bluuebunny/crossref_metadata_2025 huggingface dataset:
Cellular immunity in highly trained elite racing cyclists during periods of training with high and low intensity
Authors: Tvede N. , Steensberg J. , Baslund B. , Halkjær‐Kristensen J. , Pedersen B. K.
Published: July 2010

Cellular immunity was measured under resting conditions in 29 highly trained male racing cyclists during a period of low training intensity (winter), and in 15 untrained people. Fifteen of the cyclists were reexamined during a period of high training intensity (summer) together with 10 of the untrained people. Data on lymphocyte subpopulations, natural killer cell activity and lymphocyte proliferative responses were obtained. Changes in any of these immune parameters from low to high training seasons did not differ significantly between the trained and untrained people. The natural killer cell activity was significantly higher in the cyclists, both during the period of low training intensity (39.2±11.6%vs 30.9±6.4%) and during the period of high training intensity (55.2±18.4% vs 33.6±20.3%). Leucocyte, lymphocyte and neutrophil concentrations did not differ between the two groups. The blood mononuclear cell (BMNC) subsets, including CD3+, CD4+, CD8+ and CD16+ cells, and the BMNC proliferative responses following stimulation with either interleukin 2, purified derivative of tuberculin or phytohaemagghitinin did not differ significantly between the groups.
Gastrointestinal symptoms during endurance running
Authors: Koistinen P. O. , Jauhonen P. , Lehtola J. , Takala T. , Salokannel J.
Published: July 2010

The incidence and type of gastrointestinal complaints among endurance runners were investigated with a questionnaire among participants in a marathon event in northern Finland. The running distances were 1/4, 1/2 and full marathon. The fitness level of the participants varied from habitual joggers to national‐class endurance runners. The response rate of the 426 participants was 55% (230). Gastrointestinal disturbances during the run were reported by 32% of the respondents. The prominent symptom during the 1/4 marathon was stitch (32%). The main complaints during the 1/2 marathon were stitch (21%), pain (12%), and retching or heartburn (5%). The most frequent symptoms during the full marathon were stitch (16%), pain (9%), diarrhoea (4%) and nausea (4%). Gastrointestinal symptoms hindered maximal performance subjectively for 16%, 18% and 19% in the 1/4, 1/2 and full marathon, respectively. Most of the symptomatic runners (73%) had suffered from gastrointestinal complaints during the preceding training period, and 25% of the asymptomatic runners reported previous gastrointestinal troubles during training.
Outcome of patients with anterior cruciate ligament injuries selected for conservative treatment
Authors: Dahlstedt L. , Dalén N.
Published: July 2010

In this retrospective study, 24 patients with acute isolated complete anterior cruciate ligament (ACL) ruptures selected for conservative treatment were re‐examined a median of 45 months after injury. Selection for conservative treatment was made after careful patient information, taking into consideration desire for physical activity at work or leisure, interest in sports and muscular fitness. The reference group for the evaluation methods used included 50 students and 22 patients selected for surgical augmentation and reconstruction. In a subjective evaluation, the conservatively treated patients were satisfied, but objectively they had low functional scores and the pivot shift sign was often positive. Arthrometry showed that these patients had an increased anterior displacement of the tibia in relation to the femur in their injured knees. The patients who had a clearly positive pivot shift sign (grades III and IV) had an increased anterior laxity not only in the injured knees but also in the uninjured knees.
Increased inosine 5‐monophosphate accumulation despite no sign of increased glycolytic rate during one‐legged exercise at simulated high altitude
Authors: Terrados N. , Jansson E. , Norman B. , Kaijser L.
Published: July 2010

Muscle metabolism during one‐legged submaximal exercise executed in a hypobaric chamber (corresponding to 2300 m above sea level) was studied by percutaneous muscle biopsies from the vastus lateralis and compared with corresponding data from the other leg, exercising at the same absolute load under normobaric conditions on another Occasion. After 15 min of exercise, the adenosine triphosphate/adenosine diphosphate ratio was lower and inosine 5‐monophosphate higher in the hypobaric than in the normobaric leg. The possibility is suggested that this metabolic alteration stimulates increased expression of oxidation‐related mitochondrial enzymes. Despite this sign of energy depletion, there was no indication of increased glycolysis. A tendency to increased citrate concentration in the hypobaric leg could suggest an increased mobilization and utilization of fat, which auld have counteracted any stimulating effect on the glycolytic rate.
Blunt abdominal trauma in soccer causing duodenal rupture: case report and review
Authors: Saartok T. , Pettersson L. , Karlbom Å. , Karlsson L.
Published: July 2010

A case of blunt abdominal trauma in soccer is reported A forward player sustained a rupture of the distal duodenum in a collision with the opposing team's goalkeeper. The injured player had abdominal pain radiating to the back and a sustained high pulse but no sign of shock or peritonitis. The x‐ray diagnosis was followed by emergency surgery and uneventful recovery. Injuries from blunt abdominal trauma occur rarely in sports. In soccer, the most frequently injury from this type of trauma is abdominal wall contusion, followed by injuries to the kidneys and spleen. However, death has also been reported in soccer. Athletes sustaining blunt trauma to the upper abdomen should be carefully monitored due to the risk of possible severe intra‐abdominal injuries.
Injuries to the posterior cruciate ligament and posterolateral structures of the knee
Authors: Engebretsen L. , Lew W.
Published: July 2010

