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PubMed2005

Endothelial flow-mediated dilatation and exercise capacity in highly trained endurance athletes.

Brachial artery ultrasound during reactive hyperemia is a noninvasive method of assessing peripheral endothelium-dependent vasodilatation. Aerobic exercise has the potential to improve local endothelial function. We sought to analyze the effects of regular aerobic training on brachial artery endothelial function in endurance athletes. We studied diameter and blood flow of the brachial artery in 32 endurance male athletes and 30 healthy male subjects. In the same subjects flow-mediated dilatation of the brachial artery was recorded by inducing an ischemia through a forearm arterial occluding cuff. Maximal oxygen consumption was significantly higher in the athletes group than in the controls (61.24 +/- 5.43 vs 44.49 +/- 2.68 ml/kg/min, p < 0.001). Flow-mediated dilatation of the brachial artery induced by forearm arterial occlusion in athletes was also higher than that of the control subjects (17.1 +/- 2.3 vs 11.2 +/- 1.7, p=0.002). Furthermore, there was an association between flow-mediated dilatation and VO2max (r=0.69, p < 0.001). Baseline measurements of the diameter and the blood flow volume of the brachial artery were similar in both groups. During reactive hyperemia period, the percent of the changes of endothelial diameters and flow were significantly higher in athletes than in controls. Higher flow-mediated dilatation levels in athletes reflect better vascular adaptation to habitual aerobic exercise.

Brachial Artery↗
PubMed2005

Optimum onset period for training based on maximum peak velocity of height by wavelet interpolation method in Japanese high school athletes.

The Wavelet Interpolation Method (WIM) was applied to the longitudinal records of individuals' heights and weights from 6 to 17 years of age (1983 to 1994) in an athlete group (male: 45, female: 50) and a control group (male: 85, female: 85). The criterion of maturity was derived from age at Maximum Peak Velocity (MPV) of height in the control group. Ages at MPV of height and weight were compared between the athletes and control subjects. The WIM was also applied to mean heights from 6.5 to 17.5 years of all the subjects classified by maturation rate in order to derive a model of growth velocity types. Among the athletes, the males were early-maturing and the females tended to be late-maturing. The difference between the ages at MPV of height and weight in males and females was less in the athletes group than in the control group. For the growth velocity model, in the athlete group, three types could be confirmed among the males, and five among the females. By making use of the type models, it was possible to clarify the spans of adolescence as classified by maturation rates, and it was concluded that the period following the age at MPV seems appropriate for the introduction of regular athletic training for each level of maturity.

Adolescent↗
PubMed1990

Common cutaneous disorders in athletes.

Athletic activity may cause or aggravate skin disorders, which in turn may diminish athletic performance. Since many sporting activities necessitate prolonged exposure to the sun, athletes must avoid painful sunburn which will adversely affect their performance. Drugs and chemicals also may cause photoallergic and/or phototoxic reactions, including polymorphous light eruption and athletes should thus avoid photosensitising drugs and chemicals. The effects of chronic ultraviolet exposure include ageing, pigmentation and skin cancers. The most effective protection against excessive exposure to sunlight is the use of sunscreens, although inadequate application and poor protection in the UVA spectrum may diminish their effectiveness and contact allergies may create other problems. Viral, bacterial and fungal infections are common in athletes due to heat, friction and contact with others. Herpes simplex may be treated with any drying agents (e.g. alcohol) as they are as effective as more expensive topical agents such as acyclovir. Molluscum contagiosum may be spread by close contact or water contact and is treated by superficial incision, cryotherapy or standard wart varnishes. Plantar wart infection is transmitted by swimming pool decks, changing rooms and hand-to-hand from weights in gymnasiums. Plantar warts presenting with pain may be aggressively treated, by blunt dissection, but painless ones are best treated conservatively. Impetigo and folliculitis often develop after trauma. Antibiotics are effective against mild infections while abrasions and lacerations should be cleansed and dressed with occlusive dressings. Diphtheroid bacteria in moist footwear may produce pitted keratolysis and erythrasma. Tinea pedis is common in athletes and probably originates in swimming pools, gymnasium floors and locker rooms. Interdigital, dry-moccasin and pustular-midsole forms can be distinguished. The latter two forms respond to topical antifungal agents, while the interdigital form, a mixed fungal/bacterial infection, is treated with debridement, antibiotics and drying routine similar to the therapy of otitis externa. Nail infections by a variety of organisms may appear as onycholysis with or without paronychia and should be treated with the appropriate antibiotics. Tinea versicolor occurs in heat and humidity. Since Pityrosporum orbiculare is part of the normal flora it often recurs, necessitating regular treatment. Acute trauma injuries include contusions, black heel or petichiae of the heel, black toe (bleeding under the nail), 'jogger's nipple' caused by chafing, and foot blisters. Chronic trauma may result in calluses, corns and paronychia. Plantar corns can be disabling and may be caused by overly tight shoes or abnormalities in biomechanics; treatment includes restoring normal foot function and minimal surgical procedures. Paronychia is treated best by wedge resection.(ABSTRACT TRUNCATED AT 400 WORDS)

