Patient-related outcome measures (PROMs) are commonly used to gauge treatment effects in patients with anterior cruciate ligament (ACL) deficiency. Valid measures of specific conditions depend on relevant item content. While item content can be derived either from clinicians (face validity) or from patients, item relevance and comprehensiveness can only be confirmed by the patient (content validity). Focus group and single interviews were conducted with patients' pre- and post-ACL reconstruction in order to construct a condition-specific PROM for the target patients. One hundred fifty-seven items from a previously conducted literature search were used as a basis for content genesis. Content saturation was achieved after three focus groups and seven single interviews. Thirty-eight items from the literature search were directly endorsed, and five modified items were endorsed. Twelve new item themes with verbatim content emerged. Thus, a 55-item pilot PROM consisting of six conceptual domains was assembled. We have constructed a condition-specific PROM for measurement of surgical and non-surgical treatment effects on ACL deficiency. The instrument possesses face and content validity. A pilot survey to assess the psychometric properties will be performed using Rasch measurement theory.

The benefit of anterior cruciate ligament (ACL) reconstruction has been questioned based on patient-reported outcome measures (PROMs). Valid interpretation of such results requires confirmation of the psychometric properties of the PROM. Rasch analysis is the gold standard for validation of PROMs, yet PROMs used for ACL reconstruction have not been validated using Rasch analysis. We used Rasch analysis to investigate the psychometric properties of the Knee Numeric-Entity Evaluation Score (KNEES-ACL), a newly developed PROM for patients treated for ACL deficiency. Two-hundred forty-two patients pre- and post-ACL reconstruction completed the pilot PROM. Rasch models were used to assess the psychometric properties (e.g., unidimensionality, local response dependency, and differential item functioning). Forty-one items distributed across seven unidimensional constructs measuring impairment, functional limitations, and psychosocial consequences were confirmed to fit Rasch models. Fourteen items were removed because of statistical lack of fit and inadequate face validity. Local response dependency and differential item functioning were identified and adjusted. The KNEES-ACL is the first Rasch-validated condition-specific PROM constructed for patients with ACL deficiency and patients with ACL reconstruction. Thus, this instrument can be used for within- and between-group comparisons.

The purpose of this study was to gain insight in barriers and facilitators of sports in paralympic athletes. An online questionnaire was distributed through the Netherlands Olympic Committee and National Sports Confederation to determine personal and environmental barriers and facilitators of sports participation. The International Classification of Functioning, Disability and Health model and theory of planned behavior were used to respectively categorize the results in environmental and personal factors, and attitude, subjective norm and perceived behavioral control. Seventy-six Dutch Paralympic athletes completed the questionnaire (51% response rate). Barriers and facilitators experienced by ambulant and wheelchair athletes were compared. Most frequently mentioned personal barrier was dependency of others (22%), while most frequently mentioned environmental barrier was lack of sports facilities (30%). Wheelchair athletes mentioned more barriers (median = 3, interquartile range: 0.5–6), than ambulant athletes (median = 1.0,interquartile range:0.0–3.0, P = 0.023). One-third of the athletes did not experience any barriers. Most frequently mentioned personal facilitators to initiate sports participation were fun (78%), health (61%), and competition (53%). Most frequently mentioned environmental facilitator was social support (40%). This study indicated that barriers of sport were mostly environmental, while facilitators were usually personal factors. Attitude and subjective norm were considered the most important components for intention to participation in sports. The facilitators outweighed the barriers and kept the athletes being active in sports.

To investigate the high-energy phosphate metabolism by ³¹P-nuclear magnetic resonance spectroscopy during off-transition of exercise in different muscle groups, such as calf muscles and biceps femoris muscles, seven male long-distance runners (LDR) and nine untrained males (UT) performed both submaximal constant and incremental exercises. The relative exercise intensity was set at 60% of the maximal work rate (60%Wmax) during both knee flexion and plantar flexion submaximal constant load exercises. The relative areas under the inorganic phosphate (P_i) and phosphocreatine (PCr) peaks were determined. During the 5-min recovery following the 60%Wmax, the time constant for the PCr off-kinetics was significantly faster in the plantar flexion (LDR: 17.3 ± 3.6 s, UT: 26.7 ± 6.7 s) than in the knee flexion (LDR: 29.7 ± 4.7 s, UT: 42.7 ± 2.8 s, P < 0.05). In addition, a significantly faster PCr off-kinetics was observed in LDR than in UT for both exercises. The ratio of P_i to PCr (P_i/PCr) during exercise was significantly lower during the plantar flexion than during the knee flexion (P < 0.01). These findings indicated that the calf muscles had relatively higher potential for oxidative capacity than that of biceps femoris muscles with an association of training status.

Examinations of stress in coaches have mainly been qualitative and focused on chronic stressors. This exploratory study examined stress responses in coaches during competition, including psychological and physiological indices. Using reversal theory, we examined metamotivational state profiles during competition. Ten male team sport coaches (mean age 39.8 ± 13.12 years) reported levels of subjective stress, pleasant and unpleasant emotions, metamotivational state, and provided saliva samples, on a competition day: 15 min prior to the pre-match team talk; start of the match; end of the first half; start of the second half, and end of the match, then at equivalent times on a noncompetition day. Saliva samples were assayed for alpha-amylase activity. On competition day, alpha-amylase activity was significantly higher, as were subjective stress, arousal, and unpleasant emotions. Prior to and during active play, participants were mainly in the conformist, alloic (other-oriented), and mastery states, and at the end of the match, in the telic and sympathy states. Only 22 metamotivational state reversals were observed, mostly at the start and end of the match. The elevated levels of subjective stress, alpha-amylase activity, and unpleasant emotions suggest that educational programs may be useful for some coaches to manage psychological states during competition.

The incidence of orthostatic intolerance is elevated in endurance-trained individuals. We sought to test the hypothesis that aerobic endurance training is associated with an attenuated control of the cerebral vasculature. Endurance trained (ET, n = 13) and age-matched untrained (UT, n = 11) individuals (peak O₂ consumption, mean ± SEM; 63 ± 1 vs 42 ± 1 mL/min/kg, P < 0.05) were examined while supine and seated upright. Dynamic cerebral autoregulation (CA) was assessed by calculation of the rate of regulation (RoR) from the arterial blood pressure (ABP) and middle cerebral artery (MCA) mean blood velocity (V_mean) responses to a bilateral thigh cuff release, which evoked a transient hypotension. Cerebral oxygenation (oxyhemoglobin; HbO₂) was determined with near-infrared spectroscopy. When seated upright, cuff release evoked a greater decrease in ABP (P < 0.001), MCA V_mean (P = 0.096) and HbO₂ (P < 0.001) in ET compared with UT. However, RoR was similar in ET and UT individuals while seated upright (to 0.193 ± 0.039 vs 0.129 ± 0.029/s, P > 0.05), and there was no significant difference in the relative change in RoR from the supine to upright positions (ΔRoR: −65 ± 7 and −69 ± 7%, for ET and UT, respectively). These findings suggest that aerobic endurance training is not associated with an attenuation in dynamic CA.

Meritocratic sport cultures, media attention, coaches' ambitions, and “enthused” parents create stress and make coping pivotal for athletes' performance. A transdisciplinary dialogue between a sports-sociologist and a sport-psychologist manifests ritual practices in athletes' lived sport experiences as coping strategies. Based on two empirical strands, field observations of boy's handball and interviews with elite male wrestlers', analysis of pregame routines scrutinize psychosocial dimensions of athletes' ritual practice. The implications of ritual meaning making are investigated as a means to cope with sport specific sociocultural anxieties. Rituals are interpreted as psychosocial processes applied to construct perceived order and comfort in stressful sport milieus. We contend that it is reasonable to believe that successful coping is not solely because of athletes' psychological competencies and experiences, but also their ability to ritually use culture in meaningful ways. To manifest important contextual aspects of athletes' lived sport experiences, to nurture task-oriented sport milieus, and to create change in sport and physical cultural contexts, we consequently suggest that the cultural meanings applied in ritual should be an important aspect to address.

We examined whether post-exercise macronutrient supplementation during a 5-month home-based interval walking training (IWT) accelerated exercise-induced increases in skeletal muscle mass and strength in healthy middle-aged and older women. Thirty-five women (41–78 years) were randomly divided into two groups: IWT alone (CNT, n = 18) or IWT plus post-exercise macronutrient (7.6 g protein, 32.5 g carbohydrate, and 4.4 g fat) supplementation (NUT, n = 17). For IWT, all subjects were instructed to repeat five or more sets of 3-min low-intensity walking at 40% peak aerobic capacity (Vo_{2 peak}), followed by a 3-min high-intensity walking above 70% Vo_{2 peak} per day for 4 or more days per week. We determined Vo_{2 peak}, thigh muscle tissue area by computer tomography, and thigh muscle strength in all subjects before and after IWT. We found that an increase in hamstring muscle tissue area was 2.8 ± 1.2% in NUT vs −1.0 ± 0.7% in CNT and that in isometric knee flexion force was 16.3 ± 3.7% in NUT vs 6.5 ± 3.0% in CNT; both were significantly higher in NUT than in CNT (both, P < 0.001). Thus, post-exercise macronutrient supplementation enhanced the increases in thigh muscle mass and strength, although partially, in home-based IWT in middle-aged and older women.

In a comparative study, we investigated the effects of maximal eccentric or concentric resistance training combined with whey protein or placebo on muscle and tendon hypertrophy. 22 subjects were allocated into either a high-leucine whey protein hydrolysate + carbohydrate group (WHD) or a carbohydrate group (PLA). Subjects completed 12 weeks maximal knee extensor training with one leg using eccentric contractions and the other using concentric contractions. Before and after training cross-sectional area (CSA) of m. quadriceps and patellar tendon CSA was quantified with magnetic resonance imaging and a isometric strength test was used to assess maximal voluntary contraction (MVC) and rate of force development (RFD). Quadriceps CSA increased by 7.3 ± 1.0% (P < 0.001) in WHD and 3.4 ± 0.8% (P < 0.01) in PLA, with a greater increase in WHD compared to PLA (P < 0.01). Proximal patellar tendon CSA increased by 14.9 ± 3.1% (P < 0.001) and 8.1 ± 3.2% (P = 0.054) for WHD and PLA, respectively, with a greater increase in WHD compared to PLA (P < 0.05), with no effect of contraction mode. MVC and RFD increased by 15.6 ± 3.5% (P < 0.001) and 12–63% (P < 0.05), respectively, with no group or contraction mode effects. In conclusion, high-leucine whey protein hydrolysate augments muscle and tendon hypertrophy following 12 weeks of resistance training – irrespective of contraction mode.

Calcium and phosphate are essential for cell functions, and their serum concentrations result from the balance between intestinal absorption, bony storage, and urinary excretion. Fibroblast growth factor 23 (FGF23), expressed by osteocytes and osteoblasts, acts in the kidney, leading to hypophosphatemia and low 1,25-dihydroxycholecalciferol synthesis, but suppresses parathyroid function. The aim of this study was to explore the effects of a high-energy demanding cycling race on this bone–kidney–parathyroid axis. We studied nine cyclists during the 2011 Giro d'Italia stage race. Pre-analytical and analytical phases followed academic and anti-doping recommendations. Serum parathyroid hormone (PTH), 25(OH)D, total calcium, inorganic phosphorus, and plasma FGF23 were measured on days −1, 12, and 22 and corrected for changes in plasma volume. Dietary calcium and phosphorus, anthropometric parameters (height, weight, and body mass index) and indexes of metabolic effort (net energy expenditure, power output) were recorded. Dietary calcium and phosphorus intakes were kept at the same levels throughout the race. Twenty-five (OH)D, PTH, and calcium concentrations remained stable. FGF23 increased 50% with a positive correlation with the indexes of metabolic effort and, consequently, phosphorous decreased, although only in the first half. The strong metabolic effort acts on the bone–kidney–parathyroid system, and the rise in FGF23 plasma concentration might be aimed at maintaining calcium and phosphorus homeostasis.

We investigated longitudinal and cross-sectional relationships between eye–hand coordination (EHC) and cardiorespiratory fitness (multistage run), physical activity (pedometers), percent body fat (%BF, dual energy x-ray absorptiometry), body image, and organized sport participation (questionnaires) in 406 boys and 384 girls at 8 and 10 years of age. EHC was measured by a throw and wall-rebound catch test involving 40 attempts of increasing difficulty. Median EHC improved during two years from 18 to 32 (boys) and 9 to 24 (girls), and gender differences and improvements were both significant (P < 0.001). Cross-sectional analyses showed that boys and girls with better EHC were fitter (P < 0.001), and a longitudinal relationship showed that girls who improved their EHC over the two years became fitter (P < 0.001). There was also evidence that children with better EHC possessed a more positive body image (P = 0.05 for combined sex data), but there was no evidence of any relationships between EHC and %BF or PA (both P > 0.3). Finally, even at age 8 years, boys and girls participating in organized sport possessed better EHC than non-participants. These data provide evidence for the premise that early acquisition of this single motor skill promotes the development of a child's fitness, body image, and participation in sport.

The purpose of this study was to examine the effects of whole-body cryotherapy (WBC) on biochemical, pain, and performance parameters during the 5-day recovery period after damaging exercise for hamstrings. Participants completed a bout of damaging exercise for the hamstring muscles on two separate occasions (control and experimental condition) separated by 10 weeks. During the control condition, subjects received no treatment after the damaging exercise. The experimental condition consisted of WBC everyday during the recovery period. WBC included single 3-min daily exposures to low temperatures (−140 to −195 °C) in the cryo-cabin. During the recovery period, subjects were tested for biochemical markers, perceived pain sensation, and physical performance (squat jump, counter movement jump, maximal isometric torque production, and maximally explosive isometric torque production). Majority of the observed variables showed statistically significant time effects (P < 0.05) in control group, which indicates the presence of muscle damage. Significant interaction between the control and WBC condition was evident for the rate of torque development (P < 0.05). Pain measures substantially differed between the WBC and the control condition after the exercise. Results of this study are not completely supportive of the use of WBC for recovery enhancement after strenuous training.

The purpose of this study was to summarize the effects of physical activity and exercise on peripheral brain-derived neurotrophic factor (BDNF) in healthy humans. Experimental and observational studies were identified from PubMed, Web of Knowledge, Scopus, and SPORT Discus. A total of 32 articles met the inclusion criteria. Evidence from experimental studies suggested that peripheral BDNF concentrations were elevated by acute and chronic aerobic exercise. The majority of the studies suggested that strength training had no influence on peripheral BDNF. The results from most observational studies suggested an inverse relationship between the peripheral BDNF level and habitual physical activity or cardiorespiratory fitness. More research is needed to confirm the findings from the observational studies.

Neovascularization is frequently observed in tendinopathy. Previous studies have focused on the role of neovascularization in Achilles tendinopathy, but have been conducted in small series. It is still unclear whether the degree of neovascularization is related to severity of symptoms. The purpose was to study the relationship between ultrasonographic neovascularization and clinical severity in patients with Achilles tendinopathy. In this prospective cohort study, data on 127 patients (141 tendons) were assembled from databases of three clinical trials. All patients followed an eccentric exercise program. The Öhberg neovascularization score (0–4+) and Victorian Institute of Sports Assessment-Achilles (VISA-A) score (split into domains: pain, function and activity) were collected during baseline and follow-up. The relationship between neovascularization and VISA-A score was calculated. At baseline, 107 tendons (76%) showed some degree of neovascularization. In 556 coupled measurements, neovascularization was weakly related to the VISA-A score [Exp (B) 1.017, 95% confidence interval (CI), 1.007–1.026]. No significant relationship was found between neovascularization and the pain domain (P = 0.277) and the activity domain (P = 0.283), but there was between neovascularization and the function domain of the VISA-A score [Exp (B) = 1.067, 95% CI 1.018–1.119]. In conclusion, neovascularization in Achilles tendinopathy is weakly related to clinical severity, mainly based on the function domain of the VISA-A score.

