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PubMed2001

Cervical spinal stenosis and sports-related cervical cord neurapraxia in children.

STUDY DESIGN: Congenital spinal stenosis has been demonstrated to contribute to cervical cord neurapraxia after cervical spinal cord injury in adult athletes. A sagittal canal diameter <14 mm and/or a Torg ratio (sagittal diameter of the spinal canal: midcervical sagittal vertebral body diameter) of <0.8 are indicative of significant cervical spinal stenosis. Although sports-related cervical spine injuries are common in children, the role of congenital cervical stenosis in the etiology of these injuries remains unclear. OBJECTIVES: The authors measured the sagittal canal diameter and the Torg ratio in children presenting with cervical cord neurapraxia resulting from sports-related cervical spinal cord injuries to determine the presence of congenital spinal stenosis. METHODS: A total of 13 children (9 male, 4 female) presented with cervical cord neurapraxia after a sports-related cervical spinal cord injury. Age ranged from 7 to 15 years (mean +/- SD, 11.5 +/- 2.7 years). The sports involved were football (n = 4), wrestling (n = 2), hockey (n = 2), and soccer, gymnastics, baseball, kickball, and pogosticking (n = 1 each). Lateral cervical spine radiographs were used to determine the sagittal canal diameter and the Torg ratio at C4. RESULTS: The sagittal canal diameter (mean +/- SD, 17.58 +/- 1.63 mm) and the Torg ratio (mean +/- SD, 1.20 +/- 0.24) were normal in all of these children. CONCLUSION: Using the sagittal canal diameter and the Torg ratio as a measurement of congenital spinal stenosis, the authors did not find evidence of congenital cervical spinal stenosis in a group of children with sports-related cervical spinal cord neurapraxia. The occurrence of cervical cord neurapraxia in pediatric patients can be attributed to the mobility of the pediatric spine rather than to congenital cervical spinal stenosis.

Adolescent↗
PubMed2001

Common athletic injuries in adolescent girls.

Teenaged girls constitute the fastest growing segment of children and adolescents participating in organized athletics. Adolescent girls appear to have similar injury rates as boys in comparable activities but different injury patterns. To properly diagnose and manage athletic injuries in adolescent girls, pediatric health care providers must be aware of these differences, especially as the literature and their knowledge base may be skewed to the traditional predominance of males in sport. This review identifies athletic injuries that are unique to or especially common in adolescent girls, including apophyseal injuries; breast and pelvic injuries; scoliosis and spondylolysis; multidirectional shoulder instability and "gymnast's wrist"; anterior cruciate ligament injuries and patellofemoral pain syndrome; chronic exertional lower-leg compartment syndrome, ankle sprains, and reflex sympathetic dystrophy; and stress fractures. It also briefly discusses possible risk factors for these injuries, emphasizing the female athlete triad.

Adolescent↗
PubMed1999

Upper extremity stress fractures in athletes: clinical features of 44 cases.

PURPOSE: To review the clinical features of a large series of active patients with a stress fracture in a non-weight-bearing location of the upper extremity or ribs. DESIGN: Multicenter cross-sectional study. SETTING: Multiple academic medical centers. PARTICIPANTS: 44 patients with a diagnosis of upper extremity or rib stress fracture. MAIN OUTCOME MEASURES: Clinical features according to anatomic location, primary sport, and subdivided according to the nature of the sport-specific skills involved. RESULTS: A diagnosis of stress fracture was made in 44 patients based on history and physical examination, and confirmed by radiography, scintigraphy, magnetic resonance imaging (MRI), computed tomography (CT), or a combination of imaging techniques. Patients were subjectively divided into four categories based on the predominant type of upper extremity activity required for participation in their sport: 1) weight lifter (e.g., football, weight lifting, wrestling); 2) upper extremity weight bearer (e.g., gymnastics, diving, cheerleading); 3) thrower (e.g., pitcher, soccer goalie, javelin); or 4) swinger (e.g., golf, tennis). We noted that all fractures in the weight bearers occurred distal to the elbow, whereas in the throwers most fractures affected the shoulder girdle. Lower rib stress fractures predominated in the swingers group, whereas weight lifters had fractures located throughout the upper extremity. CONCLUSION: Stress fracture should be considered in the differential diagnosis of athletes presenting with upper extremity or rib pain of bony origin that is of insidious onset. Further study of the sport-specific patterns of injury described here may improve our ability to treat and prevent these injuries.

