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PubMed1993

Spinal sagittal mobility and joint laxity in young ballet dancers. A comparative study between first-year students at the Swedish Ballet School and a control group.

The present study compares spinal configuration, spinal range of motion and joint mobility in first-year students of the Swedish Ballet School and in nondancing students of corresponding age and sex in a state school. The study comprises all the first-year (fourth grade) students (n = 23) at the Swedish Ballet School: 11 boys and 12 girls. Their dance practice time was 10 h per week. Thirty-six children in the fourth grade at a state school comprised the control group. None of the controls took ballet classes or participated in organised gymnastics out of school. The neutral spine configuration in standing and the sagittal spine mobility were measured using Debrunner's kyphometer and Myrin's inclinometer. Joint laxity was measured by employing a modified form of the Contompasis method. Compared with the controls, the dancers showed a higher incidence of joint hypermobility, greater mobility of the thoracic spine, a less prominent lordosis of the lumbar spine and a less prominent kyphosis in the thoracic spine in the neutral standing position. The dancers had done little or no ballet training before entering the ballet school at the age of ten. The results agree with those of earlier studies and suggest that increased flexibility is an asset for those being selected as future ballet dancers.

Child↗
PubMed1995

Mental and somatic health and social adjustment in ordinary school children during childhood and adolescence related to central nervous functions as expressed by a complex reaction time.

A cohort of ordinary Swedish children were followed up from school entry through childhood and adolescence and checked retrospectively from birth to the age of 6 years regarding psychiatric and physical health and contact with the social welfare authorities. The children were allocated to different risk groups at age 7 on the basis of their psycho-physical development expressed as complex reaction time (CRT). It was previously shown that many of the slow CRT children have problems in psychomotor and language development at school, and that many leave compulsory school with poor achievements in Swedish and gymnastics as continuing signs of their developmental delay. This study shows that slow CRT children have an increased prevalence of child psychiatric problems. At an early age there were symptoms of aggression, hyperactivity and withdrawal in conjunction with developmental delay. During adolescence, depression, maladjustment and psycho-somatic disorders were prominent features, often in association with developmental delay, dyslexia and poor motoric skill. These children could have a disadvantage at school and in society and they felt themselves "handicapped" and were stressed by feelings of limited future possibilities. In adolescence, many of them were in need of help, especially financial aid from the social welfare services. The findings stress that a slow cognitive processing ability seen as a slow CRT must be considered a handicap of importance and a risk-factor in the society of today, with primary or secondary psychic and social manifestations often in a multifactorial setting of biological co-morbidity and family problems. In contrast, an advanced CNS development with a fast CRT may be seen as a protective factor.

Adolescent↗
PubMedDate not supplied

[Sports in prevention of postural defects].

Posture results from numerous alternating factors and reflects the attitude of an individual towards a definite situation. If the different conditions, namely the capacity and the willingness of posture, do not correspond to the requirements of the situation the "normal" erect posture will change. The development from abnormal posture into irreversible abnormalities and damages in posture is easy. In order to eliminate these risks one can try to reduce the potential of the situation on the one hand and to improve the capacity of the individual through adequate physical exercise on the other. The practice of daily physical activity at school or during leisure time is the best way to compensate for lack of exercise, to modify prolonged unfavourable situations, and to develop the physical capacity in such a way that dangerous loads can be supported without damage. The versatility of training, in combination with adequate gymnastical exercises and sports help to educate the sense of posture and movement with the effect that erect posture can be adopted and maintained. But only children who feel that erect posture is reflecting their personal image will finally keep the erect posture. Special attention is given to elite training in childhood and adolescence, when the vertebral column is particularly exposed to danger by the intensity of the training and must be protected against deformations by carefully chosen preventive measures.

Humans↗
PubMed1980

[Intrathoracic dislocation of a metal-piece after the use of wires in bone-surgery (author's transl)].

Two cases of intrathoracic dislocation of Kirschner's wire are reported. In one case the migration of the wire had been discovered 3 years after osteosynthesis of the acromioclavicular joint and incomplete removal of the metal. In another case a fragment of Kirschner's wire had to be removed by mediastinoscopy five months after fixation of the sternoclavicular joint. The application of wire in clavicular joint position - even in connection with cerclage - does not correspond with the conditions of osteosynthesis fit for active or passive movement. Ligament healing requires additional fixation, gymnastic mobilisation under control is necessary. The wires should be removed completely after 8-10 weeks, intrathoracic dislocation requires treatment by a surgeon with good experience in thoracic surgery.