Although the incidence of injuries to the posterior cruciate ligament (PCL) is much lower than with the anterior cruciate, recent evidence suggests that deficiency of the PCL may be a much larger problem than originally thought, in the isolated case or in combination with posterolateral structures. Although advances have been made in understanding PCL injuries, the diagnosis and treatment of PCL insufficiency remain unclear. The natural history of a PCL‐deficient knee is just beginning to be understood. Numerous methods have been reported for the surgical repair and reconstruction of the PCL, yielding less than optimal results in many cases. Controversy exists regarding the choice between conservative and surgical treatment in the isolated PCL injury. This article reviews the literature and summarizes the state of the art regarding the PCL and related posterolateral injuries, with an emphasis on anatomy, biomechanics, mechanism of injury, diagnosis and treatment Future directions in PCL research are proposed.
Anterior cruciate ligament reconstruction augmented with Leeds‐Keio polyester mesh in rabbits
Authors: Muneta T. , Yamamoto H. , Takakuda K. , Sakai H. , Hokama R. , Asahina S. , Ishibashi T. , Furuya K.
Published: July 2010

The objective of this study was to compare a nonaugmented autogenous anterior cruciate ligament (ACL) graft with an autogenous graft augmented with Leeds‐Keio polyester mesh (L‐K mesh) when the augmentation was fixed to bone at both ends or fixed to bone at one end. Twenty‐six rabbits were divided into 3 groups (nonaugmented, augmented with one‐end fixation and augmented with two‐end fixation), and were evaluated 12 weeks postoperatively. The gross findings demonstrated adhesion of the proliferated infrapatellar fat pad to the reconstructed ACL in the autogenous group, but not in the augmentation groups. The microangiographic study revealed poor revascularization in the augmentation groups. Histologically, in the L‐K two‐end fixation group, the biological segment of the reconstructed ACL remained necrotic. The biomechanical study showed that the augmentation groups were significantly stiffer and stronger than the nonaugmented graft
Effect of exercise on vasovagal (pre‐)syncope
Authors: Secher N. H. , Perko G. , Olesen H. L.
Published: July 2010

This report presents an occasion in which two lines were to be inserted and a vasovagal reaction was developed during insertion of the second catheter. Thus BP and HR were followed during development of vasovagal symptoms and during leg extension performed in an attempt to terminate the event
Evaluation of simple methods to estimate total body fat in healthy women
Authors: Sohlström A. , Forslund A. , Sjödln A. , Forsum E.
Published: July 2010

Simple methods are needed to assess the total body fat (TBF) of individual human subjects. In addition to the commonly used skinfold thickness (SFT) technique, alternative methods to estimate TBF have recently been developed. In this comparative study the TBF content of healthy Swedish women was estimated by 3 simple methods: the SFT technique, near infrared interactance (NII) and bioelectrical impedance (BEI). The results were compared with estimates obtained by underwater weighing (UWW). The SFT technique was found to have the best accuracy and precision (UWW‐SFT = 0.6±3.1% TBF, n=20; UWW‐NII=‐1.2±4.0% TBF, n=20; UWW‐BEI=3.3 ± 3.6% TBE n= 16). The NII technique was found to overestimate TBF in lean subjects and TBF was underestimated in obese subjects.
Intramuscular pressure recording in the assessment of patients with suspected chronic compartment syndrome
Authors: Rosfors S. , Eriksson M. , Åkermark C.
Published: July 2010

This report presents results from intramuscular pressure recordings in 181 consecutive patients. All patients were suspected on clinical grounds of suffering from chronic compartment syndrome (CCS). The diagnostic criterion used in this study was an intramuscular pressure exceeding 30 mmHg immediately postexercise. Most of the pressure studies were made with the micro‐capillary infusion technique. CCS in the anterior tibial compartment was diagnosed in 36 of 165 patients with anterior or anterolateral exercise‐induced pain. Regarding measurements in other lower‐leg compartments, CCS was diagnosed in only one patient in the superficial posterior compartment. CCS was more commonly found in men than in women. It is concluded that, even in highly selected cases, CCS is a rather uncommon cause of exercise‐induced pain, predominantly found in the anterior tibial compartment
Chronic instability of the ankle
Authors: Raatikainen T. , Puranen J.
Published: July 2010

Evans tenodesis is one of the techniques used much for correcting the chronic lateral instability of the ankle. Long‐term results (average follow‐up 8 years) are reported for 113 operations on 109 patients. It is concluded that the method used gives a good functional result when the major complaint is recurrent sprains of the ankle. Functional stability does not necessarily correlate with mechanical stability when tested clinically or by radiographs.
Psychological benefits of sports for disabled people: a review
Authors: Hutzter Y. , Bar‐Eli M.
Published: July 2010

