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Using Multivariate Statistics

The purpose of this Position Stand is to provide an overview of issues critical to understanding the importance of exercise and physical activity in older adult populations. The Position Stand is divided into three sections: Section 1 briefly reviews the structural and functional changes that characterize normal human aging, Section 2 considers the extent to which exercise and physical activity can influence the aging process, and Section 3 summarizes the benefits of both long-term exercise and physical activity and shorter-duration exercise programs on health and functional capacity. Although no amount of physical activity can stop the biological aging process, there is evidence that regular exercise can minimize the physiological effects of an otherwise sedentary lifestyle and increase active life expectancy by limiting the development and progression of chronic disease and disabling conditions. There is also emerging evidence for significant psychological and cognitive benefits accruing from regular exercise participation by older adults. Ideally, exercise prescription for older adults should include aerobic exercise, muscle strengthening exercises, and flexibility exercises. The evidence reviewed in this Position Stand is generally consistent with prior American College of Sports Medicine statements on the types and amounts of physical activity recommended for older adults as well as the recently published 2008 Physical Activity Guidelines for Americans. All older adults should engage in regular physical activity and avoid an inactive lifestyle.

Exercise and physical activity for older adults

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Experimental And Quasi Experimental Designs For Research

国際生活機能分類(International Classification of Functioning, Disability and Health: ICF)にみた福祉・保健・医療の専門職協働における連携に関する貢献と課題

Definition: To what extent does the study allow us to draw conclusions about a causal effect between two or more constructs? Issues: Selection, maturation, history, mortality, testing, regression towrd the mean, selection by maturation, treatment by mortality, treatment by testing, measured treatment variables Increase: Eliminate the threats, above all do experimental manipulations, random assignment, and counterbalancing.

Reliability and validity

Hamstring injuries constitute the single largest cause of lost playing time in professional football. While restoring high‐speed running ability is paramount for rehabilitation from these injuries, little evidence exists regarding the extent of return to sport running performance after hamstring injury in football. We examined medical and match performance data available from a sample of 38 professional soccer players competing in the Qatar Stars League (N = 1426 observations) to describe high‐speed running performance during match‐play prior and subsequent to a hamstring strain injury. Multivariable‐adjusted random‐effects generalized additive models estimated post‐ versus pre‐hamstring injury differences in maximal speed (km/h), high‐speed running (>20 km/h), and sprinting (>25 km/h) distance. Mean effects and uncertainty (95% confidence interval, CI) were interpreted against the estimated random match‐to‐match variability in maximal sprinting speed, high‐speed running distance, and sprinting running distance of ±1.67 km/h (95% CI, 1.62–1.72 km/h), ±102 m (95% CI, 99–105 m), and ±60 m (95% CI, 58–61 m), respectively. The estimated post‐ versus pre‐hamstring injury mean differences in maximal sprinting speed, high‐speed running distance, and sprinting running distance primary outcomes were −0.25 km/h (95% CI, −0.38 to −0.12 km/h), −43 m (95% CI, −56 to −30 m), and −22 m (95% CI, −29 to −16 m). Players returning to football match‐play after hamstring strain injury experienced reductions in high‐speed match physical performance that were well within normal match‐to‐match variation in performance.

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High‐speed running during match‐play before and after return from hamstring injury in professional footballers

This study aims to investigate the impact of combined exercise training on selected health status measures and quality of life in patients with AIDS Thirty AIDS patients were randomly divided into two groups of combined exercise training on one hand and control on the other. Combined training consisted of aerobic and resistance exercises for a duration of 12 weeks (three sessions/week). Aerobic training consisted of walking or running on a treadmill with increasing intensity from 40 to 65% of maximal heart rate for 30–60 min. Resistance sessions were made of leg press, lateral pull down, biceps curl and chest press, with 40–65% of 1-RM, two to four sets of 12–20 repetitions. Blood samples were taken from patients around 24 h before the first and 72 h after the last training sessions and cluster of differentiation four cells (CD4), serum brain-derived neurotrophic factor (BDNF), and viral load levels as well as the quality of life were assessed The results showed that although combined exercise training did not affect CD4 and viral load, quality of life increased significantly in the training group (p = 0.04). Moreover, BDNF significantly decreased in the control group but not in the training group (p = 0.03) These findings suggest that combined exercise training over 3 months resulted in increased quality of life while preventing reductions in BDNF levels in AIDS patients, while no changes in viral load and CD4 count have been noticed

Combined training in patient with aids: improved quality of life and preserved BDNF

Muscle strain accounts for ~30% of all football injuries1 and engages medical staff in a complicated process of diagnostic and management. In 90% of the cases, muscle strains affect hamstrings, rectus femoris, adductors, soleus and gastrocnemius.2 3 In particular, into the group of the so-called minor muscle injuries, a subgroup defined ‘non-structural muscle injuries’ (NSI) has been identified.2 The NSIs do not present any visible muscle fibre lesion at MRI and ultrasound examination and are classified as grade 1a, 1b2 or zero3 according to the latest classifications.2 3 Moreover, they are fare from being rare as they account for 30% – 40% of all muscle lesions recorded by professional football clubs.1 Despite the fact that NSIs are not detected by imaging, they can have functional sequelae.2 3 

The player affected by NSI generally loses between 1 and 7 days of training/match exposure, and the diagnosis of this type of injury can be challenging. Many medical centres are not adequately specialised in sports medicine injuries and the imaging exams may be negative or, at the very most, reveal an ill-defined oedematous area that may be difficult to interpret.2 3 

In …

https://bmjopensem.bmj.com/content/bmjosem/5/1/e000479.full.pdf

Risk diagnosis of minor muscle injuries in professional football players: when imaging cannot help out biology might.

Background Research focusing on reducing the risk of injuries has increased over the last two decades showing that prevention implementation in real life is challenging. Objective To explore the experience and opinions of professional football stakeholders regarding injuries, their prevention and the implementation of preventive measures. Design Qualitative study. Setting Technical and medical staff from Qatar’s premier football league. Participants 22 professionals from 6 teams. Main outcome Semistructured interviews were transcribed verbatim and analysed using the thematic analysis method. Results All the participants acknowledged the importance of injury prevention. They mentioned teamwork, trust and communication as critical factors for a successful injury prevention implementation. Teams’ doctors see themselves mainly involved in the treatment and recovery process, and to a lesser degree, in the prevention process. Physiotherapists defined their primary responsibilities as screening for injury risk and providing individual exercises to players. The participants declared that the fitness coach is responsible for injury prevention implementation. All stakeholders reported that the fitness coach plays a vital role in communication by bridging the head coach and the medical staff. Stakeholders reported that the Qatari football league has a very particular context around the player, such as socioecological factors influencing injury prevention implementation. Conclusions The fitness coach plays a vital role in the injury prevention implementation system, as one of the key actors for the process, as well as the bridge between the medical team and the head coach, resulting from their better communication with the head coaches. The findings support considering and understanding the contextual factors during the development of preventive strategies in football.

https://bmjopensem.bmj.com/content/bmjosem/9/1/e001370.full.pdf

Karim Chamari

Papers

High‐speed running during match‐play before and after return from hamstring injury in professional footballers

Combined training in patient with aids: improved quality of life and preserved BDNF

Risk diagnosis of minor muscle injuries in professional football players: when imaging cannot help out biology might.

Obstacles and opportunities for injury prevention in professional football in Qatar: exploring the implementation reality