Humans↗
PubMed1993

Bone mineral density and long term exercise. An overview of cross-sectional athlete studies.

Evidence in human studies of the association of long term habitual exercise with bone mineral content (BMC) and density (BMD) largely comes from studies in athletes. In young adults, the highest BMC and BMD values have been found in strength and power-trained athletes, while endurance activities such as long distance running and swimming seem less effective with regard to peak bone density. Intensive endurance training may even be associated with amenorrhoea and decreased trabecular bone density in young females. However, after menopause female athletes show greater bone mass indicating that they do not share the accelerated decline in BMC observed in a nonathletic population. Middle-aged and elderly male athletes from various sports have significantly higher BMC and BMD than controls, especially in trabecular bone sites, but higher cortical BMC has also been found in the dominant/nondominant arm comparisons with unilateral exercises such as tennis. The differences found between female athletes and controls have generally been less pronounced than those among men, but a number of studies suggest that in women long term physical training may counteract the low BMC and BMD associated with reduced bone mass. Although the interpretation of results of cross-sectional studies should be treated with caution, studies in athletes serve as an economical alternative approach to experimental trials with their long term follow-up and exercise compliance problems. The differences found in BMD between those who have devoted themselves to life-long training and those who have been much less active should not be underestimated.

Adult↗
PubMed1994

Infection in athletes.

Coaches and athletic team physicians have provided anecdotal information and case studies to support their beliefs that athletes may be unusually prone to illness during strenuous training or competition. Many athletes, in contrast, believe that physical activity improves their resistance to infectious disease. However, it is generally agreed that the stress of competition may make athletes temporarily more susceptible to infectious illness. A review of the literature shows that upper respiratory tract infections and skin infections are more prevalent in top level athletes than in the general population, particularly during periods of intensive training. Exercise induced changes occur in both the innate and adaptive components of the immune system; however, the relative importance of each component is unknown. Strenuous exertion and contact sports may compromise host defence both by reducing physical protection and by impairing immunosurveillance. Skin lacerations, vigorous sweating and maceration of the dermis impair the defence normally provided by the skin surface. In addition, adverse changes in soluble and cellular components of the immune system can increase susceptibility to infection. Persistence with strenuous training during an infectious illness can have deleterious effects; not only is athletic performance impaired, but the severity of the disease process can be augmented.

Exercise↗
PubMed1998

Electrocardiographic alterations associated with the hearts of athletes.

Physical conditioning induces numerous cardiovascular adaptations, including vagotonia and increased cardiac volume and mass. These adaptations characterise the 'athletic heart' and account for most of the normal variants in the athlete's electrocardiogram. Common alterations associated with vagotonia include sinus bradycardia, sinus arrhythmia, junctional escape beats, first degree atrioventricular block and second degree (Mobitz type I) atrioventricular block. Common electrocardiographic variants associated with increased cardiac mass and volume include increased voltage, prominent U waves, intraventricular conduction delays, early repolarisation and increased QT intervals. It is sometimes difficult to differentiate the healthy athlete with an athletic heart from the athletic patient with a diseased heart. Thus, further evaluation may be warranted, especially when the athlete also presents with hypertension and/or abnormalities of the cardiovascular physical examination.