Acromioclavicular Joint↗
PubMed1980

[Functional after-treatment, exercises and appraisal after lesions of the knee ligaments (author's transl)].

Lesions of the capsule and the ligaments of the knee joint require immobilization, regardless if they are treated with or without surgery. The plaster cast causes an atrophy of muscles which have an important function together with the capsule. During immobilization isometric tension exercises can work against the atrophy and are useful to regain the full mobility of the joint. The period of immobilization depends on the lesion. Active and to some extent passive exercises, gymnastics in water and combined exercises (e.g. cycling, walking in water) determine the therapy. A mobilization of the joint under anesthesia is excluded. Thermotherapy and massaging are contraindicated for an injured knee. An expert appraisal has to evaluate the injury in connection with the accident and with the degree of damage.

Bursa, Synovial↗
PubMedDate not supplied

A twelve month study of sports injuries in one Irish school.

A literature review suggested that both acute and overuse injuries were common in body contact sports. This hypothesis was tested on a group of 266 Irish adolescents in an investigation that examined the incidence of injury amongst these individuals over a twelve months period. The mean age of the subjects was:- males 14.3 +/- 0.85 years and females 14.1 +/- 0.90 years. The responses of the subjects to a questionnaire on their sporting involvement, training and sports injuries were analysed. A total of 230 injuries were incurred by the subjects during the twelve month period: 181 of these were to males. However, the number of injuries per hour of participation was similar in the two sexes. Subjects involved in body contact sports incurred the highest number of overuse injuries. The injury rate per 10,000 hours of participation was highest in badminton (70.85 injuries per 10,000 hours), gymnastics (68.18), rugby (59.77) and basketball (56.22). The rate of overuse injuries was high in swimming, badminton and athletics. The most common injuries was found to be common. The results of the study suggests that injury prevention programmes should be targeted to a wider range of sports, to females as well as to males, and that rehabilitation programmes need to be improved.

Adolescent↗
PubMed1997

[Elbow injuries in childhood].

Fractures and dislocations of the elbow are some of the most common injuries in childhood and adolescence. The majority occur in sport and play activities, e.g., a fall from gymnastics apparatus or a bike, or from popular sports items, such as skateboards or in-line skates. The injuries can be divided into pure dislocations of the joint and fractures of the distal humerus, proximal radius and ulna, or combinations of both. In addition, extra- and intraarticular fracture types are defined, with the latter as partial or complete joint lesions. Dislocations of the elbow joint or the radial head can occur as single injuries or in combination with a fracture. Supracondylar fractures and avulsion fractures of the medial epicondyle are the most frequent extraarticular lesions of the distal humerus. Fractures of the lateral condyle prevail is incomplete intraarticular lesions. In the forearm, radial head and neck fractures are predominant while typical and atypical Monteggia injuries have a special status. The complex joint construction and the age-dependent appearance of the epiphyseal ossification centers sometimes make a correct radiological diagnosis difficult. The trauma history and an exact, clinical examination help to verify the injury, as do comparative X-ray studies of the uninjured side when necessary (but not routinely). Unlike other anatomical areas, most elbow injuries-even in the growing skeleton-are treated operatively. Hereby, the growth plates have to be respected using minimal amounts of small implants. Additional immobilization in a cast for 2-4 weeks is necessary in most cases but does not lead to a functional deficit-in contrast to adults. The implants should be removed as early as possible. Despite all therapeutic efforts, a significant number of late sequelae, such as malunions and functional impairment, can be seen. The rate of long-term complications increases in cases of untreated displacement of fragments or joint instability. Corrective measures are performed only in selected cases and after the growth plates are closed. Our own treatment regime is demonstrated using exemplary clinical cases of the different injuries and the results of a long-term follow-up study on sports injuries of the elbow in children. Errors in diagnosis and therapy, as well as possible complications, are pointed out.

Adolescent↗
PubMed2003

[Therapy of postmenopausal osteoporosis].

