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PubMed1993

[Craniocerebral trauma caused by sports. Pathogenic mechanism, clinical aspects and physical therapy with special reference to manual lymph drainage].

On top of one comprehensive English accident statistics of head injuries in sports there is riding, followed by rugby and football. In Germany there is not very little of head and brain damage due to football as wide spread sports, followed by riding, athletics and gymnastics, whereas in boxing recurring head injuries of dosage underlaying concussion of the brain do play a part even in spite of wearing boxing caps. Anyway, damage of the brain will always be the most heavy complication. Besides uncomplicated wounds of the soft parts such as wounds of the scalp or contusion of the face the closed skull and brain damage will be the most generally form of head injury in sports, followed by fractures of the skull with contusion of the brain and intracranial hemorrhage. In the treatment of the post-concussion and post-contusion syndrome manual lymph drainage will achieve more importance by its anti-edematous and therefore depressant and also sedative effects.

Athletic Injuries↗
PubMed1975

[Treatment of angina pectoris by physical loading].

21 chronic anginal patients (AP), 23 patients with an overall number of 37 aorta-to-coronary artery by-passes (ACB) underwent a regular physical training (cycle, quick or uphill walking, gymnastics). The patients were compared to themselves in the course of a calibrated effort test, performed until angina occured or the maximal cardiac rate reached.

Angina Pectoris↗
PubMed1994

Ulnar variance: facts and fiction review article.

The relative length of the ulna compared to the radius, or ulnar variance, appears to be an important element in wrist pathology. The length is determined by age, genetic factors, load (i.e. gymnasts) and gross elbow pathology. The negative ulnar variance or short ulna has been associated with Kienböck's disease, avascular necrosis of the scaphoid and scapholunate dissociations. This could not be confirmed in our observations. On the contrary, a long ulna (positive ulnar variance) is harmful for the ulnar compartment of the wrist as it causes degeneration and perforation of the triangular fibrocartilage complex (TFCC) and cartilaginous wear of the carpal bones (ulnar impaction syndrome). The ulnar variance is also determinant for the morphology of the sigmoid notch of the radius. With wrist arthroscopy a more precise diagnosis of ulnar wrist pain has become possible.

Age Factors↗
PubMed1993

[PCB caulking sealants--experiences and results of measures in Berlin and decontamination of a school (Part I)].

PCB contamination of indoor air in public buildings by elastic sealants has proved to be a serious problem in West Berlin. Besides a general survey and introduction into the toxicological problem the procedure and experiences in Berlin are presented. Besides a proposal of a catalogue of several preventive measures, sampling and analytical methods are also described. During the control of about 220 buildings, 40 turned out to be PCB-contaminated, mostly gymnastic halls (30). In former East Berlin no PCB contamination by elastic sealants is known so far. In part 2 experiences and results of a restoration of a school-building are reported.

Adolescent↗
PubMed1994

Conditions of the toenails.

Athletes are susceptible to developing toenail problems because of the speed or intensity of play (runners), the starting and stopping nature of the sport (tennis, racquetball), and the type of activity and shoes they wear or do not wear (ballet dancers, gymnasts). They may also have other conditions, such as hallux valgus, claw toes, gout, diabetes, arthritis, or fungus infection of the nails, that may influence the decision on the type of treatment recommended. Nail trauma that could result in osteomyelitis; secondary effects of arthritis, such as the development of a mucous cyst; and the infected ingrown toenail are seen frequently in the athlete and can be satisfactorily treated by the orthopedist.

Adolescent↗
PubMed1993

[Orthodontic treatment in mouth breathing].

Patients with severe alterations of the maxillary growth pattern, due to long term predominant oral respiration, primarily need orthopaedic appliances, rather than common orthodontic mechanics. In cases of maxillary transversal deficiency, rapid expansion is indicated to recover an adequate width. Such treatment improves the ability for nasal ventilation. When the maxilla is sagittally underdeveloped, a facial mask is used to protract the entire maxilla. Other ways of treatment include oral screens, partial glossectomy, myofunctional therapy and respiratory gymnastics. Finally orthodontic treatment can be planned to correct irregularities of the teeth and residual malocclusions.

Activator Appliances↗
PubMed1993

[Preventive measures for early and late locomotor complications from thoracoplasty and myoplasty].

Two basic methods of prevention of early- and late-occurring complications after thoracoplastic and myoplastic surgery are defined by the authors: I. The function protective surgical method and technique: by the retention of rib 1, the extramuscular periosteal thoracoplastic surgery, resection of as few ribs as possible, total performance of thoracoplastic and myoplastic surgery, epidural assuaging of pain. II. Perioperative physiotherapy and correct rehabilitative treatment, where gymnastics plays the most important role, and also combined application of the different special methods of physiotherapy, can also contribute to favourable results. 17 patients data have been processed and set out in the report. They show the efficiency of the applied methods. Planned and purposeful co-operation between the surgeon and the physiotherapist is needed in the medical treatment of patients.