Adaptation, Physiological↗
PubMed2001

Gambling as an addictive disorder among athletes: clinical issues in sports medicine.

This article examines the role of gambling as an addictive disorder experienced by athletes, both college and professional. Gambling may often be seen as a comorbid factor with other addictions and with depression among athletes. The focus on addictions among athletes has gained considerable attention among sports medicine clinicians. Diagnostic indicators, risk and protective factors, and a stage model of addiction among athletes are addressed. An algorithm and pathway of care for athletes with an addictive disorder is offered as are recommendations that sports physicians, sports medicine specialists, coaches and counsellors need to address athletes who have an addictive disorder.

Behavior, Addictive↗
PubMed2002

The scientific basis for high-intensity interval training: optimising training programmes and maximising performance in highly trained endurance athletes.

While the physiological adaptations that occur following endurance training in previously sedentary and recreationally active individuals are relatively well understood, the adaptations to training in already highly trained endurance athletes remain unclear. While significant improvements in endurance performance and corresponding physiological markers are evident following submaximal endurance training in sedentary and recreationally active groups, an additional increase in submaximal training (i.e. volume) in highly trained individuals does not appear to further enhance either endurance performance or associated physiological variables [e.g. peak oxygen uptake (VO2peak), oxidative enzyme activity]. It seems that, for athletes who are already trained, improvements in endurance performance can be achieved only through high-intensity interval training (HIT). The limited research which has examined changes in muscle enzyme activity in highly trained athletes, following HIT, has revealed no change in oxidative or glycolytic enzyme activity, despite significant improvements in endurance performance (p < 0.05). Instead, an increase in skeletal muscle buffering capacity may be one mechanism responsible for an improvement in endurance performance. Changes in plasma volume, stroke volume, as well as muscle cation pumps, myoglobin, capillary density and fibre type characteristics have yet to be investigated in response to HIT with the highly trained athlete. Information relating to HIT programme optimisation in endurance athletes is also very sparse. Preliminary work using the velocity at which VO2max is achieved (V(max)) as the interval intensity, and fractions (50 to 75%) of the time to exhaustion at V(max) (T(max)) as the interval duration has been successful in eliciting improvements in performance in long-distance runners. However, V(max) and T(max) have not been used with cyclists. Instead, HIT programme optimisation research in cyclists has revealed that repeated supramaximal sprinting may be equally effective as more traditional HIT programmes for eliciting improvements in endurance performance. Further examination of the biochemical and physiological adaptations which accompany different HIT programmes, as well as investigation into the optimal HIT programme for eliciting performance enhancements in highly trained athletes is required.

Adaptation, Physiological↗
PubMed2002

Blood lipids and lipoproteins in child and adolescent athletes.

The purpose of this review is to describe the age- and gender-associated variation in blood lipids of young athletes and examine the association between training status, peak oxygen consumption (VO(2peak)), and body fatness with blood lipids in young athletes. Results from cross-sectional studies suggest similar levels of total cholesterol (TC), lower levels of triglycerides (TG) and low-density lipoprotein-cholesterol (LDL-C), and higher levels of high-density lipoprotein-cholesterol (HDL-C) in young athletes compared with controls. Longitudinal data show that the age- and gender-associated variation in blood lipids in young distance runners is similar to youth in the general population; TC and LDL-C remain stable, HDL-C declines during adolescence (especially in males), and TG increases with age. Considerable heterogeneity exists in the blood lipids of young athletes, including dyslipidaemic values. Age, sexual maturity status, training status, VO(2peak) and body fatness are determinants of blood lipids in young athletes. VO(2peak) is a significant predictor of HDL-C independent of body fatness. Further research is warranted to examine: the prevalence rates of dyslipidaemia in various sport groups; and the complex interactions of genes, biological maturation, exercise training, dietary intake and composition, skeletal muscle and adipose tissue properties on lipoprotein metabolism in young athletes.

