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PubMed2002

Effects of exercise practice on the maintenance of radius bone mineral density in postmenopausal women.

The effect of exercise practice on the radius bone mineral density (BMD) was investigated on 480 women at the age of perimenopause and later. The BMD at the 1/3 distal site of the radius on a non-dominant hand was measured using the Dual Energy X-ray Absorptiometry method. The subjects were divided into group E with regular exercising and group C without regular exercising. The difference of mean radius BMD values was not statistically significant between groups E and C. Each of the groups E and C was further classified into a perimenopause group and groups with stratified postmenopausal years (postmenopausal years less than 5, less than 10 and more than 10). Then, the mean radius BMD value of the perimenopause subgroup was taken as 100% for each of the groups E and C, and the relative radius BMD values of subgroups were compared between groups E and C. The relative BMD values for the subgroup of postmenopausal years more than 10 were higher in E group than those in C group, while no difference was observed in below postmenopausal 10 years between the two groups. To clarify the BMD difference among exercise events, group E was further divided into the following three subgroups: the subgroup practising events which give high-impact to arm (HI group), such as tennis, ping-pong, golf and volleyball, the subgroup practising swimming (SW group), and the subgroup practising events which give low-impact to arm (LI group), such as walking, running, aerobic dance and light gymnastics. No significant differences were observed in BMD values among the above sports event-stratified subgroups when postmenopausal years were less than 10 years, but the relative BMD values for the subgroup of postmenopausal years more than 10 were higher in HI and LI group than those in control group. These results suggest the possibility that exercise practice suppresses a postmenopausal decline in bone density for preventing osteoporosis from developing.

Adult↗
PubMed1988

The role of biomechanics in the epidemiology of injuries.

In this paper a review of the epidemiology of both traumatic and overuse injuries is presented with special emphasis on the role of biomechanics. Biomechanical analysis of injuries and the specific sports has increased in sophistication to such a degree we have a much better understanding of both aetiology and management. Particularly in the area of overuse injuries this biomechanical data can also be utilised in prevention. This paper discusses acute traumatic injuries with emphasis on knee injuries. A detailed examination of knee injuries during skiing is explored. In addition, cervical injuries in gridiron football and rugby are outlined. Overuse injuries occurring during running are next discussed. Aetiological factors including training errors, muscular dysfunction and inflexibility, footwear, running gait and lower extremity malalignment are considered. Overuse injuries in swimming, dance, gymnastics and throwing sports are briefly discussed. Biochemical analysis is felt to be important in developing strategies that lead to rule changes, alteration of training techniques and improvement in equipment and footwear.

Athletic Injuries↗
PubMed1989

Athletic amenorrhoea. An update on aetiology, complications and management.

The enormous increase in participation by women in physical recreation and sport since the early 1970s, has seen a parallel increase in research into the effects of strenuous exercise on the female neuroendocrine and reproductive systems. Oligomenorrhoea, primary or secondary amenorrhoea, altered pubertal progression, defective luteal phase, anovulation, and infertility may result, most frequently in those aerobic type activities associated with the lower bodyweight and fat percentages such as running, aerobics, and gymnastics. As well as body composition and sport specificity, intensity of training, previous menstrual history (in particular delayed menarche) and diet/eating disorders are all important associated factors. The neuroendocrinological pathogenesis to this altered menstrual function is complex and controversial; however, the evidence for accelerated bone loss in these young women with chronic hypo-oestrogenaemia is substantial. Since the first studies released in 1982 when amenorrhoeic runners' bone mineral content was measured and found equivalent to that predicted normal for 52-year-old women, further studies have proposed an association between this hypo-oestrogenaemia, reduced bone density and stress fractures. Studies so far show that this bone loss continues to occur over time, but the most rapid rate of bone loss (approximately 4%/year) occurs early on cessation of menses, thus emphasising the importance of early management in preventing bone loss occurring in young amenorrhoeic athletes. The role of calcium and oestrogen supplementation in management of the hypo-oestrogenic exercising female are unclear. The results of longitudinal studies currently under way assessing their benefits are awaited. Meanwhile an increased calcium intake to 1500mg per day should be advised and consideration of oestrogen and/or progesterone supplementation given. It is important that other causes of amenorrhoea are not overlooked in this exercising population and the diagnosis of 'athletic amenorrhoea' should not be made until a full thorough history, physical examination and blood tests have eliminated other common causes. Full dietary history and assessment for eating disorders is an essential part of this assessment.

