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Biomedical subjects

U M Kujala

Publications and source records attributed to U M Kujala.

At least 37 records · Page 2Linked to original sources
PubMed1999

QT interval and QT dispersion in endurance athletes and in power athletes using large doses of anabolic steroids.

We measured electrocardiographic repolarization indexes in athletes. Physiologic adaptive cardiac hypertrophy did not increase QT dispersion in endurance athletes despite long QT intervals due to increased vagal tone. In contrast, power athletes taking large doses of anabolic steroids had increased QT dispersion despite short QT intervals, which seems to reflect altered myocardium in the hypertrophied heart.

Adrenal Cortex Hormones↗
PubMed1999

Jumping height in former elite athletes.

To evaluate lower-limb explosive strength with respect to lifetime athletic activity, we measured vertical jumping height on a contact mat in former male runners (n = 28). soccer players (n = 31), weightlifters (n = 29) and shooters (n = 29) (age range 45 68 years). There were no statistically significant age-adjusted sport-group differences in jumping height, but differences by sport were evident among the subgroup of athletes without hip or knee osteoarthritis (n = 65) (P < 0.05). Thus, sports that increased jumping height also predisposed to lower-limb osteoarthritis. After adjustment for age and sport, the subjects without osteoarthritis jumped higher than those with osteoarthritis (n = 33) (P < 0.01). In a multiple linear regression analysis, age, reported hip and knee disability, and knee pain reduced jumping height. Hours spent in team-training during the past 12 months and the hours spent during their lifetime in power training were associated with improved vertical jumping height and together explained 41% of the difference among the subjects. The ability to jump even among athletes with hip or knee osteoarthritis would suggest that former elite athletes possess advanced lower limb muscle function.

Aged↗
PubMed1999

Prolonged low-back pain in young athletes: a prospective case series study of findings and prognosis.

We investigated the prognosis of low-back pain and the association of clinical symptoms and anatomic findings among young athletes. Consecutive patients, aged between 12 and 18 years, who had low-back pain that had interfered with their training for at least 4 weeks were included in the case series. All the patients participated in a standardized interview and clinical examination, and plain radiographs and magnetic resonance images were also obtained. Most patients also participated in technetium bone scan examination. In 15 out of 19 subjects there were anatomic abnormalities that corresponded with the location and type of clinical symptoms. Twelve subjects had changes in the disk-vertebral end plate complex and eight had a positive bone scan indicative of posterior vertebral arch stress reaction. Six out of eight boys and two out of 11 girls had stress reaction (P = 0.043). Restriction of painful activities was recommended to all subjects, restriction of activities and the use of a dynamic low-back brace for the first 3 months was recommended to patients with posterior vertebral arch stress reaction. The self-reported intensity of low-back pain (scale 0-100) among all the patients was 69 +/- 16 (mean +/- SD) at baseline and 18 +/- 21 at the 1-year follow-up (P < 0.0001). In conclusion, the reasons for prolonged back pain among young athletes are usually established by imaging studies. A knowledge of anatomic abnormalities may help in tailoring training programmes and avoiding the progression of changes during growth. Simple restriction of painful activities usually leads to good recovery.

Adolescent↗
PubMed1999

Angiotensinogen gene M235T polymorphism predicts left ventricular hypertrophy in endurance athletes.

OBJECTIVES: We studied whether left ventricular mass in athletes associates with polymorphisms in genes encoding components of the renin-angiotensin system. BACKGROUND: Adaptive left ventricular hypertrophy is a feature of the athlete's heart. However, similarly training athletes develop left ventricular mass to a different extent, suggesting that genetic factors may modulate heart size. METHODS: We measured left ventricular mass by echocardiography in 50 male and 30 female elite endurance athletes aged 25 +/- 4 (mean +/- SD) years. Deoxyribonucleic acid samples were prepared for genotyping of angiotensinogen (AGT) gene M235T polymorphism, angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism and angiotensin II type 1 receptor (AT1) gene A1166C polymorphism. RESULTS: The AGT gene M235T genotypes were significantly associated with left ventricular mass independently of blood pressure in both genders (p = 0.0036 for pooled data). TT homozygotes had greater mass compared with MM homozygotes in both men (147 +/- 12 g/m vs. 132 +/- 15 g/m, p = 0.032) and women (121 +/- 12 g/m vs. 101 +/- 13 g/m, p = 0.019). There was a gender difference in the relation between myocardial mass and AGT genotype, MT heterozygotes resembling MM homozygotes among women and TT homozygotes among men. The other studied gene polymorphisms were not associated with left ventricular mass. CONCLUSIONS: Angiotensinogen gene M235T polymorphism is associated with the variability in left ventricular hypertrophy induced by endurance training, with athletes homozygous for the T allele having the largest hearts. We found no association between ACE gene I/D or AT1 gene A1166C polymorphisms and left ventricular mass.