Adipose Tissue↗
PubMed2002

Hydration testing of athletes.

Dehydration not only reduces athletic performance, but also places athletes at risk of health problems and even death. For athletes, monitoring hydration has significant value in maximising performance during training and competition. It also offers medical personnel the opportunity to reduce health risks in situations where athletes engage in intentional weight loss. Simple non-invasive techniques, including weight monitoring and urine tests, can provide useful information. Bioimpedance methods tend to be easy to use and fairly inexpensive, but generally lack the precision and accuracy necessary for hydration monitoring. Blood tests appear to be the most accurate monitoring method, but are impractical because of cost and invasiveness. Although future research is needed to determine which hydration tests are the most accurate, we encourage sports teams to develop and implement hydration monitoring protocols based on the currently available methods. Medical personnel can use this information to maximise their team's athletic performance and minimise heat- and dehydration-related health risks to athletes.

Body Weight↗
PubMed2003

Allergic rhinoconjunctivitis in elite athletes: optimal management for quality of life and performance.

Allergic rhinoconjunctivitis is a common condition with a peak incidence in the age range of the majority of elite athletes. The condition has been shown to have a significant impact on the quality of life of those affected and poses particular challenges when present in the elite athlete. When an athlete is looking for exceptional performance at events such as the Olympic Games, any factor which affects quality of life by interfering with sleep, decreasing the ability to concentrate, or reducing peak physical fitness, may have a significant impact on the ability to perform at one's best. Optimal management begins with correct diagnosis and identification of triggering factors. There are a number of therapeutic options available to the treating physician. When formulating a management plan for the elite athlete, the physician must consider "doping" rules and the possible effect of medication on athletic performance. Medication choices include the newer, non-sedating antihistamines, used either orally or topically, and the prophylactic use of intranasal corticosteroids. When allergic conjunctivitis is the principal problem, the newer, topical antihistamines are highly effective and have a rapid onset of action. Since avoidance strategies are rarely practical for the athlete, consideration should be given to strategies such as immunotherapy, where long-term benefit is possible.

Acute Disease↗
PubMed2003

Heart rate variability in athletes.

This review examines the influence on heart rate variability (HRV) indices in athletes from training status, different types of exercise training, sex and ageing, presented from both cross-sectional and longitudinal studies. The predictability of HRV in over-training, athletic condition and athletic performance is also included. Finally, some recommendations concerning the application of HRV methods in athletes are made.The cardiovascular system is mostly controlled by autonomic regulation through the activity of sympathetic and parasympathetic pathways of the autonomic nervous system. Analysis of HRV permits insight in this control mechanism. It can easily be determined from ECG recordings, resulting in time series (RR-intervals) that are usually analysed in time and frequency domains. As a first approach, it can be assumed that power in different frequency bands corresponds to activity of sympathetic (0.04-0.15 Hz) and parasympathetic (0.15-0.4 Hz) nerves. However, other mechanisms (and feedback loops) are also at work, especially in the low frequency band. During dynamic exercise, it is generally assumed that heart rate increases due to both a parasympathetic withdrawal and an augmented sympathetic activity. However, because some authors disagree with the former statement and the fact that during exercise there is also a technical problem related to the non-stationary signals, a critical look at interpretation of results is needed. It is strongly suggested that, when presenting reports on HRV studies related to exercise physiology in general or concerned with athletes, a detailed description should be provided on analysis methods, as well as concerning population, and training schedule, intensity and duration. Most studies concern relatively small numbers of study participants, diminishing the power of statistics. Therefore, multicentre studies would be preferable. In order to further develop this fascinating research field, we advocate prospective, randomised, controlled, long-term studies using validated measurement methods. Finally, there is a strong need for basic research on the nature of the control and regulating mechanism exerted by the autonomic nervous system on cardiovascular function in athletes, preferably with a multidisciplinary approach between cardiologists, exercise physiologists, pulmonary physiologists, coaches and biomedical engineers.