Amenorrhea↗
PubMed1990

Intensive training in young athletes. The orthopaedic surgeon's viewpoint.

A young athlete's musculoskeletal system is unique, in that it is not only growing, but is giving support to the growing soft tissues as well. With this in mind, it is easily understood that the fastest growing areas of children skeletal system are at greater risk of injury. No controlled longitudinal studies have yet been performed about the long term effects of injuries occurring in intensively trained young athletes. During the growth spurt, a dissociation between bone matrix formation and bone mineralisation occurs, thus leaving the child with the risks of chronic moderate-to-high overloading, sudden great overload, and diminished bone strength. This may account for both acute and overuse bone injuries in this age group. Epiphyseal plate injuries can have disastrous consequences. About 10% of all skeletal trauma in children involves the epiphysis, but few long-lasting effects have been reported. It is not clear whether intensively trained young athletes are at greater risk of injury than children engaged in free-play activities. It is worrying, though, that about 20% of injuries in sports children require internal fixation. Few studies have addressed injuries to tendons, ligaments and the enthesis in young athletes. It seems that tendon injuries are mild, not requiring surgery, and with a low recurrence rate, but no prospective studies have been performed. Avulsion of the ligamentous insertion occurs more frequently than ligament ruptures in this age group, even though they seem on the increase. Osteochondritis dissecans affects weightbearing joints such as the hip, the knee and the ankle, but elbow lesions in gymnasts and throwers are also relatively frequent. If it occurs before epiphyseal fusion, long term effects are scarce. The centre of growth or ossification where a major tendon is attached may undergo chronic inflammation and avulsion of cartilage and bone, due to the stresses transmitted to it. Typical areas are the inferior pole of the patella, the tibial tubercle and the calcaneal apophysis. Sports activity contributes to the disease by excessive traction at the tendinous and fascial insertion, or as a result of direct pressure. The lumbar spine is subjected to enormous forces in some sports. The true incidence of lumbar disc lesions in sporting children is not known, but it seems that acute trauma may play a major role. With the increase of the intensity and duration of training programmes, degenerative changes may play an adjuvant role.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1992

The thoracolumbar spine in young elite athletes. Current concepts on the effects of physical training.

Due to the increased interest in physical fitness and to the fact that athletes start their training at younger ages the risk for injuries to the growing individual has increased. The spine, as with the rest of the skeleton, is at greater risk of injury during growth, especially during the adolescent growth spurt. Back pain is more common among athletes participating in sports with high demands on the back than other athletes and nonathletes. Disc degeneration, defined as disc height reduction on conventional radiographs and reduced disc signal intensity on MRI, has been found in a higher frequency among wrestlers and gymnasts than nonathletes. Abnormalities of the vertebral bodies including abnormal configuration, Schmorl's nodes and apophyseal changes are common among athletes. These abnormalities are similar to those found in Scheuermann's disease. Athletes with these types of abnormalities have more back pain than those without. Spondylolysis has been found in higher frequencies than expected among athletes representing many different sports. Spondylolysis has been reported in up to 50% of athletes with back pain. Scoliosis has been found in up to 80% of athletes with an asymmetric load on the trunk and shoulders, such as javelin throwers and tennis players. The scoliosis, however, is a small curvature and does not cause back pain.

Athletic Injuries↗
PubMed1995

Knee injuries in female athletes.

