Showing papers in "British Journal of Sports Medicine in 1994"

An epidemiological survey on ankle sprain.

Abstract: Ankle sprain is a common sports injury and is often regarded as trivial by athletes and coaches. This epidemiological study was conducted among three categories of Hong Kong Chinese athletes: national teams, competitive athletes and recreational athletes. This study shows that as much as 73% of all athletes had recurrent ankle sprain and 59% of these athletes had significant disability and residual symptoms which led to impairment of their athletic performance. This study indicates that a proper approach towards injury prevention and a comprehensive rehabilitation programme are required.

Massage--the scientific basis of an ancient art: Part 2. Physiological and therapeutic effects.

Abstract: The physiological and therapeutic effects of massage are frequently questioned. This article reviews previous research into the effects of massage on blood flow and composition, oedema, connective tissue, muscle and the nervous system. Although further investigations are clearly required in certain areas, the discussion demonstrates that the use of massage in sports medicine can be justified according to orthodox scientific criteria.

Massage--the scientific basis of an ancient art: Part 1. The techniques.

Abstract: Manual massage is a long established and effective therapy used for the relief of pain, swelling, muscle spasm and restricted movement. Latterly, various mechanical methods have appeared to complement the traditional manual techniques. Both manual and mechanical techniques are described systematically, together with a review of indications for use in sports medicine.

Psychological and immunological correlates of acute overtraining.

Abstract: Five men undertook two intensive interval training sessions per day for 10 days, followed by 5 days of active recovery. Subjects supplied a venous blood sample and completed a mood-state questionnaire on days 1, 6, 11 and 16 of the study. Performance capabilities were assessed on days 1, 11 and 16 using a timed treadmill test to exhaustion at 18 kmh-1 and 1% grade. These individuals became acutely overtrained as indicated by significant reductions in running performance from day 1 to day 11. The overtrained state was accompanied by severe fatigue, immune system deficits, mood disturbance, physical complaints, sleep difficulties, and reduced appetite. Mood states moved toward baseline during recovery, but feelings of fatigue and immune system deficits persisted throughout the study.

Prevalence of latent and manifest suprascapular neuropathy in high-performance volleyball players.

Abstract: The aim of the present study was to evaluate the prevalence of latent and manifest suprascapular neuropathy in high-level male volleyball players. Thirty subjects were examined clinically and electrophysiologically. Suprascapular neuropathy, most probably at the level of the suprascapular notch, was demonstrated in 12 subjects, being latent in eight. Taking into account our clinical findings in a further 36 international-level players, a remarkably high overall prevalence of suprascapular nerve lesion of 33% (22 of 66 subjects) was found. All cases involved the side of the body with the player's smashing arm. These findings suggest that careful monitoring of suprascapular nerve function may be useful in high-performance volleyball players, as early diagnosis is essential to prevent more severe damage.

Training in élite young athletes (the Training of Young Athletes (TOYA) Study): injuries, flexibility and isometric strength.

Abstract: Using a mixed longitudinal design, the incidence of injuries, and the development of flexibility and isometric strength of the upper and lower limbs were studied for 2 years in 453 elite young athletes (aged between 9 and 18 years) practising football, gymnastics, swimming or tennis. The children suffered from a low incidence of injuries. Strength and flexibility did not exert a significant role in determining injuries. The rate of injury was not significantly different between the 2 years of the study. Young swimmers showed a greater generalized flexibility. Girls were more flexible than boys between the ages of 13 to 16 years. Athletic children are able to exert greater isometric strength than normal schoolchildren. Boys diverged from the normal population at 14 years, while athletic girls were stronger at all ages. Girls were stronger than boys up to age 12, who were still increasing their muscle strength at 19 years. The average maximal isometric strength exerted in both upper and lower limbs in the four sports was not significantly different. Male gymnasts over 11 years old were significantly stronger than all other athletes.

Potential impact of physical activity and sport on the immune system--a brief review.

Abstract: Description is given of methods that can evaluate the main functional elements of the immune system. Acute responses to exercise depend on the intensity and duration of the required activity relative to the individual's fitness level. Moderate endurance exercise causes either no change or an enhancement of such indices as total leucocyte count, granulocyte, monocyte, lymphocyte and natural killer cell count, total T cell count, helper:suppressor cell ratio, cell proliferation in response to mitogens, serum immunoglobulin levels, and in vitro immunoglobulin production. However, exhausting exercise tends to produce adverse changes in these same indices, particularly if the physical activity is accompanied by environmental or competitive stress. Moderate, appropriately graded training reduces reactions to any given absolute intensity of exercise. When pursuing a more demanding training regimen, it is important that the exerciser optimize immune responses. If athletic preparation is pursued to the level of staleness and/or muscle damage, it can have substantial negative implications for many aspects of immune function, including resistance to acute infections, HIV infections, ageing, cancer and other conditions influenced by the immune system.