Adolescent↗
PubMed2000

The association of the menstrual cycle with the laxity of the anterior cruciate ligament in adolescent female athletes.

OBJECTIVE: To identify a significant change in the laxity of the anterior cruciate ligament (ACL) in the competitive adolescent female athlete throughout the different phases of the menstrual cycle. DESIGN: Prospective, single-blinded 8-week study set during a winter sports season. SETTING: Suburban Ohio Division I high school. PARTICIPANTS: 26 members of gymnastics, soccer, track, tennis, and basketball teams. All participants were screened for normal menstrual cycles (26-30 days, menses 4-7 days long). MAIN OUTCOME MEASURES: KT-1000 arthrometer was used to measure laxity by performing repeated measures throughout an 8-week period. Measurements were taken before the athletes' workouts. The athlete charted the menstrual periods on a monthly calendar. The measurements were then grouped into the three phases of the menstrual cycle (follicular, ovulatory, and luteal) and averaged. RESULTS: Right knee laxity measured 4.98 mm follicular phase, 5.24 mm ovulatory, and 5.09 mm luteal. Left knee laxity measured 4.51 mm follicular, 4.43 mm ovulatory, and 4.62 mm luteal. There was no statistical difference among the three phases in the left (p = 0.9) and right (p = 0.7977). Additionally, left ACL laxity was significantly less in all three phases. We found no statistically significant variability in laxity among the five sports sampled (p > 0.63 to 0.10) and different ages (p = 0.404). CONCLUSIONS: We found an insignificant change in ACL laxity from follicular to luteal phases of the menstrual cycle. This indicates that no single phase of the menstrual cycle clinically affects the ACL more than the next. Although the presence of sex hormones-particularly estrogen-may indeed predispose females to higher ACL injury rates, we did not find any evidence that hormonal level changes equate with significant ACL laxity changes. We conclude that the menstrual cycle does not significantly affect ACL laxity in the competitive adolescent female athlete.

Adolescent↗
PubMed2004

Response of soluble transferrin receptor and iron-related parameters to iron supplementation in elite, iron-depleted, nonanemic female athletes.

OBJECTIVES: To assess the effect of short-term iron supplementation on soluble transferrin receptor (sTfR) and the soluble transferrin receptor/log ferritin ratio in a group of elite, iron-depleted, nonanemic female athletes and to assess the relationship between soluble transferrin receptor and serum ferritin in a group of elite, iron-depleted female athletes. DESIGN: A prospective, interventional study and an observation at 1 point in time. The primary inclusion criteria for each component of the study was serum ferritin less than 30 ng/mL and hemoglobin greater than 12 g/dL. The exclusion criteria were use of iron supplementation within 1 month of the initial assessment, acute or chronic infectious or inflammatory disease, hematological disorders, and recent musculoskeletal injury. SETTING: The Department of Sports Medicine at the Australian Institute of Sport. SUBJECTS: For the prospective study, 51, and for the observational study, 85 elite, iron-depleted (serum ferritin <30 ng/mL), nonanemic (hemoglobin <12 g/dL for the prospective study only) female athletes. Athletes were participants at the elite level in netball, basketball, gymnastics, rowing, volleyball, track and field, soccer, sailing, and cricket. INTERVENTION: Ingestion of 1 iron tablet (325 mg dried ferrous sulfate, equivalent to 105 mg elemental iron) plus one 500-mg tablet of vitamin C each morning for 60 days. RESULTS: Following supplementation, the following changes were statistically significant. Serum ferritin increased (19.7 to 37.4 ng/mL; P < 0.00005), serum transferrin decreased (3.34 to 3.16 g/L; P = 0.023), sTfR decreased (3.46 to 3.16 mg/L; P = 0.006), and sTfR/log ferritin index decreased (1.34 to 1.00; P < 0.00005). If it is assumed that iron stores are depleted when serum ferritin is less than 12 ng/mL and that sTfR could be expected to be elevated below that level of serum ferritin, the following figures can be calculated for the value of sTfR in relation to absent iron stores: sensitivity, 33%; specificity, 96%; positive predictive value, 50%; and negative predictive value, 92%. CONCLUSIONS: Short-term iron supplementation increases iron stores and leads to reductions in sTfR and the sTfR/log ferritin index in elite female athletes. sTfR is not an accurate predictor of serum ferritin less than 12 ng/mL in this group.