Adult↗
PubMed1993

[Stress reactions and stress fractures in the high performance athlete. Causes, diagnosis and therapy].

From 1987 until July 1991 70 athletes with stress reactions or stress fractures were treated in the orthopaedic department of the Hannover Medical School. The average age of the 42 male and 28 female athletes was 22.6 years. The number of athletes involved in track and field sports was 29 (41.4%), in gymnastics 9 (12.9%) and in soccer 5 (7.1%). The most common bone injured was the tibia in 29 (41.4%), followed by the tarsal navicular in 21 (30.0%), the midfoot in 17 (24.3%) and the fibula in 4 (5.7%) athletes. In three cases double stress fractures were found in adjacent locations; in one case a stress fracture of the opposite navicular occurred after the initial tarsal navicular stress fracture had healed, and in another case the tarsal navicular was found to be fractured again. Thirty-seven percent of the athletes claimed sudden increase in training intensity was the cause; 33% felt that the increased sprinting and jump activities were the reason for their complaints. In some athletes pain started after an ankle sprain. Standard diagnostic procedure consisted in X-rays in two planes and three-phase bone scanning. In tarsal navicular or tibial locations additional tomograms were performed. MRI and CT scans were reserved for unclear findings and to exclude the possibility of a tumorous or inflammatory process. A new grading system was introduced that covers all forms of stress reactions from periostitis to pseudarthrosis. Clinical symptoms, sport disabilities, radiological and bone scan findings were graded from A to D. Using a modified Wilson classification, all radiologically recognizable stress reactions could be classified.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

[Determination of the acoustic climate inside elementary schools].

The evaluation of acoustic conditions in four elementary schools showed high levels of noise inside schools, especially in corridors. It refers mainly public schools, which generally are overcrowded. During breaks the most frequent noise level is 86 dB but in some parts of corridors approaches values 95-98 dB. During lessons the noise in corridors decreases to about 64 dB. However during physical exercises which take place in corridors the noise level in corridors increases up to 75-80 dB. In public schools the noise levels in corridors both during lessons and breaks are higher about 12 dB than in private schools. However during lessons in classrooms those differences are quite lower. The noise level during lessons depends mainly on number of pupils, subject of the lesson, year of schooling and period of duration of the lesson. Considerable growth of noise occurs in classes above 20 pupils and at initial and final period of the lesson. The most favourable acoustic conditions are in classes below 15 pupils but in classes above 20 pupils the noise levels increase average about 4 dB. In spite of common opinion the noise level is lower in classes with younger children than in classes with older children. In older classes the noise is higher average about 3 dB. The noise in classroom depends also on manner of teaching and type of tasks performed by schoolchildren. The work in group is noisiest (average more 8 dB than during lectures). It refers especially to gymnastics lessons during group games. In this case the noise levels usually are above 90 dB. However it was not observed significant differences in daily or weekly distribution of the noise level during lessons. Resultant daily noise exposure of schoolchildren during their school time is 80 dB (or sometimes 85 dB) in public schools and 72 dB in private schools. Average noise exposure in public schools approaches critical values accepted for hearing protection for adolescents during apprenticeship.

Acoustics↗
PubMedDate not supplied

Action of nedocromil sodium in exercise-induced asthma in adolescents.

In view of the high incidence of exercise-induced asthma (EIA) in asthmatic adolescents and adults, the aim of the present study was to examine the preventive effect of nedocromil sodium administered prior to an exercise provocation test. The study involved 30 adolescents with EIA, aged between 14 and 19 years, who attended gymnastics classes at the Children's Hospital and Aerobics School. Baseline spirometry, six-minute treadmill running and spirometry for 7-15 minutes post-exercise were performed. During the same week and under identical temperature and humidity conditions, the same test was carried out with 4 mg nedocromil sodium (two inhalations) administered 30 minutes before exercise. Original post-exercise FEV1 values were compared with the findings after administration of nedocromil sodium. Seventeen subjects (56%) were totally protected (< 5% decrease in FEV1) and 13 subjects (44%) were partially protected (< 10% decrease in FEV1). EIA persisted in the fifteen subjects who received placebo pretreatment. Nedocromil sodium, administered 30 minutes prior to exercise, was effective, providing an opportunity to enhance the quality of life of the asthmatic patient troubled by exercise-induced symptoms.

Adolescent↗
PubMed1996

[Traumatological risk in ambulatory cardiological rehabilitation].

