British Journal of Sports Medicine

Matias, Paula; Costa, Mário; Marinho, Daniel; Garrido, Nuno; Silva, António; Barbosa, Tiago

doi: 10.1136/bjsports-2013-092558.55pmid: N/A

Background Aquatic programs have gained popularity in therapy programs for a number of diseases or physical conditions. However, evidences about the effect of such programs on posture remain scarce. The aim of this study was to determine the effects of a 12-wks aquatic program on body posture and balance of sedentary women. Methods 128 females were divided in experimental group (EG; N=85; 55.56±12.92-y; 159.21±6.11-cm of height; 65.28±8.76-kg) and control group (CG; N=43; 60.67±13.48-y; 159.19±4.87-cm of height; 63.86±8.64-kg). The program was conducted throughout 12 weeks, two sessions per week with 40 minutes each. Posture measurements were conducted before starting the program and at the end of the 12th week. The static posture, including bodýs centre of mass position (CoM), was assessed based on photogrammetry,2 unipodal support (US), functional reaching (FR) and Romberg test (RT) with parallel feet. The dynamic posture was obtained by applying the Time Up & Go test (TUG).3 The functional posture was assessed based on the Berg's balance scale (BBS).1 Data variation was analyzed with ANOVA two-ways (group vs program duration) measures (P≤0.05). Results A significant effect from the program duration was observed in US (p<0.01), FR (p<0.01), RT (p=0.05), TUG (p<0.01) and BBS (p<0.01). The only exception was the CoM where a non-significant effect was determined (p=0.32). A significant effect from the group was observed for the TUG (p<0.01) and for the BBS (p=0.04) having the EG lower and higher values at the post-test than the CG, respectively. A non-significant effect was observed for the remaining assessments. The interaction between program duration vs group presented non-significant values for all the tests conducted. Discussion/Conclusions Several selected variables presented a significant time effect (i.e., a posture and balance enhancement from the beginning to the end of the training program). So a 12-wks aquatic program is enough to provide an improvement in the body posture and balance of sedentary women.

Tsoumpos, Pantelis; Kafchitsas, Kostas; Wilke, Hans-Joachim; Evaνgelou, Kostas; Kallivokas, Alkis; Habermann, Bjoern; Tsepis, Elias; Bilis, Evdokia; Matzaroglou, Charalampos

doi: 10.1136/bjsports-2013-092558.80pmid: N/A

Background Cervical whiplash syndrome, or hyperextension-hyperflexion injury, is a common traumatic injury in sports activities. The mechanisms of injury that cause cervical whiplash syndrome vary, but they may be sufficient enough to cause chronic whiplash syndrome. Methods and Patients Over 150 injuries were recorded in sports in our Orthopaedic Departments between the years of 2008 and 2011. Whiplash spine injuries have been reported in most contact sports, including indoor soccer, basketball, and wrestling, and in several non contact sports, such as diving. Whiplash spine injuries are estimated to occur in high percentage of indoor soccer players, and most commonly on defensive players. Injury usually is secondary to high-velocity collisions between players, causing acceleration or deceleration of the head on the neck. Acceleration usually causes a whiplash type of extension force on the neck, while deceleration usually results in flexion forces. Results Serious injuries with neurologic sequelae remain infrequent in our series, and most of these injuries are self-limited. Quality of life assessment with Euro Quol and Sleep quality tools, in our series, suggest that there is no practical difference with healthy control group normalized regarding to sex, age, socioeconomic status and marital status after six months from initial trauma. Discussion/Conclusions Our study shows that there is a significant risk of whiplash type injuries in sports, especially indoor soccer. But serious injuries with neurologic sequelae and Chronic Whiplash Associated Disorders (WAD) remain very infrequent.