Adolescent↗
PubMed2002

Physical leisure-time activities and long-term sick leave: a 15-month prospective study of nurses' aides.

The objective of the study was to determine the relationship between physical leisure-time activities and the occurrence of long-term sick leaves in nurses' aides. Of 5563 Norwegian nurses' aides who were not on sick leave when they completed a questionnaire in 1999, 4744 (85.3%) completed a second questionnaire 15 months later. Brisk walks (odds ratio [OR], 0.78; 95% confidence interval [CI], 0.63 to 0.98), aerobics or gymnastics (OR, 0.71; 95% CI, 0.49 to 1.02), and other physical leisure activities (OR, 0.81; 95% CI, 0.66 to 1.00) for 20 minutes or more at least once a week predicted fewer long-term sick leaves (> 14 days), after adjustments for baseline health complaints, demographic and familial characteristics, former and current smoking, and work factors. In conclusion, regular physical leisure-time activity may be associated with a reduced risk of long-term sickness absence in nurses' aides.

Adult↗
PubMed2006

The use of dietary supplements and medications by Canadian athletes at the Atlanta and Sydney Olympic Games.

OBJECTIVE: To learn more about the prevalence of dietary supplement and medication use by Canadian athletes in the Olympic Games in Atlanta 1996 and Sydney 2000. SETTING AND PARTICIPANTS: Data were collected from personal interviews with Canadian athletes who participated at the 1996 Atlanta and 2000 Sydney Olympic Games. The athletes were interviewed by Canadian physicians regarding the use of vitamins, minerals, nutritional supplements, and prescribed and over-the-counter medications. Of the 271 Canadian athletes who participated at the Atlanta Olympics, 257 athletes were interviewed; at the Sydney Olympics, 300 of 304 Canadian athletes were interviewed. MAIN OUTCOME MEASUREMENT: A quantitative and qualitative description of the use of dietary supplements by Canadian athletes at the Atlanta and Sydney Olympics. RESULTS: At the Atlanta Games, 69% of the athletes used some form of dietary supplements, whereas 74% of the athletes used dietary supplements at the Sydney Games. Vitamins were taken by 59% of men and 66% of women in Atlanta, and 65% of men and 58% women in Sydney. Mineral supplements were used by 16% of men and 45% of women in Atlanta, and 30% of men and 21% of women in Sydney. Nutritional supplements were used by 35% of men and 43% of women in Atlanta, and 43% of men and 51% of women in Sydney. The most popular vitamins were multivitamins in both Olympics. The most popular mineral supplements were iron supplements. The most commonly used nutritional supplement in Atlanta was creatine (14%), but amino acids (15%) were the most commonly used nutritional supplement in Sydney. In Atlanta, 61% of the athletes were using some form of medication, 54% of the athletes were using medications in Sydney. Nonsteroidal antiinflammatory drugs (NSAIDS) were the most commonly used medications at both Olympic Games. Among all sports, the highest prevalence of vitamin use occurred in boxing (91%) in Atlanta and swimming (76%) in Sydney. Rowers (56%) and cyclists (73%) demonstrated the highest use of mineral supplements. Nutritional supplement use occurred most often in swimming (56%) and cycling (100%). The use of NSAIDs was highest in softball (60%) in Atlanta and gymnastics (100%) in Sydney. CONCLUSION: This review demonstrates that dietary supplement use was common among Canadian athletes at both the Atlanta and Sydney Olympic Games. There was a slight increase in total dietary supplement use at the Sydney Games. Widespread use of supplements, combined with an absence of evidence of their efficacy and a concern for the possibility of "inadvertent" doping, underscore the need for appropriately focused educational initiatives in this area.