Autonomic Nervous System↗
PubMed2004

Physiological changes associated with the pre-event taper in athletes.

Some of the physiological changes associated with the taper and their relationship with athletic performance are now known. Since the 1980s a number of studies have examined various physiological responses associated with the cardiorespiratory, metabolic, hormonal, neuromuscular and immunological systems during the pre-event taper across a number of sports. Changes in the cardiorespiratory system may include an increase in maximal oxygen uptake, but this is not a necessary prerequisite for taper-induced gains in performance. Oxygen uptake at a given submaximal exercise intensity can decrease during the taper, but this response is more likely to occur in less-skilled athletes. Resting, maximal and submaximal heart rates do not change, unless athletes show clear signs of overreaching before the taper. Blood pressure, cardiac dimensions and ventilatory function are generally stable, but submaximal ventilation may decrease. Possible haematological changes include increased blood and red cell volume, haemoglobin, haematocrit, reticulocytes and haptoglobin, and decreased red cell distribution width. These changes in the taper suggest a positive balance between haemolysis and erythropoiesis, likely to contribute to performance gains. Metabolic changes during the taper include: a reduced daily energy expenditure; slightly reduced or stable respiratory exchange ratio; increased peak blood lactate concentration; and decreased or unchanged blood lactate at submaximal intensities. Blood ammonia concentrations show inconsistent trends, muscle glycogen concentration increases progressively and calcium retention mechanisms seem to be triggered during the taper. Reduced blood creatine kinase concentrations suggest recovery from training stress and muscle damage, but other biochemical markers of training stress and performance capacity are largely unaffected by the taper. Hormonal markers such as testosterone, cortisol, testosterone : cortisol ratio, 24-hour urinary cortisol : cortisone ratio, plasma and urinary catecholamines, growth hormone and insulin-like growth factor-1 are sometimes affected and changes can correlate with changes in an athlete's performance capacity. From a neuromuscular perspective, the taper usually results in markedly increased muscular strength and power, often associated with performance gains at the muscular and whole body level. Oxidative enzyme activities can increase, along with positive changes in single muscle fibre size, metabolic properties and contractile properties. Limited research on the influence of the taper on athletes' immune status indicates that small changes in immune cells, immunoglobulins and cytokines are unlikely to compromise overall immunological protection. The pre-event taper may also be characterised by psychological changes in the athlete, including a reduction in total mood disturbance and somatic complaints, improved somatic relaxation and self-assessed physical conditioning scores, reduced perception of effort and improved quality of sleep. These changes are often associated with improved post-taper performances. Mathematical models indicate that the physiological changes associated with the taper are the result of a restoration of previously impaired physiological capacities (fatigue and adaptation model), and the capacity to tolerate training and respond effectively to training undertaken during the taper (variable dose-response model). Finally, it is important to note that some or all of the described physiological and psychological changes associated with the taper occur simultaneously, which underpins the integrative nature of relationships between these changes and performance enhancement.

Adaptation, Physiological↗
PubMed2005

Asthma, airway inflammation and treatment in elite athletes.

Highly trained athletes are repeatedly and strongly exposed to cold air during winter training and to many inhalant irritants and allergens all year round. Asthma occurs most commonly in athletes engaging in endurance events such as cross-country skiing, swimming, or long-distance running. As well as the type of training, a major risk factor is atopic disposition. A mixed type of eosinophilic and neutrophilic airway inflammation has been shown to affect elite swimmers, ice-hockey players, and cross-country skiers. The inflammation may represent a form of repeated thermal, mechanical, or osmotic airway trauma resulting in a healing or remodelling process. Elite athletes commonly use antiasthma drugs to treat exercise-induced bronchial symptoms. Only a few controlled studies have been conducted on the effects of antiasthma drugs on asthma symptoms, bronchial hyperresponsiveness and airway inflammation in elite athletes. Inhaled beta(2)-adrenoceptor agonists are effective against exercise-induced bronchospasm. In contrast, airway inflammation, bronchial hyperresponsiveness and symptoms have responded poorly to inhaled corticosteroids and leukotriene antagonists. As discontinuing high-level exercise has proved effective in reducing eosinophilic airway inflammation, exercise or training should be restricted in athletes having troublesome symptoms and sputum eosinophilia. Switching training to less irritating environments should be considered whenever possible. It appears to be difficult to change the 'natural course' of asthma in athletes by anti-inflammatory treatment.