Track and field athletics injuries--a one-year survey.

Abstract: The training programmes and competitive performances of 147 track and field athletes, from many different clubs within the UK, were analysed retrospectively in order to study the incidence, severity and types of injuries which they had suffered during the year September 1989-September 1990. This information was then related to the particular event in which they specialized as well as a number of hypothetical risk factors proposed for making them more prone to injury. Of the athletes 96 (65.3%) were male and 51 (34.7%) were female, and their ages ranged from 14 to 32 years, with their levels of competition ranging from 'competitive spectators' to UK internationals. A marked correlation was noted between their age, level of competition, number of supervised training sessions which they attended, and their incidence of injuries. However, certain other factors which were studied, such as their sex, the hours they trained, and the particular event in which they specialized appeared to provide no obvious relationship.

Kinematic and kinetic parameters associated with running in different shoes.

Abstract: The characteristics of the midsole were examined in four pairs of running shoes by a materials test. The variables of interest were the peak acceleration, time to peak acceleration and the kinetic energy absorbed. Ten subjects then ran at a recreational jogging pace (3.5 ms-1) barefoot and in the shoes. An accelerometer secured to the lower tibia was used to measure the peak acceleration and time to peak acceleration associated with footstrike. Subjects were also videoed and a kinematic analysis was undertaken at the knee and ankle joints. The results from the materials test showed that the shoes differed in their midsole characteristics, however, no significant differences (P > 0.05) were observed in the peak acceleration and time to peak acceleration during running in shoes. These variables were significantly greater in the barefoot running condition (P < 0.05), as compared with running in shoes. Small and subtle kinematic differences were observed between the barefoot and shoe conditions. It appears that the differences observed between the shoes in the materials test were not sufficient to elicit the kinematic changes observed between the barefoot and shoe conditions. It is suggested that runners operate within a 'kinetic bandwidth' when responding to impact stresses.

An epidemiological investigation of training and injury patterns in British triathletes.

Abstract: During the competitive season of 1990, 155 British triathletes whose competitive distances varied from sprint to full ironman, and who self-classified themselves as recreational, intermediate or elite, kept a training diary for an 8-week period. They gave details of injuries sustained while training for, or competing in, triathlons. The mean(s.d.) distances covered each week were: swimming, 4.2(2.6) km; cycling, 100.2(70.6) km; and running 23.4(15.2) km; mean(s.d.) training time was 7(3.4) h per week, and a mean(s.d.) of 7.9(3.4) training sessions were completed per week. At least one injury was reported by 37% of the participants. The most frequently affected sites were the ankle/foot, thigh, knee, lower leg and the back. Overuse was the reported cause in 41% of the injuries, two-thirds of which occurred during running. The likelihood of an injury was positively associated with experience in triathlon. Average injury rate was 5.4 injuries per 1000 h of training (95% confidence interval: 4-7.2) and 17.4 per 1000 h of competition (95% confidence interval: 10.9-27.9). Injury incidence was unrelated to the mean amount of weekly training or competition, intensity or frequency of training.

The impact of a repeated bout of eccentric exercise on muscular strength, muscle soreness and creatine kinase.

Abstract: The purpose of this study was to determine if there were any beneficial or detrimental effects regarding delayed onset muscle soreness (DOMS), serum creatine kinase (CK), and maximum concentric strength at 80% of 1-RMconc, if a bout of eccentric exercise was repeated at 48 h after an initial bout. A secondary purpose was to determine whether unaccustomed eccentrics might affect plasma cholesterol (TC). Twenty-six men were randomly assigned to a control (Group 1) or experimental group (Group 2). Both groups performed three sets (12 repetitions per set) of the eccentric phase of a chest press, at 80% of one repetition maximum (1-RMconc); Group 2 repeated this exercise 48 h later. DOMS and CK were measured before, and every 24 h for 8 days after; TC was measured before, and every 24 h for 4 days. Maximum strength during the concentric phase of a chest press (1-RMconc) was measured before and at 48-h intervals after. A repeated measures analysis of variance revealed a significant time effect (P < 0.05) for DOMS, CK and strength, but no significant difference between groups (P < 0.05). An interesting finding was the significant (P < 0.05) reduction in TC at 24, 48 and 72 h, after exercise in both groups, which we hypothesized was associated with cellular repair. From these results we concluded that when a bout of eccentrics is repeated 48 h after an initial bout, there is no change in the characteristic time-course and/or intensity of DOMS, CK or 1-RMconc.