Doping use is an important issue in both competitive and non-competitive sports, and poses potentially irreversible health consequences to users. Scholars increasingly call for theory-driven studies on the psychosocial processes underlying doping use that will inform subsequent policy-making and prevention interventions. The aim of the study was to implement an integrative theoretical model to assess the direct and indirect effects of motivational variables, moral orientations, and social cognitions on doping intentions. A randomly selected and representative sample of 750 elite athletes anonymously completed a battery of questionnaires on motivational and moral constructs, and social cognitions related to doping. Hierarchical linear regression analysis and multiple mediation modeling were used. The effects of achievement goals and moral orientations were significantly mediated by attitudinal, normative, and self-efficacy beliefs, in both lifetime ever and never doping users. Moral orientations indirectly predicted the doping intentions of never users, but did not predict ever users' doping intentions. Achievement goals and sportspersonship orientations influence doping intentions indirectly, through the effects of attitudes and self-efficacy beliefs. Sportspersonship (moral) orientations were relevant to doping intentions among athletes with no prior experiences with doping, while achievement goals and situational temptation were relevant to both lifetime never and ever dopers.

This study explored the age-related deterioration in stretch-shortening cycle (SSC) muscle power and concurrent force–velocity properties in women and men across the adult life span.

We asked whether specific inspiratory muscle training (IMT) improves respiratory structure and function and peak exercise responses in highly trained athletes with cervical spinal cord injury (SCI). Ten Paralympic wheelchair rugby players with motor-complete SCI (C5-C7) were paired by functional classification then randomly assigned to an IMT or placebo group. Diaphragm thickness (B-mode ultrasonography), respiratory function [spirometry and maximum static inspiratory (P_I,max) and expiratory (P_E,max) pressures], chronic activity-related dyspnea (Baseline and Transition Dyspnea Indices), and physiological responses to incremental arm-crank exercise were assessed before and after 6 weeks of pressure threshold IMT or sham bronchodilator treatment. Compared to placebo, the IMT group showed significant increases in diaphragm thickness (P = 0.001) and P_I,max (P = 0.016). There was a significant increase in tidal volume at peak exercise in IMT vs placebo (P = 0.048) and a strong trend toward an increase in peak work rate (P = 0.081, partial eta-squared = 0.33) and peak oxygen uptake (P = 0.077, partial eta-squared = 0.34). No other indices changed post-intervention. In conclusion, IMT resulted in significant diaphragmatic hypertrophy and increased inspiratory muscle strength in highly trained athletes with cervical SCI. The strong trend, with large observed effect, toward an increase in peak aerobic performance suggests IMT may provide a useful adjunct to training in this population.

Three dominant techniques are used for downhill turning in cross-country skiing. In this study, kinematic, kinetic, and temporal characteristics of these techniques are described and related to skier strength and power. Twelve elite female cross-country skiers performed six consecutive turns of standardized geometry while being monitored by a Global Navigation Satellite System. Overall time was used as an indicator of performance. Skiing and turning parameters were determined from skier trajectories; the proportional use of each technique was determined from video analysis. Leg strength and power were determined by isometric squats and countermovement jumps on a force plate. Snow plowing, parallel skidding, and step turning were utilized for all turns. Faster skiers employed less snow plowing and more step turning, more rapid deceleration and earlier initiation of step turning at higher speed (r = 0.80–0.93; all P < 0.01). Better performance was significantly correlated to higher mean speed and shorter trajectory (r = 0.99/0.65; both P < 0.05) and to countermovement jump characteristics of peak force, time to peak force, and rate of force development (r = −0.71/0.78/−0.83; all P < 0.05). In conclusion, faster skiers used step turning to a greater extent and exhibited higher maximal leg power, which enabled them to combine high speeds with shorter trajectories during turns.

In athletics, efficient screening tools are sought to curb the rising number of noncontact injuries and associated health care costs. The authors hypothesized that an injury prediction algorithm that incorporates movement screening performance, demographic information, and injury history can accurately categorize risk of noncontact lower extremity (LE) injury. One hundred eighty-three collegiate athletes were screened during the preseason. The test scores and demographic information were entered into an injury prediction algorithm that weighted the evidence-based risk factors. Athletes were then prospectively followed for noncontact LE injury. Subsequent analysis collapsed the groupings into two risk categories: Low (normal and slight) and High (moderate and substantial). Using these groups and noncontact LE injuries, relative risk (RR), sensitivity, specificity, and likelihood ratios were calculated. Forty-two subjects sustained a noncontact LE injury over the course of the study. Athletes identified as High Risk (n = 63) were at a greater risk of noncontact LE injury (27/63) during the season [RR: 3.4 95% confidence interval 2.0 to 6.0]. These results suggest that an injury prediction algorithm composed of performance on efficient, low-cost, field-ready tests can help identify individuals at elevated risk of noncontact LE injury.

This study investigated the salivary secretion rates of antimicrobial proteins in response to prolonged, exhaustive exercise in both stimulated (STIM) and unstimulated (UNSTIM) saliva flow sample methods. Twenty-four trained men cycled for 2.5 h at 60% and then to exhaustion at 75% . Timed collections of whole saliva were made before exercise, mid-exercise, at the end of the moderate exercise bout and post-exhaustive exercise. After each UNSTIM collection, a STIM sample was collected following chewing flavored gum for 1 min. Saliva was analysed for lysozyme, α-amylase and salivary immunoglobulin A (s-IgA), and secretion rates were calculated. Saliva flow was 156% higher in STIM compared with UNSTIM (P < 0.001) and decreased with exercise in STIM only (P < 0.001). Exercise increased lysozyme and α-amylase levels and secretion rates were 144% higher and 152% higher in STIM compared with UNSTIM for lysozyme and α-amylase, respectively (all P < 0.001). S-IgA concentration (P < 0.05) and secretion rate (P < 0.001) increased with exercise but were both lower in STIM compared with UNSTIM (P < 0.001). In conclusion, a STIM saliva flow collection during exercise by chewing flavored gum increased the quantity of saliva and the secretion of lysozyme and α-amylase, but had a limited impact on the secretion of s-IgA.

The aim of the present systematic review was to investigate the influence of different exercise programs on brain oxidative stress. A search of the literature was conducted up to 1 December 2012 across five databases: PUBMED, SCOPUS, SPORTS DISCUS, Web of Science, and The Cochrane Library. The search strategy used in the electronic databases mentioned was established as: (swim* OR exercise OR training) AND (“oxidative stress” AND brain) for each database. A methodological quality assessment valuation/estimation was additionally carried out in the final sample of studies. Of 1553 potentially eligible papers, 19 were included after inclusion and exclusion criteria. The methodological quality assessment showed a total score in the Quality Index between 40% and 80%, with a mean quality of 56.8%. Overall, regular moderate aerobic exercise appears to promote antioxidant capacity on brain. In contrast, anaerobic or high-intensity exercise, aerobic-exhausted exercise, or the combination of both types of training could deteriorate the antioxidant response. Future investigations should be focused on establishing a standardized exercise protocol, depending on the exercise metabolism wanted to test, which could enhance the objective knowledge in this topic.

We investigated the effect of hypoxic acclimatization per se, without any concomitant influence of strenuous physical activity on muscle and cerebral oxygenation. Eight healthy male subjects participated in a crossover-designed study. In random order, they conducted a 10-day normoxic (CON) and a 10-day hypoxic (EXP) confinement. Pre and post both CON and EXP confinements, subjects conducted two incremental-load cycling exercises to exhaustion; one under normoxic, and the other under hypoxic (F_IO₂ = 0.154) conditions. Oxygen uptake (), ventilation (), and relative changes in regional hemoglobin oxygenation (Δ([HbO₂]) in the cerebral cortex and in the serratus anterior (SA) and vastus lateralis (VL) muscles were measured. No changes were observed in the CON confinement. Peak work rate and were similar pre and post in the EXP confinement, whereas increased in the EXP post normoxic and hypoxic trials (P < 0.05). The exercise-induced drop in VL Δ[HbO₂] was less in the post- than pre-EXP trial by 4.0 ± 0.4 and 4.2 ± 0.6 μM during normoxic and hypoxic exercise, respectively. No major changes were observed in cerebral or SA oxygenation. These results demonstrate that a 10-day hypoxic exposure without any concomitant physical activity had no effect on normoxic or hypoxic , despite the enhanced VL oxygenation.

The purpose of the present study was to investigate the pattern of trunk muscle activation and intra-abdominal pressure (IAP) in a somewhat modified version of the clean and jerk lift. Nine healthy physically active male amateurs performed the exercise with a 30-kg barbell. Muscle activity was registered with electromyography from transversus abdominis (TrA) and obliquus internus (OI) using intramuscular electrodes and from rectus abdominis (RA) and erector spinae (ES) with surface electrodes. IAP was recorded with a nasogastric catheter. Measurements were made in various static positions throughout the lift and in the transitional phases separating them, both during lifting and lowering. The results demonstrated that the innermost abdominal muscle, TrA, showed increased activation levels in the two highest positions, whereas ES was most active, together with the highest IAP, in the lowest position. OI and RA showed generally little activation and no obvious trend throughout the lift. The results strengthen the view of a contributing role of TrA to the upright control of the trunk and indicate that the clean and jerk lift might constitute a whole-body exercise, still targeting the TrA muscle, in late-stage rehabilitation, especially for athletes during return to sports.

This study examined the effects of post-exercise cooling on recovery of neuromuscular, physiological, and cerebral hemodynamic responses after intermittent-sprint exercise in the heat. Nine participants underwent three post-exercise recovery trials, including a control (CONT), mixed-method cooling (MIX), and cold-water immersion (10 °C; CWI). Voluntary force and activation were assessed simultaneously with cerebral oxygenation (near-infrared spectroscopy) pre- and post-exercise, post-intervention, and 1-h and 24-h post-exercise. Measures of heart rate, core temperature, skin temperature, muscle damage, and inflammation were also collected. Both cooling interventions reduced heart rate, core, and skin temperature post-intervention (P < 0.05). CWI hastened the recovery of voluntary force by 12.7 ± 11.7% (mean ± SD) and 16.3 ± 10.5% 1-h post-exercise compared to MIX and CONT, respectively (P < 0.01). Voluntary force remained elevated by 16.1 ± 20.5% 24-h post-exercise after CWI compared to CONT (P < 0.05). Central activation was increased post-intervention and 1-h post-exercise with CWI compared to CONT (P < 0.05), without differences between conditions 24-h post-exercise (P > 0.05). CWI reduced cerebral oxygenation compared to MIX and CONT post-intervention (P < 0.01). Furthermore, cooling interventions reduced cortisol 1-h post-exercise (P < 0.01), although only CWI blunted creatine kinase 24-h post-exercise compared to CONT (P < 0.05). Accordingly, improvements in neuromuscular recovery after post-exercise cooling appear to be disassociated with cerebral oxygenation, rather reflecting reductions in thermoregulatory demands to sustain force production.

One of the challenging skills in golfing is the driver swing. There have been a large number of studies characterizing golf swings, yielding insightful instructions on how to swing well. As a result, achieving a sub-18 handicap is no longer the top problem for golfers. Instead, players are now most troubled by a lack of consistency during swing execution. The goal of this study was to determine how to consistently execute good golf swings. Using 3D motion capture and full-body biomechanical modeling, 22 experienced golfers were analysed. For characterizing both successful and failed swings, 19 selected parameters (13 angles, 4 time parameters, and 2 distances) were used. The results showed that 14 parameters are highly sensitive and/or prone to motor control variations. These parameters sensitized five distinct areas of swing to variation: (a) ball positioning, (b) transverse club angle, (c) transition, (d) wrist control, and (e) posture migration between takeaway and impact. Suggestions were provided for how to address these five distinct problem areas. We hope our findings on how to achieve consistency in golf swings will benefit all levels of golf pedagogy and help maintain/develop interests to involve more golf/physical activity for a healthy lifestyle.

The objective of this study was to verify whether pre-reconstruction laxity condition effects post-reconstruction outcome. A total of 100 patients who underwent navigated Anterior Cruciate Ligament (ACL) reconstruction were included in the study and knee laxity analysed retrospectively. The knee was assessed in six different laxity tests before and after ACL reconstruction, namely antero-posterior (AP) and internal-external (IE) at 30° and 90°, and varus-valgus (VV) rotations at 0° and 30° of flexion. For each test, the least square (LS) fitting line based on pre-operative-to-post-operative laxity value was calculated. To what degree the post-operative laxity value is explainable by the corresponding pre-operative condition was evaluated by the LS line slope. Post-operatively, for each single patient, the grade of laxity decreased at any evaluated test. The strongest influence of pre-operative-to-post-operative laxity values was found during IE30 and IE90 tests. While AP30 and VV0 tests seem to be those in which the post-reconstruction laxity was barely affected by the pre-surgery condition. The analysis of the global laxity reduction confirms the previous results. Following this hypothesis, our study remarks on the importance of combined lesions to secondary restraints and the importance of fully understanding the residual laxity to optimize the surgical technique.

Lower energy cost of running (Cr) has been reported when wearing minimal (MS) vs traditional shoes (TS) on level terrain, but the effect of slope on this difference is unknown. The aim of this study was to compare Cr, physiological, and kinematic variables from running in MS and TS on different slope conditions. Fourteen men (23.4 ± 4.4 years; 177.5 ± 5.2 cm; 69.5 ± 5.3 kg) ran 14 5-min trials in a randomized sequence at 10 km/h on a treadmill. Subjects ran once wearing MS and once wearing TS on seven slopes, from −8% to +8%. We found that Cr increased with slope gradient (P < 0.01) and was on average 1.3% lower in MS than TS (P < 0.01). However, slope did not influence the Cr difference between MS and TS. In MS, contact times were lower (P < 0.01), flight times (P = 0.01) and step frequencies (P = 0.02) were greater at most slope gradients, and plantar-foot angles – and often ankle plantar-flexion (P = 0.01) – were greater (P < 0.01). The 1.3% difference between footwear identified here most likely stemmed from the difference in shoe mass considering that the Cr difference was independent of slope gradient and that the between-footwear kinematic alterations with slope provided limited explanations.

The purpose of this study was to develop and validate a questionnaire for assessing parents' perception of their involvement in their children's tennis activity (Q-PPICTA). The validation required four successive studies. In study 1, a preliminary version of the questionnaire was formulated after selecting and adapting items taken from existing questionnaires and interviews conducted with the parents of 36 young tennis players. Three factors for measuring parental involvement in sport were identified and retained: emotional, logistic, and informational supports. In study 2, exploratory factor analyses were performed on data collected from 214 parents of tennis players. Results attested the questionnaire's three-factor structure and ascertained its internal consistency. In study 3, a confirmatory factor analysis as well as tests on convergent and discriminant validity were carried out on data gathered from a different sample of 220 parents of tennis players. Statistics confirmed the questionnaire's three-factor structure and reliability. In study 4, the questionnaire's external construct validity was compared with another sample consisting of 192 parents and their children. Overall, results underlined satisfactory psychometric properties for the Q-PPICTA. Nevertheless, further studies are required to confirm the questionnaire's accuracy, reliability, and temporal validity.

Alternative measures of muscle size, strength, and power to those used in previous studies could help resolve the controversy surrounding associations between polymorphisms of the angiotensin-I converting enzyme (ACE) and α-actinin-3 (ACTN3) genes and skeletal muscle phenotypes, and the responses to resistance training (RT). To this end, we measured quadriceps femoris muscle volume (V_m), physiological cross-sectional area (PCSA), maximum isometric force (F_t), specific force (F_t per unit PCSA), maximum isoinertial strength (1-RM), and maximum power (W_max; n = 40) before and after 9-week knee extension RT in 51 previously untrained young men, who were genotyped for the ACE I/D and ACTN3 R577X polymorphisms. ACTN3 R-allele carriers had greater V_m, 1-RM, and W_max than XX homozygotes at baseline (all P < 0.05), but responses to RT were independent of ACTN3 genotype (all P > 0.05). Muscle phenotypes were independent of ACE genotype before (all P > 0.05) and after RT (all P > 0.01). However, people with the “optimal” ACE+ACTN3 genotype combination had greater baseline 1-RM and W_max compared to those with the “suboptimal” profile (both P < 0.0125). We show for the first time that the ACTN3 R577X polymorphism is associated with human V_m and (independently and in combination with the ACE I/D polymorphism) influences 1-RM and W_max.

