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Aims: To examine the influence of motivational and instructional self-talk on balance test performance of knee injured active individuals with meniscectomy. Design: One between-groups factor with f...

The purpose of the present study was to investigate, the effectiveness of a balance training program in male professional handball players. Thirty professional handball players were randomly divided into experimental and control group. The experimental group (N=15), additional to the training program, followed an intervention balance program for 12 weeks. All subjects performed a static balance test (deviations from the horizontal plane). The results revealed that the 12-week balance training program improved (p

The purpose of the present study was to investigate the effects of a soccer training session on the balance ability of the young soccer players. Participants were twenty-six young soccer players. Standard testing balance boards and Biodex Stability System were used to assess balance ability before (pre-training) and immediately after (post-training) the completion of a soccer training session. Also, Isokinetic knee joint moment measurements (60°/sec and 180°/sec) were carried out pre- and post-soccer training. The results revealed that no differences (p>0.05) were found in balance ability and knee joint moment production between pre- and post-soccer training. Result is in contrast to the notion of a link between fatigue induced by a soccer training session or game and injury caused by impaired balance.

Aims: This study aims at investigating which factors are related to the diabetic patients’ compliance to their hygiene,dietary and pharmaceutical treatment, which are able to influence the disease’ progress.Methodology: The sample consisted of 15 diabetic patients recruited at a private doctor’s office in a suburb of Athens,Greece. Data collection was done using participant-completed diaries, in which they described their perceptions.Qualitative analysis was performed. A list of categories and subclasses was created which were grouped and became the essentialcategories included in the final list. Then the diaries were re-read, but this time alongside the final list. In this way the degree towhich the categories covered the diaries’ content was checked, and adjustments were made when necessary.Results: Passivity, un-readiness, weakness to accept the disease, ignorance about the illness and its complications, poordoctor-patient relations, insufficient family supporting environment, insufficient variety of tasty foods, chronicexhaustion, and complexity of illness are shown to be detrimental for the patients’ progress. Health education can helpdiabetic patients address issues such as diet or exercise, and to recommend a healthy dietary programme whichregulates glucose levels and avoids complications.

The Emotions Scale (EMS) was developed to assess responses of patients with CLBP to pain in terms of positive and negative emotions. Such an evaluation may be able to provide an insight into the effectiveness of a rehabilitation programme in patients with CLBP. To determine the final number of factors, an initial principal component analysis without rotation was conducted. The EMS developed and validated in the present study for patients with CLBP is a tool that can be applied by all specialists and in all medical or rehabilitation settings because it is short and concise. At the same time it includes most of the main emotions affected by CLBP, so that with one tool, many assessments can be performed. The EMS may be used in controlled trials, or in observational and survey studies. The results revealed that two factors explained 56.31% of the total variance. Cronbach α coefficients were: 0.92 for factor “negative emotions” (12 items, e.g. “weak”) and 0.90 for factor “positive emotions” (8 items, e.g. “cheer”). Importantly, the component correlation matrix of the specific analysis showed a negative correlation between these two factors.

Objective The purpose of this literature review was to synthesize the existing literature on various definitions, classifications, selection criteria, and outcome measures used in different studies in patients with neck pain. Methods A literature search of MEDLINE and CINAHL through September 2008 was performed to gather articles on the reliability, validity, and utility of a wide variety of outcome measurements for neck pain. Results Different types of definitions appear in the literature based on anatomical location, etiology, severity, and duration of symptoms. Classifications according to severity and duration of pain and the establishment of selection criteria seem to play a crucial role in study designs and in clinical settings to ensure homogeneous groups and effective interventions. A series of objective tests and subjective self-report measures are useful in assessing physical abilities, pain, functional ability, psychosocial well-being, general health status, and quality of life in patients with neck pain. Self-administered questionnaires are commonly used in clinical practice and research projects. Conclusions Because of multidimensionality of chronic neck pain, more than just one index may be needed to gain a complete health profile of the patient with neck pain. The instruments chosen should be reliable, valid, and able to evaluate the effects of treatment.

Purpose: The purpose of the study was to investigate the effect of Kinesio Taping ® on quadriceps strength at maximum concentric and eccentric isokinetic exercise mode in healthy non-athlete women in order to examine the Kinesio taping effect in increasing or decreasing the muscular quadriceps strength. Methods: Three different quadriceps taping modes have been used (no taping, placebo taping, Kinesio-Taping) for the study. and isokinetic concentric and eccentric strength assessments have been done for both knee extensors and flexors. Results: One-way ANOVA for repeated measures revealed no significant differences in max concentric torque between the three different taping modes but significant differences in max eccentric torque during both the concentric and eccentric mode of the quadriceps muscle. Conclusion: The results suggest that application of Kinestio Taping on the anterior surface of the thigh, in the direction of vastus medialis, laterallis and rectus femoris fascia, could increase the eccentric muscle strength (isokinetic eccentric peak torque), in healthy adults.