Athletic footwear affects balance in men.

Abstract: Stable equilibrium during locomotion is required for both superior performance of sports and prevention of injuries from falls. A recent report indicated that currently available athletic footwear impairs stability in older men. Since this discovery, if confirmed, seems important to both competitive athletes and the physically active general public, we performed an experiment using similar methods on a younger population. We tested the hypothesis that midsole thickness is negatively, and hardness positively related to dynamic equilibrium, in 17 healthy adult men (mean(s.d.) age 33(11.13) years) via a balance beam method. Subjects walked along a 9-m long beam at 0.5 m s-1 once barefoot and six times wearing identical pairs of experimental shoes which differed only in midsole hardness and thickness which spanned the respective ranges currently available in footwear. Falls from the beam (balance failures) were quantified. Balance failures varied significantly in relation to midsole hardness and thickness, and there was a strong trend toward interaction of these variables (P = 0.09). Midsole hardness was positively related to stability, and midsole thickness was negatively related, which confirms the previous report. Hence, shoes with thick-soft soles, similar to modern athletic footwear and 'walking shoes', destabilize men, and shoes with thin-hard soles provide superior stability. The pair with the poorest stability (A 15-thick; 12.34 balance failures per 100 m) produced 217% more balance failures than those associated with the best stability (A 50-thin; 3.89 balance failures per 100 m). Since most types of athletic footwear and many other shoes incorporate midsoles with hardness and thickness associated with poor stability, we conclude that both athletic performance and public safety could be enhanced through stability optimized footwear.

Time-of-day dependence of isokinetic leg strength and associated interday variability.

Abstract: The purpose of this study was to assess the interday variability and time-of-day effects on selected isokinetic leg strength indices. Nine adult collegiate sportsmen (mean(s.e.) age 19.6(0.5) years; mean(s.e.) height 1.81(0.02) m; mean(s.e.) body mass 76.5(3.1) kg) completed a series of nine test sessions, organized so that each subject was tested three times within a day (08.00-09.00 hours; 13.00-14.00 hours; 18.00-19.30 hours), on three occasions, each separated by a minimum of 7 days. Gravity-corrected indices of extension peak torque (EPT), flexion peak torque (FPT), and the peak torque ratio (PTR), at contraction velocities of 1.05 rad s-1 and 3.14 rad s-1, were calculated for each subject using an isokinetic dynamometer. Two-way repeated measures analysis of variance of coefficient of variation (V%) scores revealed no significant differences in performance variability across within-subject factors of time-of-day and performance index (P > 0.05). Overall mean(s.e.) V% for scores across experimental conditions were 3.97(0.72)% at 1.05 rad s-1 and 5.98(1.23)% at 3.14 rad s-1, suggesting that similar levels of measurement error occur between 08.00-19.30 hours. One-way repeated measures analysis of variance of absolute strength indices (EPT, FPT and PTR) revealed that significantly higher scores were achieved during session 3 (18.00-19.30 hours), with mean(s.e.) values of 249.1(40.0) N m, 149.0(32.3) N m, 59.5(5.0)% at 1.05 rad s-1, and 172.1(38.7) N m, 121.3(27.7) N m, 71.1(6.2)% at 3.14 rad s-1, respectively (P < 0.05). This finding appears to be consistent with current knowledge about time-of-day effects on the assessment of muscular strength. Thus for stable and maximal values to be obtained during isokinetic leg testing, the use of multiple-trial protocols is recommended, with testing occurring as close to 18.00-19.30 hours as possible. In addition, the observed significant time-of-day effect suggests that appropriate comparison of maximal isokinetic leg strength can only be achieved based on data obtained within 30 min of the same time of day.

The New Zealand Rugby Injury and Performance Project: II. Previous injury experience of a rugby-playing cohort.

