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Background: Exercise forms an important component in the management of ankylosing spondylitis (AS). The objective of our study was to determine the effects of a 6-month swimming, land-based stretching, strengthening and breathing exercise intervention in AS patients. Methods/design: A total of 29 (14 females, 15 males) patients diagnosed with AS according to the Modified New York Criteria participated in our study. Participants were randomly assigned to an exercise group (ASE) (16 participants) and a control group (ASC) (13 participants). Erythrocyte sedimentation rate and C-reactive protein (CRP); anthropometric measurements; pulmonary function; aerobic capacity; balance; Bath AS Metrology Index; Bath AS Disease Activity Index and the Bath AS Functional Index were assessed. Discussion: Erythrocyte sedimentation rate and CRP did not change notably within or between the groups from pre- to post-intervention. The between group analyses of the physical assessments favoured the ASE with observable improvements in chest expansion ( p = 0.002), forced expiration volume ( p = 0.012), absolute ( p = 0.017) and relative ( p = 0.003) maximal oxygen consumption, absolute ( p = 0.028) and relative ( p = 0.001) physical work capacity. Within the ASE, there is statistical evidence of improvements in 11 of the 19 physical variables. Within the ASC, five of the physical variables deteriorated substantially ( p between 0.004 and 0.037) and only balance overall stability on the right improved ( p = 0.016). The three functional assessments in the ASE improved ( p < 0.007) compared with the ASC post-intervention. A 6-month combined exercise programme may improve physical and functional capacity of AS patients. Conclusion: A multimodal exercise intervention may be useful in the management of ankylosing spondylitis. Clinical implications: An unsupervised well -explained exercise programme combining swimming, land-based strengthening and stretching exercises and breathing exercises may be an option for patients with ankylosing spondylitis. Trial registration: Registration not undertaken at the time of writing.

Background It remains unclear if ad libitum water drinking, as a hydration strategy, prevents exercise-associated hyponatremia (EAH) during prolonged exercise. The aim of this study was to determine the incidence of EAH within the broader context of fluid regulation among soldiers performing a 40-km route-march ingesting water ad libitum. Methods Twenty-eight healthy male soldiers participated in this observational trial. Pre- and post-exercise body mass, blood and urine samples were collected. Blood samples were assessed for serum sodium ([Na+]), glucose, creatinine, urea nitrogen (BUN), plasma osmolality, creatine kinase (CK), and plasma arginine vasopressin (AVP) concentrations. Plasma volume (PV) was calculated using hematocrit and hemoglobin. Urine samples were analyzed for osmolality and [Na+]. Water intake was assessed by weighing bottles before, during and after the march. The mean relative humidity was 55.7% (21.9–94.3%) and the mean dry bulb temperature was 27.1 °C (19.5 °C - 37.0 °C) during the exercise. Results Twenty-five soldiers (72 ± 10 kg) (Mean ± SD) completed the march in 09:11 ± 00:43 (hr:min). Participants consumed 736 ± 259 ml/h of water and lost 2.8 ± 0.9 kg (4.0% ± 1.4%, P 1000 mOsmol/kg H2O) and plasma AVP. No single hydration strategy likely prevents EAH, but hypernatremia (cellular dehydration) was not seen despite > 2% body mass losses and high urine osmolality.

Background: Fitness is defined in the health context as a state of good health or physical condition, primarily as a result of exercise and proper nutrition. Conventional methods of measuring fitne...

The measurement of skinfold thickness by means of skinfold callipers (SC) is a widely accepted method to assess subcutaneous fat thickness and percentage body fat (%BF). Ultrasound imaging (USI) is a more recent technology that is becoming accessible for the same application. The objective of this study was to compare measurements recorded by SC and USI for the assessment of subcutaneous fat thickness in order to estimate %BF. Thirty adults volunteered for the study. Body mass, stature and subcutaneous fat thickness for seven sites were measured. Strong (p0.05) difference between the %BF determined by the two methods (SC=19.5±6.4 %BF and USI = 19.0±6.3 %BF). However, levels of agreement indicated that the USI could over- or underestimate %BF by ±10%. This resulted in %BF estimation errors which are deemed too large from a clinical perspective. Additional studies are recommended to investigate the lack of agreement and bias highlighted between the two methods.Keywords: Percentage body fat, field assessments, subcutaneous fat thickness