The therapy of postmenopausal osteoporosis is based on a few comprehensible assumptions. High bone resorption should be reduced by treatment with bisphosphonates, raloxifene or seldom with calcitonins. After reduction of high bone turnover and in low bone turnover situations, an osteoinductive combination therapy should be started, inducing collagen type I with parathyroid hormone or fluorides. This collagen can then be mineralized by calcium, vitamin D, and vitamin D metabolites. In addition, bone resorption should be reduced during menopause with estrogens and gestagens, in the case of a receptor-positive breast cancer with tamoxifen, and after menopause with raloxifene or a bisphosphonate. In elderly patients a depletion of vitamin D often induces an osteoporomalacia instead of an osteoporosis. In this situation, mineralization of the osteoid by calcium and vitamin D is sufficient for therapy. A daily osteoporosis gymnastic program is required and physical activity should be enhanced to increase muscle mass because bone adapts to the individual situation.

Activities of Daily Living↗
PubMed1997

[Do endurance sports lead to osteoporosis in women?].

Numerous studies show that (high) performance sport may reduce the ovarian function by disturbing the distribution of the hormones at the level of the hypothalamic-pituitary axis. Before puberty a delay in sexual maturity (in particular delayed menarche) and after menarche oligomenorrhoea or secondary amenorrhoea may result, most frequently in aerobic-type activities associated with lower body weight such as running, aerobics and gymnastics. Body composition and specificity of sport, intensity of training, previous menstrual history and eating disorders are all important factors. After stopping with performance sport, the regular menstrual cycle will return, but the chronic lack of oestrogen may reduce bone density and increase the prevalence of stress fractures. In conclusion, female performance athletes require medical facts about training and nutrition and individual information and guiding if a long-term hormone substitution is needed.

Adult↗
PubMed2002

Urinary incontinence in elite female athletes and dancers.

The aim of this study was, to determine the frequency of urinary loss in elite women athletes and dancers. Elite athletes in eight different sports, including ballet, filled in an evaluated questionnaire about urinary incontinence while participating in their sport/dancing and during daily life activities. A total of 291 women with a mean age of 22.8 years completed the questionnaire, providing a response rate of 73.9%. Overall, 151 women (51.9%) had experienced urine loss, 125 (43%) while participating in their sport and 123 (42%) during daily life. The proportion of urinary leakage in the different sports was: gymnastics 56%, ballet 43%, aerobics 40%, badminton 31%, volleyball 30%, athletics 25%, handball 21% and basketball 17%. During sport 44% had experienced leakage a few times, 46.4% now and then, and 9.6% frequently. During daily life the figures were: 61.7% a few times, 37.4% now and then, and 0.8% frequently. Of those who leaked during sport, 95.2% experienced urine loss while training versus only 51.2% during competition (P<0.001). The activity most likely to provoke leakage was jumping. Sixty per cent (91/151) occasionally wore pads or panty shields because of urine loss. Urinary leakage is common among elite athletes and dancers, particularly during training, but also during daily life activities.

Activities of Daily Living↗
PubMed2000

Critical power of knee extension exercises does not depend upon maximal strength.

A possible dependence of critical power (CP) and the Y-intercept of the work/exhaustion time relationship (Y(intercept)) on maximal muscular strength of the same muscle group has been studied in nine endurance-trained subjects, seven gymnasts, and seven weight-lifters. CP was calculated as being equal to the slope of the linear relationship between exhaustion time and the work performed at exhaustion on a knee extension ergometer. Y(intercept) was equal to the intercept between this relationship and the work axis. The muscular strength of the knee was evaluated by measuring the torques exerted on a Biodex knee isokinetic dynamometer at four angular velocities: 0 degrees x s(-1) (T0), 90 degrees x s(-1) (T90), 180 degrees x s(-1) (T180) and 240 degrees x s(-1) (T240). The results of the present study do not support the hypothesis that CP depends upon maximal strength. Indeed, CP was not correlated with T0, T90, T180 or T240 (¿r¿ < 0.01). Y(intercept) was significantly and positively correlated only with T90.

Adult↗
PubMed1998

Morphological and functional differences in the elbow extensor muscle between highly trained male and female athletes.