Abstract: The Rugby Injury and Performance Project (RIPP) is a prospective cohort study by a multidisciplinary research group. Rugby injuries constitute an important area for research because rugby union is New Zealand's national sport and because of the considerable cost of all sports injury acknowledged by the Accident Rehabilitation and Compensation Insurance Corporation (ACC). The initial phase of data collection in the RIPP involved a pre-season questionnaire which, among other things, sought to establish variables relating to the past injury experience of players. The influence of previous injury, the use of safety equipment and the availability and significance of medical advice were among the variables identified by individual questionnaires. This paper analyses the responses to pre-season questions about injury experience in the previous 12 months. In so doing, it identifies baseline data which will be used to address a possible relationship between past injury experience and the prediction of injury during the season.

Comparison of effects of two interval-training programmes on lactate and ventilatory thresholds.

Abstract: Twenty-one women subjects were matched in terms of their Vo2max and assigned to one of two groups: (1) training at 30 s; or (2) 2 min with a 1:1 work: relief ratio (1:1 WR) before participating in a 7-week training programme which began at an intensity of 85% Vo2max and increased 5% every two weeks (90% and 95% Vo2max). The subjects trained to exhaustion four times per week. Maximal oxygen consumption (Vo2max), lactate threshold (Tlac) and ventilatory threshold (Tvent) were determined before and after the training programme. After training, there were significant increases (P < 0.05) in Vo2max (5% and 6%), Tlac (19.4% and 22.4%), and Tvent (19.5% and 18.5%). There were no significant group differences on any dependent measure but this research adds support to previous training studies in that a strong correlation (P < 0.05) between Tlac and Tvent is maintained from before to after the test. It was concluded that both formats of high intensity aerobic interval-training produce similar changes in Vo2max, Tlac and Tvent and that these changes appear to be independent of the length of the work interval.

Badminton injuries--a prospective epidemiological and socioeconomic study.

Abstract: During a 1-year period 100 badminton players were registered and treated in the casualty ward of Randers City Hospital, Denmark. The injuries to the badminton players constituted 5% of all sports injuries registered during the same period in the casualty ward. At follow-up questionnaires were sent to all participants. Replies were received from 89 patients. Over the same period all sports participants in the hospital catchment area (30,254) were registered according to their sport affiliation (2620 badminton players-1650 men and 970 women). Of those injured 58% were men (mean age 31 years) and 42% were women (mean age 25 years). Of the injuries 55% occurred in club players, the remainder occurring during company and school sports activities. The active players were classified into three groups according to age: Group 1 under 18 years (31%); Group 2 18-25 years (16%); Group 3 more than 25 years (53%). According to the Abbreviated Injury Scale (AIS) 17% of the injuries were classified as minor, 56% as moderate, and 27% as severe, respectively. Of the severe injuries (AIS = 3) 56% were found in the oldest age group. AIS correlated with time absent from sport (P < 0.001). Nine players (9%) reported that earlier injuries had influenced the actual accident. Most players (96%) trained one to three times a week. Sprains were the injury most commonly diagnosed (56%), fractures accounted for 5%, torn ankle ligaments were found in 10%, and 13% had ruptures to the Achilles tendon. Overall, 21% were admitted to hospital. None of the patients treated as inpatients was kept in hospital for more than 7 days. The injury caused 56% of players to be absent from work of whom 23% were absent for more than 3 weeks. After the injury 12% of the players gave up their sport, and only 4% restarted their training/sport within 1 week. As many as 28% had to avoid training and playing in matches for 8 weeks or more.

The New Zealand Rugby Injury and Performance Project: I. Design and methodology of a prospective follow-up study.

Abstract: Injury resulting from participation in sporting and physical recreational activities is a major contributor to the overall incidence of injury in the developed world. If sports injuries are to be reduced, a comprehensive approach must be taken to define the nature and magnitude of the problem, to establish models of relationships between risk factors, protective factors and injury experience, and to address injury through well designed intervention and evaluation programmes. The Rugby Injury and Performance Project (RIPP) is a prospective cohort study designed to examine the risk and protective factors for rugby injury. Data were collected on potential risk and protective factors from the RIPP cohort pre-season. Data on exposure to rugby, injury events and medical treatments were collected from the players each week during the season through telephone interviews. Pre-season measures were repeated post-season. A key feature of the design was that data were collected on both injured and non-injured players, allowing a longitudinal comparison of the injury experience of players with and without the factors of interest. A wealth of information was collected on each cohort member during the pre-season interview. A contact rate of 90% was achieved during the weekly follow-up phase. Post-season questionnaires were completed by 76% of the players and 88% of the coaches. Recommendations are made for the use of this methodology by other researchers and future directions for RIPP are described.