This article reviews literature on the psychological benefits of sports for the disabled. Beginning with traditional models and resource development models of rehabilitation, an integrative model of sports for the disabled is suggested, emphasizing the concept of efficacy‐based empowerment through sport. Empirical research is reviewed according to the conceptual categories of this model: (a) performance accomplishments and functional efficiency, (b) perceived self‐efficacy, (c) self‐concept and self‐esteem, (d) personality disorders, mood states and locus of control and (e) activity level and social acceptance. This review suggests that most psychological constructs expressed within the empowerment model are positively affected by physical activity in disabled people, when applied properly. Several recommendations are outlined for beneficial application of the model in practice as well as for future research topics.
The main pathway to musculoskeletal disability
Authors: Schroll M.
Published: July 2010

The epidemiology of disability uses epidemiological methods to describe the disability process and to identify factors that improve or delay its course. A conceptual model for the way chronic health problems affect functional ability is examined with an emphasis on endurance and muscle strength and examples from a Danish cohort study. Disability is difficulty in doing complex activities because of a long‐term physical or mental condition. In Glostrup only 10% and 18% of 75‐year‐old men and women, respectively, were dependent on personal help to perform mobility functions such as moving or walking outdoors, but 66% of the men and 71% of the women became tired during some or all of these activities. Functional limitations are restrictions in doing basic physical and mental activities. Up to 50% of 75‐year‐olds with loss of the ability to step a height of 40 cm or‐walk at least 1.4 m/s may have difficulties in city traffic. Impairment refers to dysfunctions in specific body systems. Muscle strength is reduced in the elderly by 10% per decade. The 75‐year‐olds who performed mobility functions without tiredness had 50% higher muscle strength values in several muscle groups and 15% higher VO2max. The pathological conditions most commonly associated with functional disability in old age are in the locomotor and cardiovascular organ systems. The influence of living conditions and individual lifestyle on functional ability is mainly indirect through the influence of those factors on chronic morbidity. Smoking and low physical activity are, however, direct risk factors. At all levels of tie disability process, it is possible by regular physical activity and exercise to prevent further consequences of disease. Focused intervention strategies are needed during the total life course. In 75‐year‐olds, light physical activity 4 h per week is sufficient. Exercise in impaired but only moderately disabled people is perhaps the most cost‐effective effort against the burden of disability facing society with the increasing life‐span.
Self‐reported obstructive airway symptoms are common in young cross‐country skiers
Authors: Larsson L. , Hemminqsson P. , Boëthius G.
Published: July 2010

The reported high use of anti‐asthmatic drugs in cross‐country skiers prompted a study to assess the prevalence of self‐reported asthma, asthma‐associated symptoms and the use of anti‐asthmatic medication among cross‐country skiers. A self‐administered questionnaire based on the Medical Research Council questionnaire was answered by cross‐country skiers in the Swedish national ski team, in upper secondary school ski‐classes and in the Swedish army (n=305). Controls (n=141) were pupils from regular classes in the same upper secondary schools. Skiers more often gave posi‐ tive answers to all questions on asthma and asthma‐associated symptoms. The cumulative prevalence of asthma was 15% in skiers and 6% in controls. We conclude that the common use of anti‐asthmatic drugs among cross‐country skiers reflects a high prevalence of self‐reported asthma and asthma‐associated symptoms. The causes of these differences are un‐known.
Muscle contraction increases the lower leg structural capacity more in adult than in young rats
Authors: Nordsletten L. , Ekeland A.
Published: July 2010

The contribution of muscle contraction to the structural capacity of the lower leg has been studied in skeletally immature and mature rats. The right lower legs of both young and adult rats were fractured in 3‐point ventral cantilever bending during electrically induced muscle contraction. The left tibiae were dissected free of all soft tissues and tested as controls. The ultimate bending moment increased 73% in young and 84% in adult rats, compared with the control tibiae. The ultimate energy absorption increased 149% and 302% in the young and adult rats, respectively. Ultimate deflection increased 70% and 140%, whereas bending stiffness decreased 18% and 24% in the young and adult rats, respectively. The results show that the fracture mechanics in vivo are different in the immature and mature skeleton. This finding is discussed in relation to the differences in tibial fracture incidence in young and adult alpine skiers.
Optimal fluid replacement during long‐lasting exercise in 18°C and 32°C ambient temperature
Authors: Nielsen B. , Krog P.
Published: July 2010

Seven elite marathon runners ran 60 min at 90–96% of their average competition speed, and 4 triathletes and one cyclist bicycled for 2.5 h at 55–65% of their max V02 at 18°C and at 32°C in a climatic room. They drank 400 ml of either redistilled water or a 9% glucose polymer solution before start and every 15 min during exercise. The gastric emptying rate, sweat loss and metabolites in venous blood were measured. The gastric emptying rate limited the replacement of sweat loss. Despite an optimal fluid intake, the resulting dehydration for a whole marathon at 32°C would correspond to about 3% of body weight when drinking water (and 4.5% with glucose polymer) in the elite marathoner. Impaired performance and increased susceptibility to heat illness can be predicted in warm environments.
Change in levels of the carboxyterminal propeptide of type I procollagen, the carboxyterminal cross‐linked telopeptide of type I collagen and osteocalcin in response to exercise in well‐trained men and women
Authors: Salvesen H. , Piehl‐Aulin K. , Ljunghall S.
Published: July 2010

