Sports_Medicine RSS : Gourt

Petersburg :: Virginia :: Community Health Systems

Anesthesilogist with Pain Fellowship Training Southside Regional Medical Center (300 beds) is actively seeking an Physiatrist with a Pain Fellowship to be employed by the Hospital. This position will

Palmer :: Alaska :: Community Health Systems

Palmer is located 42 miles northeast of Anchorage on the Glenn Highway. The primary service area is over 73,000. Mat-Su Regional Medical Center is a 40 bed JCAHO accredited hospital and is the sole

First International Sports Science and Sports Medicine Conference Newcastle upon Tyne, 20-22 August 2009 Abstracts of original communications

Predicting recovery from muscle strains, a new take on "inflammation" and the Goldman Dilemma

BJSM reviews: A-Z of supplements: dietary supplements, sports nutrition foods and ergogenic aids for health and performance Part 2

Popular drugs in sport: descriptive analysis of the enquiries made via the Drug Information Database (DID)

Objective: To analyse enquiries made in the Drug Information Database (DID) to develop a better understanding of athletes’ interests and concerns regarding the prohibited status of available substances. Setting: Retrospective analyses of anonymous enquiries recorded in the DID in 2006 and 2007. Participants: Athletes and supporting personnel. Results: The DID recorded 223 717 enquiries with 200 of the >6000 UK licensed pharmaceutical products receiving over 100 enquiries each. The majority (79.2%) of these enquiries were in the pharmaceutical product category, followed by recreational drugs (10.4%). A variety of common medications were subject to enquiry, with anti-inflammatory agents, decongestants and bronchodilators being most common; a trend in keeping with reported medication use by athletes. Of all enquiries, 42% were not found owing to misspelled words or enquiries about unregulated substances. The proportion of enquiries about substances not listed in the database is relatively high and has increased over the 24 month observation period. Conclusion: The DID is a well-used information resource with some 10 000 enquiries being made each month. Of the c. 60% of successful enquiries, the major focus was on pharmaceutical products. With some 73% of enquiries being made by the athletes themselves, further investigations are warranted to explore enquiry patterns in relation to specific sports. Of the unsuccessful enquiries, a large number were related to nutritional supplements, which warrants further investigation. The DID database appears to be a valid mirror of athletes’ chemically assisted practices and may be successfully used to inform health professionals as well as antidoping prevention programmes.

Central aponeurosis tears of the rectus femoris: practical sonographic prognosis

Objective: This study is a statistical analysis to establish whether a correlation exists between the level and degree of rectus femoris (RF) central tendon injury and the amount of time that an athlete is unable to participate subsequently, referred to as "sports participation absence" (SPA). Design: Causal–comparative study. Patients: 35 players from two high-level Spanish soccer teams with an injury to the central tendon of the RF based on clinical and ultrasound criteria. Main Outcome Measure: Ultrasound examination was performed with an 8–2 MHz linear multifrequency transducer. All studies included both longitudinal and transverse RF sections. Results: At the proximal level the SPA time is 45.1 days when the injury length is 4.0 cm. This value increases by 5.3 days with each 1 cm increase in the length of injury. In the case of distal level injury, SPA time is 32.9 days when the injury length is 3.9 cm. This value increases by 3.4 days with each 1 cm increase. In the total representative sample, SPA time when the injury length is 4.2 cm corresponds to 39.1 days. This value increases by 4.2 days per length unit. Conclusions: RF central tendon injury at the proximal level is associated with a greater SPA time than at the distal level. Patients with a grade II injury have an SPA time longer than those with a grade I injury whether the injury is located proximal or distal.