The purpose of the present study was to investigate the effect of a tennis training session on the balance performance of young tennis players. The study was conducted on 36 elite tennis players (age 14 +/- 2 years; body mass 55 +/- 6 kg; body height 165 +/- 6 cm; mean +/- SD) participating in the national young tennis championship. Balance performance was assessed before and immediately after a tennis training session (pre-training and post-training, respectively). The balance assessment was performed with 2 different balance boards and the Biodex Stability System. In addition, dynamometric measurements of peak isokinetic moment in the knee flexors and extensors were performed pre and post tennis training session, to quantify the degree of muscle fatigue induced by the tennis training session. One-way analysis of variance with repeated measures was used to test for differences in balance performance and in isokinetic performance between pre and post tennis training session. The data analysis revealed no significant differences (p > 0.05) in balance performance, whereas there were significant differences in knee joint moment production between pre and post tennis training measures. Although the tennis training session of the present study had no significant effect (p > 0.05) on any of the balance performance indicators examined, there was a decline in balance performance, which suggests that different level of fatigue for an extended period (games) will have greater effect on balance performance. It is suggested that a tennis-specific balance exercise program should be included in the tennis training session.

The aim of this study was to record the injury incidence in all age categories in male volleyball players and clarify the role of age in injury occurrence. The injury incidence rate, severity, diagnosis and the anatomical location of the injuries that occurred during practice and competition in the whole championship period were recorded prospectively during the period 2005–2006. A total of 407 Greek male volleyball players participating in all Volleyball Championships in Greece according to the Greek Volleyball Federation have been observed on a weekly basis for the period 2005–2006. The injury incidence rate was recorded as the number of injured players and also the number of injuries per player per year (total exposure time). The results revealed that injury occurrence is age related and junior volleyball players have a lower injury rate than senior ones. There were significantly more acute injuries in comparison to overuse syndrome and the ankle was the most common injured anatomical location. Finally, outside hitters, universals and setters presented different injury rates to other players and the “incorrect sprawls” and “stepping on others’ feet” were the most common injury factors. In conclusion, findings in the injury occurrence rate must be interpreted in relation to the total exposure time in order to have more realistic conclusions.

Anterior cruciate ligament rupture is one of the most common knee injuries in sport. A variety of surgical techniques and rehabilitation protocols are used to treat ACL injuries. Those injuries, lead to impair function and loss of proprioception. New research demonstrates that rehabilitation should be based on proprioception. The ACL not only serves a mechanical role by limiting passive knee mobility but also serves sensory role through the mechanoreceptors deep in its tissue, which communicate with the neuromuscular system to provide proprioceptive feedback. The main purpose of the study was to assess the influence of a balance-training program on knee joint proprioception, between acl reconstructed patients who had a lack of proprioceptive ability. They had undergone acl reconstruction at a mean of 22 months (range 8-30) before the initiation of the study. They were randomly assigned into two groups, one experimental (group A) and one control (group B). We assessed proprioception using Biodex stability system and two different kinds of balance boards, in 24 patients with mean age 29,1 yr. The results shown that stability indices of balance appeared improved for the reconstructed leg and there were significant differences between the experimental group and the control group ( p< 0.05).

Objective: To investigate the effects of a preoperative or postoperative rehabilitation program on health related quality of life, for patients affected by final-stage idiopathic knee osteoarthritis, before and after primary total knee arthroplasty. Design: 53 successive patients (aged 68.76 ± 5.64 years) were randomly assigned to receive a general strengthening exercise program for 3 weeks preoperatively (PROP, n = 18) or a specific strengthening rehabilitation program for 8 weeks postoperatively (POP, n = 15). The control group followed standard preoperative and postoperative care (CON, n = 20). Measurements: Health status (Short Form-36), functional ability (Iowa Level of Assistance Scale), active range of motion (AROM). Results: PROP group showed improvement in their mental health dimensions preoperatively and better functional readiness at hospital discharge. POP group achieved higher level of functional ability (p < 0.05) after the exercise intervention and realized a substantial increment of AROM (p < 0.05). Conclusions: A preoperative general strengthening exercise program is feasible, seems to be beneficial to patients’ mental health affected by final-stage idiopathic knee osteoarthritis and assists in the early return of basic functional abilities during the in-patient rehabilitation period. A postoperative specific strengthening exercise intervention is effective in increasing the active range of motion and restoring rapidly the functional autonomy throughout the out-patient intermediate rehabilitation phase.

It is unclear whether fatigue induced by a tennis training session influences the effectiveness of balance exercise training program. Thus, the purpose of the present study was to investigate whether a balance program is more effective when performed before or after the regular tennis training session. The study was conducted on 36 young tennis players participating in the national young tennis championship. The participants were randomly divided into three subject groups, one control group (C group), and two intervention groups that performed a specific balance program for 12 weeks, three times per week, 16 min per session. One intervention group performed the balance program immediately before the regular tennis training session (Pre training group) and the other group performed the same balance program immediately after tennis training (Post training group). Balance performance was assessed in all subjects at baseline (T0) and after the completion of the 12-week balance program (T12). The balance performance assessment was performed with two different balance boards and the Biodex Stability System. Two-way repeated measures ANOVA revealed that there was no difference ( p> 0.05) in balance performance in the C group between T0 and T12. In contrast, there was significant improvement between T 0 and T12 for Pre and Post training groups. Furthermore, there were significant differences between group C and the two intervention groups after the 12-week balance training program, while there was no significant difference between the Pre and Post training groups. In conclusion, there was significant improvement in balance performance with the balance training program and there was no effect of the time the tennis training sessions were performed.