Physical exercise preserves bone mass. Measurements of bone biomarkers may reflect the events in bone during exercise. Fifteen healthy, well‐trained individuals (7 men and 8 women) performed a running test for 21 min until exhaustion. Venous blood samples were drawn before and 30 min after the exercise to measure the levels of osteocalcin, the carboxyterminal propeptide of type I procollagen (PICP) and the carboxyterminal cross‐linked telopeptide of type I collagen (ICTP). After exercise, the women had a marked increase in serum osteocalcin concentrations (from 7.5±5.0 μg/1 to 11.5±3.0 μg/1), whereas the level was unaffected in the men (from 14.5±3.0 μg/1 to 13.5±4.6 μg/l). In the men there was a marked increase in PICP (from 240±47 μg/1 to 268±56 μg/1) that was not seen in the women (from 244±70 μg/1 to 253±60 μg/1). In neither group did ICTP levels change. In conclusion, significant responses were seen in PICP and osteocalcin during exercise, indicating that such measurements may be valuable for the further delineation of the effects of physical activity on bone. Furthermore, the different responses in men and women point to interesting areas for future studies.
Elbow arthroscopy
Authors: Jaeger R. , Meyers J. F.
Published: July 2010

It is only in the last decade that elbow arthroscopy had developed as an alternative method of diagnosing and treating pathology of the elbow. When performed with careful technique and a good understanding of the bony and neurovascular anatomy around the elbow, arthroscopy can benefit a large majority of patients with a very low complication rate. The few series that have been reported have shown significant improvement in 73% to 94% of the patients treated. In most cases, functional recovery is quite rapid in the postoperative period.
Current concepts in knee arthroscopy
Authors: Grøntvedt T. , Jørgensen U. , Cohen M.
Published: July 2010

Arthroscopic methods in the knee are used for diagnostic procedures and offer the surgeon a minimally invasive method for repairing a wide variety of injuries in both the acutely and chronically injured knee. These procedures are most often associated with minimal morbidity and early initiation of rehabilitation, and patients may return to work and their daily living activities at a faster rate than with conventional surgical methods. In the acute knee injury, arthroscopy has proven to be a valuable tool in defining the type and extent of the anterior cruciate ligament injury as well as providing definitive assessment of meniscal pathology. Partial menisectomy is the most commonly performed arthroscopic procedure in the knee, acounting for approximately 41% of the total arthroscopic procedures performed. Rapid advancement of arthroscopic techniques in chronic knee injuries, including patellofemoral disorders, osteochondritis dissecans, arthrofibrosis of the knee, degenerative arthritis and cruciate ligament injuries, has resulted in less surgical morbidity without disrupting uninvolved anatomy.
Blood lactate and respiratory variables in elite cross‐country skiing at racing speeds
Authors: Mygind E. , Andersen L. B. , Rasmussen B.
Published: July 2010

The purpose of this study was to examine energy metabolism during two simulated races (skating and classical) in cross‐country skiing. In each race 15 elite subjects skied a 2.75‐km track 5 times. In laps 2 and 4, the skiers were told to skate without poles in the skating race and without the diagonal stride in the classical race. The total exercise time was between 42 and 50 min in the 2 races. The oxygen uptake was measured on flat and uphill terrain during each lap and blood lactate after each lap. The relative mean oxygen uptake for classical skiing was 88% (82‐96) for level and 93% (87‐97) for uphill terrain. The respective means for skating were 91% (85‐96) for level and 91% (81‐97) for uphill terrain. The mean values and range for blood lactate at race speeds were 10.6 mM (7.1‐18.1) and 9.2 mM (4.8‐18.8) for skating and classical, respectively. A relative steady state was achieved after the first lap, although a slight but significant blood lactate accumulation took place until finish (0.04‐0.06 mM min−1). The respiratory exchange ratio in both skiing styles varied between 0.88‐0.90 and 0.92‐0.93 for flat and uphill terrain, respectively, indicating a large lipid oxidation at these very high exercise intensities.
Arthroscopy of the hip
Authors: Grøntvedt T. , Engebretsen L.
Published: July 2010

Arthroscopy has become an important tool in the hands of orthopedic surgeons during the last decades. The hip joint is difficult to approach because it is located deep within the soft tissues covering it, thus decreasing the maneuverability of the instruments. With modern techniques, however, most of the joint space can be visualized. Today, there are several indications for hip arthroscopy and arthroscopic surgery to this joint. The surgical approach is usually made through 3 portals, one directly anterior, and two 2 cm proximal to the tip of the greater trochanter, one anteriorly and the other posteriorly. With a traction force of between 200 and 400 N applied to the leg, the joint space can be widened 5 to 10 mm, allowing space for visualization and surgical instruments. With good surgical technique, the complications are few, and the procedure produces little postoperative morbidity.
Changing injury pattern of acute anterior cruciate ligament tears treated at Tampere University Hospital in the 1980s
Authors: Natri A. , Järvinen M. , Kannus P. , Niittymäki S. , Aarnio J. , Lindholm T. S.
Published: July 2010

