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The effect of expertise in gymnastics on postural control.

The goal of this paper was (1) to investigate if gymnasts have a more stable standing posture than experts in other sports, and (2) to determine how much gymnasts are affected by the removal of vision in different postural tasks. Six expert gymnasts and six experts in other non-gymnastic sports were asked to maintain balance in three standing postures of increasing difficulty: bipedal, unipedal, and unipedal + unstable support (i.e. 7 cm thick foam surface). Each posture was tested successively with and without vision. Based on the displacement of the center of pressure (range and mean average speed), the results showed that when visual cues were available, postural sway increased with the difficulty of the task, but both groups had comparable performance in all the tasks. When vision was removed, although both groups demonstrated larger postural sway in the unipedal tasks, this effect was less accentuated for the gymnasts. We concluded that gymnasts are able to use the remaining sensory modalities to compensate for the lack of vision in unstable postures.

Adult↗

Nutritional status of young female elite gymnasts.

The purpose of this study was to evaluate the nutritional status of a group of 10 young female elite gymnasts aged 13-17 years, who do a physical exercise of 48 h/wk. Assessment included dietary intake for 7 days, body mass index, ideal body weight, and skinfold thickness. In addition, the number of total leukocytes, total lymphocytes and lymphocyte subsets CD2, CD3, CD4, CD8, CD19 and CD56 were counted. The results were compared with a control group consisting of 50 volunteer students doing less than 12 h/wk of physical exercise, who were matched by sex, age, and sociocultural level. The total weekly calorie intake was lower in gymnasts than in controls; gymnasts showed a higher calorie intake from dietary protein together with a lower calorie intake from lipid and carbohydrate sources in comparison with controls. All the anthropometric parameters, except height which was not different in the two groups, were lower in gymnasts than in controls. The lymphocyte and leukocyte counts were also lower in gymnasts in relation to controls, except CD19 and CD56 subsets which were similar in both groups. It is suggested that gymnasts are at risk of malnutrition, which when compounded with intense physical exercise could lead to immunosuppression in these athletes.

Adolescent↗

Growth and pubertal development of young female gymnasts and swimmers: a correlation with parental data.

Whereas intensive and regular physical training is known to alter female reproductive function, its potential role in growth is still controversial. At the beginning of a longitudinal growth study of young elite female gymnasts (n = 34, 15-25 h/wk training) and moderately trained swimmers (n = 19, 5-15 h/wk), patterns of recalled parental growth and pubertal maturation were compared with those of parents of 25 sedentary school girls. These data were also correlated to the height, weight, pubertal development as well as adult height prognosis of their daughters. Bone age was estimated using the methods of Greulich-Pyle and Tanner (RUS score) and adult height prognosis using the methods of Bayley-Pinneau (BP), Roche-Wainer-Thissen (RWT), and Tanner et al. (TW2). Parents of gymnasts were significantly lighter (fathers: P = 0.027; mothers: P = 0.038) and shorter (fathers: P = 0.034; mothers: P less than 0.001) than those of swimmers and controls. Consequently, target heights of gymnasts were also significantly shorter (P less than 0.001). Recalled menarche occurred significantly later (P = 0.030) in mothers of gymnasts who, in turn, grow much alike their mothers. At the first visit, the gymnasts were shorter and lighter for age than swimmers and controls. Their bone age (11.0 +/- 1.3 years, mean +/- SD) was retarded (P less than 0.001) when compared with chronological age (12.6 +/- 1.2 years). Adult height prognosis was lower for gymnasts than for other girls (BP: P less than 0.001; RWT: P = 0.023, TW2: P less than 0.001), but adequate for target height range.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Determination by Skeleton↗

Skull bone mass deficit in prepubertal highly-trained gymnast girls.