The purposes of this study were to record the injury incidence in all age categories of female volleyball players and to clarify the role of age in injury occurrence. The injury incidence rate, severity, diagnosis and the anatomical location of the injuries, which occurred during practice and competition during the championship period, were recorded prospectively during the 2005–2006 period. A total of 689 Greek female volleyball players participating in all volleyball championships in Greece were observed on a weekly basis. The injury incidence rate was recorded as number of injured players and also number of injuries per player-year (total exposure time). No significant differences in injury occurrence rate were observed between the different age categories (youth, junior, senior). Acute injuries were significantly more commonly than overuse syndromes, and the ankle was the most common injured anatomical location. The injury rate in the competitive season was significantly greater than that in the preseason and post-season periods for all the participants. We suggest that any findings in injury occurrence rate must be interpreted in relation to the total exposure time in order to have more realistic conclusions.

The purpose of this study was to determine the reproducibility of measures for maximum knee extensor and flexor concentric strength on an isokinetic dynamometer in individuals with mild and moderate osteoarthritis of the knee. Twenty eight female patients with 1 st (n = 14) and 3 rd (n = 14) grade unilateral knee OA volunteered for the study. Peak muscle torque of the knee extensors and flexors was measured using an isokinetic dynamometer at angular velocities of 90, 120 and 150 ◦ /s. Test-retest reproducibility of maximal isokinetic torque was evaluated using intraclass correlation coefficient (ICC). Absolute reproducibility was assessed using Bland-Altman analysis, the standard error of measurement (SEM and SEM%) and the smallest real differences (SRD & SRD%). Inter-session relative reproducibility was found to be high in extensor and flexor muscles of individuals with mild OA, with the ICCs values ranging from 0.89 to 0.92 for the concentric knee extension and from 0.90 to 0.93 for the concentric knee flexion, while in the group of individuals with moderate knee OA the same values varied from 0.79 to 0.91 and from 0.75 to 0.93 for the concentric knee extension and flexion, respectively. The Bland-Altman analyses support the findings of high relative reproducibility for the two groups of patients in almost all measurements, except for the extension at 120 and 90 ◦ /s and the flexion at 150 ◦ /s conducted by the individuals with moderate OA. SEM and relative SEM values ranged from 6.7 to 9.4 Nm and from 14.4% to 21.5%Nm for the group with mild OA and from 4.4 to 7.7 Nm and from 14.6% to 21.8%Nm for the group with moderate OA, respectively. SRD and SRD% values across all movement speeds for both knee flexors and extensors ranged from 18.6 to 26.1 Nm and from 39.9% to 59.6%Nm for the mild OA group, respectively, while the same values for the moderate OA group ranged from 12.2 to 21.3 Nm and from 40.5% to 56.8%Nm, respectively. These results indicate that measurements of isokinetic performance at velocities of 90, 120 and 150 ◦ /s provide acceptable reproducibility for evaluation of knee strength in individuals with mild OA of the knee. On the other hand, with regard to knee muscles isokinetic performance, testing of individuals with moderate OA should be conducted during periods of time when the symptoms of the disease subside.

The purpose of the present study was to investigate the effects of a soccer training session on the balance ability of the players and assess whether the effectiveness of a balance program is affected by its performance before or after the regular soccer training. Thirty-nine soccer players were randomly divided into three subject groups (n=13 each), one control group (C group), one training group that followed a balance program (12 weeks, 3 times per week, 20 min per session) before the regular soccer training (TxB group), and one training group that performed the same balance program after the soccer training (TxA group). Standard testing balance boards and the Biodex Stability System were used to assess balance ability in the C, TxB, and TxA groups at baseline (T0) and after completing the balance program (T12). The same tests and additional isokinetic knee joint moment measurements were carried out in the TxB and TxA groups pre- and post-soccer training. Two main results were obtained: (1) No differences (p>0.05) were found in balance ability and knee joint moment production between pre- and post-soccer training. (2) The balance program increased (p

The purpose of this study was to determine whether a high intensity (HI) versus a moderate (MI) or low-intensity (LI) training program would be more effective in improving the isokinetic knee extension muscular performance in healthy inactive men and women. Sixty-four participants, men and women, were randomly assigned to one of four groups: control group (C), LI (50% of 1RM), the MI group (70% of 1RM) and the HI (90% of 1RM). Participants exercised on three resistance exercise machines: leg extension, leg curls and leg press. The isokinetic testing method (concentric mode) applied prior to and at the end of the training period (16 weeks, three 3 times per week) to assess the knee muscular performance. MANOVA repeated measures revealed that the HI group demonstrated the most strength gains following a speed specificity pattern (most considerable improvement occurred at or near slow speeds from 7.3% to 11.2% for male and from 2.3% to 15.2% for female). In addition, males demonstrated a greater improvement of knee extension power output than females. In conclusion, HI strength training is proposed for elderly men and women as the most effective protocol. Furthermore only at low-velocity testing, women of the HI showed a greater change than men (p < 0.05). Regarding strength increase in relation to various testing velocities, a greater increase was found in HI at low velocities, with the other training groups exhibiting almost similar strength increase at all tested speeds.