During the years 1980–1989, 450 patients with an acute anterior cruciate ligament (ACL) rupture were treated at the University Hospital of Tampere, Finland. ACL ruptures were diagnosed by arthroscopy or open surgery. The data were analyzed in terms of patient age, sex, injury etiology, injury type and sports activity to determine the trends in the 1980s. The number of ACL tears seen in the Hospital increased by 247% over this period. Sixty‐three percent of the patients were male (mean age 33 years) and 37% female (mean age 39 years), and there were no changes in the sex and age distribution in 1980s. The most common injury type was the isolated ACL rupture (51%), followed by a combination injury of the ACL and medial collateral ligament (38%). Isolated ACL ruptures in the 1980s increased 6.5 times. Sports accounted for 54% of all injuries with out any sign of change in their relative proportion in 1980s. The most common sports causing the rupture were soccer (29%), downhill skiing (20%), cross‐country skiing (12%) and volleyball (12%). From 1980 to 1989, there was a decrease (2 times) in ACL injuries sustained in crosscountry skiing and a substantial (30 times) increase in ACL injuries sustained in downhill skiing.
Contraction of knee flexors and extensors in skiing related to the backward fall mechanism of injury to the anterior cruciate ligament
Authors: Aune A. K. , Schaff P. , Nordsletten L.
Published: July 2010

The purpose of this study was to examine the motion pattern and muscle activity during jumping and landing in downhill skiing to estimate the muscular involvement during the jump‐landing‐backward fall‐anterior cruciate ligament (ACL) injury. A digitized 2‐D video motion analysis and a synchronous 8‐channel electromyography registration was performed over a jump on a downhill slope during 3 runs by 2 skiers and during 6 control jumps in the laboratory. The knee flexors (lateral gastrocnemius and biceps femoris) were recruited before touchdown and mean 60 ms earlier than the extensors (vastus lateralis and rectus femoris). Extensors and flexors reached peak activity simultaneously at the instant of landing. The knee flexion angle at the instant of landing was mean 36°. As the landing was stabilized, the extensor activity persisted during eccentric work at increasing knee flexion as a corresponding flexor relaxation took place. The control jump in the laboratory showed a similar order of recruitment and timing of muscle contraction. The gastrocnemius was recruited mean 96 ms earlier and the biceps femoris mean 63 ms earlier than the extensors. This recruitment pattern during the landing movement suggest a learned motor program engaging the kinetic chain of the lower extremity to intercept the landing energy. The results also indicate that the knee flexor activity may protect the ACL at the instant of landing but that it is minimal shortly thereafter and probably not able to protect the ACL when a backward fall occurs. The knee was flexed substantially as the extensors became the dominating muscles. Thus, their ability to apply any anterior drawer force able to rupture the ACL is questioned.
Maximal and submaximal oxygen uptake during running: how should body mass be accounted for?
Authors: Svedenhag J.
Published: July 2010

Oxygen uptake during running, i.e., the running economy, is an important factor in determining running performance in endurance events. The relation to performance is particularly strong when the aerobic running capacity is calculated, i.e., when running economy is related to the maximal oxygen uptake. There is considerable interindividual variation in running economy, and the reason for this is only partly understood. To some extent, this may be due to the way in which the oxygen uptake during running is usually expressed. This may expecially be true when subjects with different or changing body masses are compared. Several lines of evidence, including earlier animal studies as well as more recent human studies, favor the expression of submaximal and maximal oxygen uptake during running in terms of ml · kg−0.75· min−1 rather than as ml · kg−1· min−1.
Prevalence of menstrual dysfunction in Norwegian long‐distance runners participating in the Oslo Marathon games
Authors: Tomten S. E.
Published: July 2010

The objective of this study was to estimate the prevalence of athletic amenorrhea in a wide range of long‐distance runners and the relation to possible risk factors. The study group consisted of 187 long‐distance runners between 16 and 46 years of age. Information was obtained through a mailed questionnaire consisting of 32 different entries, including questions on age, leanness, training history, menstrual history, performance level, stress, as well as some sociological and nutritional aspects. Seventy‐six per cent of the responding runners had normal menstrual function, 9.5% had minor irregularities (O), and 14.6% were amenorrheic (A), which is defined as absence of menstrual bleeding for more than 3 consecutive months the previous year. Half of the amenorrheic group had not had menstrual bleeding at all that year. The runners with menstrual disorders (O+A) had a significantly higher incidence of stress fractures. The most important factors associated with menstrual disorders were a feeling of conflict associated with food; age; and the age of menarche. There was no evidence that age of menarche was associated with an early training debut per se, the frequency and intensity of prepubertal training was not taken into account. All subgroups (E, O, and A) had low body mass index scores, and body composition did not seem to vary with menstrual status within the study group. Thus a high prevalence of menstrual disorders was observed in Norwegian long‐distance runners, a condition associated with increased training loads, but even more with age, menarchal age and a feeling of nutritional conflict.
Bilateral Achilles tendon rupture: a report on two cases
Authors: Orava S. , Hurme M. , Leppilahti J.
Published: July 2010