Sports injuries could be highly detrimental to the career of a physical education teacher education (PETE) student. To enable the development of future sports injury prevention programs, sports injuries in 128 first-year academic bachelor PETE students were registered prospectively during one academic year. Common risk factors for sports injuries, taken from the literature, were also evaluated by means of logistic regression analysis. We found an incidence rate of 1.91 and an injury risk of 0.85, which is higher than generally found in a sports-active population. Most injuries involved the lower extremities, were acute, newly occurring injuries, and took place in non-contact situations. More than half of all injuries lead to an inactivity period of 1 week or more and over 80% of all injuries required medical attention. A major part of these injuries happened during the intracurricular sports classes. Few differences were seen between women and men. A history of injury was a significant risk factor (P = 0.018) for the occurrence of injuries, and performance of cooling-down exercises was significantly related to a lower occurrence of ankle injuries (P = 0.031). These data can inform future programs for the prevention of sports injuries in PETE students.

Previous meta-analyses investigating the effect of exercise on depression have included trials where the control condition has been categorized as placebo despite the fact that this particular placebo intervention (e.g., meditation, relaxation) has been recognized as having an antidepressant effect. Because meditation and mindfulness-based interventions are associated with depression reduction, it is impossible to separate the effect of the physical exercise from the meditation-related parts. The present study determined the efficacy of exercise in reducing symptoms of depression compared with no treatment, placebo conditions or usual care among clinically defined depressed adults. Of 89 retrieved studies, 15 passed the inclusion criteria of which 13 studies presented sufficient information for calculating effect sizes. The main result showed a significant large overall effect favoring exercise intervention. The effect size was even larger when only trials that had used no treatment or placebo conditions were analyzed. Nevertheless, effect size was reduced to a moderate level when only studies with high methodological quality were included in the analysis. Exercise may be recommended for people with mild and moderate depression who are willing, motivated, and physically healthy enough to engage in such a program.

We aimed to determine whether a unique, ultra-high-field 7 T magnetic resonance imaging (MRI) scanner could detect occult cartilage and meniscal injuries in asymptomatic female dancers. This study had Institutional Review Board approval. We recruited eight pre-professional female dancers and nine non-athletic, female controls. We scanned the dominant knee on a 7 T MRI scanner using a three-dimensional fast low-angle shot sequence and a proton density, fast spin-echo sequence to evaluate cartilage and menisci, respectively. Two radiologists scored cartilage (International Cartilage Repair Society classification) and meniscal (Stoller classification) lesions. We applied two-tailed z- and t-tests to determine statistical significance. There were no cartilage lesions in dancers or controls. For the medial meniscus, the dancers demonstrated higher mean MRI score (2.38 ± 0.61 vs 1.0 ± 0.97, P < 0.0001) and higher frequency of mean grade 2 lesions (88% vs 11%, P < 0.01) compared with the controls. For the lateral meniscus, there was no difference in score (0.5 ± 0.81 vs 0.5 ± 0.78, P = 0.78) in dancers compared with the control groups. Asymptomatic dancers demonstrate occult medial meniscal lesions. Because this has been described in early osteoarthritis, close surveillance of dancers' knee symptoms and function with appropriate activity modification may help maintain their long-term knee health.

Various regulatory mechanisms of pulmonary oxygen uptake () kinetics have been postulated. The purpose of this study was to investigate the relationship between vagal withdrawal, measured using RMSSDRR, the root mean square of successive differences in cardiac interval (RR) kinetics, a mediator of oxygen delivery, and kinetics. Forty-nine healthy adults (23 ± 3 years; 72 ± 13 kg; 1.80 ± 0.08 m) performed multiple repeat transitions to moderate- and heavy-intensity exercise. Electrocardiography, impedance cardiography, and pulmonary gas exchange parameters were measured throughout; time domain measures of heart rate variability were subsequently derived. The parameters describing the dynamic response of , cardiac output () and RMSSDRR were determined using a mono-exponential model. During heavy-intensity exercise, the phase II τ of was significantly correlated with the τ of RR (r = 0.36, P < 0.05), Q (r = 0.67, P < 0.05), and RMSSDRR (r = 0.38, P < 0.05). The τ describing the rise in Q explained 47% of the variation in τ, with 30% of the rate of this rise in Q explained by the τ of RR and RMSSDRR. No relationship was evident between kinetics and those of Q, RR, or RMSSDRR during moderate exercise. Vagal withdrawal kinetics support the concept of a centrally mediated oxygen delivery limitation partly regulating kinetics during heavy-, but not moderate-, intensity exercise.

Excessive knee abduction loading is a contributing factor to anterior cruciate ligament (ACL) injury risk. The purpose of this study was to determine whether a double-leg landing training program with real-time visual feedback improves frontal-plane mechanics during double- and single-leg landings. Knee abduction angles and moments and vertical ground reaction forces (GRF) of 21 recreationally active women were quantified for double- and single-leg landings before and after the training program. This program consisted of two sessions of double-leg jump landings with real-time visual feedback on knee abduction moments for the experimental group and without real-time feedback for the control group. No significant differences were found between training groups. In comparison with pre-training data, peak knee abduction moments decreased 12% post-training for both double- and single-leg landings; whereas peak vertical GRF decreased 8% post-training for double-leg landings only, irrespective of training group. Real-time feedback on knee abduction moments, therefore, did not significantly improve frontal-plane knee mechanics during landings. The effect of the training program on knee abduction moments, however, transferred from the double-leg landings (simple task) to single-leg landings (more complex task). Consequently, ACL injury prevention efforts may not need to focus on complex tasks during which injury occurs.

The detection of recombinant human erythropoietin (rhEPO) is difficult and becomes more challenging when only microdoses are administered intravenously. Twenty-three subjects were divided into two groups: EPO group (n = 7) and CONTROL group (n = 16). Seven urine and blood samples per subject were collected at least 5 days apart to determine within- and between-subject standard deviations in the percentage of migrating isoforms by the MAIIA test. Six injections of 50 IU/kg bw (boosting dosage) of epoetin beta (Neorecormon, Roche Diagnostics, Hvidovre, Denmark) were performed intravenously during a 3-week period, followed by two microinjections of only 10 IU/kg bw. Blood and urine samples were collected 2, 6, 12, and 72 h after the microinjection, as well as 72 h after the last boosting dose. Sensitivities and specificities of the MAIIA test were examined by absolute and passport thresholds. Sensitivity was 100% for at least 12 h after the microinjection, with ∼30% of plasma samples still exceeding the 99.9% passport threshold 72 h after a microinjection. The specificity was higher for the passport approach compared to the absolute approach, but there were no differences in sensitivities between approaches or between specimens (urine and plasma). We conclude that the MAIIA test shows potential for detecting very small doses of rhEPO.

Very few studies examined the prevalence and sport-related predictors of disturbed eating attitudes and behaviors (DEABs) among adolescents involved in sport practice, and their results are mixed and inconclusive. These inconsistencies are most likely due to their methodological heterogeneity and to the fact that none of these studies took into consideration the potentially relevant characteristics of the sport practice context. This study attempts to answer this limitation among French adolescents not involved or involved in various sports contexts defined based on their organization, leanness-centration, and competitive level. Participants were 335 adolescents involved in sport practice, and 435 adolescents not involved in any form of regular sport practice. The DEABs were measured using the Eating Attitudes Test-26. Global results do not showed any significant association between the status of the participants and DEAB. However, these results drastically changed when we considered the potential moderating role of sex and age on these relations. Indeed, sports involvement in general, and involvement in leanness and competitive sports were found to exert sex- and age-differentiated effects on the risks of presenting clinically significant levels of DEAB. This study suggests the importance of monitoring, preventive, and early intervention mechanisms within the context of practice, particularly for adolescent girls.

The purpose of this study was to examine the motives for leisure-time physical activity among active and inactive men and women in their mid-30s. We used both cross-sectional and longitudinal designs. Altogether, 2308 participants (mean age 33.9 years, 53.4% women) were identified from the population-based FinnTwin16 Cohort. Physically active and inactive individuals were identified on the basis of their leisure-time MET h/day. We evaluated participants' physical activity motivation with a modified version of the Recreational Exercise Motivation Measure. Comparisons between active and inactive individuals were analysed using the Wald test for equality of means, and effect sizes were calculated as Cohen's d. Motives related to mastery, physical fitness, social aspect of physical activity, psychological state, enjoyment, willingness to be fitter/look better than others, and appearance were significantly more important for the active than inactive participants. Conforming to others' expectations was the only item on which the inactive persons scored higher than active persons. The longitudinal results for physical activity were parallel to the cross-sectional results. This study supports the view that motivation factors differ between active and inactive persons, and that intrinsic motives are associated with consistent leisure-time physical activity.

We have limited insight into how injuries occur in professional ski racing. The aim of this study was to describe the injury situations in World Cup alpine skiing. Injuries reported through the International Ski Federation Injury Surveillance System for three consecutive World Cup seasons (2006–2009) were obtained on video. In total, 69 injuries and 124 runs of matched controls were analysed by five experts to evaluate the skiing situation, skier behavior, as well as piste-related factors. A chi-square test (95% CI, P ≤ 0.05) was used to examine whether there was a difference between course sections regarding where the injury situation occurred. The skier was most frequently turning (n = 55) or landing from a jump (n = 13) at the time of injury. Most of the injuries to the head and upper body (96%) resulted from crashes, while the majority of knee injuries (83%) occurred while the skier was still skiing. Gate contact contributed to 30% of the injuries, while 9% occurred at contact with safety nets/material. Almost half of the injuries (46%) occurred in the final fourth of the course. A particular concern was the high contribution of inappropriate gate contact and the high-energy impacts to the body when crashing.

The aim of this study was to investigate the association between foot type and the morphometry of selected muscles and tendons of the lower limb. Sixty-one healthy participants (31 male, 30 female; aged 27.1 ± 8.8 years) underwent gray-scale musculoskeletal ultrasound examination to determine the anterior-posterior (AP) thickness of tibialis anterior, tibialis posterior, and peroneus longus muscles and tendons as well as the Achilles tendon. Foot type was classified based on arch height and footprint measurements. Potentially confounding variables (height, weight, hip and waist circumference, rearfoot and ankle joint range of motion, and levels of physical activity) were also measured. Multiple linear regression models were used to determine the association between foot type with muscle and tendon morphometry accounting for potentially confounding variables. Foot type was significantly and independently associated with AP thickness of the tibialis anterior tendon, peroneus longus muscle, and Achilles tendon, accounting for approximately 7% to 16% of the variation. Flat-arched feet were associated with a thicker tibialis anterior tendon, a thicker peroneus longus muscle, and a thinner Achilles tendon. Foot type is associated with morphometry of tendons that control sagittal plane motion of the rearfoot; and the peroneus longus muscle that controls frontal plane motion of the rearfoot. These findings may be related to differences in tendon loading during gait.

The aim of this work was to compare the joint kinetics and stroke production efficiency for the shoulder, elbow, and wrist during the serve between professionals and advanced tennis players and to discuss their potential relationship with given overuse injuries. Eleven professional and seven advanced tennis players were studied with an optoelectronic motion analysis system while performing serves. Normalized peak kinetic values of the shoulder, elbow, and wrist joints were calculated using inverse dynamics. To measure serve efficiency, all normalized peak kinetic values were divided by ball velocity. t-tests were used to determine significant differences between the resultant joint kinetics and efficiency values in both groups (advanced vs professional). Shoulder inferior force, shoulder anterior force, shoulder horizontal abduction torque, and elbow medial force were significantly higher in advanced players. Professional players were more efficient than advanced players, as they maximize ball velocity with lower joint kinetics. Since advanced players are subjected to higher joint kinetics, the results suggest that they appeared more susceptible to high risk of shoulder and elbow injuries than professionals, especially during the cocking and deceleration phases of the serve.

The purpose was to determine if an at-home resistance tubing strength training program on one shoulder (that is commonly used in rehabilitation settings) would produce increases in strength in the trained and untrained shoulders via cross-education. Twenty-three participants were randomized to TRAIN (strength-trained one shoulder; n = 13) or CONTROL (no intervention; n = 10). Strength training was completed at home using resistance tubing and consisted of maximal shoulder external rotation, internal rotation, scaption, retraction, and flexion 3 days/week for 4 weeks. Strength was measured via handheld dynamometry and muscle size measured via ultrasound. For external rotation strength, the trained (10.9 ± 10.9%) and untrained (12.7 ± 9.6%) arm of TRAIN was significantly different than CONTROL (1.6 ± 13.2%; −2.7 ± 12.3%; pooled across arm; P < 0.05). For internal rotation strength, the trained (14.8 ± 11.3%) and untrained (14.6 ± 10.1%) arm of TRAIN was significantly different than CONTROL (6.4 ± 11.2%; 5.1 ± 8.8%; pooled across arm; P < 0.05). There were no significant differences for scaption strength (P = 0.056). TRAIN significantly increased muscle size in the training arm of the supraspinatus (1.90 ± 0.32 to 1.99 ± 0.31 cm), and the anterior deltoid (1.08 ± 0.37 to 1.21 ± 0.39 cm; P < 0.05). This study suggests that an at-home resistance tubing training program on one limb can produce increases in strength in both limbs, and has implications for rehabilitation after unilateral shoulder injuries.

This study longitudinally evaluated whether maturation and relative age interact with time during adolescence to differentially affect the development of anthropometric and fitness characteristics in junior rugby league players. Anthropometric and fitness characteristics of 81 junior players selected into the UK Rugby Football League's talent identification and development process were assessed over three consecutive occasions (i.e., under-13s, -14s, -15s). Players were grouped and compared in relation to maturational status (i.e., early, average, late) and relative age quartile (i.e., quartile 1). Repeated measures multivariate analysis of variance identified significant (P < 0.001) overall main effects for maturation group, relative age quartile and importantly a maturation group by time interaction. Findings showed that the early-maturing group had the greatest anthropometric characteristics and medicine ball throw across the three occasions. However, the late-maturing group increased their height (early = 5.0 cm, late = 10.3 cm), medicine ball throw and 60-m sprint (early = −0.46 s, late = −0.85 s) the most throughout the 2-year period. Early (de)selection policies currently applied in talent identification and development programs are questionable when performance-related variables are tracked longitudinally. During adolescence, maturation status alongside relative age should be considered and controlled for when assessing athlete potential for future progression.

A ski–snow interaction model is presented. The force between ski and snow is decomposed into a penetration force normal to the snow surface, a shear force parallel to it, and friction. The purpose of this study was to investigate the benefits of a hypoplastic vs an elastic contact for penetration in the simulation of skiing turns. To reduce the number of influencing factors, a sledge equipped with skis was considered. A forward dynamic simulation model for the sledge was implemented. For the evaluation of both contact models, the deviation between simulated trajectories and experimental track data was computed for turns of 67 and 42 m. Maximum deviations for these turns were 0.44 and 0.14 m for the hypoplastic contact, and 0.6 and 7.5 m for the elastic contact, respectively. In the hypoplastic contact, the penetration depth of the ski's afterbody maintained nearly the same value as the part under maximum load, whereas it decreased in the elastic contact. Because the shear force is proportional to the penetration depth, the hypoplastic contact resulted in a higher shearing resistance. By replacing the sledge with a skier model, one may investigate more complex skier actions, skiing performance, or accident-prone skiing maneuvers.

