Journal of Sports Medicine The latest articles from Hindawi Publishing Corporation © 2016 , Hindawi Publishing Corporation . All rights reserved. Plasma Cytokine Profiles in Long-Term Strenuous Exercise Thu, 28 Apr 2016 06:17:35 +0000 The open window theory indicates altered immunity 3 to 72 hours after exercise. The J-curve describes the risk of illness in response to exercise. The aim of this study was to examine the secretion of proinflammatory and anti-inflammatory cytokines before and after long-term strenuous exercise. Fourteen marathon and 16 half-marathon runners and 10 military cadets participating in a military ranger-training course were recruited to this study. Within-subject design was used measuring levels of plasma cytokines before, during, and after exercise. Plasma cytokines were measured using Luminex multiplex technology and ELISA. Comparing pre/post plasma levels both the marathon- and the half-marathon runners showed heavily increased levels of IL-6, IL-10, and IL-8 (). LPS stimulation among the half-marathon runners decreased the postrace levels of IL-6, IL-1b, and TNFα by 45%, 24%, and 43%, respectively (). During the ranger training course the spontaneous and LPS-stimulated levels of IL-6, IL-8, IL-10, IL-1b, and TNFα changed in a similar fashion as in the half-marathon runners although the fluctuations were smaller. Our study supports the open window and the J-curve theory; the immune system is more activated and the subjects are more threatened to infectious pathogens after intensive physical activity and in the period after exercise. Hilde G. Nielsen, Olav Øktedalen, Per-Kristian Opstad, and Torstein Lyberg Copyright © 2016 Hilde G. Nielsen et al. All rights reserved. Corrigendum to “Validity and Reliability of Farsi Version of Youth Sport Environment Questionnaire” Mon, 12 Oct 2015 06:09:26 +0000 Mohammad Ali Eshghi, Ramin Kordi, Amir Hossein Memari, Ahmad Ghaziasgar, Mohammad-Ali Mansournia, and Seyed Hojjat Zamani Sani Copyright © 2015 Mohammad Ali Eshghi et al. All rights reserved. Amniotic Tissues for the Treatment of Chronic Plantar Fasciosis and Achilles Tendinosis Sun, 27 Sep 2015 14:02:28 +0000 Introduction. Allogeneic amniotic tissue and fluid may be used to treat chronic plantar fasciosis and Achilles tendinosis. This innovative approach involves delivering a unique allograft of live human cells in a nonimmunogenic structural tissue matrix to treat chronic tendon injury. These tissues convey very positive regenerative attributes; procurement is performed with maternal consent during elective caesarian birth. Materials and Methods. In the present investigation all patients were unresponsive to multiple standard therapies for a minimum of 6 months and were treated with one implantation of PalinGen SportFLOW around the plantar fascia and/or around the Achilles paratenon. The patients were given a standard protocol for postimplant active rehabilitation. Results. The analogue pretreatment pain score (VAS) of 8. By the fourth week after treatment, all patients had significantly reduced self-reported pain. Twelve weeks following the procedure the average pain level had reduced to only 2. No adverse reactions were reported in any of the patients. Conclusion. All patients in this study experienced heel or Achilles pain, unresponsive to standard therapy protocols. After treatment all patients noted significant pain reduction, indicating that granulized amniotic membrane and amniotic fluid can be successfully used to treat both chronic plantar fasciosis and Achilles tendinosis. Bruce Werber Copyright © 2015 Bruce Werber. All rights reserved. Changes in Tissue Oxygen Saturation in Response to Different Calf Compression Sleeves Tue, 08 Sep 2015 06:48:15 +0000 Aim. The purpose was to examine the changes in tissue oxygen saturation (StO2) in response to the application of different commercially available calf compression sleeves. Methods. Eight subjects came to the laboratory to complete a session in seated position including 10 min of quiet rest followed by 3 min measuring calf StO2 without compression sleeves and then alternating of 3 min of passive rest and 3 min measuring StO2 with calf compression sleeves. A total of 15 different commercially available compression sleeves were studied in a randomized order. Calf StO2 was recorded using near-infrared spectroscopy. Results. StO2 was significantly increased with all compression sleeves compared with no compression (from +6.9% for the least effective to +22.6% for the most effective). Large differences were observed between compression sleeves . StO2 was positively correlated with compression pressure (; ). Conclusion. This study shows that wearing compression sleeves from various brands differently affects tissue oxygen saturation. Differences were linked to the compression pressure: higher compression pressures were associated with higher StO2. T. Dermont, L. Morizot, M. Bouhaddi, and A. Ménétrier Copyright © 2015 T. Dermont et al. All rights reserved. Nutritional Considerations for Performance in Young Athletes Wed, 19 Aug 2015 13:50:03 +0000 Nutrition is an integral component to any athletes training and performance program. In adults the balance between energy intake and energy demands is crucial in training, recovery, and performance. In young athletes the demands for training and performance remain but should be a secondary focus behind the demands associated with maintaining the