A wide variety of anatomical structures can be involved in a sports injury. To return to play as soon as possible is of utmost importance to an athlete, and in order to achieve this, a correct, all-inclusive diagnosis, a well-focused treatment plan, and a management plan that strives to offer protection are essential.This article aims to give an overview of acute and overuse (chronic) sports injuries in adults, the approach to an accurate diagnosis and the management strategies that are available.A literature review was conducted of scientific journals, text and internet material, including a Medline and PubMed search. Literature was selected for its in-depth data and well-researched information. Key search terms included “acute and overuse injuries”, as well as “sports injuries diagnosis and management” to address current and relevant scientific data on the examination and management of sports injuries in adults.The literature review indicated that sports injuries (both acute and overuse) are inc...

This paper reports the results of a project funded by the Centers for Disease Control and Prevention intended to promote the use of science-based approaches to teen pregnancy prevention. As with other efforts to promote diffusion of innovations, adoption of these successful programs faced a number of barriers including lack of knowledge of programs that work, lack of funding for training and materials, devaluing science-based approaches, complexity of successful programs, politics, funding streams and compatibility with particular community characteristics. Nevertheless, five state and three national teen pregnancy organizations provided intensive technical assistance, produced materials, and provided training to encourage use of programs that work. Local barriers to their work included the fact that teen pregnancy rates were already dropping, instability of funding to pay for such programs, turnover of agency staff, the need for intensive follow-up to promote adoption, the internal organization of the initiative, and the fragility of local teen pregnancy prevention coalitions. Still, in each of five states, there was increased adoption of science-based approaches to prevent teen pregnancy.

Background: Over the last few years, the types of exercises prescribed for patients with rheumatoid arthritis (RA) have changed. There is also increasing knowledge on the physical status and physical activity levels of these patients. This article aims to give an overview of the physical status, physical activity levels and appropriate exercise prescription for patientswith RA.Method: A literature search was conducted of scientific journals and text, including Medline and PubMed (1980-2012). Literature was selected for its in-depth data and well researched information. Key search terms included “RA and exercise therapy”, as well as “physical activity levels and physical status of patients with RA”.Results: The literature indicated that RA has a major impact on physical and psychological health. Over the past decade, there has been growing evidence of the health benefits of physical activity for patients with RA. Despite this evidence, patients with RA are less physically active than the general population. The types of exercises prescribed for patients withRA have changed from the traditionally prescribed isometric and range-of-motion exercises. However, proper choice and appropriate utilisation of exercise is essential in order to provide a therapeutic effect.Conclusion: Although pharmacological interventions have largely improved RA management, exercise therapy remains an important part of treatment. Despite the known benefits of physical activity and exercise, patients with RA are less physically active than the general population.

The primary objective was to evaluate the effect of ad libitum vs. restricted fluid replacement protocol on hydration markers and performance in selected military tasks. The secondary objective was to determine if 300 ml x h(-1) could be considered a safe minimum fluid intake under the experimental conditions.Data were collected simulating a route march over 16 km. There were 57 subjects who participated in the study.The mean pre-exercise body mass of the ad libitum group was 70.4 +/- 13.3 (SD) kg compared to 69.3 +/- 8.9 kg in the restricted group. The mean total fluid intake of the ad libitum group was 2.1 +/- 0.9 L compared to 1.2 +/- 0.0 L in the restricted group. The ad libitum and restricted intake groups, respectively, lost a mean of 1.05 kg +/- 0.77 (1.5%) and 1.34 kg +/- 0.37 (1.9%). Calculated sweat rate was 608 +/- 93 ml x h(-1) compared to 762 +/- 162 ml x h(-1) in the ad libitum group.There were no significant differences for either urine specific gravity (USG) or urine osmolality (UOsm) before or after the exercise. It is not clear whether fluid intake and calculated sweat rates are causally related or explained by their codependence on a third variable; for example, the exercising metabolic rate. Thus, 300 ml x h(-1) intake could be considered a current safe minimum water intake for soldiers of similar mass under similar experimental conditions, namely similar exercise durations at equivalent exercise intensities in a moderate, dry climate.