BACKGROUND: In Israel in 1956 Gottheiner introduced outpatient rehabilitation programs in patients who had survived a myocardial infarction. In Germany one decade later these WHO phase III activities were established as well. At present any patient with cardiovascular disease is included unless suffering from acute illnesses or presenting with symptoms at rest. Gymnastics, stretching and the "historic" volleyball are completed by jogging, soccer, basketball and anaerobic exercise. Thus, a notable trauma rate would be expected especially in the elderly and those who are on anticoagulation. METHODS: A retrospective analysis evaluated questionnaires of 903 patients in 116 outpatient coronary care groups covering approximately equal to 270,000 patient exercise hours. RESULTS: 101 of 123 injuries (approximately equal to 1/2 200 patient exercise hours) occurred during games the majority of which having been distortions (53.7%), hematomas, or bruises (15.4%). Severe traumas included bone fractures (11.4%) and ruptured muscles, tendons, or ligaments (12.2%). One patient lost the sight of one eye due to a broken spectacle frame. Patients who had felt exercise as too exhausting (p < 0.001) or complained of cardiovascular symptoms (p < 0.01) showed a significantly elevated trauma rate. CONCLUSIONS: Thus, in outpatient cardiac rehabilitation the trauma rate is within the range of healthy sports men. To prevent injuries sports should be limited to the patient's level of activity. Improved skills in techniques and strategies as well as unbreakable glasses are recommended.

Aged↗
PubMed1996

[Wobenzyme and diuretic therapy in lymphedema after breast operation].

The authors of this clinical study report the results of a controlled clinical trial in randomized parallel groups (Wobenzym vs. diuretics) of 55 female patients suffering from brachial arm lymph edema subsequent to ablatio mammae. All patients received manual and machine lymph drainage as well as gymnastics as concomitant therapy. After 7 weeks of therapy the results of the volometric assessments of the arm, the circumference of the arm and the skinfold thickness showed significant improvements compared to diuretics. In addition, the patients receiving Wobenzym reported a significantly higher proportion of patients free of pain compared to the diuretics patients. Overall safety assessment results are satisfactory thus resulting in a superior benefit/risk relation of the Wobenzym group.

Adjuvants, Immunologic↗
PubMed1996

[Gynecologic problems in female athletes].

More than 6 million women now compete in strenous exercis, worldwide. The sports participation is a sage experience for the teenage athlete. But intense exercise had been reported to delay menarche when the sports activity was begun before puberty. Is has been shown to increase beta-endorphins and catecholamine in women. Menstrual cyclicity is influenced by prior and concomitant exercise intensity and/or duration in long-distance runners, gymnasts, ballet dancers, fencers, rowers. Altered menstrual cyclicity can approach 70% in strenuously exercising women. Menstrual dysfunction has been associated with significant weight loss, decreased body fat, previous history od menstrual dysfunction, stress and intensity of athletic training. A complication of amenorrhea is the loss of bone mineral content and bone density. Urinary incontinence during physical stresses is common in young nulliparous women. Some female athletes to increase their sports performance artificially take illegal steroid substances. Perineo-sphincter exercise must be started very early during the post-partum, before the start of sports. Most of the athletes of all ages resulted to prefer the oral contraceptive method.

Adolescent↗
PubMed1996

[Youthful sudden cardiac death and the Kawasaki syndrome. An anatomopathological case report].

In 1967 Kawasaki studied 50 cases with the same features as mucocutaneous lymph node syndrome, further reported throughout Japan with the eponym of Kawasaki's disease. It is frequent in Japan and in USA, whereas in Europe it is sporadic and often misinterpreted. It presents as an acute fever, attended by irritation of the skin and oral mucosa, with swelling of cervical lymph nodes, easily misdiagnosed as scarlet fever, Stevens Johnson syndrome, or infantile exanthema or allergy. After the acute phase, Kawasaki's disease becomes chronic and sudden death is possible even if many years have elapsed. In the chronic phase, coronaritis, coronary aneurysms, marked stenosis and/or occlusive thrombosis are often present. Cardiac Lesions were classified from stage I to IV according to the duration of illness at death. The present work deals with the case of a 17 year old man, dying from undiagnosed coronary artery chronic Kawasaki disease. The patient had been hospitalized for Wolff-Parkinson-white syndrome; ten months after discharge he died suddenly, while performing gymnastics at school. Occluding thrombosis of cylindrical aneurysm of both coronary arteries, from undiagnosed Kawasaki arteritis, was found and the young boy succumbed to hyperacute infarction. The heart was fixed in buffered formalin 10% and embedded in paraffin. Histological examination of the cardiac conduction system has been carried out on serial sections, with the technique usually adopted by one of the present authors (L. Rossi). Hema-toxylin-eosin (H-E) and trichromic (Hei-denhein-azan) stainings have routinely employed.

Adolescent↗
PubMed1995

[Obesity, overweight and physical activity in elementary school children].