proper growth and maturation. Research interventions imposing significant physiological loads and diet manipulation are limited in youth due to the ethical considerations related to potential negative impacts on the growth and maturation processes associated with younger individuals. This necessary limitation results in practitioners providing nutritional guidance to young athletes to rely on exercise nutrition recommendations intended for adults. While many of the recommendations can appropriately be repurposed for the younger athlete attention needs to be taken towards the differences in metabolic needs and physiological differences. JohnEric W. Smith, Megan E. Holmes, and Matthew J. McAllister Copyright © 2015 JohnEric W. Smith et al. All rights reserved. Validity and Reliability of Farsi Version of Youth Sport Environment Questionnaire Wed, 12 Aug 2015 07:56:10 +0000 The Youth Sport Environment Questionnaire (YSEQ) had been developed from Group Environment Questionnaire, a well-known measure of team cohesion. The aim of this study was to adapt and examine the reliability and validity of the Farsi version of the YSEQ. This version was completed by 455 athletes aged 13–17 years. Results of confirmatory factor analysis indicated that two-factor solution showed a good fit to the data. The results also revealed that the Farsi YSEQ showed high internal consistency, test-retest reliability, and good concurrent validity. This study indicated that the Farsi version of the YSEQ is a valid and reliable measure to assess team cohesion in sport setting. Mohammad Ali Eshghi, Ramin Kordi, Amir Hossein Memari, Ahmad Ghaziasgar, Mohammad-Ali Mansournia, and Seyed Hojjat Zamani Sani Copyright © 2015 Mohammad Ali Eshghi et al. All rights reserved. Physiological and Psychophysical Responses to Listening to Music during Warm-Up and Circuit-Type Resistance Exercise in Strength Trained Men Tue, 04 Aug 2015 15:55:06 +0000 The purpose of this study was to assess the effects of listening to music during warm-up and resistance exercise on physiological (heart rate and blood pressure) and psychophysical (rating of perceived exertion) responses in trained athletes. Twelve strength trained male participants performed warm-up and resistance exercise without music (WU+RE without M), warm-up and resistance exercise with music (WU+RE with M), WU with M and RE without M, and WU without M and RE with M, with 48 hours space between sessions. After completing each session, the rating of perceived exertion (RPE) was measured. Also, heart rate (HR), systolic (SBP) and diastolic blood pressure (DBP), mean arterial pressure (MAP), and rate pressure product (RPP) were assessed before, after, and 15, 30, 45, and 60 min after exercise. Results indicated that RPE was higher for WU+RE without M condition in comparison with other conditions. All conditions showed increases in cardiovascular variables after exercise. The responses of HR, SBP, and RPP were higher for WU+RE without M condition. Thus, using music during warm-up and resistance exercise is a legal method for decreasing RPE and cardiovascular responses due to resistance exercise. Hamid Arazi, Abbas Asadi, and Morteza Purabed Copyright © 2015 Hamid Arazi et al. All rights reserved. Validation of the Continuum of Care Conceptual Model for Athletic Therapy Mon, 27 Jul 2015 06:29:10 +0000 Utilization of conceptual models in field-based emergency care currently borrows from existing standards of medical and paramedical professions. The purpose of this study was to develop and validate a comprehensive conceptual model that could account for injuries ranging from nonurgent to catastrophic events including events that do not follow traditional medical or prehospital care protocols. The conceptual model should represent the continuum of care from the time of initial injury spanning to an athlete’s return to participation in their sport. Finally, the conceptual model should accommodate both novices and experts in the AT profession. This paper chronicles the content validation steps of the Continuum of Care Conceptual Model for Athletic Therapy (CCCM-AT). The stages of model development were domain and item generation, content expert validation using a three-stage modified Ebel procedure, and pilot testing. Only the final stage of the modified Ebel procedure reached a priori 80% consensus on three domains of interest: (1) heading descriptors; (2) the order of the model; (3) the conceptual model as a whole. Future research is required to test the use of the CCCM-AT in order to understand its efficacy in teaching and practice within the AT discipline. Mark R. Lafave, Dale Butterwick, and Breda Eubank Copyright © 2015 Mark R. Lafave et al. All rights reserved. The Potentially Positive Role of PRPs in Preventing Femoral Tunnel Widening in ACL Reconstruction Surgery Using Hamstrings: A Clinical Study in 51 Patients Sun, 09 Nov 2014 00:00:00 +0000 Purpose. In this study, the early and midterm clinical and radiological results of the anterior cruciate ligament (ACL) reconstruction surgery with or without the use of platelet rich plasma (PRP) focusing on the tunnel-widening phenomenon are evaluated. Methods. This is a double blind, prospective randomized study. 