Recreational soccer is an effective health-promoting activity for untrained men

To examine the effects of regular participation in recreational soccer on health profile, 36 healthy untrained Danish men aged 20–43 years were randomised into a soccer group (SO; n = 13), a running group (RU; n = 12) and a control group (CO; n = 11). Training was performed for 1 h two or three times per week for 12 weeks; at an average heart rate of 82% (SEM 2%) and 82% (1%) of HRmax for SO and RU, respectively. During the 12 week period, maximal oxygen uptake increased (p<0.05) by 13% (3%) and 8% (3%) in SO and RU, respectively. In SO, systolic and diastolic blood pressure were reduced (p<0.05) from 130 (2) to 122 (2) mm Hg and from 77 (2) to 72 (2) mm Hg, respectively, after 12 weeks, with similar decreases observed for RU. After the 12 weeks of training, fat mass was 3.0% (2.7 (0.6) kg) and 1.8% (1.8 (0.4) kg) lower (p<0.05) for SO and RU, respectively. Only SO had an increase in lean body mass (1.7 (0.4) kg, p<0.05), an increase in lower extremity bone mass (41 (8) g, p<0.05), a decrease in LDL-cholesterol (2.7 (0.2) to 2.3 (0.2) mmol/l; p<0.05) and an increase (p<0.05) in fat oxidation during running at 9.5 km/h. The number of capillaries per muscle fibre was 23% (4%) and 16% (7%) higher (p<0.05) in SO and RU, respectively, after 12 weeks. No changes in any of the measured variables were observed for CO. In conclusion, participation in regular recreational soccer training, organised as small-sided drills, has significant beneficial effects on health profile and physical capacity for untrained men, and in some aspects it is superior to frequent moderate-intensity running.

The effects of inhaled L-methamphetamine on athletic performance while riding a stationary bike: a randomised placebo-controlled trial

Objective: L-methamphetamine (the non-abused isomer of methamphetamine) is banned in athletic competition because it may improve athletic performance, but there are no studies assessing its effects on performance. In the United States L-methamphetamine is formulated in the non-prescription Vick’s Vapor Inhaler (VVI) nasal decongestant. VVIs sold elsewhere (we used ones from the UK) contain similar inactive ingredients (menthol, camphor and Siberian pine oil) but no L-methamphetamine. This study tested the effects of inhaled L-methamphetamine delivered from a widely available non-prescription product on athletic performance. Design: In a 2-session double-blind placebo-controlled study 12 participants (ages 14–17) were dosed with 4 (session 1) and 12 (session 2) inhalations from VVIs with (USA) or without (UK) L-methamphetamine and then performed two 20 minute rides on a stationary bike with rides separated by a 30 minute rest. Outcome measure: The main outcome measure was miles travelled during each 20 minute ride. Secondary outcome measures included postride urine toxicology; heart rate and blood pressure before, 1, 5 and 10 minutes postride; energy, performance, endurance, and ability to breathe; and VVI preference. Data were analysed using Excel statistical macros. Results: After ~16 µg L-methamphetamine distance travelled was 5.26 (SD 0.53) miles vs 5.30 (0.55) with placebo; p = 0.81. After ~48 µg L-methamphetamine distance travelled was 5.30 (0.51) vs 5.35 (0.43) with placebo; p = 0.85. The ~16 µg dose increased systolic blood pressure from 72.6 (4.3) to 79.6 (6.6) mm Hg (p = 0.03) at 5 minutes postride but there were no other differences in outcomes. Conclusions: Modest doses of inhaled L-methamphetamine probably do not improve athletic performance but do minimally raise diastolic blood pressure.

Personal best marathon performance is associated with performance in a 24-h run and not anthropometry or training volume

Objective: In this study, the influence of anthropometric and training parameters on race performance in ultra-endurance runners in a 24-h run was investigated. Design: Descriptive field study. Setting: 24-h run in Basel 2007. Participants: 15 male Caucasian ultra-runners (mean (SD) 46.7 (5.8 years), 71.1 (6.8 kg), 1.76 (0.07 m), body mass index 23.1 (1.84 kg/m2)). Interventions: None. Main outcome measures: Age, body mass, body height, length of lower limbs, skin-fold thicknesses, circumference of extremities, skeletal muscle mass, body mass, percentage of body fat, and training volume in 15 successful finishers were determined to correlate anthropometric and training parameters with race performance. Results: No significant association (p>0.05) was found between the reached distance and the anthropometric properties. There was also no significant association between the reached distance with the weekly training hours, running years, the number of finished marathons and the number of finished 24-h runs. The reached distance was significantly (p<0.05) positively correlated with the personal best marathon performance (r2 = 0.40) and the personal best 24-h run distance (r2 = 0.58). Furthermore, the personal best marathon performance was significantly and positively correlated (p<0.01) with the best personal 24-h run distance (r2 = 0.76). Conclusions: Anthropometry and training volume does not seem to have a major effect on race performance in a 24-h run. Instead, a fast personal best marathon time seems to be the only positive association with race performance in a 24-h run.