Background: Many studies have compared different training methods for improving muscular performance, but more investigations need to be directed to the restoration of muscular imbalances. Objective: To determine the most effective training for altering strength ratios in the shoulder rotator cuff. Methods: Forty eight physical education students were randomly assigned to four groups (12 per group): ( a ) experimental group who carried out multijoint dynamic resistance training for shoulder internal and external rotation movement (pull ups or lat pull downs, overhead press, reverse pull ups, push ups) (MJDR group); ( b ) experimental group who exercised the same muscle group using dumbbells weighing 2 kg (isolated group); ( c ) experimental group who followed an isokinetic strengthening programme for the rotator cuff muscle group (isokinetic group); ( d ) control group who had no strength training. Testing was performed in the supine position with the glenohumeral joint in 90° of abduction in the coronal plane, with a range of motion of 0–90° of external rotation and 0–65° of internal rotation at angular velocities of 60, 120, and 180°/s. The test procedure was performed before and after the exercise period of six weeks. Results: One way analysis of variance found no differences between the groups for the initial tests. Analysis of variance with repeated measures showed that the strength ratios in all the experimental groups had altered after the exercise period, with the isokinetic group showing the most significant improvement. Conclusions: Isokinetic strengthening is the most effective method of altering strength ratios of the rotator cuff muscle.

The aim of the study was to investigate the effect of balance training on proprioception and on lower limb injuries. The sample consisted of 100 young soccer players, from four different soccer teams. Two teams were the experimental group, (N = 50), and two the control group (N = 50). During the competition period, the experimental group followed a proprioception training program, 2 times per week, with 20 minute sessions. The frequency and the characteristics of injuries occurred were also recorded. Balance tests on the stability system (Biodex) were performed before and after the competition period. For the balance tests repeated measures Anova was used and the results revealed significant differences between the pre and post training measures for the experimental group. Also, the results revealed an important difference between the experimental and control group in the incidence rate of the injuries. Finally, an important difference was found between the experimental and control group in moderate severity injuries. The application of a specific balance training program on healthy young soccer players can improve their proprioception and prevent low limb injuries.

The purpose of this study was to compare 2 different training modes in improving shoulder cuff muscular performance. Thirty-nine participants were randomly assigned into 3 groups: the isolated group exercised using 2-kg dumbbells; the complex group used a protocol with complex exercises; and the control group had no training. All participants trained for 6 weeks (3 times per week) and were evaluated isokinetically before (pretest) and after the training period (posttest). Results showed that the complex group significantly improved their muscular performance, but the isolated group did not, indicating that isolated exercises are only effective when the training goal is to strengthen the weaker muscle group, but they must be replaced by more complex and closed-kinetic exercises in order to obtain considerable improvement of the rotator cuff strength. The authors propose that a strengthening program should start with isolated movements for better stimulation of the weaker muscles and continue with complex exercise for more impressive strengthening.

The purpose of the present study was to determine whether a general conditioning (callisthenic exercise) versus a machine based resistance-training protocol or an isokinetic exercise program would be similarly effective in improving knee extension muscular performance in healthy inactive elderly. Fifty two individuals, 26 men and 26 women, were randomly assigned to one of four groups: control group (C, n =1 0), the isokinetic strengthening group (ISO, n =1 2), the multi-joint resistance training group (RES, n =1 5) and the calisthenic exercised group (CAL, n =1 5). The training protocol for the ISO included concentric isokinetic extension and flexion of the knee, for the RES included leg extension, leg curls and leg press and for the CAL included aerobic exercise accompanied with music, general calisthenics and activities targeted to reaction time and agility improvement. The isokinetic concentric testing method applied prior to and at the end of the training period to assess peak muscle torque of the right knee extensors. MANOVA repeated measures (2× 4, time by treatment) revealed that at 60 ◦ /s angular velocity there was statistically significant improvement in performance for the RES group in comparison to control group. At 180 ◦ /s angular velocity the results revealed, statistically significant improvement in performance for the RES and ISO group also. In conclusion, in older adults isokinetic exercise and resistance training results in larger increases in strength compared with callisthenic exercise.

The aim of the present study was to determine the relationship between vertical jump performance and the isokinetic strength of the knee extensors in professional soccer players at the end of the of the competition period, after the detraining period (before the initiation of the preparatory period) and after the completion of the preparatory period. Eighteen professional soccer players participated in the present study. The peak jumping height (of the squat and counter movement jumps on an Ergojump device) was used as indicator of vertical jump performance. The subjects also performed three submaximal and three maximal isokinetic efforts of the knee extensors at angular velocities of 60 and 180 ◦ /s. Pearson product moment correlation analyses were conducted to determine the relationship between isokinetic strength and jumping parameters. The significance level was set at p< 0.05. The analysis indicated that jumping height was moderately correlated with the knee torques at the test velocities after the competition and preparatory period.