Eichmann, Björn; Gießing, Jürgen

doi: 10.1136/bjsports-2013-092558.63pmid: N/A

Background It is generally accepted that strength and muscle mass can be increased by strength training programs. Results are known to depend on training volume and training intensity.1 2 Strength increases when performing sets to the Repetition Maximum (PM) or even to the point of momentary muscular failure (PmF) and muscle hypertrophy has been proven to be superior to the results of sets performed at lower levels of intensity.3 4 Methods In this study (n=43) subjects trained twice a week for ten weeks. One group performed high-intensity training (n=16) and did only one drop-set of each exercise to the point of momentary muscular failure (HIT), whereas the other group (n=14) performed as many repetitions as possible in each set and did three sets of each exercise (3ST). The control group (n=13) did not strength train at all. The body composition of all groups was analysed in weeks 0 and 11. Subjects also performed strength tests for nine exercises in weeks 0 and 11. Results Strength tests and bioelectrical impedance analysis (Tanita MC 180, MA) show increased strength and muscle mass in both training groups but not in the control group.5 However, both strength and muscle mass increased to a greater extent in HIT than in 3ST. After ten weeks of training HIT increased the maximum number of repetitions in the nine test exercise by an average of 25 (15.7/40.3) repetitions per exercise while 3ST increased repetitions by an average of only 15 (6.4/24) repetitions per exercise. Furthermore, HIT increased to a significantly greater extent than 3ST while simultaneously decreasing body fat. Discussion/Conclusions One set of HIT is sufficient to improve muscle mass and strength. On average, results over a training period of ten weeks are better than those of 3ST. Further studies are needed to examine the effects of HIT and 3ST training periods longer than ten weeks.

Voborný, Jiří; Zeman, Tomáš; Blahutková, Marie; Václavíková, Dagmar

doi: 10.1136/bjsports-2013-092558.30pmid: N/A

Background For football referees supervision of a match means significant mental burden. During the match they have to deal with many disputable moments. Their decisions can evoke negative emotions both in players and spectators. Referees often cannot cope with such a burden and leave the match depressed.1 The main goal of this research was to reveal some of the factors which contribute to such situations. Methods Subjective psychological experiences and mental states of 26 football referees were evaluated. These referees supervise football competitions in one of the 14 regions of the Czech Republic. For evaluating their subjective psychological experiences and states the standardised questionnaire SUPSO2 was used. The questionnaire was filled in twice: before the match and immediately after the match. Temperament of referees was evaluated using standardised Belov's temperament test.3 To determine and describe potential causes of changes in mental states of football referees caused by a completed match factor analysis was used. Results Important factors which best reflect the dynamics of changes of subjective experiences and states of football referees were described. Most of the identified factors proved to be only consequences of the relationship among detected components of mental states assessed by the questionnaire SUPSO or were mainly related to the temperament of each referee. It was found, however, that one of these factors is strongly saturated by the referee's actual mental state before the match. This factor represents a significant agent altering referee's mental state during the given match. Conclusions Mental state of football referees just before a match determines partially the ability to manage psychological burden connected to the supervised match. Pre-match preparation should therefore focus more on a regulation of the referees' actual mental state (“pre-start mental state”). If the referees do not use regulation techniques leading to the elimination of negative mental states, it can result in stagnation or decline in their performance level.

Chrysi, Tsiouri; Chidanbaram, Ramiah; Frankiskos, Xypnitos; Mok, Daniel H

doi: 10.1136/bjsports-2013-092558.10pmid: N/A

Backround Is there a reason for repairing massive cuff tears. Methods 58 consecutive patients with a massive rotator cuff tear had arthroscopic repair between November 2004 and May 2006 with the presented technique. The average age was 68.4 years ( 49–86).Mean follow up was 46.2 months (38–56). Thirty of those patients were available for review 20 months later, follow up 65(53–76) 0.33 had ultrasound and 34 had X rays Results In 45 patients available for scoring the mean Oxford score was 44(19–48) with 42 (93%) graded as excellent or good and only one poor result and at final review 45 (27–48).The mean postoperative Constant score at follow up was 74(32.8–97.4) rising to 76 (41–96) in 2011 and statistical analysis showed that improvement in both Oxford and Constant scores was significant(probability <0.05). There was a statistically significant improvement regarding pain, movement and activities of daily living but not strength. Ultrasound findings correlated with postoperative strength and Constant scores but not with any other factor or the Oxford score. Similar was the correlation for radiographic osteoarthritis. At final follow up, improvements in all scores remain statistically significant whether there is a retear or thinning or development of osteoarthritis or not. Conclusion The results suggest that arthroscopic repair of massive rotator cuff tears can achieve excellent clinical results The outcome in the longer term is unknown.