The aim of this study was to evaluate the benefits and limitations of using three dimensional (3D) musculoskeletal modelling (LifeModeler) in assessing the safety and efficacy of exercising on an abdominal crunch resistance training machine. Three anthropometric cases were studied, representing a 5th percentile female, and 50th percentile and 95th percentile male. Results indicated that the LifeModeler default model was capable of solving the forward dynamics simulations without adjustments. The modelling was able to indicate high risk for back injury when performing the abdominal crunch exercise as a result of the unacceptable intervertebral joint loading that occurs during the exercise. Individuals with small anthropometric dimensions such as some females and children cannot be accommodated suitably on the abdominal crunch machine which negatively impacts exercise posture and technique. Hip flexor muscle contribution in the execution of the exercise for the 5th percentile female was substantial thus reducing the efficacy of the exercise in isolating the abdominal muscles.

The aim of this study was to evaluate the benefits and limitations of using three dimensional (3D) musculoskeletal modelling (LifeModeler) in assessing the safety and efficacy of exercising on a seated biceps curl resistance training machine. Three anthropometric cases were studied, representing a 5th percentile female, 50th percentile and 95th percentile male. Results indicated that the LifeModeler default model was not adequate to solve the forward dynamics simulations. Therefore adjustments had to be made to the default model to successfully complete the forward dynamics simulations. The software was able to sufficiently highlight the shortcomings of the biceps curl machine's engineered adjustability in relation to the anthropometric dimensions of the studied cases, as the 5th percentile female could not be accommodated suitably on the machine. High lumbar spine anterior/posterior shear forces for all anthropometric cases and maximum muscle tensions for the female and 50th percentile male indicate that the seated biceps curl exercise may pose risks for injuries. To conclude, it appears that 3D musculoskeletal modelling can be used to evaluate resistance training equipment such as the seated biceps curl machine. However the limitations as indicated by this study must be taken into consideration, especially when using the default LifeModeler model.

Objective. To compare the effects of a 3-month land- and waterbased exercise programme among rheumatoid arthritis (RA) sufferers. Methods. Patients with RA Functional Class I and II ( N =10) were randomly assigned to a land-based exercise group (Group L) ( N =4), water-based exercise group (Group W) ( N =4) or a control group (Group C) ( N =2). Testing parameters included swollen joint count (SJC), tender joint count (TJC), erythrocyte sedimentation rate (ESR), haemoglobin (Hb), 50-ft (15.2-m) walk test, grip strength, isokinetic strength of knee extensors and flexors, knee range of motion (ROM) and aerobic capacity. Results. There were individual improvements in most of the physical status parameters tested for the experimental groups (land-based exercise group and water-based exercise group) while the general trend for the control group was that of deterioration. Appropriate land-based exercises did not appear to aggravate disease activity. However, the water-based exercise programme was superior in controlling the disease activity with regards to the tender and swollen joint counts. Conclusion. Both exercise interventions appeared to be beneficial in the treatment of RA. Further research is required comparing various modes of exercises for the treatment of RA, using larger samples and evaluating the long-term effects.

Objective. To determine the attitudes, beliefs and knowledge of talented young athletes residing in Gauteng regarding prohibited performance-enhancing drugs (PEDs) and anti-doping rules and regulations.Methods. This was a survey study using a quantitative research approach. South African TuksSport academy athletes at the High Performance Centre, University of Pretoria, and competitive high-school athletes at four private high schools in Gauteng completed the survey. A selfdetermined, structured questionnaire was used to establish the attitudes, beliefs and knowledge of the athletes.Results. A total of 346 (208 males, 138 females) athletes, mean (standard deviation) age 16.9 (1.4) years participated in the survey. According to this survey, 3.9% of the athletes in this survey admitted to using a prohibited PED and more than 14.0% of the athletes said they would consider using a prohibited PED if they knew they would not get caught. Ambition (46.0%) and emotional pressure (22.5%) were the primary reasons why the athletes would consider using prohibited PEDs. Even though coaches appeared to be one of the main sources of information (on PEDs and anti-doping rules), only 42.1% of the athletes felt that they were well informed.Conclusion. Controlling doping by means of testing is important. However, it may be necessary to put more emphasis on changing attitudes towards doping and implementing additional educational programmes.