control group included 15 age-sex-trained and BMI-matched
athletes with metal retardation that did not perform our protocol.
Further our protocol was approved by an institutional ethic committee.
Total peroxide concentrations of plasma sample were determined by
using the FOX2 method with minor modifications 72-hours before starting
the protocol (pre-test) and after its ending (post-test).
RESULTS When compared to baseline plasmatic total peroxide concentration
was decreased significantly after our 6-week protocol (14.6 ± 1.7
vs 11.3±1.2 micromol H202/L; p<0.05). No changes were reported
DISCUSSION & CONCLUSION It was concluded a 6-week mixed protocol
based on fasting exercise and antioxidant supplementation decreased
significantly total peroxide concentration in athletes with mental
retardation. Further studies on this topic are required to improve
both their physical peformance and health status.
KEY WORDS Oxidative stress; mental retardation; exercise
effects of heat stress on eccentric exercise induced muscle damage
Harbili 3?, Haydar A. Demirel 2, Gülriz Ersöz 1 and Ercan Gencer
1 Ankara University, School of Medicine, Department of Physiology,
Ankara, Turkey, 2 Hacettepe University School of Medicine, Department
of Sports Medicine, Ankara, Turkey, 3 Selcuk University School of
Physical Education and Sports, Konya, Turkey
Heat stress has been shown to increase tissue levels of heat shock
protein 70 (HSP70), which protects cells from further stresses.
The purpose of this study was to determine if heat stress is effective
to prevent or reduce the degree of muscle damage following eccentric
METHODS 22 volunteer males were randomly assigned to either sauna
(SAU, n= 10, age: 24.90 ± 1.91 year) or control (CON, n=12, age:
23.00 ± 2.21 year) groups. SAU group was exposed to sauna for 2X20min
with 10min break at a temperature of 85 ºC and 50% humidity, 24h
before eccentric exercise. Participants in both groups performed
8X10 maximal eccentric knee flexion (from a 180 degree full extension
to 90 degree flexion) at 60 rad degrees/s. Plasma HSP70 levels were
evaluated before and 24h after sauna exposure. To evaluate biochemical
muscle damage markers; plasma CK, LDH, AST and ALT enzymes were
determined just before and 1, 2, 3, 4, and 7 days after eccentric
exercise. Isometric knee flexion and extension strengths were measured
on the same time frame at a joint angle of 90 degree. In addition,
neutrophil chemiluminescence, ADP and collagen induced thrombocyte
aggregations were measured.
RESULTS There were no significant differences in resting plasma
HSP70 levels between SAU and CON groups (p>0.05). Sauna exposure
resulted in 94% increase in plasma HPS70 levels (p<0.05). Although
CK activity significantly increased in both groups following exercise
(p<0.01), there were no differences between SA and CON groups
(p>0.05). LDH, ALT or AST enzyme levels did not change following
exercise in either group (p>0.05). While eccentric exercise resulted
in decreases in isometric extension strength in both groups (p<0.01),
flexion strength was protected in sauna group, and it was higher
than that of CON group (p<0.01). Neutrophil chemiluminescence
values decreased after exercise in SAU (p<0.01) group, and it
was lower than that of CON (p<0.01) group. ADP induced thrombocyte
aggregation increased 24 hours after exercise (p<0.05), however,
there were no significant group differences (p>0.05). On the
other hand, no significant change was observed in collagen induced
thrombocyte aggregation after exercise (p>0.05) in both groups.
DISCUSSION & CONCLUSION This study has shown that heat stress
induced by sauna results in increased levels of plasma HSP70 and
decreased neutrophil functions. Although heat stress did not effect
on biochemical damage markers following eccentric exercise, it resulted
in mild degree of protection of muscle strength which could be an
important for exercise performance.
KEY WORDS Heat stress, muscle damage, eccentric exercise
age and physical fitness affects resistance exercise intensity progression
Gomes Ciolac?, Luiz Eugênio Garcez-Leme and Júlia Maria Greve
Institute of Orthopedics and Traumatology do Hospital das Clínicas
da Faculdade de Medicina da USP / Laboratory of Kinesiology / Sao
It has been recommended that older people must increase resistance
exercise (RE) training intensity more slowly than young people,
indepently of health or physical fitness status. However, there
is no scientific evidence supporting this recommendation. Our purpose
was to compare the RE intensity progression between older (sedentaries
or activies) and young men.
Healthy men, divided in young sedentaries (YS; n = 8; age = 25.9±3.7
years, BMI = 23.5±5.1 kg/m2), older sedentaries (OS; n = 7; age
= 67.4±5.2 years; BMI = 26.5±4.5 kg/m2), and older runners (OR;
age = 71.3±3.0 years; BMI = 22.7±0.5 kg/m2), were submitted to a
13-week RE program. RE was performed 2 times a week, and consisted
of 2 sets of 8 to 12 repetitions in 9 exercises; initial intensity
= 60% of 1 repetition maximum (1-RM). Exercise intensity was increased
in 5% to 10% each time 2 sets of 12 repetitions were performed in
a determined exercise. 1-RM test was used before and after follow-up
to measure muscle strength.
RESULTS Muscle strength increased 35.4% after 6 month of training,
followed by lower but significant increases of 8.4%, 4.2% and 5.1%
at post-12, post-24 and post-36 month of follow-up, respectivelly
(p<0.01). Cardiorespirespiratory fitness was continuously increased
by 5.4%, 6.1% and 2.3% at post-12, post-24 and post-36 month of
follow-up (p<0.05). Resting HR was reduced 6.1 beats per minute
at post-12, did not changed at post-24, and reduced 5.3 beats per
minute at post-36 month of follow-up (p<0.05). Peak HR did not
changed significantly during the follow-up, and recovery HR reduced
6.15, 5.0 and 7.9 beats per minute at post-12, post-24 and post-36
month of follow-up (p<0.05).
DISCUSSION & CONCLUSION The results suggest that two times-a-week
multi-component exercise training is enough to improve physical
fitness and HR profile to exercise of middle-aged and older women,
and that the improvements continue even after a three-year follow-up,
although in an lower intensity.
KEY WORDS Aging; exercise; exercise progress; muscle strength; older.