This research presents an epidemiological study on the prevalence of obesity and overweightness in an Elementary School population. 243 children of third and fourth grade (males 52.26% and females 47.74%, 9-10 years old) of the Selvazzano (Padova) District, were evaluated during the annual medical visit. The Body Max Index (BMI) and the Cole index were calculated. The parents filled out a questionnaire which investigated the level and quality of involvement in sports. The statistical analysis was executed by the ANOVA test and post Hoc analysis. 59.02% of the children resulted within the ponderal normality with the Cole index < or = 110, 13.5% resulted overweight (Cole index 110 divided by 120), 20% resulted obese (Cole index 120 divided by 140), 7.3% resulted highly obese (Cole index > 140). High level obesity was found in fourth grade boys (p < 0.0001). As far as sports are concerned, it is noted that 173 children (73.3%) practise some sport. The more practised sports, swimming (44.5%), soccer (27.1%) and gymnastic (15.02%), are practised twice a week by 58.3% of the children. Obesity and overweight in the examined population result high even in relation to data found in literature. When choosing a sport activity to prevent overweightness or obesity, one should advise parents, school operators and students to choose a sport with a great caloric consumption, at least 250-300 kcal per session, twice a week, along with a change in active lifestyle. Regarding swimming, the most practised sport, children should be sent at an early age (4-5 years old) in order to anticipate learning of the athletic gesture, and to do this at an age in which obesity and overweightness have less an incidence.

Body Mass Index↗
PubMed1996

[The anorectic life of Empress Elisabeth of Austria (1837-1898). Slenderness cult of the Habsburg family].

Empress Elisabeth of Austria (1837-1898), known for her beauty as well as for her opposition to the ceremonial court of the Austrian ruling family, suffered from a disease that has been termed typical for modern-day industrial nations. The biography of the Empress discloses information revealing symptoms of anorexia nervosa. Over a period of decades she developed strategies for weight reduction such as fasting rituals, gymnastics, hour-long horse-riding and forced marching. Numerous documents repeatedly describe her considerable fear of weight gain and the psychopathological changes specific for anorexia nervosa. Up to her death she succeeded in restricting to a minimum not only her body weight but also her social obligations. The documents on the life of Empress Elisabeth suggest that cultural, historical and psychodynamic factors play an important role in the genesis of this disorder.

Anorexia Nervosa↗
PubMedDate not supplied

[Clinical aspects of cranio-mandibular disorders. III. Principles of elective therapy].

The therapeutic approaches on 406 patients of both sexes, agent between 9 and 78 (mean age 30.47) and suffering from cranio-mandibular disorders, have been analyzed, in order to evaluate the more frequent measures of treatment and to improve the management of pain and dysfunction of the stomatognathic system. Having confirmed the multifactorial aetiology, an individual treatment plan was worked out. Of the initial therapies, active gymnastics (63.58%), bland aspecific drugs (21.02%), assisted relaxation practices (7.17%) were of particular importance. As occlusion measures, stabilisation splint (44.61%) had precise instruction for use; in case of mandibular dislocation, a repositioning splint was constructed in articulator, in order to achieve a new therapeutic position (30.51%); sometimes, only a vertical dimension increase of previous prosthesis was made (14.35%). The specific symptom profiles of the diagnostic subgroups in which the sample was subdivided induced to adopt considerably different procedures, due to the basic pathology. The final therapy considered above all prosthetic (35.64%) and orthodontic (25.12%) rehabilitations, whether structural changes were necessary; moreover occlusal adjustment (5.64%); only few cases (2.05%) required a surgical consultation. A deliberate choice of conservative approach was evident in a remarkable number of patients (26.15%), treated in an absolutely reversible way.

Adolescent↗
PubMed1977

[Forms and method of rehabilitation therapy and social-occupational rehabilitation of patients with the sequelae of cerebrovascular diseases].

The authors give some data on restitutional therapy of 516 patients (400 with sequelae following strokes and 116 with transient disorders of cerebral circulation). Treatment of the first group was made in a neurological ward, the second--in a cardiological sanatorium. The programme of restitutional therapy provided the use of psychosocial and biological methods, an appeal to the personality and stage-by-stage accomplishment of rehabilitative measures. Comprehensive restitutional therapy included psychotherapy, medical-activizing regimes, medical gymnastics, massage, occupational therapy, medicinal therapy, etc. The authors elaborated differentiated complexes of rehabilitative treatment for patients with spastic hemiparesis, normal or decreased tone, as well as for patients with transient disorders of cerebral circulation in conditions of a cardiological sanatorium. The indices of effectiveness were the following: an improvement of the condition in patients after brain strokes--97.8%, in patients with transient disorders of cerebral circulation--94%.

Cerebrovascular Disorders↗