Female athletes are at increased risk for certain sports-related injuries, particularly those involving the knee. Factors that contribute to this increased risk are the differences in sports undertaken and in gender anatomy and structure. Gender differences include baseline level of conditioning, lower extremity alignment, physiological laxity, pelvis width, tibial rotation and foot alignment. Sports like gymnastics and cheerleading create a noncontact environment, but can result in significant knee injuries. In quick stopping and cutting sports, females have an increased incidence of anterior cruciate ligament (ACL) injury by noncontact mechanisms. Patellofemoral (PF) disorders are also very common in female athletes. Awareness of these facts helps the sports medicine professional make an accurate diagnosis and institute earlier treatment-focused rehabilitation with or without surgery. Further prospective and retrospective research is needed in areas of epidemiology, mechanisms, severity and types of knee injuries. The goal is to lessen the severity of certain knee injuries and to prevent others.

Athletic Injuries↗
PubMed1995

Aging, physical activity and sports injuries. An overview of common sports injuries in the elderly.

Illness and aging both cause many structural and functional alterations in the human body, rendering elderly people liable to overloading of the musculoskeletal and cardiovascular systems. It should, however, be kept in mind that immobilisation and inactivity have even more deleterious effects on structures and functions in the elderly than in younger adults. Most physically active elderly people are selected individuals with respect to their superior health and physical capacity compared with inactive persons of the same age, thus making it possible to further improve their physical capacity. They will, however, be affected by some of the drawbacks of physical overloading, mostly due to the diminished ability of aging body systems to adapt to high levels of loading. The safety margin of an exercise dose tends to decline with aging. Exertional injuries are common among the elderly, and are connected mostly with degenerative aging processes. Acute injuries are common in those elderly people participating in sport activities which demand high coordination, reaction time, and balance capabilities, such as ball games, down-hill skiing, and gymnastics. Muscle has been reported to be the most commonly acutely injured tissue among active elderly athletes. The lower extremities are the most susceptible to injury. A large proportion of injuries (acute and exertional) are mild and can be treated by brief cessation of training and competition activities. Some of the injuries are, however, long term and cause disability not only during training and competition, but also in the normal activities of daily living. It is important that these injuries are treated as soon as possible and in the most effective way, similarly to injuries suffered by younger people. In treating elderly people, it is most important to avoid the detrimental effects of immobilisation; this requires active treatment and rehabilitation with compensatory exercise therapy. The best 'treatment' for sports-related injuries is prevention. Good agility, technical skills, and cardiovascular and musculoskeletal fitness are important in injury prevention among the elderly. Appropriate training programmes, the use of safe and familiar equipment, careful warming up and cooling down, multiphasic training [including the training of neurophysiological functions (balance, coordination and reaction time)] and muscle strength are essential aspects of injury prevention.

Aged↗
PubMed1998

Stress fractures of the upper limb.

Stress fractures are commonly found in the lower limb, but also occur in the upper limb, and are particularly associated with upper limb-dominated sports such as tennis and swimming and those involving throwing activities. Stress fractures of the clavicle and scapula are rare but have been reported, whereas those of the humerus are more frequent and have been described mainly in adolescent baseball pitchers. Olecranon stress fractures occur in throwers and gymnasts. Stress fractures of the ulna and radius have also been reported in a number of different upper limb-dominated sports. In all cases, these fractures heal with conservative management. The physician should consider stress fracture as a possible diagnosis in cases of upper limb pain of bony origin where the pain is associated with overuse.

Arm Injuries↗
PubMed2002

Physiological profiles of elite senior wrestlers.