It is known that impact loading sport can increase the bone mineral density in the stressed sites of the skeleton in athletes. However, non weight-bearing sites are seldom studied in healthy young girl athletes. In order to study the effects of a long term intensive training on the non-stressed region of the skeleton (skull), we investigated both highly-trained girl athletes, involved in sports requiring or not significant impact loading on the skeleton and a girl control group. Bone mineral content (BMC) and density (BMD) were measured in the whole body, at lumbar spine, femoral neck, trochanter, Ward's triangle, radius, head and ribs, in 60 prepubertal girls including 12 swimmers, 32 gymnasts and 16 controls. Measurements were made by DXA. There were no statistical differences between the groups as regards age, height, body weight, body mass index, lean tissue mass and dietary calcium intake. Mean BMD in gymnasts was statistically higher than in other groups for radius (p < 0.001), femoral neck (p < 0.05) and Ward's triangle (p < 0.05) while there was no difference between swimmers and controls. Head BMC was significantly lower in gymnasts compared to other groups (241.9+/-41 g vs. 285.8+/-34.7 g and 291.1+/-50.2 g respectively in swimmers and controls, p < 0.001). The same observation was made for head BMD (p < 0.01). When body weight was used as a covariant, the contribution of the head BMC to the whole body was significantly lower (p < 0.001) in gymnasts (24.97%) than in swimmers (27.88%) and controls (27.77%). When compared between groups, the slopes of the regressions for head/whole body BMC or BMD were significantly lower in gymnasts (p < 0.05) than in other groups. These data suggest that in prepubertal children the increased bone density induced by gymnastic training in the stressed sites of the body could be related to a decreased skull bone mass.

Bone Density↗

Resting metabolic rate and energy intake in female gymnasts, figure-skaters and soccer players.

We examined the hypothesis that lean female athletes, as compared to other female athletes and controls, have a greater deficit between reported energy intake (EI) and estimated energy expenditure (EE), and a reduction in resting energy expenditure adjusted to fat free and fat masses (REEADJ). The subjects were 12 gymnasts and figure-skaters (lean athletes), 12 soccer players (normal-weight athletes) and 10 normal-weight, untrained, controls. Body composition was calculated from a 3-compartment model (underwater weighing and dual energy x-ray absorptiometry). REE was assessed by indirect calorimetry. Physical activity and EI were estimated from 7-day records. EE was calculated using activity records and REE. REEADJ was similar in all groups (p > 0.05). EI was 8.29 (SD 1.84), 7.04 (SD 2.23) and 8.95 (SD 1.68) MJ.d-1 in controls, gymnasts and soccer players, respectively (p = 0.06). In gymnasts, reported EI was 3.19 (SD 2.63) MJ.d-1 lower than estimated EE. EI minus EE in controls was -0.18 (SD 1.80; different from gymnasts, p < 0.01) MJ.d-1, and in soccer players -0.47 (SD 1.89; different from gymnasts, p < 0.05) MJ.d-1. Low reported energy intake in gymnasts might reflect their attitudes on diet and body image.

Adolescent↗

Withdrawal predictors among physical and performance characteristics of female competitive gymnasts.

Future drop-outs (n = 27) and continuing (n = 41) female competitive gymnasts were compared with respect to their physical, performance and injury characteristics measured through a large battery of tests completed while they were participants in competition. Included were anthropometric variables, body composition and somatotype, strength, flexibility, endurance, power, speed and balance measurements, and previous injury information. Differences were examined through t-tests and through discriminant analyses of principal components. The results indicate that the drop-outs were as a group distinguishable from the continuing gymnasts: they were significantly older, taller and heavier which may account for the finding that they were significantly stronger, more powerful and faster, and had greater endurance. They also had a slightly more linear/ectomorphic physique with less muscularity, and performed better on most flexibility tests. Only in a gymnastic-specific flexibility variable did the continuing gymnasts out-perform the drop-outs. It was concluded that it was mainly the age factor, and presumably the social and psychological factors associated with it, that distinguished the future drop-outs from the continuing gymnasts, and that factors related to the physical make-up and performance capacities of gymnasts cannot readily predict withdrawal from the sport.