Two cases of traumatic bilateral Achilles tendon rupture are reported. One of the patients was a healthy middle‐aged man, who had been an active nationallevel gymnast 20 years earlier. He had not suffered any complaints of Achilles tendons before. The ruptures occurred when, after a sauna, he showed his guests a vault forwards, which he had been able to perform easily. This time the landing took place on the toes, causing a high peak stretch to the calf muscles and Achilles tendons. The total rupture of both Achilles tendons was treated surgically, with an excellent result 2 days after the trauma. End‐to‐end suturation and a fascial flap plasty were made on both sides. No macroscopic degeneration could be detected on the rupture sites. He was allowed to walk freely 6 weeks after the surgery. The second case was a 54‐year‐old woman, who had suffered from Achilles tendinitis and peritendinitis for 2 years. Both tendons had been surgically treated, and severe adhesions and local degenerative changes had been found. The tendon rupture occurred when she injured her left ankle while getting out of the car. Two days later she fell at home, because of the weakness of the left side, and consequently the right Achilles tendon was injured. She was treated conservatively for 10 days, before the surgery was performed. Both tendons were ruptured and an extensive degeneration of the area was observed. The right side suffered from a rerupture, which was again treated surgically. After surgery the recovery was slow, but the final result 3 years later was moderate. Neither of the patients had any systemic diseases.
Diagnosis, treatment and rehabilitation principles in complete tendon ruptures in sports
Authors: Kibler W.B.
Published: July 2010

Complete tendon ruptures may occur in any tendor subjected to athletic stress. This article discusses diagnostic, treatment and rehabilitation principles that are common to all tendon ruptures. The most common tendon ruptures are then discussed more specifically, presenting pertinent diagnostic tests, treatment considerations and principles of rehabilitation.
Anterior cruciate ligament strength. Can it be estimated by non‐destructive testing?
Authors: Nordsletten L. , Aune A. K. , Madsen J. E. , Skjeldal S. , Falch J. A. , Ekeland A.
Published: July 2010

For structural and material bone strength, non‐destructive tests exist, while no such tests have been developed for ligaments. In the present study we compared the geometry and bone mineral content (BMC) of the rat tibia with the tensile strength of the anterior cruciate ligament (ACL). A significant correlation was found between the mediolateral diameter of the tibial condyle and ACL load to failure (r=0.83). Calculating the area of the condyle as an ellipse increased this correlation to r=0.93. No significant correlation was found to BMC. If this correlation is also found in humans, the mediolateral tibial head diameter may be used to estimate the strength of the ACL non‐destructively.
Associations between central obestiy and indexes of hemostatic, carbohydrate and lipid metabolism. Results of a 1‐year intervention from the Oslo Diet and Exercise Study
Authors: Anderssen S. A. , Holme I. , Urdal P. , Hjermann I.
Published: July 2010

The relationships of central obesity and physical fitness to indexes of hemostatic, lipid and glucose metabolism both at baseline and after 1 year of diet and exercise intervention were examined in 209 sedentary middleaged men and women with increased coronary risk factor levels. Central obesity was measured as either waist circumference or waist/hip ratio. Maximal oxygen uptake was used as a measure of physical fitness. The cross‐sectional results show that there were significant correlations between waist circumference and euglobuline clot lysis time (r=0.23), factor VII (r=0.16), glucose and insulin before and after 1 h glucose load (r ranging from 0.32 to 0.50). The 1‐year intervention gave the following associations between changes in waist circumference and changes in: euglobuline clot lysis time (r=0.27), factor VII (r=O. 19), carbohydrate variables and lipids (IrI ranging from 0.19 to 0.43). Also the other indexes of obesity and physical fitness showed significant correlations to indexes of hemostatic, lipid and glucose variables, both cross‐sectionally and for changes after the 1 ‐year intervention. The associations between changes in central obesity and changes in indexes of hemostatic, carbohydrate and lipids were generally stronger during 1 year of diet and exercise intervention than those found at baseline. Multiple regression analyses with waist circumference, waistlhip ratio, percent body fat and Vo2max as independent variables and indexes of hemostatic, carbohydrate and lipid metabolism as dependent variables showed that waist circumference was a significant predictor for indexes of the hemostatic, carbohydrate and lipid metabolism, mostly independent of physical fitness. The cross‐sectional and 1‐year change results support each other and therefore underscore the importance of abdominal obesity as an important risk factor for cardiovascular disease.
Joint mobility and the oscillation characteristics of muscle
Authors: Hein V. , Vain A.
Published: July 2010

The aim of this study was to investigate which muscle characteristics of oscillation of the lower extremities have influence on trunk forward flexion and knee extension. The frequency and the decrement of damped oscillation of the muscles m. rectus femoris, m. biceps femoris, m. semitendinosus and t. semimembranosus in relaxed, contracted or stretched states were recorded by the myometer among the 22 first‐year male students of the department of physical education. The subjects were divided twice into two groups according to: 1) the values of the trunk forward flexion, and 2) the values of the knee extension range of motion. The oscillation frequency of m. rectus femoris of the groups with high trunk forward flexion and high knee extension range of motion was lower than in groups with less range of motion. The similarity was followed in the decrement of m. semitendinosus. The difference between the decrements of the relaxed and stretched state of m. semitendinosus and the decrement of the relaxed state of the same muscle tendon correlated with the knee extension range of motion (r=0.46 and r=0.48, P<0.05). The relationship between the decrement of the relaxed state of m. biceps femons and the range of motion was r=‐0.51 (P<0.01). The results of this study showed that the characteristics of the damped oscillation as indirect parameters of viscoelastic properties of the muscles were related to the joint mobility.
Osteoid osteoma as a cause of hip pain in a young athlete
Authors: Gisselbæk M. , Kirchoff R. , Jørgensen U.
Published: July 2010