This study aimed to compare objectively recorded physical activity (PA) levels and walking steps among pregnant women. Cross-sectional data from a multiethnic cohort (n = 823) of pregnant women consisting of 44% from Western countries, 24% from South Asia, 14% from Middle East, and 18% from other countries. PA and steps were recorded by the activity monitor SenseWear™ Pro3 Armband. A total of 678 women were included in the analysis. Western women walked significantly more steps and had higher moderate-to-vigorous-intensity physical activity (MVPA) levels compared with South Asian women per weekday and weekend day. Interaction terms (P = 0.008) between ethnicity (Western vs South Asian) and parity, and education, respectively, were identified: having ≥1 children was positively associated with steps during weekends in South Asians in contrast to Western women. Having <12 years education was associated with more MVPA time among South Asians in contrast to Western women. South Asian women are prone to low levels of PA during pregnancy and South Asian women without children and with higher education may have an elevated risk for an inactive lifestyle during pregnancy.

Endurance athletes have an increased risk of atrial fibrillation. We performed a longitudinal study on elite runners of the 2010 Jungfrau Marathon, a Swiss mountain marathon, to determine acute effects of long-distance running on the atrial myocardium. Ten healthy male athletes were included and examined 9 to 1 week prior to the race, immediately after, and 1, 5, and 8 days after the race. Mean age was 34.9 ± 4.2 years, and maximum oxygen consumption was 66.8 ± 5.8 mL/kg*min. Mean race time was 243.9 ± 17.7 min. Electrocardiographic-determined signal-averaged P-wave duration (SAPWD) increased significantly after the race and returned to baseline levels during follow-up (128.7 ± 10.9 vs. 137.6 ± 9.8 vs. 131.5 ± 8.6 ms; P < 0.001). Left and right atrial volumes showed no significant differences over time, and there were no correlations of atrial volumes and SAPWD. Prolongation of the SAPWD was accompanied by a transient increase in levels of high-sensitivity C-reactive protein, proinflammatory cytokines, total leucocytes, neutrophil granulocytes, pro atrial natriuretic peptide and high-sensitivity troponin. In conclusion, marathon running was associated with a transient conduction delay in the atria, acute inflammation and increased atrial wall tension. This may reflect exercise-induced atrial myocardial edema and may contribute to atrial remodeling over time, generating a substrate for atrial arrhythmias.

We studied if salt and water ingestion alleviates the physiological strain caused by dehydrating exercise in the heat. Ten trained male cyclists ( : 60 ± 7 mL/kg/min) completed three randomized trials in a hot-dry environment (33 °C, 30% rh, 2.5 m/s airflow). Ninety minutes before the exercise, participants ingested 10 mL of water/kg body mass either alone (CON trial) or with salt to result in concentrations of 82 or 164 mM Na⁺ (ModNa⁺ or HighNa⁺ trial, respectively). Then, participants cycled at 63% of for 120 min immediately followed by a time-trial. After 120 min of exercise, the reduction in plasma volume was lessened with ModNa⁺ and HighNa⁺ trials (−11.9 ± 2.1 and −9.8 ± 4.2%) in comparison with CON (−16.4 ± 3.2%; P < 0.05). However, heat accumulation or dissipation (forearm skin blood flow and sweat rate) were not improved by salt ingestion. In contrast, both salt trials maintained cardiac output (∼1.3 ± 1.4 L/min; P < 0.05) and stroke volume (∼10 ± 11 mL/beat; P < 0.05) above CON after 120 min of exercise. Furthermore, the salt trials equally improved time-trial performance by 7.4% above CON (∼289 ± 42 vs 269 ± 50 W, respectively; P < 0.05). Our data suggest that pre-exercise ingestion of salt plus water maintains higher plasma volume during dehydrating exercise in the heat without thermoregulatory effects. However, it maintains cardiovascular function and improves cycling performance.

The purpose of this study was to evaluate the effects of a 4-week familiarization to simulated barefoot running (SBR) on running economy (RE) when compared with shod running. Fifteen trained male runners (age: 24 ± 4 years; stature: 177.2 ± 6.21 cm; mass: 67.99 ± 7.36 kg and VO_2max 70.2 ± 5.2 mL/kg/min) were recruited. Subjects completed two RE tests, 24 h apart, in a random order, in both the SBR and shod condition (pretest) at 11 km/h and 13 km/h. Oxygen uptake, heart rate, stride frequency, and foot strike patterns were measured in both conditions. Subjects then completed a 4-week familiarization period of SBR, before repeating the two RE tests (post-test). At pretest, there was no significant difference in RE between SBR and shod running (P = 0.463), but following the 4-week familiarization period, RE significantly improved by 6.9% in the SBR condition compared with shod running (46.4 ± 0.9 vs 43.2 ± 1.2 mL/kg/min; P = 0.011). A significant improvement in RE was observed in the SBR condition (8.09%) between the pretest and post-test (47.0 ± 1.2 vs 43.2 ± 1.2 mL/kg/min; P = 0.002). RE improved in the SBR condition as a result of familiarization, and became significantly lower in SBR compared with shod running.

To investigate the combined influence of diet quality and physical activity on cardiovascular disease (CVD) risk factors in adolescents, adolescents (n = 1513; 12.5–17.5 years) participating in the Healthy Lifestyle in Europe by Nutrition in Adolescence study were studied. Dietary intake was registered using a 24-h recall and a diet quality index was calculated. Physical activity was assessed by accelerometry. Lifestyle groups were computed as: healthy diet and active, unhealthy diet but active, healthy diet but inactive, and unhealthy diet and inactive. CVD risk factor measurements included cardiorespiratory fitness, adiposity indicators, blood lipid profile, blood pressure, and insulin resistance. A CVD risk score was computed. The healthy diet and active group had a healthier cardiorespiratory profile, fat mass index (FMI), triglycerides, and high-density lipoprotein cholesterol (HDL-C) levels and total cholesterol (TC)/HDL-C ratio (all P ≤ 0.05). Overall, active adolescents showed higher cardiorespiratory fitness, lower FMI, TC/HDL-C ratio, and homeostasis model assessment index and healthier blood pressure than their inactive peers with either healthy or unhealthy diet (all P ≤ 0.05). Healthy diet and active group had healthier CVD risk score compared with the inactive groups (all P ≤ 0.02). Thus, a combination of healthy diet and active lifestyle is associated with decreased CVD risk in adolescents. Moreover, an active lifestyle may reduce the adverse consequences of an unhealthy diet.

Endurance training is accompanied by important adaptations in both cardiovascular and autonomic nervous systems. Previous works have shown that the main component of gap junctions in the ventricular myocardium (connexin 43 (Cx43) can be regulated by adrenergic stimulus. On the other hand, training raises vagal and decreases sympathetic tone, while augmenting myocardial sensitivity to sympathetic stimulation during exercise. We therefore evaluated the regulation of Cx43 expression by sympathetic tone during exercise in trained and sedentary mice. Training induced an increase in the protein level of Cx43 by 45–70% under resting conditions. The expression of Cx43 was inhibited in trained but not in untrained mice in response to a 60 min exercise bout. Normal basal expression was restored after 60 min of resting. Cx43 reached a minimum that was not different from basal expression in untrained mice. In accordance, electrocardiography and action potential analysis did not reveal major electrophysiological implications for the drop in Cx43 abundance in trained-exercise mice. We prevented Cx43 inhibition using propranolol, and observed increased basal mRNA levels of β-adrenergic receptors without significant changes in the ratio β₁ to β₂. In conclusion, we showed that Cx43 expression is transiently inhibited by β-adrenergic stimulus in trained mice during acute exercise.

This registry study was set up to evaluate the effect of smoking on the pre-operative status, intraoperative findings, and post-operative status after rotator cuff reconstruction. Five hundred seventy-six consecutive shoulders with primarily arthroscopically repaired penetrating rotator cuff tear were followed up. Tobacco consumption was recorded as pack-years. Age-adjusted Constant score was used as an outcome measure. Five hundred sixty-four patients were available for 1-year follow-up (dropout rate 2%). One hundred fourteen (20%) and 450 (80%) patients were pre-operatively recorded to be smokers and non-smokers, respectively. The gender distribution did not differ between the groups (P = 0.286). The mean age of all patients was 55 years in smokers (SD 9.1) and 61 years in non-smokers (SD 9.4) (P < 0.001). There was no statistically significant difference in pre-operative Constant score (P = 0.075) or mean size of intraoperatively measured tendon tear (P = 0.290) between the groups. At final follow-up, there was a statistically significant difference in Constant scores between smokers [71 (SE 1.4)] and non-smokers [75 (SE 0.7)] (P = 0.017). The pack-years of smoking correlated with neither the Constant score (P = 0.815) nor the size of the tear (P = 0.786). We conclude that operatively treated rotator cuff tear patients who smoked were significantly younger than non-smokers, and that smoking was associated with lower post-operative Constant score.

This investigation was designed to analyse the kinematics and kinetics of cross-country skiing at different velocities with the herringbone technique on a steep incline. Eleven elite male cross-country skiers performed this technique at maximal, high, and moderate velocities on a snow-covered 15° incline. They positioned their skis laterally (25 to 30°) with a slight inside tilt and planted their poles laterally (8 to 12°) with most leg thrust force exerted on the inside forefoot. Although 77% of the total propulsive force was generated by the legs, the ratio between propulsive and total force was approximately fourfold higher for the poles. The cycle rate increased with velocity (1.20 to 1.60 Hz), whereas the cycle length increased from moderate up to high velocity, but then remained the same at maximal velocity (2.0 to 2.3 m). In conclusion, with the herringbone technique, the skis were angled laterally without gliding, with the forces distributed mainly on the inside forefoot to enable grip for propulsion. The skiers utilized high cycle rates with major propulsion by the legs, highlighting the importance of high peak and rapid generation of leg forces.

The purpose of this study was to determine the long-term dose–response relationship of exercise frequency on areal bone mineral density (aBMD) in early post-menopausal women with osteopenia. Based on the 12-year results of the consequently supervised exercise group (EG) of the Erlangen Fitness and Osteoporosis Prevention Study, we retrospectively structured two exercise groups according to the overall exercise frequency. Changes in aBMD at lumbar spine and proximal femur as assessed by dual-energy x-ray absorptiometry technique were compared between a low-frequency exercise group (LEF-EG, n = 16) with 1.5–<2 sessions/week and a high-frequency exercise group (HEF-EG, n = 25) with ≥2–3.5 sessions/week. Changes in aBMD at the lumbar spine and proximal femur were significantly more favorable in the HEF-EG compared with the LEF-EG; lumbar spine: (mean value ± standard deviation) 1.1 ± 4.7% vs −4.1 ± 3.0%; P = 0.001, ES: d' = 1.26; total hip: −4.4 ± 3.9% vs −6.7 ± 3.5%, P = 0.045, ES: d' = 0.70). BMD results of the LEF-EG did not significantly differ from the data of the non-training control group (lumbar spine: −4.4 ± 5.2%, total hip: −6.9 ± 5.0%). Although this result might not be generalizable across all exercise types and cohorts, it indicates that to impact bone, an overall exercise frequency of at least 2 sessions/week may be crucial, even if exercise is applied with high intensity/impact.

This study aimed to record and analyse incidence and characteristics of injuries and illnesses incurred during the Indoor Athletics Championships. During the 2011 European Indoor Athletics Championships in Paris, incidence and characteristics of new injuries and illnesses were recorded prospectively by physicians and physiotherapists from national teams and local organizing committee in 631 registered athletes. Around 70% of athletes were covered by the medical teams (response rate: 84%). Thirty injuries, including eight time-loss injuries, were reported, representing an incidence of 47.5 injuries and 29.4 time-loss injuries per 1000 registered athletes. Injury and time-loss injury risk were highest in heptathlon and hurdles. Three-quarters of injuries affected the lower extremity. Thigh strain was the most common diagnosis (n = 7; 23%). Noncontact trauma (n = 9; 30%) was the predominant cause. A total of 18 illnesses were reported. Incidence of illnesses was 28.5 per 1000 registered athletes, with 17% resulting in time lost from sport. Upper respiratory tract infection was the most common diagnosis (n = 8; 44%) followed by upper respiratory tract allergy (n = 3; 17%) and gastroenteritis (n = 3; 17%). Injury and illness incidence and severity were lower during the 2011 European Indoor Athletics Championships than during outdoor championships, probably due to the shorter duration, the fewer number of events, and shorter sprint distances.

Change of direction speed (CODS) is often considered a main determinant of successful performance in many team sports and is routinely measured using field-based tests. However, controversy regarding test selection still exists based upon the reliability and specificity of the tests. The purpose of this study was to determine and compare the reliability, factorial validity, and interrelationships of five frequently used CODS tests (Illinois, L-Run, Pro-Agility, T-test, and 505). Forty-four physical education students (male n = 24; female n = 20; age; 16.7 ± 0.6), who compete within team sports, to varying levels of competition, participated in this study. Three trials for each of the five tests were recorded. All tests had high (intraclass correlation coefficient) test–retest reliability (r = 0.88–0.95) and low typical percentage error (1.95–2.40%). The principle component factor analysis resulted in the extraction of one significant component which explained 89.52% of the total variance. All selected tests were positively and strongly correlated (r = 0.84–0.89). Based upon the results of this study, it was concluded that all tests are highly reliable and valid measures of CODS, with all tests assessing a general athletic ability to change direction. Future research should investigate the factorial validity of the CODS test within homogenous samples.

There is mounting evidence that genetic factors located in mitochondrial and nuclear genomes influence sport performance. Certain mitochondrial haplogroups and polymorphisms were associated with the status of elite athlete, especially in endurance performance. The aim of our study was to assess whether selected mitochondrial DNA (mtDNA) and nuclear DNA variants are associated with elite athlete performance in a group of 395 elite Polish athletes (213 endurance athletes and 182 power athletes) and 413 sedentary controls. Our major finding was that the mtDNA haplogroup H and HV cluster influence endurance performance at the Olympic/World Class level of performance (P = 0.018 and P = 0.0185, respectively). We showed that two polymorphisms located in the mtDNA control region were associated with achieving the elite performance level either in the total athlete's group as compared with controls (m.16362C, 3.8% vs 9.2%, respectively, P = 0.0025, odds ratio = 0.39, 95% confidence interval: 0.21–0.72), or in the endurance athletes as compared with controls (m.16080G, 2.35% vs 0%, respectively, P = 0.004). Our results indicate that mtDNA variability affects the endurance capacity rather than the power one. We also propose that mtDNA haplogroups and subhaplogroups, as well as individual mtDNA polymorphisms favoring endurance performance, could be population-specific, reflecting complex cross-talk between nuclear and mitochondrial genomes.

In randomized controlled trials (RCTs), with customized structured physical exercise activity (SPEA) interventions, the dose of leisure-time physical activity (LTPA) should exceed the LTPA dose of the nonexercising control (C) group. This increase is required to substantiate health improvements achievable by exercise. We aimed to compare the dose of SPEA, LTPA, and total LTPA (SPEA + LTPA) between a randomized Nordic walking (NW) group, a power-type resistance training (RT) group, and a C group during a 12-week exercise intervention in obese middle-aged men (n = 144) with impaired glucose regulation. The dose of physical activity was measured with diaries using metabolic equivalents. No significant difference (P > 0.107) between the groups was found in volume of total LTPA. The volume of LTPA was, however, significantly higher (P < 0.050) in the C group than in the NW group, but not compared with the RT group. These results indicate that structured exercise does not automatically increase the total LTPA level, possibly, as a result of compensation of LTPA with structured exercise or spontaneous activation of the C group. Thus, the dose of total LTPA and the possible changes in spontaneous LTPA should be taken into account when implementing a RCT design with exercise intervention.