Thirty six Physical Education students participated in this study and were randomly assigned in three groups: a. The first experimental 'isokinetic group' (N = 12) followed an isokinetic strengthening program for the rotator cuff muscle group. Its isokinetic exercise protocol consisted of 10 set of 10 repetitions at 90, 120, 180, 210, 240, 240, 210, 180, 120 and 90 deg/sec respectively, b. The second experimental 'MJDR group' (N = 12) used the multi joint dynamic resistance training mode for the same muscle group. Its exercise program consisted of four exercises: 1. Pull-ups or lat pull downs, 2. Overhead press, 3. Reverse pull ups and 4. Push-ups (submaximal effort, 8-15 repetitions in 3-7 sets, rest between sets ranging from 2-4 minutes), c. The 'control' group (N = 12) had no strengthening training. Testing was performed in the supine position with the glenohumeral joint in 900 of abduction in the coronal plane, with a range of motion of 0-900 of external rotation and 0-650 of internal rotation at 60, 120 and at 1800/sec. The testing procedure was performed before and after the exercise period of six weeks. The results showed that in both movements and extremities the performance improvement was not the same for the three groups (interaction 'group' and 'test'). In both internal and external rotation and both extremities, statistically significant improvement in performance was observed only for the two experimental groups.

Objective: To pilot a newborn screening program for sickle cell disease (SCD) in St. Vincent and the Grenadines using a novel partnership method to determine the feasibility of a universal newborn screening program in this country. Methods: A prospective study of mothers and their newborns was conducted between January 1, 2015, and November 1, 2015, at the country’s main hospital. Mothers of infants born at this hospital were offered screening for SCD for their infants. If accepted, the newborn’s heel-stick blood specimen was obtained and mailed to the South Carolina Department of Health and Environmental Control Newborn Screening Laboratory for testing. Samples were analyzed for variant hemoglobins using standard laboratory techniques and results were communicated to local physicians. Feasibility was determined by a benchmark of having >50% of SCD patients receive the diagnosis and initiate disease-specific care by 3 months of age. Descriptive statistics were completed using SAS 9.4. Results: There were 1147 newborn infants screened for SCD. Of these, 123 (10.7%) had results indicative of sickle trait and 3 patients (0.3%) were diagnosed with SCD: 1 with HbSS and 2 with HbSC. All 3 patients with SCD received treatment before 3 months of age. Conclusions: A newborn screening program is feasible in this population when partnered with an established newborn screening laboratory.

BACKGROUND There is limited information on injury patterns in Step Aerobic Instructors (SAI) who exclusively execute "step" aerobic classes. OBJECTIVE To record the type and the anatomical position in relation to diagnosis of muscular skeletal injuries in step aerobic instructors. Also, to analyse the days of absence due to chronic injury in relation to weekly working hours, height of the step platform, working experience and working surface and footwear during the step class. METHODS The Step Aerobic Instructors Injuries Questionnaire was developed, and then validity and reliability indices were calculated. 63 SAI completed the questionnaire. For the statistical analysis of the data, the method used was the analysis of frequencies, the non-parametric test χ ^{2} (chi square distribution), correlation and linear and logistic regressions analysis from the SPSS statistical package. RESULTS 63 SAI reported 115 injuries that required more than 2 days absence from step aerobic classes. The chronic lower extremity injuries were 73.5%, with the leg pain, the anterior knee pain, the plantar tendinopathy and the Achilles tendinopathy being most common overuse syndromes. The working hours, the platform height, the years of aerobic dance seem to affect the days of absence due to chronic lower limb injury occurrence in SAI.

The aim of this study was to examine the effectiveness of goal setting on isokinetic parameters (peak torque and isokinetic work). An experimental group (n = 20) and a control group (N = 20) of healthy physical education students were studied. Both groups participated in a four week quadriceps strengthening program on an isokinetic dynamometer with the experimental group setting specific personal goals in each training session and receiving visual feedback of their performance. Results showed that the experimental group improved both isokinetic parameters (peak torque, work) significantly more than the control (p < 0.05) group. The findings indicate that personal goal settings when used with visual feedback might be an important determinant for improvement of isokinetic performance.

The aim of the present study was to evaluate balance deficits after an ankle sprain in collegiate students and to examine the effectiveness of 2 different balance rehabilitation programs on balance ability. Thirty collegiate students with functional ankle instability were randomly divided into 2 groups. Both groups followed an intervention balance program for 6 weeks, 3 times per week, 20 minutes per session, using balance boards. One of the 2 training groups performed the exercises on the ground—the “Land” group ( n = 15), and the other in a swimming pool—the “Aquatic” group ( n = 15). Balance ability was assessed before and after the 6-week intervention program. Balance assessments included static (stability indices: total, anterior–posterior, medial–lateral) and dynamic (dynamic moving the cursor) stability tests on the Biodex Stability System (Biodex, Inc, Shirley, NY). The results showed that in both training groups balance ability of the injured leg was significantly improved after the training period. In the final measurements, no statistically significant differences between the injured and healthy limb were found. The present study indicates that the performance of balance exercises in or out of water by collegiate students with functional ankle instability improves their balance ability. Level of Evidence: Therapeutic, Level 1