We report a case of osteoid osteoma as a cause of hip pain in a young athlete. Excision of the lesion resulted in complete relief of the symptoms.
Bone graft fixation in anterior cruciate ligament reconstruction evaluated by radiostereometric analysis
Authors: Thuresson P. , Nyquist F. , Önsten I.
Published: July 2010

For most anterior cruciate ligament reconstruction techniques, the tensile strength of the ligament substitutes and the surgical methods of fixation have been examined. In the present study seven consecutive patients with a chronic anterior cruciate ligament deficiency, who were reconstructed with a bone‐patellar tendon‐bone graft, were followed. The migration of the bone blocks was examined with radiostereometric analysis immediately postoperatively and after 3 and 12 months. The median migration of the bone blocks in the femur was 0.4 mm and in the tibia 0.4 mm. Clinical examination was undertaken preoperatively and one year postoperatively. We conclude that the use of interference screws seems to be a reliable method for fixation in anterior cruciate reconstruction and that healing of the bone blocks occurs during the first three postoperative months.
“Little league elbow”— acute traction apophysitis in an adolescent badminton player
Authors: Blohm D. , Kaalund S. , Jakobsen B.W.
Published: July 2010

A case of an acute traction apophysitis, “little league elbow”, in an adolescent badminton player is presented. After a period of intense badminton activity, the patient developed typical signs of inflammation related to his elbow. X‐ray showed soft tissue calcifications and ultrasound showed intra‐articular swelling and a possible apophysitis related to the elbow. After a period of immobilization followed by low activity he could return to normal sports activity.
Total daily energy expenditure and patterns of physical activity in adolescents assessed by two different methods
Authors: Ekelund U. , Yngve A. , Sjöström M.
Published: July 2010

Minute‐by‐minute heart rate monitoring and an activity diary were used simultaneously during three days in 30 randomly selected adolescents (16 boys, 14 girls; mean age 15.0±1.0). Total daily energy expenditure (TDEE) and its components (energy expenditure during sleep, during rest and in physical activity) and times spent at different intensity levels (sedentary, light, moderate physical activity and vigorous physical activity) were compared. TDEE from heart rate monitoring averaged 10.9±2.7 MJ · d−1 compared to 11.3 ± 2.3 MJ · d−1 from the activity diary (NS). The limits of agreement (mean ± 2 SD) were ‐3.54 MJ · d−1 and 2.74 MJ · d−1. There was no significant difference for any of the TDEE components between the methods (MANOVA). A significant method effect (P < 0.001) was observed for time spent in sedentary and light physical activity (MANOVA). No significant difference was observed for time spent in moderate and vigorous physical activity. According to this, heart rate monitoring and activity diary are comparable for group assessment of TDEE and its components, and for estimating time spent in moderate and vigorous physical activity. The activity diary underestimated time spent in moderate and vigorous physical activity for inactive subjects and consequently overestimated highly active subjects.
Operative treatment of stress fractures of the proximal second metatarsal
Authors: Sarimo J. , Orava S. , Alanen J.
Published: July 2010

Proximal stress fractures of the second metatarsal are rare. They have been reported mainly in classical ballet dancers. Non‐operative treatment has usually led to good results and rapid return to full activities.

We present a series of nine cases with stress fractures of the proximal second metatarsal. The patients were all actively involved in sports. None of them were dancers. In all of these patients non‐operative treatment lasting for an average of 13 months had failed.

All of the patients were operated on using the same method. In the operation drilling was performed around and through the fracture line. The patients were followed for an average of 38 months. All except one of the patients were able to return to their prior level of activity within 4–6 months.

In conclusion if non‐operative treatment fails surgery seems to give good results in most patients with a stress fracture of the proximal second metatarsal.
Global changes in anaerobic fitness test performance of children and adolescents (1958–2003)
Authors: Tomkinson G. R.
Published: July 2010

Aim: To quantify the global changes in anaerobic fitness (operationalized as power and speed test performance) of children and adolescents.

Methods: Following an extensive review of the literature, 32 studies examining secular changes in power and speed test performance of children and adolescents were analysed. Performance changes were calculated at the country × age × sex × test level using weighted least‐squares regression, and were expressed as a percentage of the weighted mean value for all data points in the regression. Negative values indicated performance declines, and positive values indicated improvements.

Results: Changes in power (n=20 802 925) and speed (n=28 320 308) test performance were calculated for 6–19 year olds from 27 countries and five geographical regions, for the period 1958–2003. Overall, power and speed test performances improved at +0.03% and +0.04% per annum, respectively. Performance changes were remarkably similar for boys and girls, and children and adolescents, and somewhat similar for different geographical regions, and high and low income economies. The pattern of change was reasonably consistent over time.