Adult↗
PubMed1998

Asymmetrical muscle hypertrophy simulating a localised soft tissue mass.

Three children with a soft tissue mass presented to the Department of Radiology for investigation. Two children had a mass in the right axilla and the third had a mass overlying the right scapula. Cross-sectional imaging in each case revealed muscle hypertrophy rather than a discrete mass. The radiological diagnosis was later confirmed by histology. Minor asymmetry of muscles is quite common as a normal finding, but gross asymmetry of normal muscle is rare. Localised hypertrophy of muscle may result from exercise in children, but a history of excessive gymnastic exercise was apparent in only one child. The cause of the hypertrophy in the other two children is unknown.

Axilla↗
PubMed2005

The I Ching and the psyche-body connection.

Carl G. Jung's fateful meeting with Richard Wilhelm in 1929 has helped to build a bridge of depth psychological understanding between the East and the West. When Jung emerged from his 'confrontation with the unconscious', he felt validated by Wilhelm in his discovery of the healing power of medieval alchemical symbolism for the European psyche. Analytical psychology however offers a scientific, psychological understanding of Chinese wisdom as contained in the I Ching and Taoist alchemy. The Taoist alchemical tradition (also known as the Inner Elixir tradition of which 'The Secret of the Golden Flower' is a sample text) is based on the premise that psychological experience of the Tao can be achieved through mental and physiological means such as breathing and meditative techniques, gymnastics, dietary regimens such as fasting, consumption of medicinal herbs and minerals, and special sexual practices. This tradition incorporates the I Ching and traditional Chinese medicine in the alchemical opus. Taoist alchemy assumes the primacy of the physical body in the process of self-realization. The psychological and cosmic forces of the trigrams of the I Ching are stored in the internal organs of the body and are the basic material for the experience of Tao. The internal organs are the foundation of the material and subtle bodies and through cultivation, the body becomes spiritualized as the spirits are embodied. The body as a reflection of the entire cosmos becomes the residence of the gods. The realization of a new consciousness is symbolized by the hexagram Fu, meaning rebirth. The Chinese notion of Tao coincides with Jung's postulation of the unus mundus, the unity of existence which underlies the duality of psyche and matter, the psycho-physical background of existence. In this light, in the world of inner experience, East and West follow similar paths symbolically.

Alchemy↗
PubMed1993

Quality of life and daily management of children with rheumatic disease.

Appropriate management of the daily life of patients with rheumatic diseases is an important part of therapy for favorable results and a high quality of life. At home, gymnastic exercise, night splints and appropriate fun activities will help to preserve the function of affected joints of patients with juvenile rheumatoid arthritis (JRA). Improvement of home fixtures according to patient disability will provide a higher quality of life for the patients. The patient should be helped to perform as many school activities as would normally be possible. Instructional charts for management of school life for patients with JRA and systemic lupus erythematosus is shown in this article. Cooperation with school personnel is also crucial to support the patient emotionally and physiologically. For the best long-term treatment and a good relationship between patient and physician, comprehensive management is essential. Not only physicians, but also psychiatrists, occupational therapists, physical therapists and social workers should be involved in the treatment of children with rheumatic diseases.

Activities of Daily Living↗
PubMed1990

Bilateral elbow dislocation.

Bilateral dislocation of the elbow joint is a rare injury. Five previous descriptions involved female gymnasts who fell with their arms extended. This report is of a hang-gliding accident involving a middle aged man.

Humans↗
PubMed1994

Physical activity and related factors among nursing home residents.