Adaptation, Physiological↗
PubMed1999

Spinal cord injuries in ice hockey in Finland and Sweden from 1980 to 1996.

Traumatic spinal cord injury (SCI) in the cervical or thoracic region is one of the most catastrophic types of sport injuries. This study was designed to determine incidence and mechanisms of major SCI in ice hockey in Finland and Sweden from 1980 to 1996 in order to find possibilities for prevention. Retrospective analysis of injury occurrence were carried out. Medical case records were reviewed and injured players were interviewed to complete the data. From 1980 to 1996, there were 16 accidents involving spinal cord injury with permanent disability. All players were male. The mean age was 21.1 years (range = 14 to 33 yr). In 50% of the cases the mechanism was body checking from behind and a blow to the head from the boards. In 69% of the cases the vertebral injury was fracture or/and luxation between C5 and C7. The neurological endstate was tetraplegia/paresis in 10 cases and paraplegia/paresis of the lower extremities in 6 cases. Ice hockey is one of the most popular sports in Europe, and the number of participants is still increasing. The typical mechanism in SCI is body checking from behind, falling down and a head-first blow from the boards. These serious injuries may be prevented by changing the rules (banning body checking near the boards) with strict refereeing and education of trainers and players.

Adolescent↗
PubMed1999

Heart attacks and lower-limb function in master endurance athletes.

PURPOSE: Whether very vigorous physical activity bestows on the participant more health benefits or more adverse effects is unclear: we investigated whether men participating in competitive endurance sports in middle and old age are at increased risk of heart attacks as well as of lower-limb osteoarthritis and disability. METHODS: In our cohort study with an 11-yr follow-up, we studied 269 male orienteering runners (mean age 48.6 yr at baseline; range 37-61), who in 1984 were placed among the 60 best in their master orienteer age-class in Finland, and 188 male nonsmoking controls (mean age 50.4 yr; range 39-61) classified as healthy at 20 yr of age and without overt ischemic heart disease up until 1985. We followed mortality and studied the prevalence of questionnaire-reported physician-diagnosed diseases and disabilities at the end of the follow-up in late 1995. RESULTS: Two (0.7%) of the 269 runners and 10 (5.3%) of the 188 controls had suffered myocardial infarctions during the follow-up, the age-adjusted odds ratio (95% confidence interval) being 0.15 (0.03-0.67) in runners compared with controls (P = 0.0059). At follow-up, orienteering runners reported knee osteoarthritis and knee pain more often than did the controls, whereas the occurrence of hip osteoarthritis and hip pain did not differ. Disability due to hip or knee pain after the same everyday activities tended to be less in the runners. CONCLUSION: In top-level master endurance athletes having a long-term training background and participating in competitive endurance sports, the risk both of heart attack and of lower-limb disability is low.

Adult↗
PubMed1999

Leisure physical activity and various pain symptoms among adolescents.

OBJECTIVES: To investigate the association between leisure physical activity and various pain symptoms in adolescents. METHODS: In this nationwide cohort based cross sectional study in Finland, 698 schoolchildren, 344 girls and 354 boys, aged 10 to 17 years responded to a questionnaire on pain symptoms (neck and shoulder pain, upper back pain, low back pain, upper limb pain, lower limb pain, headache, and abdominal pain) and physical activity habits and also participated in a fitness test. RESULTS: Reported physical activity correlated with measured fitness. Musculoskeletal pains (p = 0.013) (in particular low back pain (p = 0.022), upper limb pain (p<0.001), and lower imb pain (p<0.001)) were found more often in subjects participating in large amounts of leisure physical activity, while non-musculoskeletal pains (p = 0.065) (in particular headache among boys (p = 0.004)) tended to be less common. Co-occurrence of different musculoskeletal pains was common in subjects participating in sports. CONCLUSIONS: In addition to its likely long term health benefits, vigorous physical activity causes musculoskeletal pains during adolescence. This should be considered when tailoring health promotion programmes to adolescents. Also, co-occurrence of musculoskeletal pains may occur as the result of sports activity, which should be considered as a confounder in epidemiological studies on fibromyalgia and related issues.

Adolescent↗
PubMed1999

Joint-specific twin and familial aggregation of recalled physician diagnosed osteoarthritis.