To perform excellently in international competitions, wrestlers have to achieve an excellent level of physical fitness and physical condition during training. This article reviews the physiological profiles of elite wrestlers. In general, successful wrestlers showed higher dynamic and isokinetic strength than unsuccessful wrestlers. In particular, upper body strength and anaerobic power were significantly different between the two groups. Aerobic capacity is one of the most important physical factors to achieve good results in wrestling competitions. The maximal oxygen uptake of national and international wrestlers taking part in international competition has been shown to be about 53 to 56 ml/kg/min. Around the time of the Seoul Olympics, typical values for wrestlers were about 60 ml/kg/min, with values of >70 ml/kg/min in some cases (the latter being similar to values reported for some endurance runners). The flexibility of the wrestlers was found to be lower than that of weight lifters and gymnasts. However, the flexibility of top-level wrestlers was higher than that of lower level wrestlers. To fully understand the physiological profiles of successful wrestlers, further research regarding anaerobic and aerobic energy metabolism, cardiopulmonary responses, body fat content, and changes in muscle hypertrophy both during the wrestling season and off-season is warranted.

Adolescent↗
PubMed2004

Urinary incontinence, pelvic floor dysfunction, exercise and sport.

Urinary incontinence is defined as "the complaint of any involuntary leakage of urine" and is a common problem in the female population with prevalence rates varying between 10% and 55% in 15- to 64-year-old women. The most frequent form of urinary incontinence in women is stress urinary incontinence, defined as "involuntary leakage on effort or exertion, or on sneezing or coughing". The aim of this article is to systematically review the literature on urinary incontinence and participation in sport and fitness activities with a special emphasis on prevalence and treatment in female elite athletes. Stress urinary incontinence is a barrier to women's participation in sport and fitness activities and, therefore, it may be a threat to women's health, self-esteem and well-being. The prevalence during sports among young, nulliparous elite athletes varies between 0% (golf) and 80% (trampolinists). The highest prevalence is found in sports involving high impact activities such as gymnastics, track and field, and some ball games. A 'stiff' and strong pelvic floor positioned at an optimal level inside the pelvis may be a crucial factor in counteracting the increases in abdominal pressure occurring during high-impact activities. There are no randomised controlled trials or reports on the effect of any treatment for stress urinary incontinence in female elite athletes. However, strength training of the pelvic floor muscles has been shown to be effective in treating stress urinary incontinence in parous females in the general population. In randomised controlled trials, reported cure rates, defined as <2g of leakage on pad tests, varied between 44% and 69%. Pelvic floor muscle training has no serious adverse effects and has been recommended as first-line treatment in the general population. Use of preventive devices such as vaginal tampons or pessaries can prevent leakage during high impact physical activity. The pelvic floor muscles need to be much stronger in elite athletes than in other women. There is a need for more basic research on pelvic floor muscle function during physical activity and the effect of pelvic floor muscle training in female elite athletes.

Exercise↗
PubMed2006

How does exercise affect bone development during growth?

It is increasingly accepted that osteoporosis is a paediatric issue. The prepubertal human skeleton is quite sensitive to the mechanical stimulation elicited by physical activity. To achieve the benefits for bone deriving from physical activity, it is not necessary to perform high volumes of exercise, since a notable osteogenic effect may be achieved with just 3 hours of participation in sports. Physical activity or participation in sport should start at prepubertal ages and should be maintained through the pubertal development to obtain the maximal peak bone mass potentially achievable. Starting physical activity prior to the pubertal growth spurt stimulates both bone and skeletal muscle hypertrophy to a greater degree than observed with normal growth in non-physically active children. High strain-eliciting sport like gymnastics, or participation in sports or weight-bearing physical activities like football or handball, are strongly recommended to increase the peak bone mass. Moreover, the increase in lean mass is the most important predictor for bone mineral mass accrual during prepubertal growth throughout the population. Since skeletal muscle is the primary component of lean mass, participation in sport could have not only a direct osteogenic effect, but also an indirect effect by increasing muscle mass and hence the tensions generated on bones during prepubertal years.

Bone Density↗
PubMed2006

Adaptive skeletal responses to mechanical loading during adolescence.