The purpose of this study was to compare the effects of two different methods of organizing endurance training in trained cyclists during a 12-week preparation period. One group of cyclists performed block periodization (BP; n = 8), wherein every fourth week constituted five sessions of high-intensity aerobic training (HIT), followed by 3 weeks of one HIT session. Another group performed a more traditional organization (TRAD; n = 7), with 12 weeks of two weekly HIT sessions. The HIT was interspersed with low-intensity training (LIT) so that similar total volumes of both HIT and LIT were performed in the two groups. BP achieved a larger relative improvement in VO_2max than TRAD (8.8 ± 5.9% vs 3.7 ± 2.9%, respectively, P < 0.05) and a tendency toward larger increase in power output at 2 mmol/L [la⁻] (22 ± 14% vs 10 ± 7%, respectively, P = 0.054). Mean effect size (ES) of the relative improvement in VO_2max, power output at 2 mmol/L [la⁻], hemoglobin mass, and mean power output during 40-min all-out trial revealed moderate superior effects of BP compared with TRAD training (ES range was 0.62–1.12). The present study suggests that BP of endurance training has superior effects on several endurance and performance indices compared with TRAD.

Maximal oxygen uptake (VO_2max) is an important, independent predictor of cardiovascular health and mortality. Despite this, it is rarely measured in clinical practice. The aim of this study was to create and evaluate a submaximal cycle ergometry test based on change in heart rate (HR) between a lower standard work rate and an individually chosen higher work rate. In a mixed population (n = 143) with regard to sex (55% women), age (21–65 years), and activity status (inactive to highly active), a model included change in HR per unit change in power, sex, and age for the best estimate of VO_2max. The association between estimated and observed VO_2max for the mixed sample was r = 0.91, standard error of estimate = 0.302 L/min, and mean measured VO_2max = 3.23 L/min. The corresponding coefficient of variation was 9.3%, a significantly improved precision compared with one of the most commonly used submaximal exercise tests, the Åstrand test, which in the present study was estimated to be 18.1%. Test–retest reliability analysis over 1 week revealed no mean difference in the estimated VO_2max (−0.02 L/min, 95% confidence interval: −0.07–0.03). The new test is low-risk, easily administered, and valid for a wide capacity range, and is therefore suitable in situations as health evaluations in the general population.

This review describes the psychosocial factors that affect recovery following anterior cruciate ligament (ACL) injury and reconstructive surgery in athletes. A systematic search in literature with inclusion and exclusion criteria on PubMed, PsycINFO, and Embase was performed. Articles used in this review were divided in five different parts according to the biopsychosocial model of Wiese-Bjornstal, with the addition of intervention studies. The results showed that a high internal Health Locus of Control and a high self-efficacy were useful cognitive factors to facilitate the recovery. Athletes with a low level of fear of reinjury had the best knee outcome after the injury followed by a reconstruction. In addition, athletes who returned to sport had less fear of reinjury and were more experienced and established athletes compared with athletes who did not return to sport. Furthermore, researchers showed that there was a positive relation between goal setting and adherence, which in turn yielded a positive relation with the outcome of the rehabilitation of an ACL injury. There were several psychosocial interventions that appeared to be facilitating the rehabilitation process.

The purpose of this study was to investigate the influence of classical style roller skis' grip (static friction coefficients, μ_S) on cross-country skiers' oxygen consumption and leg forces during treadmill roller skiing, when using the diagonal stride and kick double poling techniques. The study used ratcheted wheel roller skis from the open market and a uniquely designed roller ski with an adjustable camber and grip function. The results showed significantly (P ≤ 0.05) higher oxygen consumption (∼14%), heart rate (∼7%), and lower propulsive forces from the legs during submaximal exercise and a shorter time to exhaustion (∼30%) in incremental maximal tests when using roller skis with a μ_S similar to on-snow skiing, while there was no difference between tests when using different pairs of roller skis with a similar, higher μ_S. Thus, we concluded that oxygen consumption (skiing economy), propulsive leg forces, and performance time are highly changed for the worse when using roller skis with a lower μ_S, such as for on-snow skiing with grip-waxed cross-country skis, in comparison to ratcheted wheel roller skis with several times higher μ_S.

Previous research highlights the critical role that contextual factors play in shaping athlete development. The purpose of the present study was to investigate two of these contextual factors: birth date (known as the relative age effect, RAE) and city of development as determinants of participation in a sample of youth ice hockey players. The sample included 146 424 athletes registered with Ontario youth ice hockey between the 2004 and 2010 seasons. Chi-square statistics determined a significant RAE in youth ice hockey. Findings also revealed a significant association between small cities of development and increased youth ice hockey participation. Finally, there was no evidence of an interaction between relative age and city of development. The characteristics of smaller communities that may facilitate sport participation across all youth are discussed, along with recommendations for future research.

Handbikes come in different models and setups, but only limited knowledge is available on the handbike-user interface. The aim of this study was to identify optimal handbike setups, assuming that in such a setup mechanical efficiency is high, while shoulder load is low. Thirteen subjects with a spinal cord injury (paraplegia) performed handcycling with different handbike setups at constant power output: four crank positions (two distances, two heights) and four backrest inclinations. The O₂-consumption, kinetics, and kinematics were measured to calculate mechanical efficiency and shoulder load (glenohumeral contact force, net shoulder moments, and rotator cuff force). The analysis showed that more upright backrest positions resulted in lower shoulder load compared with the most reclined position [glenohumeral contact force (260 vs 335 N), supraspinatus (14.4% vs 18.2%), and infraspinatus force (5.4% vs 9.8%)], while there was no difference in efficiency. Except for a reduction in subscapularis force at the distant position, no differences in shoulder load or efficiency were found between crank positions. Recreational handbike users, who want to improve their physical capacity in a shoulder-friendly way, should set up their handbike with a more upright backrest position and a distant crank placement.

The study examined the independent and combined effects of coach leadership and coaching relationships on team efficacy. A total of 150 sport performers from football teams across a range of competitive levels completed a multisection self-report instrument to assess their individual perceptions of the level of collective efficacy, the type of coach leadership, and the quality of the coach–athlete relationship. Multiple regression analyses revealed that perceptions of both coach leadership and the coach–athlete relationship predicted variance in team efficacy. Overall, the findings suggest that the quality of coach–athlete relationships added to the prediction of individuals’ collective efficacy beyond what was predicted by coaches’ behaviors of leadership alone. Limitations and future research directions are discussed.

Whole-body heating increases the likelihood of syncope, whereas utilizing lower-body compression garments may reduce syncope risk. We hypothesized that graded compression garments would reduce the typically observed large postural reductions in arterial blood pressure and middle cerebral artery velocity, in normothermia and especially once passively heat stressed. Fifteen men (age: 27 ± 4 years, aerobic fitness range: 30–75 mL/kg^/min) completed a supine-to-stand orthostatic challenge for 3 min at normothermia and after passive heating (esophageal temperature, +0.5 °C from baseline) on two occasions (> 7 days): once wearing commercially available compression trousers and once wearing low-compression placebo trousers (randomized order). Blood flow velocity in the middle cerebral artery (transcranial Doppler), mean arterial blood pressure (mean BP: Finometer) and end-tidal carbon dioxide pressure were measured continuously. During normothermia, compression, garments did not alter the magnitude of the postural changes in mean BP or middle cerebral artery velocity. After passive heating, although the magnitudes of these changes were exaggerated, they were not significantly affected by compression garments. Compression garments did not attenuate the initial or sustained orthostatic hypotension associated with posture change, either during normothermia or following passive heat stress.

Spontaneous behavior of ventricular extrasystoles (VE) was analysed. From a database containing 578 athletes with VE, 84 males and 11 females (29.9 ± 18.1 years) having ≥ 100 VE or repetitive VE [ventricular couplets (VC) or ventricular tachycardias (VT)] at first 24-hour Holter electrocardiographic monitoring (24-h-HM) (baseline) and at least 1-year of follow-up (3.1 ± 2.2 years) over the past 10 years were selected. The baseline was compared with the last 24-h-HM to establish DVE (VE reduction of at least 98%/24 h in the absence of VC or VT). SDVE was calculated as standard deviation of the number of VE on serial 24-h-HMs. DVE and SDVE were considered as dependent variables. Independent variables were: age, sex, type of sport, symptoms, baseline VE rate (BVE), baseline VC and VT, VE morphology, VE behavior during the baseline training session, disqualification from competitive sports, echocardiographic abnormalities. DVE occurred in 32 athletes (34%). SDVE varied from 0 to 12 658 VE/24 h (1916 ± 2649.9). Disappearance of VE during the baseline training session (DVET) correlated to DVE (P = 0.0319). BVE directly correlated to SDVE (P = 0.0008). Athletes' VE are highly variable over time, their variability depending on BVE, and they not infrequently tend to disappear. The only useful variable for predicting DVE is DVET.

Although sport promotion may play an important role in achieving the recommended levels of physical activity for health, until now, there has been no comprehensive assessment of how sport policies in Europe address health. This article aimed at filling this gap by reviewing and analyzing recent national policy developments in the area of sport promotion, with a focus on synergies and discrepancies with the promotion of health-enhancing physical activity. By applying various search methods, 130 documents focusing on sport and physical activity were identified in the World Health Organization (WHO) European Region. An analysis grid covering key indicators was developed for a systematic content analysis of 25 documents, selected according to established criteria. Analysis showed that general recommendations for good policy making were followed, such as establishing general goals, specifying time frame and responsible body for implementation and addressing different target groups. Furthermore, all sport strategies addressed health on an overall level and recognized the importance of Sport for All. However, in several strategies, there was a lack of measurable targets, specified budgets, and evaluation plans. The analysis showed that there is a great opportunity for health and sport sectors to work more closely together in the future, and identified areas where this could take place.

The aim of this study was to evaluate the impact of serious sport and active recreation injury on 12-month physical activity levels. Adults admitted to hospital with sport and active recreation-related injuries, and captured by the Victorian Orthopaedic Trauma Outcomes Registry were recruited to the study. Changes between preinjury and 12 month post-injury physical activity was assessed using the short International Physical Activity Questionnaire (IPAQ). Independent demographic, injury, and hospital variables were assessed for associations with changes in physical activity levels, using multivariate linear regression. A total of 324 patients were recruited, of which 98% were followed up at 12 months. Mean short IPAQ scores decreased from 7650 METS (95% CI: 7180, 8120) preinjury to 3880 METS; (95% CI: 3530, 4250) post-injury, independent of functional recovery. Education level and occupation group were the only variables independently associated with changes in physical activity levels post-injury. These results highlighted that sport and active recreation injuries lead to significant reductions in physical activity levels. Hence, the prevention of sport and active recreation injuries is important when considering promotion of activity at a population level.

The extent to which aerobic processes contribute to energy supply during short duration sprint swimming is not known. Therefore, the energy contribution to a maximal 30 s fully tethered swim (FTS), and repeated 4 × 30 s high intensity semi-tethered swimming bouts (STS) with 30 s of passive rest at 95% of the 30 s FTS intensity was estimated in eight elite male swimmers. Blood lactate concentration and pH after the 4 × 30 s test were 12.1 ± 3.6 mmol/L and 7.2 ± 0.1, respectively. Accumulated oxygen demand was estimated to be 50.9 ± 9.6 mL/kg and 48.3 ± 8.4, 47.2 ± 8.5, 47.4 ± 8.3, and 45.6 ± 6.8 mL/kg for the 30 s FTS and 4 × 30 s bouts, respectively. Accumulated oxygen uptake was 16.6 ± 3.6 for the 30 s FTS and progressively increased during the 4 × 30 s bouts 12.2 ± 2.1, 21.6 ± 2.5, 22.8 ± 1.8, and 23.5 ± 2.0 mL/kg (P < 0.01). The estimated aerobic contribution therefore was 33 ± 8% for the 30 s FTS and 25 ± 4, 47 ± 9, 49 ± 8, 52 ± 9% for bouts 1–4 during the 4 × 30 s STS test (P < 0.01). The results underline the importance of aerobic energy contribution during single and repeated high intensity swimming, which should be considered when prescribing swimming training sets of this nature.

Mechanical loading plays an important role not solely in cartilage development, but also in cartilage degeneration. Its adaptation behavior to mechanical loading has not been clearly delineated. The aim of the study was to examine the effect of different running modes (with different muscle contraction types) on morphological, biochemical, and mechanical properties of articular cartilage in the knee of growing rats. Thirty-six female Sprague–Dawley rats were randomly assigned into a nonactive age-matched control (AMC), level (LEVEL), and 20° downhill (DOWN) running group (n = 12 each). Running groups were trained on a treadmill for 30 min/day, 5 days/week for 6 weeks. Immunohistochemical staining and analysis of expression for collagen II, collagen IX, cartilage oligomeric matrix protein (COMP), and matrilin-3, histomorphometry of femoral cartilage height and femoral COMP staining height, and indentation testing of tibial articular cartilage were performed. Rats subjected to downhill running showed a significantly (P = 0.015) higher COMP staining height and a tendentially (P = 0.084) higher cartilage height in the high-weight bearing area of femoral articular cartilage. Cartilage thickness, mechanical properties, and expression of cartilage network proteins in tibial cartilage remained unaffected by different running modes. Our data suggest that joint loading induced by eccentric muscle contractions during downhill running may lead to a site-specific adaptation.

The pathogenesis of trigger finger has generally been ascribed to primary changes in the first annular ligament. In contrast, we recently found histological changes in the tendons, similar to the findings in Achilles tendinosis or tendinopathy. We therefore hypothesized that trigger finger tendons would show differences in gene expression in comparison to normal tendons in a pattern similar to what is published for Achilles tendinosis. We performed quantitative real-time polymerase chain reaction on biopsies from finger flexor tendons, 13 trigger fingers and 13 apparently healthy control tendons, to assess the expression of 10 genes which have been described to be differently expressed in tendinosis (collagen type 1a1, collagen 3a1, MMP-2, MMP-3, ADAMTS-5, TIMP-3, aggrecan, biglycan, decorin, and versican). In trigger finger tendons, collagen types 1a1 and 3a1, aggrecan and biglycan were all up-regulated, and MMP-3and TIMP-3 were down-regulated. These changes were statistically significant and have been previously described for Achilles tendinosis. The remaining four genes were not significantly altered. The changes in gene expression support the hypothesis that trigger finger is a form of tendinosis. Because trigger finger is a common condition, often treated surgically, it could provide opportunities for clinical research on tendinosis.

Contracting the knee flexor muscles immediately before a maximum voluntary contraction (MVC) of knee extension increases the maximal force that the extensor muscles can exert. It is hypothesized that this phenomenon can be impaired by muscle fiber damage following eccentric exercise [delayed onset muscle soreness (DOMS)]. This study investigates the effect of eccentric exercise and DOMS on knee extension MVC immediately following a reciprocal-resisted knee flexion contraction. Electromyography (EMG) was recorded from the knee extensors and flexors of 12 healthy men during knee extension MVCs performed in a reciprocal (maximal knee extension preceded by resisted knee flexion), and nonreciprocal condition (preceded by relaxation of the knee flexors). At baseline, knee extension MVC force was greater during the reciprocal condition (P < 0.001), whereas immediately after, 24 and 48 h after eccentric exercise, the MVC force was not different between conditions. Similarly, at baseline, the EMG amplitude of the quadriceps during the MVC was larger for the reciprocal condition (P < 0.001). However, immediately after, 24 and 48 h postexercise the EMG amplitude was similar between conditions. In conclusion, eccentric exercise abolished the facilitation of force production for the knee extensors, which normally occurs when maximum knee extension is preceded by activation of the knee flexors.

Exercise addiction is characterized by excessive exercise behavior with potential negative consequences. The symptoms consist of salience, mood modification, tolerance, withdrawal symptoms, conflicts, and relapse. The purpose of this study was to test the psychometric properties of the exercise addiction inventory (EAI) and to estimate the prevalence of exercise addiction in a Danish normal weight sport population. A sample of 780 habitual fitness and football exercisers were contacted and 590 completed the EAI and an in-house questionnaire containing questions about variables related to exercise addiction: (a) exercise frequency; (b) continuance despite injuries; and (c) personal perception of addiction. The results demonstrated an overall prevalence of exercise addiction of 5.8%. There was no significant difference between fitness and football prevalences. The internal reliability of EAI was acceptable with a Cronbach's α of 0.66. The criterion validity was tested toward the three variables related to exercise addiction. The dependent group had significantly higher scores on the three variables than the non-dependent group. Exercise addiction seems to exist in both fitness and football. The EAI is a useful screening tool and might be applicable in future screening and prevention of exercise addiction. However, further investigation about the population is needed to understand the phenomenon and to identify the risk group.