Scheer, Bernd Volker; Valero Burgos, Encarna

doi: 10.1136/bjsports-2013-092558.20pmid: N/A

Background Ultramarathon races have gained popularity in recent years and test the limits of human endurance. Runners often take analgesic medication during endurance foot races which may lead to gastrointestinal complications, altered renal function, and is associated with the development of hyponatremia and rhabdomyolysis. Methods We conducted a prospective survey study to gather data on prevalence, awareness, and reasons for consumption of analgesic medication used among ultramarathon runners during the Al Andalus Ultimate Trail 2012. Data were obtained post race using a direct-interview technique on standardized questionnaires. Results Thirty-two ultramarathon runners (26 male, 6 female, mean age 39.5±7.9, previous ultramarathon experience 7.7±9) participated in the study. The majority of runners (53%) did not take any form of analgesic; 44% said they had used them sometime during the race and training; and 3% had used them regularly. Nonsteroidal anti-inflammatory drugs (NSAID) were most commonly used (60%) followed by Paracetamol (40%). The reasons for use were to reduce musculoskeletal pain (65%) or to combat fatigue (24%). All runners felt that taking an analgesic provided effective relief. Only 6 % of athletes obtained them through a prescription from their doctor. The main sources of recommendation were fellow runners and friends (56%), self initiative (22%) or coaches (6%). They were mainly obtained in shops (47%) and chemists (47%) and rarely on the Internet (6%). Two thirds of runners said they were aware of adverse effects, naming mainly renal failure (27%), gastrointestinal problems (18%) and liver failure (9%). Conclusion We found a high prevalence of analgesic medication use among ultramarathon runners. A third of runners were not aware of any adverse effects or dangers associated with analgesic consumption. Analgesic medication may have deleterious effects on the body and its performance. Pre-race education programmes may help increase awareness of effects, risks and appropriate use, and consumption.

Kakoura, Eleni; Baka, Katerina; Katsoulaki, Marianna; Dang, Mai; Fotiou, Stella; Nowicky, Alexander

doi: 10.1136/bjsports-2013-092558.31pmid: N/A

Background Healthy ageing is accompanied by cognitive and functional deficits which result in decreased ability to respond quickly and accurately to different stimuli. Whilst a general decline is observed in manual dexterity and hand motor function of older adults affecting their daily life, learning ability is almost completely intact. NIBS techniques such as tDCS has been found to have effective results by enhancing cortical excitability and motor learning and function in the younger adults. The purpose of this study was to further investigate any improvements in non-dominant hand motor function, examining the effects of tDCS alongside a motor skill rehabilitation task (MSRT) in motor learning in the ageing brain, focusing on any age-related differences. Methods Thirty-two healthy subjects (YAs: n=20, mean age= 24.4± 2.03; OAs: n=12, mean age= 64.3± 9.56) participated in this double-blinded, sham-controlled study, undertaking a single session of either anodal or sham tDCS on the non- dominant M1. The MSRT was carried out as an outcome measure to investigate any changes in hand function, speed and accuracy, with TPR scores indicating level of MSRT performance. TMS was used to detect any changes in cortical excitability of the non-dominant hemisphere, measuring the MEPs of the non-dominant APB. The cortical excitability assessment through paired-pulse TMS was based on Kujirai protocol, measuring the SICI/F) and the LICI/F at predetermined delays. At baseline, behavioural functional tasks were carried out to evaluate speed and accuracy of the participant before intervention. The statistical data analysis was carried out using mixed analysis of ANOVA (P<0.05). Results There were significant differences between the type of tDCS application (anodal versus sham) regarding the APB MEP responses detected by TMS (P= 0.03). Also, a significant effect of age was found on overall TPR scores with younger individuals obtaining lower scores than the older (P =0.003), indicating better MSRT performance. Another outcome was the significant improvement level of the MSRT for all groups across the time intervals (P<0.001). However, no significant age- related differences found concerning the overall facilitation or inhibition. Conclusion Though some findings did not reach at a statistical significance level, a-tDCS coupled with MSRT did ameliorate motor performance and therefore suggests that brain stimulation can enhance motor function in the ageing brain, facilitating motor learning through a-tDCS. Further research into neurorehabilitation can continue to contribute to the understanding of normal ageing and confirm the positive impacts of a-tDCS alongside motor tasks for ageing individuals as well as its potential as a poststroke intervention. Additionally this research could be used further as a post-traumatic sport rehabilitation because of the impact on the healthy younger groups.