In our three-stage questionnaire study we investigated patterns of twin and familial aggregation of osteoarthritis (OA) for commonly affected joints. The baseline questionnaire study of the Finnish Twin Cohort was performed in 1975. In 1990, 4095 twin pairs of the same gender born 1930-1957 responded to a questionnaire and reported whether they had OA diagnosed by a physician. In 1996 both twins of 266 pairs of which at least one had reported OA in 1990 responded to a detailed questionnaire on joint-specific OA, including family history of OA. In male pairs shared (non-genetic) familial effects accounted for 37% of the total variance in liability to OA and unshared environmental effects for 63%. In female pairs additive gene effects explained 44% of the variance in liability to OA, and unshared environmental effects for 36%. Familial aggregation of finger and knee OA was clearly higher than that of hip OA. Twin-pair discordance for OA was, to some extent, associated with body-mass index, occupational loading and trauma. Our results indicate that genetic effects may be modulated by sex or by environmental factors distributed differently between men and women. Based on our joint-specific data finger and knee joints are the most optimal targets for studies of genetic factors predisposing to the development of OA.

Adult↗
PubMed1999

Future hospital care in a population-based series of twin pairs discordant for physical activity behavior.

OBJECTIVES: This study investigated the association between physical activity behavior and morbidity, taking into account genetic selection. METHODS: Hospitalizations were followed from the beginning of 1977 to the end of 1986 in 710 same-sex healthy twin pairs discordant for leisure-time physical activity and in 151 pairs discordant for all physical activity at base-line in 1975. RESULTS: During the follow-up, among twin pairs discordant for leisure activity, the active member spent, on average, 43% fewer days in the hospital than the inactive member; the corresponding percentage was 55% among pairs discordant for all activity. CONCLUSIONS: Physically inactive behavior is associated with increased need for hospital treatments, even after genetic and other confounding factors are taken into account.

Adult↗
PubMed1998

Relationship of leisure-time physical activity and mortality: the Finnish twin cohort.

CONTEXT: Physical activity and fitness are believed to reduce premature mortality, but whether genetic factors modify this effect is not known. OBJECTIVE: To investigate leisure physical activity and mortality with respect to familial aggregation of health habits during childhood and factors that may enable some individuals to achieve higher levels of fitness. DESIGN: Prospective twin cohort study. SETTING: Finland. SUBJECTS: In 1975, at baseline, 7925 healthy men and 7977 healthy women of the Finnish Twin Cohort aged 25 to 64 years who responded to a questionnaire on physical activity habits and known predictors of mortality. Those who reported exercising at least 6 times per month with an intensity corresponding to at least vigorous walking for a mean duration of 30 minutes were classified as conditioning exercisers, those who reported no leisure physical activity were classified as sedentary, and other subjects were classified as occasional exercisers. MAIN OUTCOME MEASURES: All-cause mortality and discordant deaths among same-sex twin pairs from 1977 through 1994. RESULTS: Among the entire cohort, 1253 subjects died. The hazard ratio for death adjusted for age and sex was 0.71 (95% confidence interval [CI], 0.62-0.81) in occasional exercisers and 0.57 (95% CI, 0.45-0.74) in conditioning exercisers, compared with those who were sedentary (Pfor trend <.001). Among the twin pairs who were healthy at baseline and discordant for death (n=434), the odds ratio for death was 0.66 (95% CI, 0.46-0.94) in occasional exercisers and 0.44 (95% CI, 0.23-0.83) in conditioning exercisers compared with those who were sedentary (P for trend, .005). The beneficial effect of physical activity remained after controlling for other predictors of mortality. CONCLUSION: Leisure-time physical activity is associated with reduced mortality, even after genetic and other familial factors are taken into account.

Adult↗
PubMed1998

Back extensor and psoas muscle cross-sectional area, prior physical training, and trunk muscle strength--a longitudinal study in adolescent girls.

The association between physical training, low back extensor (erector spinae plus multifidus muscles) and psoas muscle cross-sectional areas (CSA) and strength characteristics of trunk extension and flexion were studied in adolescent girls. A group of athletes (n = 49) (age range 13.7-16.3 years) consisting of gymnasts, figure skaters and ballet dancers was age-matched with non-athletes (n = 17) who acted as a sedentary control group. The CSA of psoas muscles and multifidus plus erector spinae muscles were measured from lumbar axial images by magnetic resonance imaging. Maximal trunk extension and flexion forces were measured in a standing position using a dynamometer and trunk musculature endurance was evaluated using static holding tests. When CSA were adjusted with body mass, the athletes showed significantly greater CSA in both muscles studied (psoas P < 0.001; erector spinae plus multifidus P < 0.05) than the non-athletes. The athletes also had a greater absolute psoas muscle CSA (P < 0.01) and trunk flexion force (P < 0.01) compared to the controls. When the forces were expressed relative to body mass, the athletes were superior both in trunk flexion (P < 0.001) and extension (P < 0.001). There was a significant correlation between muscle CSA and strength parameters, but the force per muscle CSA did not differ significantly between the athletes and the non-athletes. In addition, the athletes showed a better body mass adjusted muscle endurance in trunk flexion (P < 0.05) than the non-athletes. Our study indicated that regular physical training enhances trunk musculature hypertrophy, force and endurance in adolescent girls, and that there is an association between muscle CSA and strength parameters.