Social-psychological predictors of self-reported actual and intended physical activity in a university workforce sample.

Abstract: This study investigated the social-psychological predictors of self-reported actual and intended physical activity in a university workforce sample. Based on the 'Theory of Planned Behaviour', but with additional variables of benefits, barriers and self-efficacy, it was found that both intended and actual activity could be predicted but only when strenuous activity was considered. In addition, the predictors were different for men and women. Specifically, the best predictors of intention to exercise were attitude, perceived control, benefits and self-efficacy for women, but only attitude for men. Predicting self-reported strenuous activity for women were intention and self-efficacy, and for men intention and attitude. Theoretical and practical implications for attitude research and exercise promotion are discussed.

The influence of pre-exercise glucose ingestion on endurance running capacity.

Abstract: Drinking a concentrated glucose solution less than 1 h before the start of prolonged submaximal exercise has been reported to reduce endurance capacity during cycling. The purpose of this study was to re-examine the influence of pre-exercise ingestion of a concentrated glucose solution on endurance running capacity. Nine recreational runners (five men and four women) ran to exhaustion on a level treadmill, at speeds equivalent to 70% VO2max, on two occasions separated by at least 1 week. The runners ingested either a solution containing 75 g of glucose in 300 ml of water (G trial), or 300 ml of sweetened water (P trial) 30 min before each trial. As a consequence, the blood glucose concentrations were 55% higher at the beginning of the G trial compared with those recorded for the P trial (G trial, mean(s.e.) blood glucose = 6.3(0.7) mmol l-1 versus P trial, mean(s.e.) blood glucose = 4.1(0.3) mmol l-1; P < 0.01). Nevertheless, there were no differences in the running times to exhaustion between the two trials (G trial, mean(s.e.) 133.79(11.0) min versus P trial, mean(s.e.) 121.16(8.1) min). The results of this study show that ingesting a 25% glucose solution 30 min before exercise does not reduce the endurance capacity of recreational runners when the exercise intensity is equivalent to 70% VO2max.

Brisk walking and serum lipid and lipoprotein variables in previously sedentary women--effect of 12 weeks of regular brisk walking followed by 12 weeks of detraining.

Abstract: The purpose of this study was to examine the effectiveness of brisk walking as a means of improving endurance fitness and influencing serum lipid and lipoprotein variables in previously sedentary women. Walkers (n = 10, mean (s.e.m.) age 47.3(2.0) years) followed a programme of brisk walking (mean(s.e.m.) speed 1.76(0.03) m s-1) for 12 weeks, after which the training stimulus was withdrawn. Controls (n = 10, mean(s.e.m.) age 41.6(1.2) years) maintained their habitual sedentary lifestyle throughout. Endurance fitness was determined using laboratory measures of responses to treadmill walking. Serum lipid and lipoprotein variables were determined in venous blood (12-h fasted). Body fatness was assessed by anthropometry and dietary practice using the 7-day weighed food intake technique. Measurements were repeated after 12 and 24 weeks. Brisk walking resulted in a decrease in heart rate and blood lactate concentration during exercise, while detraining was accompanied by a reversal of these changes. Changes in body mass and the ratio of circumferences at the waist and hip did not differ between groups but the sum of four skinfolds decreased with brisk walking and increased with detraining. High density lipoprotein (HDL) and HDL2 cholesterol increased with walking and decreased with detraining but no between group changes (analysis of variance, P < 0.05) were found in other lipid and lipoprotein variables. These findings suggest that regular brisk walking can improve endurance fitness and increase HDL cholesterol concentration in sedentary women.

Extra-articular tenodesis for anterior cruciate ligament rupture in amateur skiers.

Abstract: Thirty one amateur skiers with 33 knees which had had a symptomatic chronic rupture of the anterior cruciate ligament (ACL) treated with the Lemaire operation were reviewed retrospectively at an average of 4.5 years. Of the patients 23 were women. The operation failed to control symptoms in 17 out of the 33 knees. However the operation did control symptoms in 13 out of 19 knees in patients over 35 years old, compared with only three out of 14 knees in patients under 35 years old. Clinical and objective testing however showed that most knees were still unstable. Despite this 21 patients continued skiing. One patient with a successful result switched to playing tennis. Five patients gave up all sports. Four further patients, all under 35 years old, returned to skiing after an additional intra-articular reconstruction of the anterior cruciate ligament. An isolated extra-articular procedure in amateur skiers under 35 years old with symptomatic chronic ACL rupture is not recommended. They need at least an intra-articular reconstruction to control their symptoms and to stabilize the knee.