Conclusion: The relative stability in anaerobic fitness test performances in recent decades could be due to the negating effects of increases in fat mass and fat‐free mass on anaerobic performance.
Carbohydrate ingestion during prolonged high‐intensity intermittent exercise: impact on affect and perceived exertion
Authors: Backhouse S. H. , Ali A. , Biddle S. J. H. , Williams C.
Published: July 2010

This study was designed to determine the effects of ingesting a carbohydrate (CHO) solution on affective states and rating of perceived exertion (RPE) during prolonged intermittent high‐intensity exercise. Seventeen male soccer players completed a prolonged intermittent high‐intensity exercise protocol for 90 min on two occasions, separated by at least 7 days. Participants consumed either a 6.4% CHO (0.6 g/kg body mass (BM)/h) or an artificially sweetened placebo (PLA) solution immediately before (8 mL/kg BM) and every 15 min (3 mL/kg BM) during exercise in a double‐blind, counterbalanced design. Pleasure–displeasure, perceived activation, RPE and plasma glucose concentration was assessed. The results showed that compared with the CHO trial, perceived activation were lower in the placebo trial during the last 30 min of exercise and this was accompanied by lowered plasma glucose concentrations. In the CHO trial, RPE was maintained in the last 30 min of exercise but carried on increasing in the PLA trial. Therefore, CHO ingestion during prolonged high‐intensity exercise appears to elicit an enhanced perceived activation profile that may impact upon task persistence and performance. This finding is in addition to the physiological and metabolic benefits of the exogenous energy supply.
The structure of the coracoacromial ligament: fibrocartilage differentiation does not necessarily mean pathology
Authors: Milz S. , Jakob J. , Büttner A. , Tischer T. , Putz R. , Benjamin M.
Published: July 2010

The coracoacromial ligament forms part of the coracoacromial arch and is implicated in impingement syndrome and acromial spur formation. Here, we describe its structure and the composition of its extracellular matrix. Ligaments were obtained from 15 cadavers, nine from older people (average age 74.7 years) and six from younger individuals (average age 24.2 years). Cryosections of methanol‐fixed tissue were cut and sections were immunolabelled with monoclonal antibodies against collagens, glycosaminoglycans, proteoglycans, matrix proteins and neurofilament proteins. Both ligament entheses were highly fibrocartilaginous and immunolabelled strongly for type II collagen, aggrecan and link protein. The area of labelling was more extensive in older people. However, fibrocartilage also characterized the ligament midsubstance, particularly with increased age. Signs of fibrocartilage degeneration were more common in older people. Ligament fat (containing blood vessels and nerve fibers) was conspicuous in both age groups, especially between fiber bundles at the entheses. We conclude that fibrocartilage is a normal feature but becomes more pronounced with age. It is not necessarily pathological, for it simply indicates that the ligament is subject to compression and/or shear. Nevertheless, the prominence of fibrocartilage at the acromial enthesis may relate to the frequency with which enthesophytes develop.
The reduction of physical activity reflects on the bone mass among young females: a follow‐up study of 142 adolescent girls
Authors: Rautava E. , Lehtonen‐Veromaa M. , Kautiainen H. , Kajander S. , Heinonen O. J. , Viikari J. , Mottonen T.
Published: July 2010

AIM: Maintenance of positive effects of physical activity on growing bone is unknown. Physical activity was associated with increased BMC and BMD in a 7‐year follow‐up with 142 adolescent girls. Marked reduction in physical activity had an unfavorable effect on bone measurements, which is an important finding when the prevention of osteoporosis is considered.

INTRODUCTION: Environmental factors influence quality and durability of bone. Physical activity, with high‐impact weight bearing activity during puberty in particular, has been shown to have a beneficial effect on growing bone. Only few studies have been published on the maintenance of these effects.

METHODS: At baseline, 142 girls aged 9–15 years participated in the present 7‐year follow‐up study. Growth and development, physical activity and intakes of calcium and vitamin D were recorded at intervals. BMC and BMD measurements were repeated using DXA. Based on the recording of physical activity during the follow‐up measurements, the effect of the reduction in physical activity was examined with the bone measurements, and the measurements in the tertiles based on the amount of physical activity during the whole follow‐up period were compared.

RESULTS: Physical activity was positively associated with the development of BMC and BMD during the follow‐up. The mean BMC of the lumbar spine increased 1.69 g (3%) (P=0.021) more among those girls who maintained the physical activity level as compared with those who reduced it during last 4 years. In the femoral neck, the corresponding difference was 0.14 g (4.6%) (P=0.015) between the same two groups of girls. The mean increases in BMC at lumbar spine and femoral neck were more substantial among those girls having the highest physical activity levels during the 7‐year follow‐up (46.7% and 22.6%) as compared with those having the lowest physical activity levels (43.3% and 17.4%, respectively).

CONCLUSIONS: The findings of the present study show that regular physical activity is valuable in preserving the peak bone mass acquired at puberty in particular. Many of the girls who markedly reduced their activity levels lost bone in their femoral neck before their 25th birthday.