Intervention studies have shown that high-intensity training programs with duration of 1–3 years can influence bone mass in post-menopausal women. We wanted to investigate whether moderate physical activity could be associated with reduced post-menopausal bone loss also in the long-term perspective. We evaluated changes in bone mass and bone structure by repeated single-photon absorptiometry measurements of the distal forearm in 91 moderately physically active and 21 inactive women, categorized according to information from questionnaires, from menopause and on average 25 years onwards. Data were calculated with analysis of variance and analysis of covariance tests and presented as means with 95% confidence interval. There were no group differences in bone mass or bone structure at menopause. The mean annual loss in bone mineral content was 1.2% (1.1, 1.3) in the physically active and 1.6% (1.3, 1.8) in the inactive women (after adjustment for menopausal age P = 0.02) and the mean decline in a strength index based on bone mass and bone structure was 0.7% (0.6, 0.8) in the physically active and 1.2% (0.8, 1.5) in the inactive women (P = 0.004). There were no group differences in the changes in bone structure. Physical activity is also in a long-term perspective associated with reduced post-menopausal bone loss.

Studies regarding ankle and foot overuse injuries are quite diverse in research methodology, data reporting, and outcomes. The aims of this systematic review were to analyze the methodology of published studies regarding ankle and foot overuse injuries in different sports disciplines and to summarize epidemiological data of ankle and foot overuse injuries. Four electronic databases, PubMed (MEDLINE), EMBASE, CINAHL, and SPORTDiscus^® were systematically searched up to June 2011. A total of 89 articles on 23 sports disciplines were included in this review. Soccer, running, and gymnastics were the most frequently studied sports. Achilles tendinopathy, plantar fasciitis, and stress fracture were the most frequently studied injuries. Study design and reporting methods were heterogeneous. Most studies suffered from a weak methodology and poor reporting. The most common weaknesses were lack of a clear case definition, describing assessment procedures and reporting sample characteristics. Due to methodological heterogeneity of studies, inter-sports and intra-sports comparisons and meta-analysis were not possible. Methodology of most studies on incidence and prevalence of ankle and foot overuse injuries is insufficient. Based on the results, we recommend authors to clearly define cases, describe assessment procedures and report sample characteristics adequately.

This study reports the results of a content analysis of interviews with 28 Norwegian world-class athletes and 28 controls, matched for gender, age, and type of sport. Semi-structured interviews explored their perceptions of their best performance. The interviews were analyzed using the ATLAS.ti and yielded 20 higher-order codes. Nine higher-order codes were categorized as inner-oriented, five were categorized as outer-oriented, and six were a combination of inner- and outer-oriented. Statistical analysis, using the Mann-Whitney test, showed significant group differences for seven higher-order codes: (a) two outer-oriented codes relating to “mastery – achievements” and “training – outer”; and (b) five inner-oriented codes relating to “mental preparation,” “self-reliance,” “training – inner,” “wholeness,” “performance – inner,” and “growth orientation.” These findings highlight the importance of both inner- and outer-oriented development for high-level achievement in sports – the “mental game” is as important as the physical game, both during training and competitions. Previously published quantitative data reported higher levels of brain integration, faster habitation to a loud tone, and higher ego and moral development in these world-class athletes. These findings are interpreted in light of a Unified Theory of Performance, which proposes that higher mind-brain development provides a basis for higher performance in any activity.

The purpose was to examine cigarette smoking, use of snus, alcohol, and performance-enhancing illicit drugs among adolescent elite athletes and controls, and possible gender and sport group differences. First-year students at 16 Norwegian Elite Sport High Schools (n = 677) and two randomly selected high schools (controls, n = 421) were invited to participate. Totally, 602 athletes (89%) and 354 (84%) controls completed the questionnaire. More controls than athletes were smoking, using snus, and drinking alcohol. Competing in team sports was associated with use of snus [odds ratio = 2.8, 95% confidence interval (CI) 1.6 to 4.7] and a similar percentage of male and female handball (22.2% vs 18.8%) and soccer players (15.7% vs 15.0%) reported using snus. For controls, not participating in organized sport was a predictor for smoking (odds ratio = 4.9, 95% CI 2.2 to 10.9). Female athletes were more prone to drink alcohol than males (46.3% vs 31.0%, P < 0.001). Only, 1.2% athletes and 2.8% controls reported use of performance-enhancing illicit drugs. In conclusion, use of legal drugs is less common among athletes, but this relationship depends on type of sport and competition level. The association between team sports and use of snus suggests that sport subcultures play a role.

Overarm movements are essential skills in many different sport games; however, the adaptations to different sports are not well understood. The aim of the study was to analyze upper-body kinematics in the team-handball throw, tennis serve, and volleyball spike, and to calculate differences in the proximal-to-distal sequencing and joint movements. Three-dimensional kinematic data were analyzed via the Vicon motion capturing system. The subjects (elite players) were instructed to perform a team-handball jump throw, tennis serve, and volleyball spike with a maximal ball velocity and to hit a specific target. Significant differences (P < 0.05) between the three overarm movements were found in 17 of 24 variables. The order of the proximal-to-distal sequencing was equal in the three analyzed overarm movements. Equal order of the proximal-to-distal sequencing and similar angles in the acceleration phase suggest there is a general motor pattern in overarm movements. However, overarm movements appear to be modifiable in situations such as for throwing or hitting a ball with or without a racket, and due to differences at takeoff (with one or two legs).

Anterior glenohumeral dislocation is common among athletes and may progress to recurrent instability. The pathoanatomy of instability and specific needs of each individual should be considered to prevent unnecessary absence from sport. Traditionally, primary dislocations have been managed with immobilization followed by rehabilitation exercises and a return to sporting activity. However, arthroscopic stabilization and external rotation bracing are increasingly used to prevent recurrent instability. In addition to the typical capsulolabral disruptions seen following a primary dislocation, patients with recurrent instability often have coexistent osseous injury to the humeral head and glenoid. In patients without significant bone loss, open soft-tissue stabilizations have long been considered the ‘gold standard treatment’ for recurrent instability, but with advances in technology, arthroscopic procedures have gained popularity. However, enthusiasm for arthroscopic repair has not been supported with evidence, and there is currently no consensus for treatment. In patients with greater bone loss, soft-tissue stabilization alone is insufficient to treat recurrent instability and open repair or bone augmentation should be considered. We explore the recent advances in epidemiology, classification, pathoanatomy and clinical assessment of young athletes with anterior shoulder instability, and compare the relative merits and outcomes of the different forms of treatment.

The purpose of the present study was to examine the time course of passive range of motion (PROM), passive torque (PAS_TQ), and musculo-tendinous stiffness (MTS) responses during constant-angle (CA) and constant-torque (CT) stretching of the leg flexors. Eleven healthy men [mean ± standard deviation (SD): age = 21.5 ± 2.3 years] performed 16 30-s bouts of CA and CT stretching of the leg flexors. PROM, PAS_TQ, and MTS were measured during stretches 1, 2, 4, 8, and 16. For PROM and PAS_TQ, there were no differences between CA and CT stretching treatments (P > 0.05); however, there were stretch-related differences (P < 0.001). PROM increased following one 30-s bout of stretching (collapsed across CA and CT stretching) with additional increases up to 8 min of stretching. PAS_TQ decreased following one 30-s bout of stretching (collapsed across CA and CT stretching) and continued to decrease up to 4 min of stretching. In contrast, only the CT stretching treatment resulted in changes to MTS (P < 0.001). MTS decreased after one 30-s bout of CT stretching, with subsequent decreases in MTS up to 6 min of stretching. These results suggested that CT stretching may be more appropriate than a stretch held at a constant muscle length for decreasing MTS.

This study assessed the effect of resistance training (RT) in 60 healthy postpartum women. Participants were randomized to 18 weeks of RT or an active comparison group (flexibility training). RT and flexibility training (FT) exercises were completed twice-weekly based on the American College of Sports Medicine recommendations. Study outcomes included muscular strength, body composition (dual-energy x-ray absorptiometry), exercise self-efficacy, depressive symptoms [Center for Epidemiological Studies Depression Scale (CES-D)], and physical activity (accelerometery). For completers (n = 44), the RT group showed greater strength gains than the FT group, respectively (bench press: +36% vs +8%, P < 0.001; leg press: +31% vs +7%, P < 0.01; abdominal curl-ups: +228% vs +43%, P < 0.01); however, body composition changes were not different. There was a significant group × time interaction for exercise self-efficacy (F = 5.33, P = 0.026). For CES-D score, the RT group decreased (F = 4.61, P = 0.016), while the FT group did not; however, the group × time interaction in CES-D score was not significant (F = 1.33, P = 0.255). Sedentary time decreased (F = 5.27, P = 0.027) and light-intensity activity time increased (F = 5.55, P = 0.023) more in the RT than FT group. Intent-to-treat analyses did not alter the results. Twice-weekly RT increases strength and may be associated with better exercise self-efficacy and improved physical activity outcomes compared with FT in postpartum women.

Exercise-induced muscle damage (EIMD) is characterized by pain, swelling, and shortening of the muscle; increased serum creatine kinase; decreased force output; and altered neuromuscular function. The aim of this study was to investigate the effects of EIMD to determine the relationship between the peripheral symptoms, neuromuscular changes, and delayed pain sensation during a submaximal movement of the biceps brachii on cortical alpha (α) activity. In contrast to the control (n = 12) group, the experimental (n = 16) group participated in an EIMD protocol, and both groups were monitored for 132 h post-EIMD protocol. At 12 h, neuromuscular functioning was already disturbed while the sensation of pain was perceived, but not fully developed. Muscle pain scores in the experimental group peaked after 36 h with the lowest torque reported at 12 h. α-1 activity increased significantly in the motor and somatosensory area 12 h post-EIMD while α-2 activity increased in the contralateral fronto-central area. At 36 h, pain had further increased and neuromuscular function improved while α-1 and α-2 activities had decreased. We hypothesize that α-1 activity over the motor and somatosensory cortex of the experimental group displays a compensatory increase in response to the changes in neuromuscular function during movement, while an increase in α-2 activity is related to the suppression of pain experienced within the first 12 h.

We examined the effects of blood flow-restricted, low-intensity resistance exercise (termed kaatsu) using an elastic band for resistance on muscle activation. Nine men performed triceps extension and biceps flexion exercises (four sets respectively) using an elastic band for resistance with blood flow restriction (BFR) or CON (unrestricted blood flow). During a BFR session, subjects wore pressure cuffs inflated to 170–260 mmHg on the proximal region of both arms. Surface electromyography (EMG) was recorded from the triceps brachii and biceps brachii muscles, and mean integrated EMG (iEMG) was analyzed. Blood lactate concentration was obtained before (Pre) and immediately after two exercises (Post). During triceps extension and biceps flexion exercises, muscle activation increased progressively (P < 0.05) under BFR (46% and 69%, respectively) but not under CON (12% and 23%, respectively). Blood lactate concentration at Post was higher (P < 0.05) under BFR than under CON (3.6 and 2.1 mmol/L, respectively). Blood lactate concentration at Post was significantly correlated with increased iEMG in both triceps extension (r = 0.65, P < 0.01) and biceps flexion exercises (r = 0.52, P < 0.05). We conclude that kaatsu training using elastic bands for resistance enhances muscle activation and may be an effective method to promote muscle hypertrophy in older adults or patients with a low level of activity.

We studied relationships between age and aerobic capacity in three groups of subjects adhering to different exercise modalities. A total of 203 men aged 20–90 years were examined: 52 speed-power track and field athletes (SP), 89 endurance runners (ER) and 62 untrained individuals (UT). Maximal exercise characteristics were obtained during a graded treadmill test until exhaustion: oxygen uptake (), heart rate (HR_max), oxygen pulse (O₂ Pulse_max) and maximal distance (Dist_max). Information about training history and weekly training amount was collected. A linear model of regression was adopted. in SP was lower than in ER, but significantly higher than in UT. The cross-sectional rates of decline in body mass-adjusted and Dist_max were significantly smaller in SP than in ER and UT. About 80 years of age, the levels of and Dist_max reached similar values in SP and ER. The decline in HR_max, but not in O₂ Pulse_max was suggested as a cardiac adaptation accounting for between-group differences in loss. Weekly training volume was a significant positive predictor of age-related changes in aerobic capacity. In conclusion, not only endurance, but also speed-power exercise appears adequate to ensure an elevated aerobic capacity at old age.

Little is known about long-term effects of neonatal intensive care on exercise capacity, physical activity, and fatigue in term borns. We determined these outcomes in 57 young adults, treated for neonatal respiratory failure; 27 of them had congenital diaphragmatic hernia with lung hypoplasia (group 1) and 30 had normal lung development (group 2). Patients in group 2 were age-matched, with similar gestational age and birth weight, and similar neonatal intensive care treatment as patients in group 1. All patients were born before the era of extracorporeal membrane oxygenation, nitric oxide administration, and high frequency ventilation. Exercise capacity was measured by cycle ergometry, daily physical activity with an accelerometry-based activity monitor, and fatigue by the fatigue severity scale. Median (range) VO _2peak in mL/kg/min was 35.4 (19.6–55.0) in group 1 and 37.6 (15.7–52.7) in group 2. There was a between-group P-value of 0.65 for exercise capacity. Daily activity and fatigue were also similar in both groups. So, residual lung hypoplasia did not play an important role in this cohort. There were no significant associations between exercise capacity and perinatal characteristics. Future studies need to elucidate whether exercise capacity is impaired in patients with more severe lung hypoplasia who nowadays survive.

This study evaluated the short-term recovery of function after an acute Achilles tendon rupture, measured by a single-legged heel-rise test, with main emphasis on the relation to the patient-reported outcomes and fear of physical activity and movement (kinesiophobia). Eighty-one patients treated surgically or non-surgically with early active rehabilitation after Achilles tendon rupture were included in the study. Patient's ability to perform a single-legged heel-rise, physical activity level, patient-reported symptoms, general health, and kinesiophobia was evaluated 12 weeks after the injury. The heel-rise test showed that 40 out of 81 (49%) patients were unable to perform a single heel-rise 12 weeks after the injury. We found that patients who were able to perform a heel-rise were significantly younger, more often of male gender, reported a lesser degree of symptoms, and also had a higher degree of physical activity at 12 weeks. There was also a significant negative correlation between kinesiophobia and all the patient-reported outcomes and the physical activity level. The heel-rise ability appears to be an important early achievement and reflects the general level of healing, which influences patient-reported outcome and physical activity. Future treatment protocols focusing on regaining strength early after the injury therefore seem to be of great importance. Kinesiophobia needs to be addressed early during the rehabilitation process.

Systemic inflammation in patients with chronic obstructive pulmonary disease (COPD) has been related to the development of comorbidities. The level of systemic inflammatory mediators is aggravated as a response to exercise in these patients. The aim of this study was to investigate whether unloading of the respiratory muscles attenuates the inflammatory response to exercise in COPD patients. In a cross-over design, eight muscle-wasted stable COPD patients performed 40 W constant work-rate cycle exercise with and without non-invasive ventilation support (NIV vs control). Patients exercised until symptom limitation for maximally 20 min. Blood samples were taken at rest and at isotime or immediately after exercise. Duration of control and NIV-supported exercise was similar, both 12.9 ± 2.8 min. Interleukin- 6 (IL-6) plasma levels increased significantly by 25 ± 9% in response to control exercise, but not in response to NIV-supported exercise. Leukocyte concentrations increased similarly after control and NIV-supported exercise by ∼15%. Plasma concentrations of C-reactive protein, carbonylated proteins, and production of reactive oxygen species by blood cells were not affected by both exercise modes. This study demonstrates that NIV abolishes the IL-6 response to exercise in muscle-wasted patients with COPD. These data suggest that the respiratory muscles contribute to exercise-induced IL-6 release in these patients.