Overtraining--what do lactate curves tell us?

Abstract: In a cyclist, competing at national and international level, submaximal lactate concentrations were initially interpreted as improved endurance capacity. However, 2 weeks later, a test in which maximal lactate was measured showed that maximal lactate was decreased as well. Together with the complaints of deteriorating performance and subjective complaints of irritability and sleep disturbances, overtraining was diagnosed. After decreasing the training load, performance was gradually restored. This example indicates that athletes should be carefully questioned on their ability to perform their regular training programme, their motivation, possible sleeping disorders and eating problems. This case serves as a reminder to interpret lactate curves carefully and shows how important it is to obtain maximal lactate from a graded exercise test.

Trampolines in New Zealand: a decade of injuries.

Abstract: Despite international concern about the safety of trampolines, they have become increasingly popular in New Zealand. While internationally attention has centred on a relatively few cases of catastrophic cervical spine injury, little research effort has been directed at placing these incidents in a wider context. To redress this, a descriptive epidemiological study of trampoline-related injury in New Zealand was undertaken. National hospitalization and mortality data for a 10-year period revealed 2098 hospitalizations and two deaths. The incidence rate for hospitalizations increased from 3.1 per 100,000 population per year in 1979 to 9.3 in 1988. Of the hospitalized victims, 71% were injured on home trampolines and 80% fell from the trampoline to the surrounding surface. Fractures were the commonest type of injury (68%), and the body site most frequently involved was the upper limb (53%). There was no evidence of a high incidence of severe head and neck injuries. It was concluded that, although existing trampoline standards addressed many of the issues raised by this research, measures to reduce the impact of falls from trampolines to the ground and to prohibit the provision of trampolines as 'play equipment' are required.

The scientific basis for the use of biomechanical foot orthoses in the treatment of lower limb sports injuries--a review of the literature.

Abstract: While it is documented that many overuse injuries of the lower limb can be relieved with the use of biomechanical foot orthoses, what remains unclear is how an orthosis can produce this effect. A review of the literature indicates that biomechanical orthoses will reduce rearfoot movement, but the effect on knee function is negligible and the clinical significance of excessive rearfoot movement is yet to be proven. While many athletes may potentially benefit from the use of biomechanical orthoses, further research is necessary to justify and, if indicated, promote the use of biomechanical foot arthoses by athletes suffering from overuse injuries.

Paralympics--Barcelona 1992.

Abstract: The British Team at the 9th Paralympic Games in September 1992 in Barcelona comprised 151 men and 54 women athletes in a total of 15 sports. They were supported by a staff of 86 including a 12-strong medical team. The athletes were selected from the National Championships of the five disability organizations: British Wheelchair Sports Federation; British Blind Sport; Cerebral Palsy Sport; British Amputee Sports Association; and the British Les Autres Sports Association. This article outlines the organization and experience of the medical support team. The injury/illness profile was similar to those in able bodied sport. The team went on to achieve 40 gold, 47 silver and 41 bronze medals, maintaining third place on the medal table as achieved in Seoul in 1988.

Radiographic changes in the hands of rock climbers.

Abstract: Radiographs of the hands of 36 rock climbers were compared with radiographs of the hands of controls matched for age and sex. Subchondral cysts were present in the hands of 17 climbers and only two controls. Osteophytes or bony spurs were present in 14 climbers but not in any of the controls, and the only two cases of frank osteoarthrosis were in the hands of climbers. Cortical thickness of the proximal and middle phalanges was significantly greater in the hands of climbers (P = < 0.01). Pronounced 'scalloping' of the necks of the proximal phalanges was only seen in climbers, and is due to thickening of the attachment of the distal end of the fibrous A2 pulley of the flexor sheath.

Sport and exercise headache: Part 2. Diagnosis and classification.