Adolescent↗

Level of gymnastic skill as an intrinsic constraint on postural coordination.

In this study, we considered the interacting effects of expertise in gymnastics, the type of support surface and the required frequency of head movement on the emergence of postural modes of coordination. A group of elite female gymnasts and a control group of non-gymnasts were asked to track the fore-aft motion of a target with their heads. Two support surface conditions (a balance beam vs the floor) were crossed with four frequencies of target motion. The relative phase between the angular motion of the ankles and hips was analysed. Two stable patterns emerged: an in-phase mode and an anti-phase mode, with the hip-ankle relative phase close to 0 degrees and 180 degrees, respectively. Increasing target frequency produced a change from in-phase to anti-phase coordination, in conditions where no instructions were given to the participants (Experiment 1) as well as in those where participants were instructed to maintain an in-phase mode for as long as possible (Experiment 2). This change, however, occurred earlier for the non-gymnasts than for the gymnasts. We conclude that 0 degrees and 180 degrees are two stable postural coordination modes, that expertise in gymnastics leads to a functional modification of existing patterns of coordination, and that expertise in general can be considered an intrinsic constraint on coordination.

Adaptation, Physiological↗

Low back pain in elite rhythmic gymnasts.

BACKGROUND: Rhythmic gymnastics is a sport that blends the athleticism of a gymnast with the grace of a ballerina. The sport demands both the coordination of handling various apparatus and the flexibility to attain positions not seen in any other sport. To attain perfection and reproducibility of their routines, the athletes must practice and repeat the basic elements of their routines thousands of times. In so doing, the athlete places herself at risk of a myriad of overuse injuries, the most common being low back pain. METHODS: To document the presence and severity of low back pain in elite rhythmic gymnasts, a prospective study of seven national team members was undertaken that documented injuries and complaints with daily medical reports over a 7-wk period. These findings were correlated with a retrospective review of 11 elite level gymnasts followed over a 10-month period whose complaints ultimately required evaluation by a physician. RESULTS: Eighty-six percent of the gymnasts in the prospective study complained of back pain at some point over the course of the study. The only injury recorded that required a time loss from sport was a low back injury. The most common complaint requiring a physician's evaluation was low back pain with the diagnoses varying from muscle strains to bony stress reaction or complete fracture of the pars inter-articularis (spondylolysis). No athlete had a spondylolisthesis or ruptured disk. Two had mild scolioses which did not appear to be associated with their low back pain. CONCLUSIONS: It would appear that rhythmic gymnasts are at relative increased risk of suffering low back complaints secondary to their sport.

Adolescent↗

Premenarcheal gymnasts possess higher bone mineral density than controls.

PURPOSE: The purpose of this study was to examine bone mineral density (BMD), body composition, dietary intake, physical activity, and energy expenditure (EE) in premenarcheal gymnasts (N = 16; age = 10.5 +/- 1.5 yr) in comparison to age- (+/- 0.35 yr), height- (+/- 2.6 cm), and weight- (+/- 1.5 kg) matched controls (N = 16; age = 10.5 +/- 1.3 yr). It was hypothesized that premenarcheal gymnasts would have higher BMD, fat-free soft tissue (FFST) mass, physical activity, and EE, but lower fat mass, percent body fat, and dietary intake than controls. METHODS: Dual energy x-ray absorptiometry was used to measure whole body, femur, and lumbar spine (L1-4) BMD, FFST, and fat mass. Three-day diet records were used to estimate mean daily dietary energy, macronutrient, and calcium intakes. Physical activity and EE were estimated by the Seven-Day Physical Activity Recall. RESULTS: The BMD means of the gymnasts were significantly higher (P < 0.05) than controls at all sites, except whole body, as were lumbar spine and femoral neck bone mineral apparent densities, despite lower protein intake expressed per kg FFST mass. Fat mass was significantly lower in gymnasts versus controls (P < 0.01) as was percent body fat (P < 0.001). Very hard physical activity during weekdays (P < 0.0001) and estimated EE (P < 0.01) were significantly higher in gymnasts compared with controls. CONCLUSION: Premenarcheal gymnasts have higher BMD than age-, height-, and weight-matched controls.