51 patients have completed the assigned protocol. Recruited individuals were divided into two groups: a group with and a group without the use of PRPs. Patients were assessed on the basis of MRI scans, which were performed early postoperatively and repeated at least one-year postoperatively. The diameter was measured at the entrance, at the bottom, and at the mid distance of the femoral tunnel. Results. Our study confirmed the existence of tunnel widening as a phenomenon. The morphology of the dilated tunnels was conical in both groups. There was a statistical significant difference in the mid distance of the tunnels between the two groups. This finding may support the role of a biologic response secondary to mechanical triggers. Conclusions. The use of RPRs in ACL reconstruction surgery remains a safe option that could potentially eliminate the biologic triggers of tunnel enlargement. The role of mechanical factors, however, remains important. Konstantinos A. Starantzis, Dimitrios Mastrokalos, Dimitrios Koulalis, Olympia Papakonstantinou, Panayiotis N. Soucacos, and Panayiotis J. Papagelopoulos Copyright © 2014 Konstantinos A. Starantzis et al. All rights reserved. Strength Gains as a Result of Brief, Infrequent Resistance Exercise in Older Adults Tue, 30 Sep 2014 11:41:22 +0000 Chronological aging is associated with a decrease in skeletal muscle mass and bone mineral density, an increase in fat mass, frequency of falls and fractures, and the likelihood of obesity, diabetes, and coronary heart disease. Resistance exercise has been shown to counter all of these effects of aging and, in turn, reduce the risk of all-cause mortality. However, variables such as volume and frequency have become contentious issues, with recent publications suggesting that similar physiological adaptations are possible with both high- and low-volume approaches. The aim of this research was to consider strength increases as a result of brief, infrequent resistance exercise. The present study offers data from 33 (14 male and 19 female) older adults ( years) who underwent brief (<15 minutes per exercise session), infrequent (2×/week), resistance exercise to a high intensity of effort (6-repetition maximum) at a controlled repetition duration (10 seconds concentric : 10 seconds eccentric) on 5 resistance machines (chest press, leg press, pull-down, seated row, and overhead press). Data is presented for training interventions of 12 weeks (male) and 19 weeks (female). Significant strength increases were identified for all exercises. With the detailed health benefits obtainable, the present study suggests that resistance exercise can be efficacious in much smaller volumes than previously considered. James Fisher, James Steele, Pat McKinnon, and Stephen McKinnon Copyright © 2014 James Fisher et al. All rights reserved. Functional Popliteal Artery Entrapment Syndrome: Poorly Understood and Frequently Missed? A Review of Clinical Features, Appropriate Investigations, and Treatment Options Sun, 07 Sep 2014 07:03:03 +0000 Functional popliteal artery entrapment syndrome (PAES) is an important and possibly underrecognized cause of exertional leg pain (ELP). As it is poorly understood, it is at risk of misdiagnosis and mismanagement. The features indicative of PAES are outlined, as it can share features with other causes of ELP. Investigating functional PAES is also fraught with potential problems and if it is performed incorrectly, it can result in false negative and false positive findings. A review of the current vascular investigations is provided, highlighting some of the limitations standard tests have in determining functional PAES. Once a clinical suspicion for PAES is satisfied, it is necessary to further distinguish the subcategories of anatomical and functional entrapment and the group of asymptomatic occluders. When definitive entrapment is confirmed, it is important to identify the level of entrapment so that precise intervention can be performed. Treatment strategies for functional PAES are discussed, including the possibility of a new, less invasive intervention of guided Botulinum toxin injection at the level of entrapment as an alternative to vascular surgery. Matthew Hislop, Dominic Kennedy, Brendan Cramp, and Sanjay Dhupelia Copyright © 2014 Matthew Hislop et al. All rights reserved. Effects of Cooling on Ankle Muscle Strength, Electromyography, and Gait Ground Reaction Forces Sun, 04 May 2014 10:24:01 +0000 The effects of cooling on neuromuscular function and performance during gait are not fully examined. The purpose of this study was to investigate the effects of local cooling for 20 min in cold water at 10°C in a climate chamber also at 10°C on maximal isometric force and electromyographic (EMG) activity of the lower leg muscles. Gait ground reaction forces (GRFs) were also assessed. Sixteen healthy university students participated in the within subject design experimental study. Isometric forces of the tibialis anterior (TA) and the gastrocnemius medialis (GM) were measured using a handheld dynamometer and the EMG was recorded using surface electrodes. Ground reaction forces during gait and the required coefficient of friction (RCOF) were recorded using a force plate. There was a significantly reduced isometric maximum force in the TA muscle () after cooling. The mean EMG amplitude of GM muscle was increased after cooling (), indicating that fatigue was induced. We found no significant changes in the gait GRFs and RCOF on dry and level surface. These findings may indicate that local moderate cooling 20 min of 10°C cold water, may influence maximal muscle performance without affecting