Abstract: A group of 129 subjects (67 men and 62 women) experiencing sports headache was established using a questionnaire A wide range of information was gathered, focusing on the mode of onset, time course, characteristic features and associated symptoms of sports-related headache Criteria for the varieties of sports headaches were established using head trauma and then migraine to divide subgroups of sports headaches Cases were classified into four categories: effort migraine, trauma-triggered migraine, effort-exertion headache, and post-traumatic headache The percentages of each sports-related headache found were: effort migraine 9%, trauma-triggered migraine 6%, effort-exertion headache 60%, post-traumatic headache 22% and miscellaneous 3% Sports migraine accounted for 15% of the total sports headache sample Effort-exertion headache was the most common type of sports headache Although effort-exertion headache could be separated into subjects who had an acute severe headache induced by anaerobic exercise (exertion headache) from those having a substantial headache lasting hours initiated by aerobic exercise (effort headache), most subjects with effort-exertion headache in this study appeared not to fall into any discrete subgroups Trauma-related headaches were experienced mainly by men in contact sports, while women more commonly had non-trauma-related headache in running and jogging

Precompetition anxiety in women volleyball players: a test of ZOF theory in a team sport.

Abstract: Consistency in psychological factors is widely regarded to be important for successful performance in team sports, but the Zone of Optimal Function (ZOF) theory contends that athletes should exhibit considerable variability in the level of anxiety that will optimize performance. In an attempt to determine if tenets of ZOF theory held for athletes in a team sport, anxiety was measured using Spielberger's state-trait anxiety inventory (STAI) at the baseline and before easy and difficult competitions in nine members of a collegiate women's volleyball team. The ability to predict precompetition anxiety was assessed by having the athletes complete the STAI both 3 weeks and 2 days before each match according to how they thought they would feel 1 h before competition. Each athlete also completed the STAI on the basis of how she recalled feeling before her best competition. Four anxiety units were added and subtracted from this value to establish the ZOF of each player. Actual precompetition anxiety was assessed 1 h before each match. In accordance with ZOF theory, considerable variability was found in the range of optimal anxiety, and 55.5% of the team members reported performing best at either low or high levels of anxiety. The prediction of precompetition anxiety made 2 days before competition was significantly correlated to actual anxiety for the difficult match (r = 0.69, P 0.05). Predictions made 3 weeks before competition were not significant (P > 0.05). More (P < 0.05) of the player possessed anxiety levels within the ZOF for the difficult match compared with the easy match (77.7% versus 22.2%). In summary, athletes in the team sport of volleyball exhibit considerable variation in optimal precompetition anxiety in accordance with ZOF theory. As posited by ZOF theory, the athletes were able to predict anxiety before a difficult match accurately and were more likely to have anxiety levels with ZOF.

Isokinetic profile of dorsiflexors and plantar flexors of the ankle--a comparative study of élite versus untrained subjects.

Abstract: A comparative study was made of the isokinetic characteristics of the ankle (plantar-flexion and dorsiflexion) in young men. Six cyclists, seven gymnasts, 10 soccer players and 25 non-athletic young men were tested on the Cybex II+ dynamometer. Peak torque, torque acceleration energy (TAE), total work and average power were measured. Cyclists had slightly higher (5%) mean plantar flexion than the others, but this was not significant. The situation was reversed for dorsiflexion. Moreover, the average dorsiflexion per unit of plantar flexion was significantly higher in the gymnasts than it was in the cyclists for both torque and work. This suggests that at a specific level of plantar flexion, the gymnasts had stronger dorsiflexion compared with the cyclists and that in sports involving jumping and running, increased attention should be given to strengthening the antagonist muscle groups (dorsiflexors) in order to achieve greater agonist-to-antagonist muscle balance thus preventing injury. The non-athletic subjects had substantially lower endurance capability in both flexors as measured by the endurance ratio. This implies that identifiable specialization in particular muscles results from training or participating in specialized sports.

Neuropsychological investigation of amateur boxers.

Abstract: Amateur boxing is faced with criticism over the potential damage the sport inflicts on those who participate. The most sensitive measure of early neurological dysfunction is neuropsychological investigation. Ten studies employing such assessments on 289 amateur boxers are reviewed. The forms of analysis undertaken include controlled comparison with other sportsmen, of both active and former boxers, detailed pre- and post-bout analysis, analysis of the influence of within-boxing variables, length of career, level of competition and prospective longitudinal investigation. Amateur boxers were found to exhibit no signs of neuropsychological dysfunction in any analysis. However some trends emerged suggesting a long career in amateur boxing might reduce fine motor reactions, although such findings are within the normal range and do not represent central neuropsychological functioning. Thus amateur boxing does not appear to expose individuals to neurological dysfunction.