The aim of this study was to evaluate the application of the Yo-Yo intermittent endurance test level 2 (Yo-Yo IE2) to elite female soccer populations. Elite senior (n = 92), youth (n = 42), domestic (n = 46) and sub-elite female soccer players (n = 19) carried out the Yo-Yo IE2 test on numerous occasions across the season. Test–retest coefficient of variation (CV) in Yo-Yo IE2 test performance in domestic female players was 4.5%. Elite senior female players' Yo-Yo IE2 test performances were better (P < 0.01) than elite youth, domestic and sub-elite players (mean ± standard deviation; 1774 ± 532 vs 1490 ± 447, 1261 ± 449, and 994 ± 373 m). For elite senior female players, wide midfielders (2057 ± 550 m) had a higher Yo-Yo IE2 test performance (P < 0.05) than central defenders (1588 ± 534 m) and attackers (1516 ± 401 m), but not central midfielders (1764 ± 473 m) or full-backs (1964 ± 522 m). Large correlations were observed between Yo-Yo IE2 test performance and the total and high-intensity distance covered (r = 0.55; P < 0.05) during elite senior soccer matches (r = 0.70; P < 0.01). A large correlation was also obtained between Yo-Yo IE2 test performance and (r = 0.68; P < 0.01). Performances in the Yo-Yo IE2 test were greater (P < 0.05) in the middle and the end of the season compared with the preparation period for elite youth female players (1767 ± 539 and 1742 ± 503 vs 1564 ± 504 m) and in elite senior female players, Yo-Yo IE2 test performance increased by 14% (P < 0.01) after completing 4 weeks of intense training prior to the FIFA Women's World Cup Finals (2049 ± 283 vs 1803 ± 342 m). The data demonstrate that the Yo-Yo IE2 test is reproducible and is an indicator of the match-specific physical capacity of female soccer players. Furthermore, the Yo-Yo IE2 test illustrates sensitivity by differentiating intermittent exercise performance of female players in various competitive levels, stages of the season and playing positions.

One of the most frequently used methods for training the sprint-specific strength is the sled towing. To date, no studies have been conducted to explore the effects of this method after a training period in well-trained athletes. The purpose of this study was to determine the effects of 4 weeks of resisted sprint training with sled towing. Twenty-two trained athletes experienced in the use of weighted sled (WS) participated in the study. They conducted the same 3-week training to level their initial condition. After that they were distributed in two groups, unresisted (UR) and WS training. They carried out the same 4-week, 2 days/week sprint-specific training, only differing in that the experimental group performed sprints with a (WS) which caused a reduction of 7.5% of their maximum velocity. Pre- and posttest were conducted which included the measurement of sprint kinematics, muscular strength (including isoinertial, isokinetic, and jump measurements), and sprinting stiffness (leg and vertical). Results show different adaptations in the groups although no interaction effect was found. The WS group improved the velocity in the transition phase, while the UR group improved the velocity in the maximum velocity phase. No improvements in the height of the jump tests were found.

Prolonged running is known to induce hemolysis. It has been suggested that hemolysis may lead to a significant loss of red blood cells; however, its actual impact on the erythrocyte pool is unknown. Here, we test the hypothesis that prolonged running with high hemolytic potential decreases total red blood cell volume (RCV). Hemolysis (n = 22) and RCV (n = 19) were quantified in ultra-marathon runners before and after a 166-km long mountain ultra-endurance marathon (RUN) with 9500 m of altitude gain/loss. Assessment of total hemoglobin mass (Hb_mass) and RCV was performed using a carbon monoxide rebreathing technique. RUN induced a marked acute-phase response and promoted hemolysis, as shown by a decrease in serum haptoglobin (P < 0.05). Elevated serum erythropoietin concentration and reticulocyte count after RUN were indicative of erythropoietic stimulation. Following RUN, runners experienced hemodilution, mediated by a large plasma volume expansion and associated with a large increase in plasma aldosterone. However, neither Hb_mass nor RCV were found to be altered after RUN. Our findings indicate that mechanical/physiological stress associated with RUN promotes hemolysis but this has no impact on total erythrocyte volume. We therefore suggest that exercise ‘anemia’ is entirely due to plasma volume expansion and not to a concomitant decrease in RCV.

The purpose of this study was to compare the effect of two different methods of organizing endurance training in trained cyclists. One group of cyclists performed block periodization, wherein the first week constituted five sessions of high-intensity aerobic training (HIT), followed by 3 weeks of one weekly HIT session and focus on low-intensity training (LIT) (BP; n = 10, VO_2max = 62 ± 2 mL/kg/min). Another group of cyclists performed a more traditional organization, with 4 weeks of two weekly HIT sessions interspersed with LIT (TRAD; n = 9, VO_2max = 63 ± 2 mL/kg/min). Similar volumes of both HIT and LIT was performed in the two groups. While BP increased VO_2max, peak power output (W_max) and power output at 2 mmol/L [la⁻] by 4.6 ± 3.7%, 2.1 ± 2.8%, and 10 ± 12%, respectively (P < 0.05), no changes occurred in TRAD. BP showed relative improvements in VO_2max compared with TRAD (P < 0.05). Mean effect size (ES) of the relative improvement in VO_2max, W_max, and power output at 2 mmol/L [la⁻] revealed large to moderate effects of BP training compared with TRAD training (ES = 1.34, ES = 0.85, and ES = 0.71, respectively). The present study suggests that block periodization of training provides superior adaptations to traditional organization during a 4-week endurance training period, despite similar training volume and intensity.

Greater gender differences have been found in exercise modes where the upper body is involved. Therefore, the present study investigated the influence of poling on gender differences in endurance performance by elite cross-country skiers. Initially, the performance of eight male and eight female sprint skiers was compared during four different types of exercise involving different degrees of poling: double poling (DP), G3 skating, and diagonal stride (DIA) techniques during treadmill roller skiing, and treadmill running (RUN). Thereafter, DP was examined for physiological and kinematic parameters. The relative gender differences associated with the DP, G3, DIA and RUN performances were approximately 20%, 17%, 14%, and 12%, respectively. Thus, the type of exercise exerted an overall effect on the relative gender differences (P < 0.05). In connection with DP, the men achieved 63%, 16%, and 8% higher VO_2peak than the women in absolute terms and with normalization for total and fat-free body mass (all P < 0.05). The DP VO_2peak in percentage of VO_2max in RUN was higher in men (P < 0.05). The gender difference in DP peak cycle length was 23% (P < 0.05). In conclusion, the present investigation demonstrates that the gender difference in performance by elite sprint skiers is enhanced when the contribution from poling increases.

Hemodynamic changes induced by self-contained underwater breathing apparatus diving were investigated using Doppler echocardiography. We detected circulating bubbles in both right and left cavities of the heart and in the cerebral circulation in two divers with a large patent foramen ovale. A reduction in the left ventricular preload was suggested by echocardiographic measurements. The decreased cardiac preload was paralleled to a lower stroke volume and cardiac output. These findings were also observed in divers with no evidence of circulating bubbles. In these subjects, pulmonary vascular resistances remained unchanged while an increase was observed in the two divers with arterial bubbles. This increase could promote right-to-left shunting.

The aim of the present study was to profile shoulder passive range of motion (ROM) and isometric strength for external (ER) and internal (IR) rotation as part of a preseason screening in adolescent national badminton players. Passive external range of motion (EROM) and internal range of motion (IROM) were examined on the dominant and nondominant shoulder in 31 adolescent national badminton players (12 females and 19 males) with a standard goniometer. Muscle strength was examined with a hand-held dynamometer in ER and IR. Total range of motion (TROM = EROM+IROM) was lower on the dominant side compared with the nondominant side in both groups (P < 0.001). Males were generally stronger than females in all strength measurements except for IR on the dominant side (P < 0.01). In females, IR dominant side strength was greater compared with IR on the nondominant side (P < 0.05). TROM was reduced on the dominant side compared with the nondominant side in young elite badminton players, irrespective of gender. No rotational strength differences existed between the dominant and nondominant side in male players, but in female players a higher IR strength on the dominant side was not balanced by a higher ER strength.

To evaluate the effects of cooling between exercise sessions on intramuscular water movement and muscle performance, the lower extremities of nine untrained men were assigned to either a cooling protocol (20-min water immersion, 15 °C) or a noncooling protocol. Each subject performed two exercise sessions involving maximal concentric knee extension and flexion (three repetitions, 60°/s; followed by 50 repetitions, 180°/s). The peak torque at 60°/s and total work, mean power, and decrease rate of torque value at 180°/s were evaluated. Axial magnetic resonance diffusion-weighted images of the mid-thigh were obtained before and after each exercise session. Apparent diffusion coefficient (ADC) values for the quadriceps and hamstrings were calculated for evaluating intramuscular water movement. Both groups exhibited significantly increased ADC values for the quadriceps and hamstrings after each exercise session. These ADC values returned to the pre-exercise level after water immersion. No significant difference was observed in muscle performance from first exercise session to the next in either group, except for increased total work and mean power in knee flexion in the cooled group. Cooling intervention between exercise sessions decreased exercise-induced elevation of intramuscular water movement and had some beneficial effects on muscle endurance of knee flexors, but not knee extensors.

Unexplored in scientific literature, Q Factor describes the horizontal width between bicycle pedals and determines where the foot is laterally positioned throughout the pedal stroke. The aim of the study was to determine whether changing Q Factor has a beneficial effect upon cycling efficiency and muscular activation. A total of 24 trained cyclists (11 men, 13 women; VO_2max 57.5 ml·kg/min ± 6.1) pedaled at 60% of peak power output for 5 min at 90 rpm using Q Factors of 90, 120, 150, and 180 mm. Power output and gas were collected and muscular activity of the gastrocnemius medialis (GM), tibialis anterior (TA), vastus medialis (VM), and vastus lateralis (VL) measured using surface electromyography. There was a significant increase (P < 0.006) in gross mechanical efficiency (GME) for 90 and 120 mm (both 19.38%) compared with 150 and 180 mm (19.09% and 19.05%), representing an increase in external mechanical work performed of approximately 4–5 W (1.5–2.0%) at submaximal power outputs. There was no significant difference in the level of activity or timing of activation of the GM, TA, VM, and VL between Q Factors. Other muscles used in cycling, and possibly an improved application of force during the pedal stroke may play a role in the observed increase in GME with narrower Q Factors.

The aim of this study was to monitor injury incidence and pattern in Norwegian male professional football over six consecutive seasons and compare the risk of injury between the preseason and competitive season. All time loss injuries were recorded by the medical staff of each club. In total, 2365 injuries were recorded. The incidence of acute injuries was 15.9/1000 match hours [95% confidence interval (CI): 14.9–16.8], 1.9/1000 training hours (95% CI: 1.7–2.0), and 1.4 (95% CI: 1.3–1.5) overuse injuries/1000 h. A linear regression model found an annual increase of 1.06 acute match injuries/1000 h (95% CI: 0.40–1.73), corresponding to a total increase of 49% during the 6-year study period. When accounting for interteam variation and clustering effects using a general estimating equation model, the increase in injury incidence was 0.92 (95% CI: −0.11–1.95, P = 0.083). No difference in the risk of acute match injuries (rate ratio (RR): 0.86, 95% CI: 0.73–1.01), acute training injuries (RR: 1.16, 95% CI: 0.99–1.36), or overuse injuries (RR: 1.04, 95% CI: 0.89–1.21) was observed between the preseason and competitive season. In conclusion, the overall risk of acute match injuries in Norwegian male professional football increased by 49% during the study period, although this increase was not fully consistent across teams. We detected no change in the risk of training and overuse injuries or any difference between the preseason and competitive season.

The purpose of this study was to analyze the participation and performance trends of male triathletes in the “Ironman Switzerland” from 1995 to 2010. Participation trends of all finishers aged between 18 and 64 years were analyzed over the 16-year period by considering four 4-year periods 1995–1998, 1999–2002, 2003–2006, and 2007–2010, respectively. The 3.8-km swimming, 180-km cycling, 42-km running times, and total race times were analyzed for the top 10 triathletes in each age group from 18 to 64 years. The participation of master triathletes (≥40 years old) increased over the years, representing on average 23%, 28%, 37%, and 48% of total male finishers during the four 4-year periods, respectively. Over the 1995–2010 period, triathletes older than 40 years significantly improved their performance in swimming, cycling, running, and in the total time taken to complete the race. The question whether master Ironman triathletes have yet reached limits in their performance during Ironman triathlon should be raised. Further studies investigating training regimes, competition experience, or socio-demographic factors are needed to gain better insights into the phenomenon of the relative improvement in ultra-endurance performance with advancing age.

Elite athletes often find themselves in a dilemma between maintaining optimal health to be successful and accepting health risks by pushing their physical limits. For elite adolescent athletes, this dilemma becomes a trilemma as they are also confronted with developmental challenges typical for adolescence. As many adolescents encounter different substances during this critical period of development, we analyzed prevalence of substance use to identify determinants related to these behaviors and to compare the prevalences with nonelite athletes. Our main data were drawn from the German Young Olympic Athletes’ Lifestyle and Health Management Study (GOAL Study) including 1138 elite adolescent athletes (14–18 years). For comparisons, the data were combined with data from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS). Beside uni- and bivariate analyses, we conducted (conditional) logistic regression analyses. Eighty-six percent had consumed alcohol at least once. Binge drinking was performed by 24% during the last month. Alcohol consumption was positively associated with age, education, technical sports, lower squads, and attending boarding schools. Binge drinking was higher in males, older adolescents, and in technical sports. Smoking (3%) and marijuana use (3%) were less prevalent. Compared with nonelite athletes, they showed less risky behavior except for binge drinking. As we could identify risk groups, prevention and health promotion programs could be developed for this specific target group.

Fatigue during prolonged exercise is related to brain monoamines concentrations, but the mechanisms underlying this relationship have not been fully elucidated. We investigated the effects of increased central tryptophan (TRP) availability on physical performance and thermoregulation in running rats that were pretreated with parachlorophenylalanine (p-CPA), an inhibitor of the conversion of TRP to serotonin. On the 3 days before the experiment, adult male Wistar rats were treated with intraperitoneal (ip) injections of saline or p-CPA. On the day of the experiment, animals received intracerebroventricular (icv) injections of either saline or TRP (20.3 μM) and underwent a submaximal exercise test until fatigue. Icv TRP-treated rats that received ip saline presented higher heat storage rate and a 69% reduction in time to fatigue compared with the control animals. Pretreatment with ip p-CPA blocked the effects of TRP on thermoregulation and performance. Moreover, ip p-CPA administration accelerated cutaneous heat dissipation when compared with saline-pretreated rats. We conclude that an elevated availability of central TRP interferes with fatigue mechanisms of exercising rats. This response is modulated by serotonergic pathways, because TRP effects were blocked in the presence of p-CPA. Our data also support that a depletion of brain serotonin facilitates heat loss mechanisms during exercise.

To examine effects of 21-week twice/week strength training (ST) period followed by an additional 21-week twice or once/week ST period on force production, walking and balance in aging people. Seventy-two women (58 ± 7 years; W) and 63 (58 ± 6 years) men (M) were randomized for the first 21-week ST period: STW and STM, control (C) CW and CM. Training participants were randomized for the second 21-week ST period: once/week STWx1 and STMx1, twice/week STWx2 and STMx2. LegPress, isometric leg extension rate of force development (RFD), walking time, and balance. First 21-week ST period: leg press, RFD, balance, and walking improved significantly in STW and STM. Second 21-week ST period: leg press first increased in STMx1 and STMx2, and then decreased to the level of 21 weeks in STMx2 and remained unchanged in STWx2 and decreased in STWx1 and STMx1. Walking and balance improved significantly in STWx1 and STWx2. A progressive 21-week ST period twice/week in aging people can lead to large improvements in maximal strength, walking time, and balance in both genders. A further strength training period with the same amount of training may maintain the strength gains, whereas balance and walking may be maintained with less training.