Background: Obesity is associated with osteoarthritis and it is accompanied by chronic inflammation and elevated oxidative stress. Strengthening-type exercise is used in knee osteoarthritis (KOA) rehabilitation. This study determined how acute isokinetic exercise influences inflammatory responses of obese middle-aged women with KOA. Methods: Ten obese women with KOA and 10 age/weight-matched controls performed an isokinetic exercise protocol. Assessment of performance (knee extensor/flexor torque), muscle soreness (DOMS), knee flexibility (KJRM), and pain, and blood collection were performed pre-exercise, post-exercise, and at 24. h post-exercise. Blood was analyzed for creatine kinase activity (CK), lactate dehydrogenase activity (LDH), CRP, leukocytes, uric acid, IL-6, TBARS, lipid hydroperoxides (LPX), protein carbonyls (PC), oxidized (GSH) and reduced glutathione (GSSG), total antioxidant capacity (TAC), catalase activity, and glutathione peroxidase activity (GPX). Results: Physical function remained unaltered by exercise (only torque at 90°/s decreased at 24 h). Exercise increased DOMS throughout recovery but KJRM and pain remained unchanged. CK, LDH, and uric acid increased similarly in both groups. CRP remained unaffected by exercise while IL-6 increased only post-exercise. TBARS, PC, LPH, GSSG, and TAC increased only post-exercise in both groups. GSH and GSH/GSSG declined post-exercise and normalized thereafter. Catalase and GPX increased only in patients post-exercise. Conclusion: Isokinetic exercise induces only a mild inflammatory response of very short duration (< 24 h) without affecting physical function and pain in KOA patients suggesting that moderate strengthening-type exercise may be safe for this patient cohort. These results indicate that KOA patients may be able to receive another exercise stimulus after only 48. h. Clinical relevance: Isokinetic exercise produces minimal inflammation and pain in knee osteoarthritis patients, could be performed every 48. h during rehabilitation, and up-regulates patients' antioxidant system. © 2012 Elsevier B.V.

A 17 year old female athlete presented with Achilles tendinopathy. A protocol of water and land based rehabilitation was designed to achieve non-weight bearing and pain free activity, so that she could rapidly return to her event (400 m hurdles). After three weeks, she returned to regular training, and after a further three weeks she successfully competed in a 400 m hurdle event. She has been able to compete at national level symptom free for the last 18 months. The Achilles tendon is the largest and strongest tendon in the human body and experiences high loads in all sporting activities. It has been shown to have a high capacity to withstand tensional forces.1 Chronic painful conditions located in the Achilles tendon are relatively common, especially in runners.2 The cause of such conditions is not known, but they are often associated with repetitive loading and overuse.3 Achilles tendinopathy is difficult to treat.1 Most recommend a conservative regimen as the initial strategy.4–6 Non-surgical treatments include a combination of rest, anti-inflammatory drugs, correction of malalignments, and stretching and strengthening exercises. There is sparse scientific evidence that these treatments are successful, and surgical treatment is required in about 25% of patients.1 In a recent prospective study, treatment with heavy load, eccentric calf muscle training showed very promising results and may reduce the need for surgical treatment of tendinopathy located in the mid-portion of the Achilles tendon.1 The short term results of surgery are often very good, but in the few studies with long term follow up there are signs of deterioration with time.1,7 In addition, over the last two decades there has been a considerable increase in the incidence of Achilles tendon rupture.8 Many athletic trainers propose an active land based rehabilitation training …

To determine the time course of performance responses after an acute bout of plyometric exercise combined with high and low intensity weight training, a 3-group (including a control group), repeated-measures design was employed. Changes in performance were monitored through jumping ability by measuring countermovement and squat jumping, and strength performance assessment through isometric and isokinetic testing of knee extensors (at two different velocities). Participants in both experimental groups performed a plyometric protocol consisting of 50 jumps over 50 cm hurdles and 50 drop jumps from a 50 cm plyometric box. Additionally, each group performed two basic weight exercises consisting of leg presses and leg extensions at 90-95% of maximum muscle strength for the high intensity group and 60% of maximum muscle strength for the low intensity group. The results of the study suggest that an acute bout of intense plyometric exercise combined with weight exercise induces time-dependent changes in performance, which are also dependent on the nature of exercise protocol and testing procedures. In conclusion, acute plyometric exercise with weight exercise may induce a substantial decline in jumping performance for as long as 72 hours but not in other forms of muscle strength.

Objectives The purpose of this study was to record the incidence of Sport Injuries (acute and overuse syndromes) in Greek artistic gymnasts in relation to sex, age, event and exercise phase. Methods 187 Greek elite artistic gymnastic athletes (100 male and 87 female athletes) participating in Greek artistic gymnastic championship involving all age-related categories, were observed on a weekly basis for a year. The athletes consisted of the pre-national team that was chosen to prepare for the next Olympic games. Results 147 (61.5%)acute injuries and 93 (38.5%) overuse syndromes were recorded. The most common anatomical location of injury was the ankle (110 cases, 46%), followed by the knee (63 cases, 26.2%). According to the results, the rate which involved mild injuries was 26.8% (64 cases, 34 males, 30 females) moderate injuries was 44% (106 cases, 59 males, 48 females), major injuries was 29% (70 cases, 38 males, 31 females). For the total sport injuries recorded, the injury incidence on the "floor" and especially during "landing phase", were statistically significant. Conclusions Artistic gymnastics predisposes to acute injuries, by its nature, but up to 70% are mild and moderate. Special attention needs to be given during "floor exercises", especially on landing phase.