Absorptiometry, Photon↗

A nutrition study in juvenile elite gymnasts.

Twenty-two female teenagers engaged in elite gymnast training and 22 healthy girls of comparable age were studied with regard to nutritional intake. The mean daily intakes of most nutrients in both groups were in accordance with the Swedish Nutritional Recommendations; exceptions were iron and dietary fibre which were too low in both groups. The individual variation was large in both groups and many subjects had an intake below the nutritional recommendations. Both the gymnasts and the reference group had an energy intake significantly below the estimated energy need. The mean daily energy intake was 725 kcal less than the energy need in the gymnast group and 450 kcal less in the reference group. The clinical investigation revealed that several gymnasts had delayed menarche or irregular menstruation as well as less body fat than the reference group. Among the gymnasts, girls with a regular menstrual pattern had more body fat than those who had not started to menstruate. The higher energy expenditure of the gymnasts could partly explain their smaller amounts of body fat, late pubertal development and menstrual patterns.

Adipose Tissue↗

Injury prediction in female gymnasts.

In order to identify injury-proneness in female competitive gymnasts, 20 measures of flexibility, hypermobility, spinal posture and anthropometry were performed on 40 competitive gymnasts and injury scores were derived from the severity and extent of previous gymnastic injury and inherent hypermobility traits. Results were compared between contrasting groups of "low" and "high" injury gymnasts respectively (both N = 10). Nine variables demonstrated significant differences between the "low" and "high" injury risk status groups namely, weight (p less than 0.001), height (p less than 0.001), age (p less than 0.001), mesomorphy (p less than 0.01), Quetelet Index (p less than 0.01), shoulder flexion (p less than 0.05) and lumbar extension (p less than 0.05), standing lumbar curvature and total peripheral flexibility score (both p less than or equal to 0.05). Multiple regression analysis was applied to determine the relative contribution of these variables to the estimation of injury-proneness as evidenced by previous history of injury and hypermobility traits. Using 9 independent variables, multiple regression yielded a multiple correlation coefficient (R) = 0.840, accounting for over 70% of the observed variance (R2 = 0.706) in injury scores among the total group of gymnasts. However, a subset of five variables, (weight, mesomorphy, standing lumbar curvature, age and height) yielded a multiple correlation coefficient (R) = 0.834 accounting for almost 70% of the observed variance (R2 = 0.696). This was not significantly different from the larger subset. Using injury classification system of "low", "medium", and "high" risk categories, comparisons were made between predicted and observed injury scores in the respective risk categories. In "high" risk and "low" risk gymnasts, injury scores could be classified correctly with 70% and 79% accuracy respectively, so that relative risk status could be determined from simple physical tests which may be employed by practitioners in the field.

Adolescent↗

Do team gymnasts compete in spite of symptoms from an injury?

BACKGROUND: Gymnasts practise many hours a week, and symptoms from injuries do not seem to stop them from continuing with practice. They may even compete with symptoms from injuries, which could increase the risk of reinjury, or of the occurrence of a more severe injury. OBJECTIVES: To investigate whether team gymnasts compete at high level in spite of symptoms from an injury. METHODS: 188 male and female competitors participating in the Swedish Cup for juniors and seniors answered a questionnaire about symptoms from injuries on the day of the competition. RESULTS: More than half the gymnasts (58%) competed despite having symptoms from an injury on the day of the competition. More seniors than juniors competed in spite of symptoms from an injury (p = 0.006). Two of three team gymnasts (65%) reported symptoms from the lower extremities and around one in five (22%) reported back symptoms. Fifty five per cent of the gymnasts reported recurrence of an injury at the same site (reinjury). CONCLUSIONS: There was a high prevalence of symptoms from injuries on the day of competition. This did not stop the team gymnasts from competing.