activities at sub-maximal effort. Amitava Halder, Chuansi Gao, and Michael Miller Copyright © 2014 Amitava Halder et al. All rights reserved. The Effect of Acute Rhodiola rosea Ingestion on Exercise Heart Rate, Substrate Utilisation, Mood State, and Perceptions of Exertion, Arousal, and Pleasure/Displeasure in Active Men Sun, 27 Apr 2014 08:58:27 +0000 The aim of this study was to examine the effect of acute Rhodiola rosea (R. rosea) ingestion on substrate utilisation, mood state, RPE, and exercise affect. Ten males (mean age ± S.D. = 26 ± 6 years) completed two 30-minute cycling trials at an intensity of 70% of following ingestion of either 3 mg·kg−1 body mass of R. rosea or placebo using a double-blind, crossover design. During exercise, heart rate and RPE were recorded. Participants completed measures of mood state and exercise affect before and after exercise. Expired air samples were taken during exercise to determine substrate utilisation. Repeated measures analysis of variance indicated that RPE was significantly lower at 30 minutes into exercise versus placebo (). Perceptions of arousal () and pleasure were significantly higher after exercise with R. rosea compared to placebo (). Mood state scores for vigor were also higher in R. rosea condition compared to placebo (). There were no significant differences in energy expenditure, carbohydrate, or fat oxidation between conditions (). Ingestion of R. rosea favourably influenced RPE and exercise affect without changes in energy expenditure or substrate utilization during 30-minute submaximal cycling performance. Michael J. Duncan and Neil D. Clarke Copyright © 2014 Michael J. Duncan and Neil D. Clarke. All rights reserved. Immediate Effects of Neurodynamic Sliding versus Muscle Stretching on Hamstring Flexibility in Subjects with Short Hamstring Syndrome Tue, 15 Apr 2014 12:40:13 +0000 Background. Hamstring injuries continue to affect active individuals and although inadequate muscle extensibility remains a commonly accepted factor, little is known about the most effective method to improve flexibility. Purpose. To determine if an isolated neurodynamic sciatic sliding technique would improve hamstring flexibility to a greater degree than stretching or a placebo intervention in asymptomatic subjects with short hamstring syndrome (SHS). Study Design. Randomized double-blinded controlled trial. Methods. One hundred and twenty subjects with SHS were randomized to 1 of 3 groups: neurodynamic sliding, hamstring stretching, and placebo control. Each subject’s dominant leg was measured for straight leg raise (SLR) range of motion (ROM) before and after interventions. Data were analyzed with a mixed model ANOVA followed by simple main effects analyses. Results. At the end of the study, more ROM was observed in the Neurodynamic and Stretching groups compared to the Control group and more ROM in the Neurodynamic group compared to Stretching group. Conclusion. Findings suggest that a neurodynamic sliding technique will increase hamstring flexibility to a greater degree than static hamstring stretching in healthy subjects with SHS. Clinical Relevance. The use of neurodynamic sliding techniques to improve hamstring flexibility in sports may lead to a decreased incidence in injuries; however, this needs to be formally tested. Yolanda Castellote-Caballero, Maríe C. Valenza, Emilio J. Puentedura, César Fernández-de-las-Peñas, and Francisco Alburquerque-Sendín Copyright © 2014 Yolanda Castellote-Caballero et al. All rights reserved. Clinical and Functional Outcomes following Primary Repair versus Reconstruction of the Medial Patellofemoral Ligament for Recurrent Patellar Instability Thu, 20 Mar 2014 11:37:45 +0000 Background. The purpose of this study was to compare outcomes of medial patellofemoral ligament (MPFL) repair or reconstruction. Methods. Fourteen knees that underwent MPFL repair and nine (F5, M4) knees that underwent reconstruction at our institution were evaluated for objective and subjective outcomes. The mean age at operation was 20.1 years for repair and 19.8 years for reconstruction. All patients had a minimum of 2 years of follow-up (range: 24–75 months). Patient subjective outcomes were obtained using the International Knee Documentation Committee (IKDC) and Kujala patellofemoral subjective evaluations, as well as Visual Analog (VAS) and Tegner Activity Scales. Bilateral isometric quadriceps strength and vastus medialis obliquus (VMO) and vastus lateralis (VL) surface EMG were measured during maximal isometric quadriceps contractions at 30° and 60° of flexion. Results. There were no redislocations in either group. There was no difference in IKDC (), Kujala (), Tegner (), or VAS () scores at follow-up. There were no differences between repair and reconstruction in torque generation of the involved side at 30° () and 60° (). In addition, there was no side to side difference in torque generation or surface EMG activation of VL or VMO. Conclusions. There were minimal differences found between patients undergoing MPFL repair and MPFL reconstruction for the objective and subjective evaluations in this study. Marc Tompkins, Christopher M. Kuenze, David R. Diduch, Mark D. Miller, Matthew D. Milewski, and Joseph P. Hart Copyright © 2014 Marc Tompkins et al. All rights reserved. Incidence and Time to Return to Training for Stress Fractures during Military Basic Training Tue, 21 Jan 2014 14:25:27 +0000 Currently, little