Adolescence, defined as the period between puberty and maturity, provides a 'window of opportunity' for positive skeletal adaptations to mechanical loading unlike any other period in life. Age-related bone loss highlights the importance of accumulating sufficient bone mass during formative years. Adolescents who regularly engage in weight-bearing mechanical loading appear advantaged in site-specific markers of bone mass. The positive influence of physical activity on bone mineral accrual during growth has been extensively studied; however, few studies have examined skeletal responses to mechanical loading during adolescence. Weight-bearing physical activity, particularly high-impact sports such as gymnastics, is recognised as being more osteogenic than weight-supported activities. Unilateral loading activities such as tennis or squash provide a direct comparison of skeletal response without sampling bias or genetic confounding. Intervention and longitudinal studies show evidence of positive skeletal adaptations; however, sustainability of skeletal advantages remains unclear. Limitations inherent with single-plane dual x-ray absorptiometry technology are well recognised. The integration of densitometric data with structural responses to mechanical loading using 3-dimensional imaging technologies such as peripheral quantitative computed tomography and magnetic resonance imaging appears vital to enhancing our understanding of adolescent musculoskeletal health.

Adolescent↗
PubMed2006

Perimesencephalic nonaneurysmal subarachnoid hemorrhage caused by physical exertion.

The clinical characteristics of perimesencephalic nonaneurysmal subarachnoid hemorrhage (SAH) caused by physical exertion were analyzed to investigate the causes and mechanisms of perimesencephalic nonaneurysmal SAH. Nine of 209 patients with spontaneous SAH were identified as having perimesencephalic nonaneurysmal SAH. Perimesencephalic nonaneurysmal SAH in four males and three females was precipitated by exertion. Age, sex predominance, type of exertion, symptoms, loss of consciousness during bleeding, clinical grade, angiographic spasm, hydrocephalus, delayed ischemic deficit, rebleeding, hypertension, and outcome were evaluated in these seven patients. Outcomes were assessed using the Glasgow Outcome Scale. Patients showed male predominance (57.1%), relatively young age (mean 50 years), low frequency of hypertension (28.6%), good clinical grade (World Federation of Neurological Surgeons grade I or II), and excellent outcomes including no rebleeding, no symptomatic hydrocephalus, and no delayed ischemic deficits. The type of exertion was swimming in two patients, golfing in two patients, heavy lifting in two patients, and bending forward during gymnastics in one patient. Physical exertion including components of the Valsalva maneuver is an important predisposing factor for perimesencephalic nonaneurysmal SAH. Such physical exertion produces increased intrathoracic pressure, which blocks the internal jugular venous return, resulting in elevated intracranial venous pressure or mechanical swelling of the intracranial veins, and leads to venous or capillary breakdown.

Adult↗
PubMed1998

Relationship between exercise and bone mineral density among over 5,000 women aged 40 years and above.

An epidemiological survey was conducted to clarify the relationship between bone mineral density(BMD) and exercise at 14 health centers in Ibaraki Prefecture, Japan from September 1994 through March 1995. More than 5,000 women participated in this survey. Second metacarpal BMD was measured by CXD(Computed X-ray Densitometry) method. Information about past history of exercise was obtained by questionnaire. sigma GS/D < 2.3(sigma GS/D: a parameter of BMD) was used to estimate the suspicion of osteoporosis. Data on 5,124 women aged 40 years and above were analyzed. Subjects were categorized into two groups according to the presence(n = 1,687) or absence(n = 3,437) of past history of regular exercise. sigma GS/D values were significantly (p < or = 0.05) higher in women who have had regular exercise in the past than those of the non-exercise group except those aged over 70 years. Ball game, foot sports and gymnastics were the main exercises. When osteoporosis was suspected based on the measurements of bone mineral density, the odds ratio (exercise present/absent) was 0.27 (95% confidence limits: 0.08-0.94), 0.82 (0.65-1.04), 0.78 (0.61-0.99), and 1.25 (0.67-2.35) at 40-49, 50-59, 60-69, and over 70 years, respectively. The results of the present study suggest the beneficial influence of exercise on bone mineral density and its utility for preventing osteoporosis.