Adolescent↗

Effect of active and passive recovery on blood lactate and performance during simulated competition in high level gymnasts.

The purpose of this study was to investigate the effect of two recovery strategies between men's gymnastics events on blood lactate removal (BL) and performance as rated by expert "blind" judges. Twelve male gymnasts (21.8 +/- 2.4 years) participated. The sessions were composed of routine performances in the six Olympic events, which were separated by 10 min of recovery. All gymnasts performed two recovery protocols between events on separate days: Rest protocol, 10 min rest in a sitting position; Combined protocol, 5 min rest and 5 min self-selected active recovery. Three blood samples were taken at 2, 5, and 10 min following each event. Gymnasts produced moderate values of BL following each of the six events (2.2 to 11.6 mmol.L-1). There was moderate variability in BL values between events that could not be accounted for by the athlete's event performance. Gymnasts showed higher BL concentration (p > .05) and significantly (p < .05) higher scoring performances (as rated by a panel of certified judges) when they used a combined recovery between gymnastics events rather than a passive recovery (delta BL = 40.51% vs. 28.76% of maximal BL, p < .05, and total score = 47.28 +/- 6.82 vs. 38.39 +/- 7.55, p < .05, respectively).

Adult↗

Wrist pain, distal radial physeal injury, and ulnar variance in young gymnasts: does a relationship exist?

BACKGROUND: Chronic wrist pain affects up to 79% of young gymnasts. Distal radial growth plate injury and positive ulnar variance have also been reported in this population. HYPOTHESIS: There is a relationship between wrist pain, radiographic findings of distal radial growth plate injury, and ulnar variance in skeletally immature young gymnasts. STUDY DESIGN: Cross-sectional study. METHODS: Fifty-nine gymnasts (28 girls and 31 boys; average age, 9.3 years) completed a questionnaire detailing training and wrist pain symptoms. Each received a wrist examination, grip strength measurement, and bilateral wrist radiographs. RESULTS: Wrist pain was reported by 56% of the gymnasts (33 of 59), with 45% (15 of 33) describing pain of at least 6 months' duration. Factors significantly associated with wrist pain included higher skill level, older age, and more years of training. For those between 10 and 14 years of age, 83% had wrist pain, compared with 44% for those outside of that age range. Fifty-one percent of the gymnasts (30 of 59) had findings of stress injury to the distal radial physis of at least a grade 2; 7% (4) had frank widening of the growth plate. Wrist pain prevalence was significantly related to the grade of radiographic injury. Mean ulnar variance was significantly more positive than established norms. Ulnar variance was not associated with wrist pain or radiographic injury of the distal radial physis. CONCLUSIONS: Radiographic findings of distal radial physeal injury are associated with wrist pain among young nonelite gymnasts.

Adolescent↗

Disc degeneration in young gymnasts. A magnetic resonance imaging study.

Magnetic resonance imaging (MRI) was performed on 35 young competitive gymnasts and 10 control subjects in order to detect the number of degenerated discs and other lumbar spinal disorders. Lumbar radiographs were obtained from all gymnasts who showed evidence of disc abnormality on MRI. Eleven gymnasts had suffered from episodes of low back pain during exercises and eight were found to have evidence of back trauma. Only 3 of the 35 gymnasts had MRI evidence of degenerated discs associated with Scheuermann's manifestations and spondylolysis. Lumbar radiographs confirmed the diagnosis in these three cases. The results indicate that despite the excessive range of motion and strong axial loading of the lumbar spine that are associated with gymnastic maneuvers, incurable primary damage to the intervertebral discs is uncommon in young gymnasts during growth.

Adolescent↗

Distal radial growth plate injury and positive ulnar variance in nonelite gymnasts.