is known about the length of time required to rehabilitate patients from stress fractures and their return to preinjury level of physical activity. Previous studies have looked at the return to sport in athletes, in a general population, where rehabilitation is not as controlled as within a captive military population. In this study, a longitudinal prospective epidemiological database was assessed to determine the incidence of stress fractures and the time taken to rehabilitate recruits to preinjury stage of training. Findings demonstrated a background prevalence of 5% stress fractures in Royal Marine training; femoral and tibial stress fractures take 21.1 weeks to return to training with metatarsal stress fractures being the most common injury taking 12.2 weeks. Rehabilitation from stress fractures accounts for 814 weeks of recruit rehabilitation time per annum. Stress fracture incidence is still common in military training; despite this stress fracture recovery times remain constant and represent a significant interruption in training. It takes on average 5 weeks after exercise specific training has restarted to reenter training at a preinjury level, regardless of which bone has a stress fracture. Further research into their prevention, treatment, and rehabilitation is required to help reduce these burdens. Alexander M. Wood, Richard Hales, Andre Keenan, Alexandra Moss, Michael Chapman, Trish Davey, and Andrew Nelstrop Copyright © 2014 Alexander M. Wood et al. All rights reserved. Experiences of Injuries and Injury Reporting among Swedish Skydivers Thu, 16 Jan 2014 09:24:41 +0000 The objective was to illuminate the experience of injuries and the process of injury reporting within the Swedish skydiving culture. Data contained narrative interviews that were subsequently analyzed with content analysis. Seventeen respondents (22–44 years) were recruited at three skydiving drop zones in Sweden. In the results injury events related to the full phase of a skydive were described. Risk of injury is individually viewed as an integrated element of the recreational activity counterbalanced by its recreational value. The human factor of inadequate judgment such as miscalculation and distraction dominates the descriptions as causes of injuries. Organization and leadership act as facilitators or constrainers for reporting incidents and injuries. On the basis of this study it is interpreted that safety work and incident reporting in Swedish skydiving may be influenced more by local drop zone culture than the national association regulations. Formal and informal hierarchical structures among skydivers seem to decide how skydiving is practiced, rules are enforced, and injuries are reported. We suggest that initial training and continuing education need to be changed from the current top-down to a bottom-up perspective, where the individual skydiver learns to see the positive implications of safety work and injury reporting. Mats Jong, Anton Westman, and Britt-Inger Saveman Copyright © 2014 Mats Jong et al. All rights reserved. Interrater and Intrarater Reliability of the Tuck Jump Assessment by Health Professionals of Varied Educational Backgrounds Mon, 16 Dec 2013 08:53:46 +0000 Objective. The Tuck Jump Assessment (TJA), a clinical plyometric assessment, identifies 10 jumping and landing technique flaws. The study objective was to investigate TJA interrater and intrarater reliability with raters of different educational and clinical backgrounds. Methods. 40 participants were video recorded performing the TJA using published protocol and instructions. Five raters of varied educational and clinical backgrounds scored the TJA. Each score of the 10 technique flaws was summed for the total TJA score. Approximately one month later, 3 raters scored the videos again. Intraclass correlation coefficients determined interrater (5 and 3 raters for first and second session, resp.) and intrarater (3 raters) reliability. Results. Interrater reliability with 5 raters was poor (ICC = 0.47; 95% confidence intervals (CI) 0.33–0.62). Interrater reliability between 3 raters who completed 2 scoring sessions improved from 0.52 (95% CI 0.35–0.68) for session one to 0.69 (95% CI 0.55–0.81) for session two. Intrarater reliability was poor to moderate, ranging from 0.44 (95% CI 0.22–0.68) to 0.72 (95% CI 0.55–0.84). Conclusion. Published protocol and training of raters were insufficient to allow consistent TJA scoring. There may be a learned effect with the TJA since interrater reliability improved with repetition. TJA instructions and training should be modified and enhanced before clinical implementation. Lisa A. Dudley, Craig A. Smith, Brandon K. Olson, Nicole J. Chimera, Brian Schmitz, and Meghan Warren Copyright © 2013 Lisa A. Dudley et al. All rights reserved. The Incidence of Concussion in a Professional Australian Rugby League Team, 1998–2012 Tue, 03 Dec 2013 14:26:25 +0000 Background. Rugby league is a physically demanding team sport and the National Rugby League is the highest-level competition of rugby league in Australia. Frequent tackles and collisions between players result in a high incidence of injury to players. Concussion injuries have been the source of much debate, with reporting varying greatly depending on the definition used. Method. Injury records of 239 players from one professional National Rugby League were analysed during a continuous period of 15 years, with particular interest