Adult↗
PubMed1982

Increased peripheral insulin sensitivity and muscle mitochondrial enzymes but unchanged blood glucose control in type I diabetics after physical training.

Nine male, insulin-dependent diabetic patients participated in a 16-wk training program consisting of 1 h of jogging, running, ball games, and gymnastics, performed 2-3 times/wk. The training resulted in an 8% increase of maximal oxygen uptake (P less than 0.01). Insulin sensitivity as determined by the insulin clamp technique increased 20% (P less than 0.05). Glycosylated hemoglobin showed no change (10.4 +/- 0.7% versus 11.3 +/- 0.5%), 24-h urinary glucose excretion was not reduced, and home-monitored urine tests were unchanged. The frequency of hypoglycemic attacks did not change during the training period and body weight remained constant. There was a 14% fall in plasma cholesterol (P less than 0.01) and a rise in the proportion of HDL-cholesterol from 24 +/- 2% to 30 +/- 3% (P less than 0.01). Thigh muscle oxidative capacity increased, as indicated by a 24% increase in succinate dehydrogenase activity (P less than 0.05). The number of capillaries/muscle fiber increased 15% (P less than 0.01). However, as the mean muscle fiber cross-sectional area increased to a similar extent (11%, P less than 0.05), capillary density (cap x mm-2) was unchanged. In conclusion, this study demonstrates that physical training in insulin-dependent diabetics results in increased peripheral insulin sensitivity, a rise in muscle mitochondrial enzyme activities, decreased total plasma cholesterol levels, and unchanged blood glucose control. The findings suggest that in the absence of efforts to alter dietary regulation and insulin administration, physical training consisting of 2-3 weekly bouts of moderate exercise may not of itself improve blood glucose control in type I diabetes.

Adult↗
PubMed2005

Body mass index in female Spanish Olympic athletes.

The purpose of this study was to examine the Body Mass Index of 180 female Spanish Olympic athletes (M age = 27.1 yr., SD = 5.9 yr.) who participate in presentation sports and nonpresentation sports, in comparison with 114 female nonathletes (M age = 20.7, SD = 1.5 yr.). Presentation sports athletes have a profile similar to that of a university student but by age with a lower Body Mass Index. In particular, rhythmic gymnasts have a lower weight and Body Mass Index than other athletes and nonathletes.

Adult↗
PubMed1983

Role of field dependence in perception of movements.

194 male students in physical education were administered the Group Embedded Figures Test. Those who scored high or low were selected for a perceptual experiment (n = 49). Expecting that the analyzing and (re)structuring ability of the field-independent person also applies to complex movement stimuli, subjects had to describe eight complex gross-motor gymnastic skills, demonstrated on a video system. field-independent persons tended to give more detailed descriptions of observed movements; in 5 of 8 cases the difference was statistically significant. Perhaps the field-independent person builds a more structured visual image of movements than the field-dependent person. If so, the former is probably in a better position to learn new motor skills.

Adult↗
PubMed1988

Effect of concurrent visual feedback on acquisition of a weightlifting skill.

Practice in front of a mirror is a common procedure for activities such as dance, gymnastics, and other sports. The purpose of this study was to examine the effect that performing with concurrent visual feedback from a mirror had on the acquisition of the power clean movement. 18 college-age males who had no prior experience with the power clean movement served as subjects who were assigned to one of two groups. One group had use of a mirror during the practice trials and the other practiced without the mirror. All subjects viewed an instructional videotape and had practice trials. All subjects were evaluated for proper technique on a pretest, a posttest without the mirror, and a posttest with the mirror. Analysis showed a significant difference between pre- and posttest performances for both groups and a significant difference between groups on the posttest performances with the mirror. Evidently the videotaped instruction was sufficient to allow both groups to improve in performance of the power clean. Differences in posttest performances with the mirror reflected the type of feedback (with or without the mirror) available during training.

Adult↗