OBJECTIVE: The purpose of this study was to examine physical activity and the predictors of physical activity and exercise among nursing home residents. DESIGN: Population study. PARTICIPANTS: The sample (n = 190) was obtained by selecting every man and every second women from the entire nursing home population (n = 346) in the city of Jyväskylä, central Finland, in autumn 1989. Information was eventually collected by interview from 158 persons (49 men and 109 women). SETTING: An in-home interview carried out among nursing home populations. MEASUREMENTS: Independent variables were the questions describing physical activity among nursing home populations. Dependent variables were the predictors of physical activity: depression, contentment with nursing home living, activities outside the nursing home, and self-rated functioning. MAIN RESULTS: Walking and home gymnastics were the most common forms of physical exercise. The intensity of overall exercise was rather low, and the men carried out physical exercise more intensively than the women. More than 30% of the respondents reported decreased physical activity during their stay in the nursing home. However, attitudes toward physical exercise among the residents were largely positive. The primary factor limiting physical exercise was poor health status. Among the men, physical exercise was significantly associated with self-rated functioning, depressive symptoms, and contentment with life in the nursing home. Among the women, higher contentment with the nursing home and less depression were associated with a physically active life. CONCLUSIONS: The results suggest that living conditions and factors related to health and functional capacity affect the level of physical activity among nursing home residents. In order to encourage this population to be physically active, attention should be paid not only to physical exercise but also to associated factors, such as satisfaction with everyday life and health.

Activities of Daily Living↗
PubMed2003

Variability of airborne cat allergen, Fel d1, in a public place.

Allergen exposure is a risk to develop an IgE-mediated sensitization. The amount of allergen inhaled per unit time should be related to the amount present in the air, i.e. airborne allergen. Thus, measuring allergen levels in the air would be more relevant than measuring allergen levels in dust. Allergens are present in the air in very minute quantities and usually become airborne after disturbance. Large variation of allergen levels have been found in dust. In this study, we measured variability of airborne cat allergen, Fel d1, in a public place using a high-volume air-sampler. We also studied the distribution and relationship between dust and airborne cat allergens in homes and schools. Air samples were collected at three different airflow rates, i.e. 55, 40, and 30 m3 of air per hour. The concentration of airborne Fel d1 in the community gymnastic hall varied from 1 to 10 pg/m3 within a period of 3 weeks, at airflow rates 55-30 m3/h. The coefficient of variation for repeated samplings was 14-43% (day-to-day variation) and 27-38% (within-day variation). As expected, higher levels of airborne cat allergens were found in homes with cats than in cat-free environments. There was a significant relationship between cat allergen levels in dust and air (r=0.7, P<0.01). Our study demonstrates that when measuring airborne cat allergen a large variation is observed within a day and between days. The large variability of measurement may be explained by the disturbance in the environments. We suggest, that when exposure assessment is made the environment in question should be analyzed, if possible in several occasions.

Air Pollution, Indoor↗
PubMed2002

The female athlete triad: a terrible trio implications for primary care.

PURPOSE: To describe the components of the female athlete triad, including definitions and clinical criteria for diagnosis, methods of screening, and treatment options. DATA SOURCES: Selected scientific literature; standard diagnostic guidelines. CONCLUSIONS: The female athlete triad is a cascading event consisting of disordered eating, amenorrhea, and osteoporosis. This disorder can occur in any sport but is seen most often in events that emphasize thinness and appearance such as gymnastics, ballet, and diving. It can often go unrecognized and result in irreversible bone loss and possible death. IMPLICATIONS FOR PRACTICE: Primary care nurse practitioners (NPs) may be the first health care professionals encountering these females; they need to recognize the risk factors and institute a multidisciplinary approach to treatment. The treatment team should be composed of the patient, the NP, a dietitian, a psychologist, psychiatrist, or psychiatric nurse specialist, and the patient's family, coaches, and trainers.

Amenorrhea↗
PubMed1987

Mechanical jumping power in young athletes.