in the incidence and recurrence of concussions and the change in incidence over time. Result. A total of 191 concussions were recorded, affecting 90 players. The incidence of concussion injuries was found to be 28.33 per 1000 player match hours, with an increase over time (). Multiple concussions were recorded for 51 players. Conclusion. A statistically significant increase in the incidence of concussion injuries was found, without a concurrent increase in the number of head injuries or total injuries. New rules which mandate removal of players from the field may be beneficial for protection of players on the long term, although they risk being counterproductive, if they make players less likely to report their symptoms during matches. Jason Savage, Chloe Hooke, John Orchard, and Richard Parkinson Copyright © 2013 Jason Savage et al. All rights reserved. The Injury/Illness Performance Project (IIPP): A Novel Epidemiological Approach for Recording the Consequences of Sports Injuries and Illnesses Wed, 27 Nov 2013 13:17:45 +0000 Background. Describing the frequency, severity, and causes of sports injuries and illnesses reliably is important for quantifying the risk to athletes and providing direction for prevention initiatives. Methods. Time-loss and/or medical-attention definitions have long been used in sports injury/illness epidemiology research, but the limitations to these definitions mean that some events are incorrectly classified or omitted completely, where athletes continue to train and compete at high levels but experience restrictions in their performance. Introducing a graded definition of performance-restriction may provide a solution to this issue. Results. Results from the Great Britain injury/illness performance project (IIPP) are presented using a performance-restriction adaptation of the accepted surveillance consensus methodologies. The IIPP involved 322 Olympic athletes (males: 172; female: 150) from 10 Great Britain Olympic sports between September 2009 and August 2012. Of all injuries (), 216 were classified as causing time-loss, 346 as causing performance-restriction, and 3 were unclassified. For athlete illnesses (), the majority () resulted in time-loss (270) compared with performance-restriction (101) (7 unclassified). Conclusions. Successful implementation of prevention strategies relies on the correct characterisation of injury/illness risk factors. Including a performance-restriction classification could provide a deeper understanding of injuries/illnesses and better informed prevention initiatives. Debbie Palmer-Green, Colin Fuller, Rod Jaques, and Glenn Hunter Copyright © 2013 Debbie Palmer-Green et al. All rights reserved. The Acute Effects of Upper Extremity Stretching on Throwing Velocity in Baseball Throwers Thu, 07 Nov 2013 08:57:45 +0000 Purpose. To examine the effects of static and proprioceptive neuromuscular facilitation (PNF) stretching of the shoulder internal rotators on throwing velocity. Subjects. 27 male throwers (mean age = 25.1 years old, SD = 2.4) with adequate knowledge of demonstrable throwing mechanics. Study Design. Randomized crossover trial with repeated measures. Methods. Subjects warmed up, threw 10 pitches at their maximum velocity, were randomly assigned to 1 of 3 stretching protocols (static, PNF, or no stretch), and then repeated their 10 pitches. Velocities were recorded after each pitch and average and peak velocities were recorded after each session. Results. Data were analyzed using a repeated measures ANOVA. No significant interaction between stretching and throwing velocity was observed. Main effects for time were not statistically significant. Main effects for the stretching groups were statistically significant. Discussion. Results suggest that stretching of the shoulder internal rotators did not significantly affect throwing velocity immediately after stretching. This may be due to the complexity of the throwing task. Conclusions. Stretching may be included in a thrower's warm-up without any effects on throwing velocity. Further research should be performed using a population with more throwing experience and skill. Michael Williams, Lanisa Harveson, Jason Melton, Ashley Delobel, and Emilio J. Puentedura Copyright © 2013 Michael Williams et al. All rights reserved. A Review of Treatments for Iliotibial Band Syndrome in the Athletic Population Wed, 02 Oct 2013 11:52:58 +0000 Iliotibial band syndrome (ITBS) is a common injury in runners and other long distance athletes with the best management options not clearly established. This review outlines both the conservative and surgical options for the treatment of iliotibial band syndrome in the athletic population. Ten studies met the inclusion criteria by focusing on the athletic population in their discussion of the treatment for iliotibial band syndrome, both conservative and surgical. Conservative management consisting of a combination of rest (2–6 weeks), stretching, pain management, and modification of running habits produced a 44% complete cure rate, with return to sport at 8 weeks and a 91.7% cure rate with return to sport at 6 months after injury. Surgical therapy, often only used for refractory cases, consisted of excision or release of the pathologic distal portion of the iliotibial band or bursectomy. Those studies focusing on the excision or release of the pathologic distal portion of the iliotibial band showed a 100% return to sport rate