Adolescent↗
PubMed1998

Fasciotomy of the posterior femoral muscle compartment in athletes.

Over a period of 13 years fasciotomy was performed on 46 athletes with chronic pain located at the posterior femoral muscle compartment. The patients could be divided, according to the etiology, in two groups: exertion (26 patients) and trauma (20 patients). In the first group the symptoms appeared without any sudden trauma and most of the athletes competed in endurance sports (e.g. 16 long distance runners). In the second group there was a history of hamstring muscle rupture or recurrent injuries. The symptoms were dull pain, stiffness, cramps and weakness of the posterior thigh during and after training. Conservative treatment methods did not help to eliminate the symptoms during a long preoperative follow-up period. Posterior fasciotomy (minimum 20 cm) to the thigh was performed through one or two incisions. In four patients a simultaneous liberation, division or suturation of the muscle scar was done. The patients were followed up for 19 months and the results of the fasciotomy were good or excellent in 39 cases. Pain at the posterior thigh muscle compartment may sometimes become chronic and hamper the training of athletes. Fasciotomy seems to be an effective method to help these patients return to their previous level of sports.

Adolescent↗
PubMed1998

Hypertension in master endurance athletes.

OBJECTIVE: To determine whether long-term very vigorous endurance training prevents hypertension. DESIGN: Cohort study of master orienteering runners and controls. SETTING: Finland. SUBJECTS AND METHODS: In 1995, a health questionnaire was completed by 264 male orienteering runners (response rate 90.4%) who had been top-ranked in competitions among men aged 35-59 years in 1984, and by 388 similarly aged male controls (response rate 87.1%) who were healthy at the age of 20 years and free of overt ischemic heart disease in 1985. MAIN OUTCOME MEASURE: Self-report of medication for hypertension. RESULTS: In the endurance athlete group, the crude prevalence (8.7%) of subjects who had used medication for hypertension was less than a third of that in the control group (27.8%). Even after adjusting for age and body mass index, the difference between the groups was still significant (odds ratio for athletes 0.43, 95% confidence interval 0.25-0.76). CONCLUSIONS: Long-term vigorous endurance training is associated with a low prevalence of hypertension. Some of the effect can be explained by a lower body mass, but exercise seems to induce a lower rate of hypertension by other mechanisms than by decreasing body weight

Aged↗
PubMed1998

Reduced oxidized LDL levels after a 10-month exercise program.

PURPOSE: We studied the effect of a 10-month exercise program on LDL oxidation and other lipid risk factors in 34 sedentary men and 70 women. We hypothesized that decreasing LDL oxidation by raising exercise activity would decrease the risk of atherosclerosis. METHODS: The men and women subjects had a mean (range) age of 43.6 (34-52) and 44.6 (31-58) yr, a body mass of 94.4 (78-144) and 77.6 (56-117) kg, a body mass index of 29.6 (24-44) and 28.6 (21-41), a body fat percentage of 20.4 (13-29) and 31.4 (16-39), and a maximal oxygen uptake of 33.3 (15-50) and 30.4 (18-49) mL.kg-1.min-1, respectively. We measured the baseline levels of conjugated dienes extracted from LDL (LDL-BDC) to assess the amount of circulating LDL oxidation products. The antioxidant potential of LDL samples was estimated in vitro by their potency to resist 2,2'-azobis(2-amidinopropane)HCl-induced peroxidation. The exercise program was tailored individually based on indirect measurement of VO2max at baseline. RESULTS: The mean time of exercise was 257 min.wk-1 for men and 209 min.wk-1 for women. Estimated VO2max increased by 19% during the exercise program in both men and women (both P < 0.0001). Concurrently, the concentration of HDL cholesterol increased by 15% in men (P = 0.0004) and 5% in women (P = 0.043) and that of LDL cholesterol decreased by 10% (P = 0.026) and 11% (P < 0.0001), respectively, whereas serum total cholesterol and triglyceride concentrations remained unchanged. The concentrations of LDL-BDC decreased by 23% (P = 0.0010) and 26% (P < 0.0001) and the ratio of LDL-BDC to LDL by 14% (P = 0.016) and 18% (P < 0.0001) in men and women. The ratio of LDL antioxidant potential to LDL rose by 16% (P = 0.011) and 11% (P = 0.0016), respectively. The mean weight loss during the exercise program was 2.9 kg in men and 1.8 kg in women (both P < 0.0001), whereas body fat percentage fell by 2.3% and 3.2%, respectively. CONCLUSIONS: In addition to increasing HDL cholesterol and decreasing LDL cholesterol, the exercise program is concluded to have improved the quality of the circulating LDL (less oxidized LDL), which may reduce the risk of atherosclerosis.