Mechanical jumping power was determined for 286 young male athletes representing six sports events and ranging in calendar and skeletal ages from 8.8 to 17.1 and from 7.8 to 18.1 years, respectively. The subjects performed successive maximal vertical jumps on a contact mat for 30 s. The number of jumps and their cumulative flight time after 15 and 30 s were used for calculations of mechanical power. The jumping performances of the young athletes were found to be reproducible from the age of 10-12 years in respect to the angular displacement of the knee and duration of contact. Absolute mechanical power, as well as power related to body weight, increased with calendar and skeletal ages. Of the anthropometric characteristics, the circumference of the thigh and body weight showed the highest correlation with mechanical power; subjects with the greatest thigh circumference and body weight having the lowest mechanical power. The subjects were divided into 'power' (track and field, gymnastics) and 'endurance' (skiing, orienteering) groups. The former reached higher mechanical power values than the latter. Mechanical power for the second 15-s jumping period was on average 4.7% lower than for the first. The events did not differ from each other in respect of the decrease in power.

Adolescent↗
PubMed2005

Regular exercise as a part of treatment for patients with end-stage renal disease.

Physical inactivity and its negative influence on health and the quality of life is a common problem generally, especially in patients with chronic illness and also in patients with end-stage renal disease. Motivation for regular physical exercise could be a problem. A supervised outpatient program in a rehabilitation center, a home exercise rehabilitation program and an exercise rehabilitation program during the first hours of the hemodialysis treatment with a bed bicycle ergometer in the renal unit could be carried out. Low intensity aerobic activity has a favorable effect on cardiovascular risk factor, and gymnastics to increase strength, flexibility and coordination, as well as relaxation techniques are very effective exercises in a rehabilitation program. The positive influence of individual regular exercise on health, quality of life, physical exercise capacity, endurance, muscle strength, social, professional and emotional status is also very high in patients. Side effects of exercise are very rare.

Attitude to Health↗
PubMed1995

Dietary intake and nutritional status of athletic and nonathletic children in early puberty.

Dietary intakes, trace element status, and anthropometric measures were studied in 12- to 13-year-old boys (n = 49) playing ice hockey (AB) and in 11- to 12-year-old girls who were gymnasts, figure skaters, and runners (AG; n = 43). Thirty-five boys (CB) and 53 girls (CG) not involved in supervised sports were controls. After adjustment for sexual maturation, ABs had larger upper arm muscle circumference than CBs. The sum of four skinfolds was smaller in AGs than in CGs. The intake of energy and all micronutrients examined was higher in ABs than in CBs. Micronutrient intakes were not different between AGs and CGs. Compared to CBs, serum ferritin and copper concentrations were lower, but serum zinc concentration was higher in ABs. No differences in trace element status were found between AGs and CGs. Blood investigations did not indicate inadequate trace element status in any of the groups studied.

Adolescent↗
PubMed2004

Evaluation of nutrition knowledge and dietary recommendations by coaches of adolescent Brazilian athletes.

The objectives of this study were to describe the dietary practices recommended by coaches working with adolescent athletes and to assess their nutritional knowledge. During a regional competition in the state of Sao Paulo, Brazil, 55 coaches were interviewed. These coaches represented 22 cities with athletes enrolled in Olympic gymnastics, tennis, swimming, and judo events. A 3-section questionnaire was used to obtain data on demographic characteristics, dietary recommendations, and nutrition knowledge. Results showed that all coaches recommended general dietary practices during training, with no specific strategies for pre-, during-, and post-training periods. The main objectives of the recommendations for the training period were weight control and muscle mass gain. Deleterious weight control practices were recommended by 27% of the coaches. Specific dietary practices pre and post competition were recommended by 93% and 46% of the coaches, respectively. Participants responded correctly to 70% (SD = 3.2) of the nutrition knowledge questions, with no significant differences (p =.61) between sports. The knowledge test identified a tendency to over-value proteins, excessively low-fat diets, and food myths. These findings indicate the importance of developing strategies that will enhance the nutritional training of coaches.

Adolescent↗