Preliminary study of the effects of Tai Chi and Qigong medical exercise on indicators of metabolic syndrome and glycaemic control in adults with raised blood glucose levels

Objectives: To evaluate the feasibility, acceptability and effects of a Tai Chi and Qigong medical exercise programme that aimed to improve indicators of metabolic syndrome and glycaemic control in adults with raised blood glucose levels. Design, setting, and participants: A single-group pre-post trial of 11 participants (3 men and 8 women; age 42–65 years) with raised blood glucose levels conducted from August to November 2005 at a university in Australia. Invervention: Participants attended Tai Chi and Qigong exercise training for 1–1.5 h 3 times per week for 12 weeks and were encouraged to practise the exercises at home. Main outcome measures: Indicators of metabolic syndrome (body mass index, waist circumference, blood pressure, fasting blood glucose, triglycerides, HDL-cholesterol) and glucose control (HbA1c, fasting insulin and insulin resistance). Results: There was good adherence and high acceptability for the group-based programme. Significant improvements were seen in four of the seven indicators of metabolic syndrome including body mass index (mean difference –1.05 (95% CI –1.48 to –0.63), p<0.001), waist circumference (–2.80 cm (95% CI –4.97 to –0.62), p<0.05) and both systolic (–11.64 mm Hg (95% CI –19.46 to –3.51), p<0.01) and diastolic blood pressure (–9.73 mm Hg (95% CI –13.58 to –5.88), p<0.001). There were also small improvements in HbA1c (–0.32% (95% CI –0.49% to –0.15%), p<0.01), fasting insulin (–9.93 pmol/l (95% CI –19.93 to 0.07), p = 0.051) and insulin resistance (–0.53 (95% CI –0.97 to –0.09), p<0.05). Conclusions: The programme was shown to be feasible and acceptable and the findings suggest that it may be helpful for the control of indicators of metabolic syndrome and glycaemic control. Larger controlled studies are needed to confirm these promising results.

Regular Tai Chi Chuan exercise improves T cell helper function of patients with type 2 diabetes mellitus with an increase in T-bet transcription factor and IL-12 production

Background: Exercise has been shown to be beneficial in the treatment of type 2 diabetes mellitus (DM); its benefit to immune function, however, remains to be determined. Objective: This study investigated the effect of a 12-week course of Tai Chi Chuan (TCC) exercise on T cell helper (Th) reaction in patients with type 2 DM. Methods: A case-control study was performed in 30 pairs of patients with type 2 DM and normal age-matched adults. Fasting blood glucose, HbA1c, mediators (interleukin (IL)-12, IL-4 and transforming growth factor (TGF)β) and transcription factors (T-bet, GATA-3 and FoxP3) of Th1/Th2/T regulatory (Treg) reaction were measured before and after a 12-week TCC exercise programme. Results: Fasting glucose and HbA1c levels in the patients with type 2 DM were significantly higher than in age-matched controls before exercise. After TCC exercise, HbA1c levels in patients with type 2 DM significantly decreased (7.59 (0.32)% vs 7.16 (0.22)%; p = 0.047) and blood levels of IL-12 increased significantly (5.96 (1.10) vs 12.96 (3.07); p = 0.035). To study the molecular Th1/Th2/Treg reaction, patients with type 2 DM were found to have lower T-bet but not GATA-3 or FoxP3 expression than normal controls before TCC exercise. After the 12-week TCC exercise T-bet expression significantly increased in patients with type 2 DM. Conclusions: A 12-week TCC exercise programme decreases HbA1c levels along with an increase in the Th1 reaction. A combination of TCC with medication may provide an even better improvement in both metabolism and immunity of patients with type 2 DM.

Does occupational success influence longevity among England test cricketers?