Adipose Tissue↗
PubMed1998

Chronic compartment syndrome of the quadriceps femoris muscle in athletes. Diagnosis, imaging and treatment with fasciotomy.

BACKGROUND AND AIMS: Chronic quadriceps femoris muscle compartment syndrome is described. MATERIAL AND METHODS: Over a 13 year period nine patients were diagnosed, treated surgically by fasciotomy and followed up at a referral center specialized in sports traumatology. There were four power lifters, three body builders, one endurance walker and one cyclist in the series. The use of anabolic steroids was admitted by four of the nine patients. The patients complained of gradually worsening pain on the anterolateral side of the thigh during training. Initially the pain appeared only at the end of the training session. As the syndrome became more severe, the pain began earlier during exercise and gradually became worse preventing maximal training. Skeletal radiographs and ultrasound examinations were normal, except in two patients, who had a positive echography finding with local atrophy. MRI examination confirmed the US diagnosis. RESULTS AND CONCLUSIONS: As conservative treatment did not provide relief of symptoms, a fasciotomy anterior to the iliotibial tract was performed bilaterally to seven patients and unilaterally to two patients. Biopsies from the atrophied sites showed muscle cell necrosis. All the patients recovered well after the surgery and were able return to their original level of sport. The only complication of surgery was a postoperative hematoma in one patient, which delayed the beginning of the training, but did not result in any persistent complaints.

Adult↗
PubMed1998

Effect of Elmslie-Trillat and Roux-Goldthwait procedures on patellofemoral relationships and symptoms in patients with patellar dislocations.

Seventeen patients (18 knees) with a history of one or more patellar dislocations underwent Elmslie-Trillat (9 knees [group 1]) or Roux-Goldthwait (9 knees [group 2]) patellar realignment surgery. Anterior knee pain was evaluated with a questionnaire, and lateral patellar displacement and tilt were analyzed by magnetic resonance imaging both pre- and postoperatively. Postoperative evaluations were performed after 44 and 50 months (mean) in groups 1 and 2, respectively. The Elmslie-Trillat procedure provided better subjective relief of anterior knee pain and symptoms. One redislocation occurred in each group. Both procedures relieved excessive patellar lateralization, but the effect on patellar tilt was less marked. In patients who underwent the Roux-Goldthwait operation, a less pronounced correction of tilt and lateralization appeared to correlate with more satisfactory subjective results.

Adolescent↗
PubMed1997

The prevalence of low back pain among children and adolescents. A nationwide, cohort-based questionnaire survey in Finland.

STUDY DESIGN: A nationwide, cohort-based cross-sectional questionnaire survey as a part of a population study. OBJECTIVES: To evaluate the prevalence of low back pain among Finnish children and adolescents. SUMMARY OF BACKGROUND DATA: Low back pain is common already in adolescence, but the results concerning sex differences and peak age of the prevalence have been partly controversial. Also, previous studies have been limited to smaller geographic areas. METHODS: The subjects were 594 girls and 577 boys, a total of 1171 children and adolescents. They were pupils of 45 different public schools. Various areas of Finland were included in the sampling process to represent different parts of the country and different living conditions. The subjects completed a validated questionnaire by themselves or with the help of a parent or guardian. The questionnaire was checked by a supervisor when entering the field study. The questionnaire included items that investigated the subjects' past and current low back pain. Low back pain was classified on the basis of timing, duration, and location. Subjects reporting pain in the low back area that interfered with school work or leisure activities during the previous 12 months were defined as having low back pain. RESULTS: The prevalence of back pain was low (1%) among the 7-year-old and 10-year-old (6%) schoolchildren, but increased with age, being 18% both among 14- and 16-year-old adolescents. No gender difference was found. Recurrent or chronic pain was reported by 26% of the boys and 33% of the girls who reported low back pain, and the proportion of recurrent and chronic pains of all low back pain incidents increased with age. CONCLUSIONS: Low back pain is a relatively common complaint at adolescence. In addition, a significant part of the pains are recurrent or chronic already with 14-year-old adolescents.

Adolescent↗