Adrenal Cortex Hormones↗
PubMed2006

Meniscal extrusion in young athletes: associated knee joint abnormalities.

OBJECTIVE: The objective of our study was to assess the rate of meniscal extrusion and its connection with common meniscal and joint abnormalities. MATERIALS AND METHODS: MR signs of meniscal extrusion were evaluated retrospectively in 24 rugby and soccer players (40 knees) who are currently free of pain in the knee, impaired mobility, and joint swelling. The control group consisted of 23 consecutive active individuals (36 knees) with no history of knee problems. The criterion for extrusion of the meniscus was defined as a distance of 3 mm or more between the peripheral border of the meniscus and the edge of the tibial plateau measured on coronal images. RESULTS: Forty-eight percent of the athletes' knees and 30% of the control subjects' knees showed evidence of meniscal extrusion. Among the athletes, a significant association between meniscal extrusion and joint effusion (11 cases), meniscal tears (seven cases), and anterior cruciate ligament (ACL) tear (four cases) was found (p < or = 0.004). In the control group, no significant association was found between meniscal extrusion and joint effusion (three cases), meniscal tears (four cases), and ACL tears (two cases) (p = 1.00). A significant association was not found between degenerative change and meniscal extrusion in either the athletes (p = 0.23) or the control subjects (p = 1.00). The most commonly associated knee abnormality was joint effusion in 73% of knees with meniscal extrusion in athletes. CONCLUSION: Meniscal extrusion is a common finding on MRI of athletes' knees. Meniscal extrusion in association with meniscal tear and joint effusion is postulated as a significant injury in athletes and its recognition as such in this group is important because it may prompt orthopedic intervention.

Adolescent↗
PubMedDate not supplied

[Sudden cardiac death in athletes].

Sudden cardiac death in an athlete is rare and tragic event. An athlete's death draws high public attention given that athletes are considered the healthiest category of society. The vast majority of sudden cardiac death in young athletes is due to congenital cardiac malformations such as hypertrophic cardiomyopathy and various coronary artery anomalies. In athletes over age 35, the usual cause of sudden cardiac death is coronary artery disease. With each tragic death of a young athlete, there is a question why this tragedy has not been prevented. The American College of Sports Medicine and the American Heart Association recommend that a pre-participation exam should include a complete cardiovascular history and physical examination.

Death, Sudden, Cardiac↗
PubMed1988

Use of the personal orientation inventory with disabled athletes.

Athletes who are blind or have impairments in hand-eye coordination that prevent writing are unable to complete psychological inventories in the standardized manner, i.e., read silently and answered independently and anonymously. Two studies were conducted on the oral administration of the Personal Orientation Inventory as a measure of self-actualization of disabled athletes. Reliabilities were examined across modalities (oral vs written) by administering the inventory both ways to 25 high school and college athletes, M age = 21.6 yr. Test-retest reliability for oral administration was affirmed in a study of 15 blind elite male athletes and 15 cerebral palsied elite male and female athletes. It was concluded that the inventory, administered orally, may be appropriately used with disabled athletes.

Adolescent↗
PubMed1991

Perceptions of current and ideal body shape of athletes and nonathletes.

This study was done to examine the relationship between sex and perception of body image among athletes and nonathletes. A total of 211 men and women athletes and nonathletes completed a questionnaire which asked them to identify from a nine-figure body-silhouette scale their current image and the image that they thought was most ideal. t tests showed no significant differences for men based upon athletic participation and that both athletes and nonathletes were satisfied with their body image. However, when comparing current image and ideal image, significant differences were found for women athletes and nonathletes. These data support previous research documenting women's dissatisfaction with their body images and show athletic participation is not associated with this perception.

Adult↗