The purpose of the present study was to investigate the effect of a tennis training session on the balance performance of young tennis players. The study was conducted on 36 elite tennis players (age 14 6 2 years; body mass 55 ± 6 kg; body height 165 ± 6 cm; mean ± SD) participating in the national young tennis championship. Balance performance was assessed before and immediately after a tennis training session (pre-training and post-training, respectively). The balance assessment was performed with 2 different balance boards and the Biodex Stability System. In addition, dynamometric measurements of peak isokinetic moment in the knee flexors and extensors were performed pre and post tennis training session, to quantify the degree of muscle fatigue induced by the tennis training session. One-way analysis of variance with repeated measures was used to test for differences in balance performance and in isokinetic performance between pre and post tennis training session. The data analysis revealed no significant differences (p > 0.05) in balance performance, whereas there were significant differences in knee joint moment production between pre and post tennis training measures. Although the tennis training session of the present study had no significant effect (p > 0.05) on any of the balance performance indicators examined, there was a decline in balance performance, which suggests that different level of fatigue for an extended period (games) will have greater effect on balance performance. It is suggested that a tennis-specific balance exercise program should be included in the tennis training session. © 2010 National Strength and Conditioning Association.

The objectives of the present investigation were to study the inflammatory and performance responses after an acute bout of intense plyometric exercise during a prolonged recovery period. Participants were randomly assigned to either an experimental group (P, n = 12) that performed intense plyometric exercises or a control group (C, n = 12) that rested. The delayed onset of muscle soreness (DOMS), knee range of motion (KROM), creatine kinase (CK) and lactate dehydrogenase (LDH) activities, white blood cell count, C reactive protein (CRP), uric acid (UA), cortisol, testosterone, IL-6, IL-1b strength (isometric and isokinetic), and countermovement (CMJ) and static (SJ) jumping performance were measured at rest, immediately postexercise and at 24, 48, 72, 96, and 120 hours of recovery. Lactate was measured at rest and postexercise. Strength remained unchanged throughout recovery, but CMJ and SJ declined (p < 0.05) by 8-20%. P induced a marked rise in DOMS, CK, and LDH (peaked 24-48 hours postexercise) and a KROM decline. An acute-phase inflammatory response consisting of leukocytosis (postexercise and at 24 hours), an IL-6, IL-1b, CRP, and cortisol elevation (during the first 24 hours of recovery) and a delayed increase of UA (peaked at 48 hours) and testosterone (peaked at 72 hours) was observed in P. The results of this investigation indicate that performing an acute bout of intense plyometric exercise may induce a short-term muscle damage and marked but transient inflammatory responses. Jumping performance seems to deteriorate for as long as 72 hours postexercise, whereas strength appears to remain unchanged. The acute-phase inflammatory response after a plyometric exercise protocol appears to follow the same pattern as in other exercise models. These results clearly indicate the need of sufficient recovery between successive plyometric exercise training sessions. © 2010 National Strength and Conditioning Association.

It is unclear whether fatigue induced by a tennis training session influences the effectiveness of balance exercise training program. Thus, the purpose of the present study was to investigate whether a balance program is more effective when performed before or after the regular tennis training session. The study was conducted on 36 young tennis players participating in the national young tennis championship. The participants were randomly divided into three subject groups, one control group (C group), and two intervention groups that performed a specific balance program for 12 weeks, three times per week, 16 min per session. One intervention group performed the balance program immediately before the regular tennis training session (Pre training group) and the other group performed the same balance program immediately after tennis training (Post training group). Balance performance was assessed in all subjects at baseline (T0) and after the completion of the 12-week balance program (T12). The balance performance assessment was performed with two different balance boards and the Biodex Stability System. Two-way repeated measures ANOVA revealed that there was no difference (p > 0.05) in balance performance in the C group between T0 and T12. In contrast, there was significant improvement between T0 and T12 for Pre and Post training groups. Furthermore, there were significant differences between group C and the two intervention groups after the 12-week balance training program, while there was no significant difference between the Pre and Post training groups. In conclusion, there was significant improvement in balance performance with the balance training program and there was no effect of the time the tennis training sessions were performed. © 2008 IOS Press. All rights reserved.