at both 7 weeks and 3 months after injury. Despite many options for both surgical and conservative treatment, there has yet to be consensus on one standard of care. Certain treatments, both conservative and surgical, in our review are shown to be more effective than others; however, further research is needed to delineate the true pathophysiology of iliotibial band syndrome in athletes, as well as the optimal treatment regimen. Corey Beals and David Flanigan Copyright © 2013 Corey Beals and David Flanigan. All rights reserved. A Structured and Flexible Language for Physical Activity Assessment and Characterization Wed, 25 Sep 2013 11:20:13 +0000 Developing more accurate assessments of physical activity (PA) and sedentary behavior (SB) is an important public health research priority. Assessing PA and SB is challenging in all segments of the population, but it is especially difficult in children due to cognitive limitations and more sporadic and intermittent activity patterns. Moreover, they are influenced by several factors including temporal-spatial constraints and social conditions. To accurately assess PA and SB, it is essential to clearly define methods for describing all these factors. The goal of this paper is to potentiate advances in the field by proposing a base ontology for characterizing physical activity, sedentary behavior, and the context in which it occurs. The ontology would establish a flexible base language to facilitate standardized descriptions of these behaviors for researchers and public health professionals. Pedro Silva, Maria Teresa Andrade, Pedro Carvalho, and Jorge Mota Copyright © 2013 Pedro Silva et al. All rights reserved. A Meta-Analysis of Soccer Injuries on Artificial Turf and Natural Grass Wed, 19 Jun 2013 08:22:25 +0000 The goal of this investigation was to determine if playing or training on third-generation artificial turf (AT) surfaces increases the incidence rate of injuries compared to natural grass (NG) surfaces. This was accomplished by a meta-analysis performed on previously published research. Eight studies met the criteria of competitive soccer players, participation on both surfaces, and presentation of both exposure time and injury occurrence. Exposure time and injury incidence values were used to generate injury rate ratios (IRRs, AT/NG) for all injuries as well as specific injuries. Subgroup analyses were also performed by condition (match or training), gender, and age (youth or adult). The overall IRR was 0.86 () suggesting a lower injury risk on AT than NG. However, there was considerable heterogeneity between studies. Analyses of individual injuries and subgroups found that in many cases IRR values were significantly less than 1.0. In no case was the IRR significantly greater than 1.0. Based on this, it appears that the risk of sustaining an injury on AT under some conditions might be lowered compared to NG. However, until more is known about how issues such as altered playing styles affect injury incidence, it is difficult to make firm conclusions regarding the influence of AT on player safety. Jay H. Williams, Emmanuel Akogyrem, and Jeremy R. Williams Copyright © 2013 Jay H. Williams et al. All rights reserved. The Relationship between Cortisol and Bone Mineral Density in Competitive Male Cyclists Wed, 29 May 2013 08:38:29 +0000 Objective. The purpose of this study was to determine whether race day cortisol was related to bone mineral density (BMD) in competitive male cyclists. A secondary purpose was to determine additional factors associated with BMD in competitive male cyclists. Methods. Measurements of lumbar spine and hip BMD were performed in 35 male competitors in a state championship cycling time trial event. Salivary cortisol was measured 10 minutes prior to the start of the race and 5 minutes after race finished. Participants reported daily calcium intake, age, years of bike training, races per season, and average weekly minutes spent riding a bike, weight training, and running on a survey. Results. Cortisol level increased significantly from pre- to postcompetition but was not significantly associated with BMD. Increased weekly minutes of weight training was associated with higher BMD of the lumbar spine and the hip. The increased number of years of cycling experience was associated with lower BMD of the femoral neck. Increased daily calcium intake was associated with higher BMD of the lumbar spine and femoral neck. Conclusions. Findings indicate that cyclists should participate in weight training and increase calcium intake in order to increase or maintain BMD of the lumbar spine and hip. Shannon L. Mathis, Richard S. Farley, Dana K. Fuller, Amy E. Jetton, and Jennifer L. Caputo Copyright © 2013 Shannon L. Mathis et al. All rights reserved. Shoulder Muscle Activation of Novice and Resistance Trained Women during Variations of Dumbbell Press Exercises Wed, 15 May 2013 14:12:34 +0000 Previous research has compared the effects of trunk inclination angle on muscle activation using barbells and Smith machines in men. Whether similar effects occur with the use of dumbbells or in women remains unknown. The purpose was to compare upper extremity surface electromyographical (EMG) activity between dumbbell bench, incline, and shoulder presses. Dominate arm EMG data were recorded for collegiate-aged female resistance trained individuals () and novice female resistance trained exercisers () from which average