Objective: To determine whether the longevity of England test cricketers is influenced by occupational success, controlling for the influence of social background. Design: Archival survey. Setting: England. Subjects: Those 418 cricketers who played for England in a test match from the first test in 1876 to 1963 when the distinction between amateur and professional status was removed. Main outcome measures: Length of life. Results: Survival analysis of players born between 1827 and 1941 (349 dead, 69 alive) showed a significant relation between mortality and year of birth (p<0.001), amateur/professional status (p = 0.042) and the number of test matches played (p = 0.042). Captaining England was not related to survival. Conclusion: The link between longevity and both social background and occupational success is supported among test match cricketers. Amateur (or "gentlemen") cricketers from more privileged social backgrounds survived longer than professionals (or "players"). The most successful cricketers who played in a larger number of tests lived longer than those who played in a smaller number of tests. Captaining England, which could be regarded as a form of occupational "control", was not associated with longevity.

The ABCs of the anterior cruciate ligament: a primer for magnetic resonance imaging assessment of the normal, injured and surgically repaired anterior cruciate ligament

This article reviews the magnetic resonance imaging (MRI) findings of the native and reconstructed anterior cruciate ligament (ACL). MRI is the most accurate non-invasive modality to evaluate the ACL. Tears of the ACL manifest with direct and indirect signs. The reconstructed ACL has several complications including re-tear and anterior arthrofibrosis, which are also accurately assessed using MRI.

Non-steroidal anti-inflammatory drugs in sports medicine: guidelines for practical but sensible use

Introduction: Non-steroidal anti-inflammatory drugs (NSAID) are commonly used in sports medicine. NSAID have known anti-inflammatory, analgesic, antipyretic and antithrombotic effects, although their in-vivo effects in treating musculoskeletal injuries in humans remain largely unknown. NSAID analgesic action is not significantly greater than paracetamol for musculoskeletal injury but they have a higher risk profile, with side-effects including asthma exacerbation, gastrointestinal and renal side-effects, hypertension and other cardiovascular diseases. Discussion: The authors recommend an approach to NSAID use in sports medicine whereby simple analgesia is preferentially used when analgesia is the primary desired outcome. However, based both on the current pathophysiological understanding of most injury presentations and the frequency that inflammation may actually be a component of the injury complex, it is premature to suppose that NSAID are not useful to the physician managing sports injuries. The prescribing of NSAID should be cautious and both situation and pathology specific. Both dose and duration minimisation should be prioritised and combined with simple principles of protection, rest, ice, compression, elevation (PRICE), which should allow NSAID-sparing. NSAID use should always be coupled with appropriate physical rehabilitation. Conclusion: NSAID are probably most useful for treating nerve and soft-tissue impingements, inflammatory arthropathies and tenosynovitis. They are not generally indicated for isolated chronic tendinopathy, or for fractures. The use of NSAID in treating muscle injury is controversial. Conditions in which NSAID use requires more careful assessment include ligament injury, joint injury, osteoarthritis, haematoma and postoperatively.

Clinics in neurology and neurosurgery of sport. Mass lesions: cavernoma

Comparison of fat oxidation during exercise in lean and obese pubertal boys: clinical implications

Objective: To examine fat oxidation rates during exercise in lean and obese pubescent children. Design: A graded leg cycle ergometry test was performed by two groups of pubescent boys (13 lean: mean (SD) age 12.0 (0.5) years, body mass index (BMI) 18.56 (1.12) kg/m2; 17 obese: mean (SD) age 12.1 (0.1) years, BMI 26.68 (3.37) kg/m2; p<0.001). The first step of the test was fixed at 30 W and power was gradually increased by 20 W every 3.5 min. The mean ventilatory gas measurement was obtained during the last 30 s of each step for calculation of fat oxidation rate vs exercise intensity. Results: At low intensity (0–30% of peak oxygen consumption) when fat-free mass is considered, the fat oxidation rate was identical for the two groups. At higher intensities (40%, 50% and 60% of peak oxygen consumption) the fat oxidation rate was significantly higher in lean boys than in obese boys. Conclusion: These results confirm that obese pubertal boys have fat-free mass decreased capacities to use fat during moderate exercise. The findings suggest that obese boys need to practise physical activity at a lower intensity than healthy boys to enhance lipolysis and diminish adipose tissue and the consequences of obesity.