Baliotis, Konstantinos; Korakakis, Vasileios; Dragioti, Elena; Kotrsotsiou, Evangelia; Gouva, Mary

doi: 10.1136/bjsports-2013-092558.49pmid: N/A

Introduction Chronic pain can lead the subjective emotional pain response of an individual and has the potential to interplay with emotions at a cognitive level such as internal or external shame. Aim The present study examined the relationship of internal and external shame with chronic low back pain (CLBP) and the differences between genders of athletes with CLBP. Materials and Methods Two hundred athletes with CLBP participated in the present study (110 men, 90 women, mean age±SD 24,5±6,7). The measures used were: Other As Shamer Scale-OAS, (Goss, Gilbert & Allan, 1994), Experience of Shame Scale-ESS (Andrews, Qian & Valentine, 2002) and another questionnaire with socio-demographics, attitudes and self-reported questions data on the impact of the chronic pain in their life. Results The mean scores (±SD) for men and women with CLBP and the p values from the T-tests were respectively: for total OAS, 12.96±7.0 and 15.68±8.8 (p=0.045) and for total ESS, 48.8±9.7 and 50.3±13 (p=0.366). Despite that there were no significant differences in ESS, the subscale of ESS regarding bodily shame revealed statistically significant difference between men and women (p=0.002). Conclusion The results of the present study revealed the high levels of external shame in athletes of both genders with CLBP and confirmed that shame is an emotion highly connected with woman nature. Furthermore, from the subscale of ESS regarding bodily shame was presented that women have the self-perception of lower social power and the trend to judge there self less favorably to others.

Jin Hong, Kim; Jung Sok, Oak; Dong Kyu, Lee; Byung Roh, Kim; Moon Jib, Yoo; Joong Bae, Seo; Yun-a, Shin; Hoseong, Lee

doi: 10.1136/bjsports-2013-092558.67pmid: N/A

Background Neuromuscular training protocols that plyometrics, dynamic balance exercises, agility training, etc, can significantly improve biomechanics and neuromuscular performance and reduce anterior cruciate ligament (ACL) injury risk in athletes.1 2 Objective The purpose of this study was to investigate the effect of 6weeks TDS Jump training on muscle reaction time after surgical reconstruction of the ACL. Methods Seven patients men 12 to 36 months following reconstructive ACL operation continuously participated TDS Jump training at seven sets of five times (7 sets×5 times=35 jumps), 3 days/week, for 6 weeks. Premotor reaction time (PRT) of vastus medialis (VM), vastus lateralis (VL), hamstring medialis (HM), and hamstring lateralis (HL) were recorded by electromyography through the examination sudden knee eversion stress. Two physical therapists evaluated each subject's performance ability using a talent diagnose system (TDS Jump). Results PRT of all tested muscles were significantly decreased after both three and six weeks of TDS Jump training than at before training (p<.05). Grounding time (TDS Jump) of operated legs was significantly decreased after both three and six weeks of TDS Jump training than at before training (p<.05). Conclusions These results demonstrated in the present that TDS Jump training could improve PRT and grounding time in operated legs. Therefore, suggested that TDS Jump training applying in not only an assessment of the neuromuscular function after reconstructive ACL operation but also training and rehabilitation.

Domingues, Marcio

doi: 10.1136/bjsports-2013-092558.76pmid: N/A

Sport and more specifically football is an important asset in youth lives. Much has been written regarding functional capacities and dimensions in pre-adolescence and adolescence but there's a consistent lack of information concerning the ages of 6–10 years of age. Biological factors, such as body size and maturity status, have been documented as predictors of athlete selection and performance in several sports (Malina, Bouchard, & Bar-Or, 2004). As some authors contest, advanced biological maturity status constitutes an asset positively associated with selection process and success in several sports in early adolescence (Malina, Pena Reyes, Eisenmann, Horta, Rodrigues, & Miller, 2000), as chronological age and sport specialization increase. Children are very responsive to systematic instructional and training programs for the development of motor skills. Moreover, studies of youth football players start to consider the potential influence of variation in growth and biological maturity status upon sport-specific football skills. Attention is given to functional capacities and performance outcomes in young athletes at relatively young age as they relate to growth and maturation. The multilateral development emphasis should be placed ahead when elaborating youth programs as coaches should be careful in using body size as cut-points in sport and should be aware of individual differences (Malina, 2004). Care should therefore be taken in developing football skills regarding performance with full respect to youth development.