The purpose of this study was to determine the reproducibility of measures for maximum knee extensor and flexor concentric strength on an isokinetic dynamometer in individuals with mild and moderate osteoarthritis of the knee. Twenty eight female patients with 1st (n=14) and 3rd (n=14) grade unilateral knee OA volunteered for the study. Peak muscle torque of the knee extensors and flexors was measured using an isokinetic dynamometer at angular velocities of 90, 120 and 150°/s. Test-retest reproducibility of maximal isokinetic torque was evaluated using intraclass correlation coefficient (ICC). Absolute reproducibility was assessed using Bland-Altman analysis, the standard error of measurement (SEM and SEM%) and the smallest real differences (SRD & SRD%). Inter-session relative reproducibility was found to be high in extensor and flexor muscles of individuals with mild OA, with the ICCs values ranging from 0.89 to 0.92 for the concentric knee extension and from 0.90 to 0.93 for the concentric knee flexion, while in the group of individuals with moderate knee OA the same values varied from 0.79 to 0.91 and from 0.75 to 0.93 for the concentric knee extension and flexion, respectively. The Bland-Altman analyses support the findings of high relative reproducibility for the two groups of patients in almost all measurements, except for the extension at 120 and 90°/s and the flexion at 150°/s conducted by the individuals with moderate OA. SEM and relative SEM values ranged from 6.7 to 9.4 Nm and from 14.4% to 21.5%Nm for the group with mild OA and from 4.4 to 7.7 Nm and from 14.6% to 21.8%Nm for the group with moderate OA, respectively. SRD and SRD% values across all movement speeds for both knee flexors and extensors ranged from 18.6 to 26.1 Nm and from 39.9% to 59.6%Nm for the mild OA group, respectively, while the same values for the moderate OA group ranged from 12.2 to 21.3 Nm and from 40.5% to 56.8%Nm, respectively. These results indicate that measurements of isokinetic performance at velocities of 90, 120 and 150°/s provide acceptable reproducibility for evaluation of knee strength in individuals with mild OA of the knee. On the other hand, with regard to knee muscles isokinetic performance, testing of individuals with moderate OA should be conducted during periods of time when the symptoms of the disease subside. © 2007 - IOS Press and the authors. All rights reserved.

The aim of the study was to investigate the effect of a muscular training program on soccer players' performance which initially appeared imbalanced or bilaterally asymmetrical. During the preparation period, 35 soccer players performed an isokinetic measurement of knee flexors and extensors (60°.−1 and 180°sec.−1). 15 of these had muscular imbalances or deficits and followed a specific isokinetic training program for 2 mo., 3 times per week. After the completion of the isokinetic training program, the 35 players underwent the same isokinetic test. Significant differences were noted between the pre- and posttraining measures at both angular velocities in peak torque values, in differences from one limb to the other, and in peak torque ratios for flexors and extensors. Consequently, the application of this specific isokinetic training program can restore imbalances in knee muscle strength efficiently.

Objectives: To record the incidence of lower limb injuries (acute and overuse syndromes) in Greek artistic gymnasts in relation to the event and exercise phase. Methods: A total of 162 gymnasts (83 male and 79 female athletes) participating in the Greek artistic gymnastic championships were observed weekly for the 1999–2000 season. Results: Ninety three (61.6%) acute injuries and 58 (38.4%) overuse syndromes were recorded. The most common anatomical location was the ankle (69 cases, 45.7%), followed by the knee (40 cases, 26.5%). The rate of mild injuries was 26.6% (25 cases), that of moderate injuries was 44% (41 cases), and that of major injuries was 29% (27 cases). The incidence of injury to the ankle and knee was significantly higher in the floor exercise, especially during the landing phase, than in the other events. Conclusions: By its nature, gymnastics predisposes to acute injuries, but up to 75% are mild or moderate. Special attention should be paid to the floor exercise, especially the landing phase.

Background Cross-education (CE) is being studied for several decades and refers to the power transfer and proprioception in untrained limb after training of the homologous contralateral limb. Objective To examine whether unilateral strengthening of lower limbs with Thera-Band ® elastic resistance bands is beneficial also for the untrained contralateral limb in functional ability and balance. Design A double blinding randomized prospective study. Setting The study was conducted in the Department of P.E and Sports, Democritus University of Thrace, Greece. Participants 15 healthy physically active students (at least three training per week) were randomly selected to participate. Interventions The participants performed strength training with progressive overload for lower limbs, for 4 weeks, with frequency 3 times per week (12 sessions), duration of 30 minutes with 10 min warm up, 20 min strengthening exercises with Bands (Thera-Band ® ) of quadriceps, hamstrings and gastrocnemius muscles. The exercises were executed at stations from supine, lateral and sitting position (4 sets of 10 reps with 15 sec break between sets). Main outcome measurements A. Balance performance (total stability index as dependent variable of the Biodex Stability test) and b. functional ability (Single leg triple jump hop for distance with distance as dependent variable) at 3 times, before exercise period (pre), at the end (post) and 2 weeks after (retention). The hypothesis was formulated before data collection. Results One way repeated measures Anova revealed improvement for both limbs: a. Stability index trained pre 5.87±1.15, post 3.44±1.11, retention 3.61±1.12 untrained pre 5.90±1.82, post 3.61±1.61, retention 3.20±1.71 b. Triple jump trained pre 3.70±.89, post 4.06±.91, retention 4.01±.88, untrained pre 3.78±.83, post 4.09±.85, retention 4.12±.71. Conclusions Unilateral strength training with Thera-Band® elastic resistance bands at lower limbs is effective in improving functional ability and balance of untrained limb.