Would you dope? A general population test of the Goldman dilemma

Objective: To test Goldman's dilemma on a general population sample by asking whether they would take the Faustian bargain of a drug that guaranteed sporting success but would result in their death in 5 years' time. Between 1982 and 1995 a bi-annual survey using this dilemma suggested half of all elite athletes would take the drug. Design: A random telephone survey of 250 members of the Australian general public, with counterbalanced presentation of success and death. Main outcome measures: Respondents gave age, gender, sports engagement and response to the dilemma (yes/no). Results: Only two of a sample of 250 reported they would take the bargain offered by the dilemma. Conclusions: Athletes differ markedly from the general population in response to the dilemma. This raises significant practical and ethical dilemmas for athlete support personnel. The psychometry of the dilemma needs to be established more comprehensively for general and athlete populations.

SportsMedUpdate

BASEM Annual Congress 2008 8-10 October 2008, Brighton, UK

Does cryotherapy aid proprioception and Throwing Accuracy in the Dominant Shoulder?

The use of cold therapy such as ice packs following an acute shoulder injury is common, as well as part of the rehabilitation plan. During athletic events, athletes may return to play following the cold therapy, however while the effects of this treatment on shoulder proprioception has been assessed, the effects on throwing performance is as yet unknown.

Physical activity reduces the risk of work-related repetitive strain injuries (RSI)

A new study has demonstrated that being physically active in leisure time is associated with a lower risk of developing upper limb occupational repetitive strain injuries (RSI). The study considered a cross section of 58,622 Canadian residents between the ages of 15 and 74 who had been employed full time in the previous 12 months.

Can the single leg balance test identify risk of ankle sprains?

Ankle sprains are a common injury which can often be disabling in the athlete. The ability to predict the susceptibility of an athlete to ankle sprain injuries with a simple test could allow a coach to develop preventative strategies such as balance and proprioceptive training alongside taping techniques to support the ankle, hence reducing the risk of injuries occurring.

What are the injury risks to elite windsurfer's?

This study investigated the incidence of injury and considered methods of prevention of injury amongst windsurfer's. 107 windsurfer's from recreational through to international level responded to the questionnaire with regards to their injuries over the previous two year period. They were also asked to note any recurrent injuries, level of ability and any preventative measures they were taking.

Is spine disc replacement the answer for degenerative spine disease in athletes?

Injuries to the vertebral disks are becoming far more common amongst sporting and non sporting injuries, however currently there is no treatment available to "replace" the disk.

Does vibration therapy influence delayed onset of muscle soreness?

This study considered whether the use of Vibration Training improved muscle performance by preventing or controlling Delayed Onset Muscle Soreness (DOMS) – the phenomenon of experiencing muscular pain some time after exercise.

Is early rehabilitation important in the recovery of Anterior Cruciate Ligament (ACL) injury?.

This study, although broadly scientific and lab-based, may have implications in the rehabilitation of injuries to the anterior cruciate ligament (ACL).

Is intermittent application of cryotherapy more effective than standard protocols when treating acute ankle sprains?

The use of cryotherapy (ice packs) in the management of acute injuries is largely anecdotal, however there is some evidence to suggest that intermittent application is more effective at reducing tissue temperature to optimal levels.

Can sport specific balance training can prevent acute injuries in high school basketball players?

In a study by Emery & colleagues, 920 basketball players from Calgary, Canada were studied in two groups. Both groups were taught basic warm up techniques, but the second group were also taught an additional warm up component and given a home based balance training programme involving the use of a wobble board.

Does injury in a previous season predispose a football player to injury the following season?

A study in Sweden looked at the injuries sustained by 12 elite Swedish male football teams during the 2001 and 2002 seasons.

Does fatigue cause women to be at higher risk of ACL injuries?

A small study of 20 NCAA (National Collegiate Athletic Association) athletes suggests that due to biomechanical differences between male and female athletes when landing jumps, females may have higher risks of injuring Anterior Cruciate Ligament (ACL) when fatigued.