To assess the prevalence of stress injury to the distal radial growth plate and of positive ulnar variance in a nonelite gymnast population, we administered a radiographic survey and questionnaire to 44 skeletally immature nonelite gymnasts (27 girls and 17 boys). The subjects trained an average of 11.9 hours per week. Radiographic findings consistent with stress injury of the distal radial physis were found in 25% (11 of 44) of participants. Ulnar variance was found to be more positive in the gymnasts when compared with age-predicted norms. An average side-to-side difference in ulnar variance of 0.9 mm was observed. Radiographic findings of stress injury to the growth plate and the amount of ulnar variance were not associated with age, sex, training intensity, wrist pain, height, or weight. There was also no significant relationship between ulnar variance and radiographic findings. The mean ulnar variance in nonelite gymnasts was between that measured for elite gymnasts and nongymnasts. These results indicate that stress injury of the distal radial growth plate occurs in a significant percentage of nonelite gymnasts. It also appears that ulnar variance is more positive than would otherwise be predicted, suggesting growth inhibition of the distal radius, a growth stimulation of the ulna, or a combination of both.

Adolescent↗

Proprioception of the ankle: a comparison between female teenaged gymnasts and controls.

Proprioceptive mechanisms appear to play a role in stabilizing the joints and may serve as a means for interplay between static stabilizers and dynamic muscular restraints. The purpose of our study was to investigate whether or not gymnastic training has any effect on the balance and on proprioception in an ankle, as seen in gymnasts and in nongymnasts. We evaluated the proprioceptive ability of the ankle using four different tests (a one-leg-standing test, a single-limb-hopping test, an active angle-reproduction test, and a passive angle-reproduction test). Proprioception of the ankle was measured in 40 subjects who were assigned to two experimental groups. Group 1 (n: 20) were healthy control subjects, and group 2 (n: 20) were teenaged female gymnasts. The sense of position of a joint was actively measured using a Cybex NORMTM isokinetic dynamometer and measured passively with a proprioception-testing device. A Mann-Whitney U test was used to compare mean values of the gymnasts to the controls. Results revealed statistically significant differences (p<0.05) between two groups. We found no statistically significant differences between the dominant and nondominant ankle in volunteers or in gymnasts, in all tests. The results of this study suggest that gymnastic training has a positive influence on sense of position of the ankle joint and on balance, in addition to increasing muscle tone.

Adolescent↗

Height velocity and skeletal maturation in elite female rhythmic gymnasts.

Rhythmic gymnasts performing under conditions of high intensity are exposed to particularly high levels of psychological stress and intense physical training, factors that can contribute to the observed delay in skeletal maturation and pubertal development, and alter optimal growth. The study was conducted in the field, during the International, European, and World Rhythmic Sports Gymnastics Championships of the years 1997-2000, and included 104 elite female rhythmic gymnasts, aged 12-23 yr. The study included height and weight measurements, estimation of body fat and skeletal maturation, and registration of parental height. Height, weight, target height, and predicted adult height were expressed as the SD score of the mean height and weight for age, according to Tanner's standards. Gymnasts were taller and thinner than average for age, with height velocity SD score for each age group above the 50th percentile for all age groups (n = 140, mean = 1.9 +/- 2.5). Interestingly, although height velocity in normal girls comes to an end by the age of 15, in our examined rhythmic gymnasts it continues up to the age of 18. There was a delay of skeletal maturation of 1.8 yr (n = 72, r = 0.730, P < 0.001), compensated by an acceleration of height velocity toward the end of puberty. The final adult height was identical to the estimated predicted height at first evaluation, and significantly higher than the genetically determined target height (n = 35, r = 0.58, P < 0.001), denoting that genetic predisposition to final height is not only achieved, but even exceeded. Using multiple regression analysis, target height was the only independent parameter that has been proven to influence positively the height velocity SD score (b = 0.233, t = 2.215, P = 0.029), denoting that genetic predisposition remains the main driving force for the observed efficient catch up growth. In conclusion, the elite rhythmic gymnasts compensate for their loss of pubertal growth spurt by a late acceleration of linear growth. Despite the delay in skeletal maturation, genetic predisposition of growth is not only preserved, but even exceeded.

Adolescent↗