Methodological differences in epidemiologic studies have led to significant discrepancies in injury incidences reported. The aim of this study was to evaluate text messaging as a new method for injury registration in elite female football players and to compare this method with routine medical staff registration. Twelve teams comprising 228 players prospectively recorded injuries and exposure through one competitive football season. Players reported individually by answering three text messages once a week. A designated member of the medical staff conducted concurrent registrations of injuries and exposure. Injuries and exposure were compared between medical staff registrations from nine teams and their 159 affiliated players. During the football season, a total of 232 time-loss injuries were recorded. Of these, 62% were captured through individual registration only, 10% by the medical staff only, and 28% were reported through both methods. The incidence of training injuries was 3.7 per 1000 player hours when calculated from individual registration vs 2.2 from medical staff registration [rate ratio (RR): 1.7, 1.2–2.4]. For match injuries, the corresponding incidences were 18.6 vs 5.4 (RR: 3.4, 2.4–4.9), respectively. There was moderate agreement for severity classifications in injury cases reported by both methods (kappa correlation coefficient: 0.48, confidence interval: 0.30–0.66).

The purpose of this study was to characterize the effect of a 2-week overload period immediately followed by a 1-week taper period on different cognitive processes including executive and nonexecutive functions, and related heart rate variability. Eleven male endurance athletes increased their usual training volume by 100% for 2 weeks, and decreased it by 50% for 1 week. A maximal graded test, a constant speed test at 85% of peak treadmill speed, and a Stroop task with the measurement of heart rate variability were performed at each period. All participants were considered as overreached. We found a moderate increase in the overall reaction time to the three conditions of the Stroop task after the overload period (816 ± 83 vs 892 ± 117 ms, P = 0.03) followed by a return to baseline after the taper period (820 ± 119 ms, P = 0.013). We found no association between cognitive performance and cardiac parasympathetic control at baseline, and no association between changes in these measures. Our findings clearly underscore the relevance of cognitive performance in the monitoring of overreaching in endurance athletes. However, contrary to our hypothesis, we did not find any relationship between executive performance and cardiac parasympathetic control.

The aim of this study was to examine anatomical properties of the adductor magnus through a detailed classification, and to hypothesize its function and size to gather enough information about morphology. Ten cadaveric specimens of the adductor magnus were used. The muscle was separated into four portios (AM1–AM4) based on the courses of the corresponding perforating arteries, and its volume, muscle length, muscle fiber length and physiological cross-sectional area were assessed. The architectural characteristics of these four portions of the adductor magnus were then classified with the aid of principal component analysis. The results led us into demarcating the most proximal part of the adductor magnus (AM1) from the remaining parts (AM2, AM3, and AM4). Classification of the adductor magnus in terms of architectural characteristics differed from the more traditional anatomical distinction. The AM2, AM3, and AM4, having longer muscle fiber lengths than the AM1, appear to be designed as displacers for moving the thigh through a large range of motion. The AM1 appears instead to be oriented principally toward stabilizing the hip joint. The large mass of the adductor magnus should thus be regarded as a complex of functionally differentiable muscle portions.

Lower-extremity injury is common in soccer. A number of studies have begun to assess why specific lower-extremity injuries occur. However, currently few studies have examined how footwear affects lower-extremity mechanics. In order to address this question, 14 male (age: 22.1 ± 3.9 years, height: 1.77 ± 0.06 m, and mass: 73.3 ± 11.5 kg) and 14 female (age: 22.8 ± 3.1 years, height: 1.68 ± 0.07 m and mass: 64.4 ± 9.2 kg) competitive soccer players underwent a motion analysis assessment while performing a jump heading task. Each subject performed the task in three different footwear conditions (running shoe, bladed cleat, and turf shoe). Two-way analyses of variance were used to examine statistical differences in landing mechanics between the footwear conditions while controlling for gender differences. These comparisons were made during two different parts (prior to and following) of a soccer-specific jump heading task. A statistically significant interaction for the peak dorsiflexion angle (P = 0.02) and peak knee flexion angle (P = 0.05) was observed. Male soccer players exhibited a degree increase in dorsiflexion in the bladed cleat while female soccer players exhibited a three-degree reduction in peak knee flexion in the bladed cleat condition. Other main effects for gender and footwear were also observed. The results suggest that landing mechanics differ based upon gender, footwear, and the type of landing. Therefore, training interventions aimed at reducing lower-extremity injury should consider utilizing sport-specific footwear when assessing movement patterns.

In medial tibial stress syndrome (MTSS) bone marrow and periosteal edema of the tibia on the magnetic resonance imaging (MRI) is frequently reported. The relationship between these MRI findings and recovery has not been previously studied. This prospective study describes MRI findings of 52 athletes with MTSS. Baseline characteristics were recorded and recovery was related to these parameters and MRI findings to examine for prognostic factors. Results showed that 43.5% of the symptomatic legs showed bone marrow or periosteal edema. Absence of periosteal and bone marrow edema on MRI was associated with longer recovery (P = 0.033 and P = 0.013). A clinical scoring system for sports activity (SARS score) was significantly higher in the presence of bone marrow edema (P = 0.027). When clinical scoring systems (SARS score and the Lower Extremity Functional Scale) were combined in a model, time to recovery could be predicted substantially (explaining 54% of variance, P = 0.006). In conclusion, in athletes with MTSS, bone marrow or periosteal edema is seen on MRI in 43,5% of the symptomatic legs. Furthermore, periosteal and bone marrow edema on MRI and clinical scoring systems are prognostic factors. Future studies should focus on MRI findings in symptomatic MTSS and compare these with a matched control group.

Beginning Movement Load (BML) training is a unique form of light-load training that comprises a lengthening–shortening sequence of muscle actions about multiple degrees of freedom. The purpose of the study was to determine the effectiveness of BML training at improving the performance of old adults on four functional tasks and to identify some of the neuromuscular adaptations that contributed to these gains. Healthy old adults (67.5 ± 5.23 years) were randomly assigned to either a BML training group (n = 17) or a control group (n = 7). The training group exercised with a 30% of the one repetition-maximum (1-RM) load and performed five to seven sets of 15 repetitions, three times per week for 8 weeks. BML training increased maximal voluntary contraction (MVC) force significantly for the knee extensors (31.6%), but not the elbow flexors (9.8%), and improved the steadiness of isometric contractions (10%, 30%, and 65% MVC forces). Training-associated changes in times for ascending and descending stairs and one-legged balance, but not the chair rise, were predicted by changes in selected combinations of MVC force and steadiness. The attributes of BML training that enabled it to elicit functionally meaningful adaptations in the neuromuscular system of older adults should be explored with more mechanistic studies.

Posterior tibial tendon is particularly vulnerable and is responsible for much morbidity in sportspersons. Some patients have a predisposition without a clinically recognized cause, suggesting that individual characteristics, inclusive genetic inheritance, play an important role in tendinopathy. Matrix metalloproteinase (MMP)-8 is a proteinase capable of degrading a large amount of extracellular proteins, and influence degradation and remodeling of collagen. To determine whether the −799 polymorphism in the promoter of MMP-8 gene is associated with tendinopathy in posterior tibial tendon, 50 patients undergoing surgical procedures and anatomopathological diagnosis of degenerative lesions of the posterior tibial tendon and 100 control patients with posterior tibial tendon integrity and without signs of degeneration in magnetic resonance imaging were evaluated for the −799 MMP-8 polymorphism. There was a significant difference in the presence of the different alleles (P = 0.001) and genotype (P = 0.003) between the control group and the test group for the MMP-8 gene. The polymorphism at position −799 of the gene for MMP-8 is associated with tendinopathy primary posterior tibial tendon in the population studied. The results suggest that individuals with the T allele are at greater risk of developing tendinopathy.

Exercise efficiency at low power outputs, energetically comparable to daily living activities, can be influenced by homeostatic perturbations (e.g., weight gain/loss). However, an appropriate efficiency calculation for low power outputs used in these studies has not been determined. Fifteen active subjects (seven females, eight males) performed 14, 5-min cycling trials: two types of seated rest (cranks vertical and horizontal), passive (motor-driven) cycling, no-chain cycling, no-load cycling, cycling at low (10, 20, 30, 40 W), and moderate (50, 60, 80, 100, 120 W) power outputs. Mean delta efficiency was 57% for low power outputs compared to 41.3% for moderate power outputs. Means for gross (3.6%) and net (5.7%) efficiencies were low at the lowest power output. At low power outputs, delta and work efficiency values exceeded theoretical values. In conclusion, at low power outputs, none of the common exercise efficiency calculations gave values comparable to theoretical muscle efficiency. However, gross efficiency and the slope and intercept of the metabolic power vs mechanical power output regression provide insights that are still valuable when studying homeostatic perturbations.

Analyzing an athlete's “technique,” sport scientists often focus on preselected variables that quantify important aspects of movement. In contrast, coaches and practitioners typically describe movements in terms of basic postures and movement components using subjective and qualitative features. A challenge for sport scientists is finding an appropriate quantitative methodology that incorporates the holistic perspective of human observers. Using alpine ski racing as an example, this study explores principal component analysis (PCA) as a mathematical method to decompose a complex movement pattern into its main movement components. Ski racing movements were recorded by determining the three-dimensional coordinates of 26 points on each skier which were subsequently interpreted as a 78-dimensional posture vector at each time point. PCA was then used to determine the mean posture and principal movements (PM_k) carried out by the athletes. The first four PM_k contained 95.5 ± 0.5% of the variance in the posture vectors which quantified changes in body inclination, vertical or fore-aft movement of the trunk, and distance between skis. In summary, calculating PM_k offered a data-driven, quantitative, and objective method of analyzing human movement that is similar to how human observers such as coaches or ski instructors would describe the movement.

Cross-education strength training has being shown to retain strength and muscle thickness in the immobilized contralateral limb. Corticospinal mechanisms have been proposed to underpin this phenomenon; however, no transcranial magnetic stimulation (TMS) data has yet been presented. This study used TMS to measure corticospinal responses following 3 weeks of unilateral arm training on the contralateral, immobilize arm. Participants (n = 28) were randomly divided into either immobilized strength training (Immob + train) immobilized no training (Immob) or control. Participants in the immobilized groups had their nondominant arm rested in a sling, 15 h/day for 3 weeks. The Immob + train group completed unilateral arm curl strength training, while the Immob and control groups did not undertake training. All participants were tested for corticospinal excitability, strength, and muscle thickness of both arms. Immobilization resulted in a group x time significant reduction in strength, muscle thickness and corticospinal excitability for the untrained limb of the Immob group. Conversely, no significant change in strength, muscle thickness, or corticospinal excitability occurred in the untrained limb of the Immob + train group. These results provide the first evidence of corticospinal mechanisms, assessed by TMS, underpinning the use of unilateral strength training to retain strength and muscle thickness following immobilization of the contralateral limb.

The time spent in sedentary behaviors has been shown to be independent of exercise in epidemiological studies. We examined within an individual whether exercise alters the time of muscular inactivity within his/her normal daily life. Quadriceps and hamstring muscle electromyographic activities and heart rate were measured during 1 to 6 days of normal daily living of ordinary people. Of 84 volunteers measured, 27 (15 men, 12 women, 40.7 years ± 16.5 years) fulfilled the criteria of having at least 1 day with and 1 day without exercise for fitness (total of 87 days analyzed, 13.0 h ± 2.5 h/day). Reported exercises varied from Nordic walking to strength training and ball games lasting 30 min–150 min (mean 83 min ± 30 min). Exercise increased the time spent at moderate-to-vigorous muscle activity (6% ± 4% to 9% ± 6%, P < 0.01) and energy expenditure (13% ± 22%, P < 0.05). Muscular inactivity, defined individually below that measured during standing, comprised 72% ± 12% of day without and 68% ± 13% of day with exercise (not significant). Duration of exercise correlated positively to the increase in moderate-to-vigorous muscle activity time (r = 0.312, P < 0.05) but not with inactivity time. In conclusion, exercise for fitness, regardless of its duration, does not decrease the inactivity time during normal daily life. This is possible by slight modifications in daily nonexercise activities.

We aimed to (a) examine the validity and reliability of the International FItness Scale (IFIS) in Spanish young adults and (b) compare the capacity of self-reported vs measured fitness to predict cardiovascular disease (CVD) risk. The study comprised 276 participants (18–30 years). Fitness level (overall and specific components) was both self-reported (IFIS) and measured using standard fitness tests. Total and trunk fat was assessed by dual-energy X-ray absorptiometry. We computed a previously validated metabolic syndrome score. A separate sample of 181 of same age and characteristics fulfilled IFIS twice for reliability purposes. The results of the present study support the validity and reliability of self-reported fitness, as measured by IFIS, in Spanish young adults. Our data also suggest that not only measured cardiorespiratory fitness but also self-reported cardiorespiratory fitness predicts CVD risk, as assessed by adiposity and metabolic syndrome indicators. The associations for muscular fitness (both reported and measured) differed depending on how it was expressed (i.e., absolute vs relative terms). Self-reported fitness, as assessed by IFIS, can be a good alternative when physical fitness cannot be measured in large surveys.

The aim of this work was to study the effect of training volume on activation of satellite cells. Healthy untrained men were randomly assigned into two groups. The 3L-1UB group (n = 10) performed three-set leg exercises and single-set upper body exercises, and the 1L-3UB group (n = 11) performed single-set leg exercises and three-set upper body exercises. Both groups performed three sessions (80–90 min) per week for 11 weeks. Biopsies were taken from m. vastus lateralis and m. trapezius. The number of satellite cells, satellite cells positive for myogenin and MyoD, and the number of myonuclei were counted. Homogenized muscle was analyzed for myogenin and MyoD, and extracted ribonucleic acid (RNA) was monitored for selected growth factor transcripts. Knee extensor strength increased more in the 3L-1UB group than in the 1L-3UB group (48 ± 4% vs 29 ± 4%), whereas the strength gain in shoulder press was similar in both training groups. The number of satellite cells in m. vastus lateralis increased more in the 3L-1UB group than in the 1L-3UB group. The number of myonuclei increased similarly in both groups. The messenger RNA expression of growth factors peaked after 2 weeks of training. In conclusion, increasing training volume enhanced satellite cell numbers in the leg muscle, but not in the upper body muscle.

Both baseline values and adaptive changes in mice can vary depending on the genetic background. We aimed to assess variation in a battery of variables and their adaptations to endurance training in six inbred mouse strains.

In this paper, we report survival estimates for male and female Olympic medal winners and for male and female finalists at the British and US national tennis championships. We find a consistent longevity advantage of Olympic medal-winning female athletes over Olympic medal-winning male athletes competing separately in the same events since 1900 and for female finalists over male finalists competing separately in the finals of the national tennis championships of Britain and of the United States since the 1880s. This is the case for sample mean comparisons, for Kaplan–Meier survival function estimates, including life expectancy, and for Cox proportional hazard estimates, which show statistically significant lower hazard rates for women with birth year and other variables constant. The female longevity advantage over males is similar in the early period samples (birth years before1920) and in the full period samples, and is 5–7 years.

The long history of the conception of physical exercise in France may be viewed as a function of a series of changes in understanding the body. Scientific concepts were used to present the body in official texts by authors specializing in the subject, or to describe them, as did Michel Foucault, as epistemicchanges. A departure occurred during the 19th century that is clearly demonstrated in the writings of Gustave Adolphe Hirn. This breakthrough concerned the idea of considering the organism as an energy-generating machine. This metaphor was employed in describing the body during physical exercise from the 17th to the 19th centuries, when the body was thought of as mechanical. Such metaphors were used by the most relevant figures writing at the end of the 19th century in the rationale that is examined in this paper. It shows how Hirn, Marey, Lagrange, Demenij, Hebert, and Tissié saw the body and how they employed machine metaphors when referring to it. These machine metaphors are analyzed from the time of their scientific and technological origins up to their current use in physical and sports education. This analysis will contribute to the understanding of how a scientific metaphor comes to be in common use and may lead to particular exercise practices.