The purpose of this study was to investigate the difference in the morphological and functional aspects of the triceps brachii muscle between highly trained male and female athletes who were members of the 1996 Japanese Olympic teams in each of three different events: soccer, gymnastics and judo. The thickness (TBmt) and fibre pennation angle (TBpen) of the triceps brachii muscle and force output during elbow extensions were determined using a B-mode ultrasound apparatus and an isokinetic dynamometer, respectively. The TBmt and its value relative to upper arm length (TBmt/l(ua)) were significantly larger in the men than in the women in all the events except judo. In all the subjects, a significant correlation was found between TBmt/l(ua)) and TBpen (r = 0.721, P < 0.05). The existence of the sex difference in TBpen within the same event was in agreement with that observed in TBmt/l(ua) except for the soccer players. The TBpen of the soccer players were similar in both sexes although a significant sex differences was found in TBmt/l(ua). The isokinetic forces measured using the two velocities 60 degrees x s(-1) (F60) and 180 degrees x s(-1) (F180) were significantly correlated to the cross-sectional area (CSA) of the triceps brachii muscle estimated from TBmt (r = 0.702, P < 0.05 for F60, and r = 0.776, P < 0.05 for F180). No significant sex differences were found in either F60/CSA or F180/CSA in any of the events. From these results, it could be assumed, at least in the Olympic athletes tested in this study, that the fibre angulation of the triceps brachii muscle was almost the same in the two sexes if allowance was made for the difference in the muscle size, and the sex difference in force generation capability of the triceps brachii muscle could in the main be attributed to the difference in CSA rather than in the architectural characteristics.

Adult↗
PubMed1999

Relaxation effects in humans of underwater exercise of moderate intensity.

In this study we investigated the effects of underwater exercise in warm water (34 degrees C) on physiological and psychological relaxation. Eight healthy young men (aged 20-26 years) volunteered for the experiment. The experiment consisted of the following three successive segments: a pre-exercise period of 20 min, during which the subjects rested in a semi-supine posture with their eyes closed for the final 10 min; an underwater exercise period of approximately 60 min, during which the subjects performed gymnastic exercises or aerobic dancing with occasional movements or jumping; a post-exercise recovery of 20 min, which was similar to the pre-exercise rest period. We compared the relative power values (power %) of the electroencephalogram alpha bands (8-13 Hz) and profile of moods states (POMS) before and after the underwater exercise. We also estimated the percentage of maximal heart rate (%HRmax) throughout the experiment to ascertain the intensity of the underwater exercise. The results of %HRmax indicated that the intensity of underwater exercises practised in the experiments ranged from low to moderate. The power % of EEG alpha bands had increased significantly after the underwater exercise compared with the pre-exercise rest (P<0.05). From the POMS results, we observed that positive mood (vigour) increased and negative mood (tension and anxiety, depression and dejection) decreased significantly after the underwater exercise (P<0.05). This study found that the subjects showed increased physiological and psychological indices of relaxation after underwater exercise.

Adult↗
PubMed1999

A model of induced coupled movements in the human body: a case study.

We present a case study of involuntary motion in one part of the body induced by a voluntary motion in another part. The case investigated was that of a steady-state motion of the fingers at various frequencies, which induced a similar kind of motion in the legs. These phenomena were observed in a subject practicing sphincter gymnastics, a physical therapy method in which repetitive motion of different muscles is exercised, and is known to induce motions in other muscles of the body. We show that a linear model, for which we give an experimental transfer function and demonstrate its validity, can describe the generation of the induced periodic motions by the voluntary motions. We compare the results of the transfer function with those of Von Holst's statistical analysis.

Biomechanical Phenomena↗
PubMed2001

Effect of exercise training and detraining on bone mineral density in postmenopausal women with osteoporosis.

We examined the effect of exercise training and detraining on bone mineral density (BMD) in postmenopausal women with osteoporosis. Thirty-five postmenopausal women with osteoporosis, aged 53-77 years, were randomly assigned to three groups: a control group (n = 20), a 2-year exercise training group (n = 8), and an 1-year exercise training plus 1-year detraining group (n = 7). Exercise training consisted of daily brisk walking and gymnastic training. Calcium lactate, 2.0 g, and 1alpha-hydroxyvitamin D3, 1 microg were supplied daily to all subjects. No significant differences in initial lumbar BMD, measured by dual-energy X-ray absorptiometry (DXA) were found among the three groups. The mean percent change in BMD compared with the baseline was significantly higher at 1 and 2 years in the exercise training group and at 1 year in the detraining group than in the control group, and did not differ significantly at 2 years between the detraining and control groups. These findings indicate that our exercise training program led to a significant increase in lumbar BMD in postmenopausal women with osteoporosis compared with the control, but that the BMD reverted toward a level that was not significantly different from the control with detraining. Continued exercise training is needed to maintain the bone mass gained through exercise training.