EMG amplitude for each repetition phase (concentric, eccentric) was computed. No significant differences were found between experienced and novice resistance trained individuals. For the upper trapezius and anterior deltoid muscles, shoulder press activation was significantly greater than incline press which in turn was significantly greater than bench press across both phases. The bench and incline presses promoted significantly greater pectoralis major sternal activation compared to the shoulder press (both phases). While pectoralis major clavicular activation during the incline press eccentric phase was significantly greater than both the bench and shoulder presses, activation during the bench press concentric phase promoted significantly greater activation than the incline press which in turn was significantly greater than the shoulder press. These results provide evidence for selecting exercises in resistance and rehabilitation programs. Joshua Luczak, Andy Bosak, and Bryan L. Riemann Copyright © 2013 Joshua Luczak et al. All rights reserved. Statins Attenuate the Increase in P-Selectin Produced by Prolonged Exercise Tue, 07 May 2013 11:24:31 +0000 Strenuous endurance exercise increases inflammatory markers and acutely increases cardiovascular risk; however, statins may mitigate this response. We measured serum levels of p-selectin in 37 runners treated with statins and in 43 nonstatin treated controls running the 2011 Boston Marathon. Venous blood samples were obtained the day before (PRE) as well as within 1 hour after (FINISH) and 24 hours after (POST) the race. The increase in p-selectin immediately after exercise was lower in statin users (PRE to FINISH: 20.5 ± 19.4 ng/mL) than controls (PRE to FINISH: 30.9 ± 27.1 ng/mL; ). The increase in p-selectin 24 hours after exercise was also lower in statin users (PRE to POST: 21.5 ± 26.6 ng/mL) than controls (PRE to POST: 29.3 ± 31.9 ng/mL; ). Furthermore, LDL-C was positively correlated with p-selectin at FINISH and POST ( and , resp.), irrespective of drug treatment, suggesting that lower levels of LDL-C are associated with a reduced inflammatory response to exercise. We conclude that statins blunt the exercise-induced increase in p-selectin following a marathon and that the inflammatory response to a marathon varies directly with LDL-C levels. Amanda Zaleski, Jeffrey Capizzi, Kevin D. Ballard, Christopher Troyanos, Aaron Baggish, Pierre D'Hemecourt, Paul D. Thompson, and Beth Parker Copyright © 2013 Amanda Zaleski et al. All rights reserved. Soccer and Sudden Cardiac Death in Young Competitive Athletes: A Review Tue, 26 Mar 2013 14:02:55 +0000 Sudden cardiac death (SCD) in young competitive athletes (<35 years old) is a tragic event that has been brought to public attention in the past few decades. The incidence of SCD is reported to be 1-2/100,000 per year, with athletes at a 2.5 times higher risk. Soccer is the most popular sport in the world, played by people of all ages. However, unfortunately it is cardiovascular diseases such as hypertrophic cardiomyopathy and arrhythmogenic right ventricular cardiomyopathy that have subtly missed screening and claimed the lives of soccer stars such as Marc Vivien Foe and Antonio Puerta during live action on the field and on an internationally televised stage. This paper covers the physiological demands of soccer and the relationship between soccer and SCD. It also reviews the most common causes of SCD in young athletes, discusses the current guidelines in place by The Fédération Internationale de Football Association (FIFA) for screening among professional soccer players, and the precautions that have been put in place to prevent SCD on the field in professional soccer. John P. Higgins and Aldo Andino Copyright © 2013 John P. Higgins and Aldo Andino. All rights reserved. Feasibility of an Isometric Maximal Voluntary Contraction Test in Hematological Cancer Patients during Thrombocytopenia Thu, 21 Mar 2013 15:14:25 +0000 Introduction. Resistance training is rarely offered to hemato-oncological patients in the daily clinical routine due to its potential harmful impact on the cardiovascular system and the long periods of thrombocytopenia experienced by these patients. Therefore, it is important to determine a valid assessment to define and control resistance training. In this study, the feasibility of a maximal voluntary contraction (MVC) test was investigated in hemato-oncological patients. This inexpensive assessment may be a practicable alternative to the one repetition maximum test which is currently described as the gold standard. Methods. 29 hemato-oncological patients with platelet counts between 30000/μL and 70000/μL were recruited for this pilot study. Complications like petechial bleedings, muscle convulsion, and pain were assessed using the Brief Pain Inventory before and 48 hours after the MVC test, which was performed unidirectionally for the quadriceps muscle. Results. We did not detect any statistically significant test-related exacerbations or pain development. Discussion. MVC testing seems to be a feasible method to control a resistance training program in hemato-oncological patients. Further studies need to extend their methods and, for example, compare the MVC test with the one repetition maximum test. Philipp Zimmer, Freerk T. Baumann, Janis Ebel, Eva Maria Zopf, Wilhelm Bloch, and Thomas Elter Copyright © 2013 Philipp Zimmer et al. All rights reserved.