Aged↗
PubMed2002

[Effect of a sensorimotor training program on patients with subacromial pain syndrome].

The purpose of the present study was to evaluate the effectiveness of a special sensorimotor exercise rehabilitation program on shoulder function. In a prospective intervention study we evaluated 32 patients with subacromial pain syndrome, all of whom took part in a conservative rehabilitation program. No patient had surgery on the shoulder involved prior to the study. All patients performed a standardised sensorimotor training for the glenohumeral joint, which involved, in particular, the glenohumeral and scapulothoracal stabilisers. In this rehabilitation program special proprioceptive exercise tools (body-blade, BOING) were used as well as Tai Chi and aquatic gymnastics. The entire program lasted 4 weeks and was performed and supervised by the same physiotherapist. Prior to and after the program all patients underwent a standardised series of tests. These included the Constant- and the UCLA-Score tests and sensorimotor functions with an angle reproduction test, a threshold to motion test as well as isometric strength testing with a Cybex unit. Prior to the rehabilitation program all subjects showed decreased proprioceptive capabilities. This was particularly evident in the threshold to motion test. After 4 weeks of rehabilitation, significant increases in the Constant- and UCLA-Score tests were found. The sensorimotor test also showed an increased proprioceptive capability especially in the threshold to motion test. The angle reproduction test showed only moderate improvement, whereas the isokinetic strength test showed no improvement at all. The present study shows that patients with subacromial pathology suffer from a proprioceptive deficit which can be improved by a special rehabilitation program within only 4 weeks.

Adult↗
PubMed2002

[Spondylolysis and spondylolisthesis during growth].

Spondylolysis and Spondylolisthesis present with typical age and activity-related issues: in newborns the pars interarticularis is always intact. Only bipedal ambulators develop spondylolysis, mostly during early childhood. Corresponding to the mechanical etiology, the incidence of spondylolysis is higher in athletes who repeatedly have to hyperextent and rotate their lumbar spine for example gymnasts, javelin throwers etc. Spondylolysis is one of the most frequent diagnosis among adolescents with lumbar back pain. However, most of the people with an interrupted Pars interarticularis (about 6% of the population) never become symptomatic or if they do, they respond very well to conservative treatment (adaptation of physical activity, active physical therapy and bracing). If pain persists in combination with an intact intervertebral disc of the slipped segment, we recommend a direct repair of the Pars interarticularis instead of an intersegmental fusion. Patients with low grade Spondylolisthesis (Meyerding I, II) require repeated radiological follow-up during growth because of the inherent risk of slip progression. If a slip of more than 50% is detected before the end of growth, operative treatment is indicated. High grade olisthesis (Meyerding III, IV) leads to anterior shift of the whole trunk, kyphosis of the slipped vertebra with subsequent compensatory lumbar hyperlordosis and flattening of the thoracic spine. Pelvic flexion is clinically evident. Reduction of the slipped and kyphotic vertebra with correction of the spinal, sacral and pelvic profile is recommended and preferable to simple fusion in situ.

Adolescent↗
PubMedDate not supplied

Comparative study of diagnostic systems: Chinese Classification of Mental Disorders-Second Edition versus DSM-III-R.

We report on the diagnostic comparative study of the Chinese Classification of Mental Disorders-Second Edition (CCMD-2) and the DSM-III-R in a field trial in China. The Adult Diagnostic Interview Schedule-Second Edition (ADIS-2), a modified diagnostic interview schedule that can generate both CCMD-2 and DSM-III-R diagnoses, was used to test 254 psychiatric patients in China. It was found that the reliability and validity of the CCMD-2 and DSM-III-R are compatible in most diagnostic categories such as schizophrenia, delusional disorder, bipolar disorders, and depressive disorders. The discrepancies between Chinese and American diagnostic systems were found mainly in neurasthenia and hysterical neuroses. Such discrepancies may have resulted from frequent changes of the diagnostic terms in the West, such as the phenomenon of neurasthenia, or from creating a new disorder entity in CCMD-2, such as "Eastern gymnastic exercises-induced mental disorder. "Further cross-cultural studies focusing on these discrepant disorders are urgently needed to understand the cultural influences on diagnosis, as well as to improve the professional classification of mental disorders in different diagnostic systems.

Adolescent↗