Asian Journal of Sports Medicine
Volume:7 Issue: 1, Mar 2016

Visual skills are one of the main pillars of intangible faculties of athletes that can influence their performance. Great number of vision tests used to assess the visual skills and it will be irrational to perform all vision tests for every sport..
The purpose of this protocol article is to present a relatively comprehensive battery of tests and assessments on static and dynamic aspects of sight which seems relevant to sports vision and introduce the most useful ones for archery..
Through extensive review of the literature, visual skills and respective tests were listed; such as ‘visual acuity, ‘contrast sensitivity’, ‘stereo-acuity’, ‘ocular alignment’, and ‘eye dominance’. Athletes were defined as “elite” and “non-elite” category based on their past performance. Dominance was considered for eye and hand; binocular or monocular aiming was planned to be recorded. Illumination condition was defined as to simulate the real archery condition to the extent possible. The full cycle of examinations and their order for each athlete was sketched (and estimated to take 40 minutes). Protocol was piloted in an eye hospital. Female and male archers aged 18 - 38 years who practiced compound and recurve archery with a history of more than 6 months were included..
We managed to select and design a customized examination protocol for archery (a sight-intensive and aiming type of sports), serving skill assessment and research purposes. Our definition for elite and non-elite athletes can help to define sports talent and devise skill development methods as we compare the performance of these two groups. In our pilot, we identified 8 “archery figures” (by hand dominance, eye dominance and binocularity) and highlighted the concept “congruence” (dominant hand and eye in the same side) in archery performance..

The word “stress” describes the status of the body affected by external or internal forces, or “stressors”, threatening to alter its dynamic balance or homeostasis. The adaptive changes which occur in reply to stressors are either behavioral or physical. Once a given threshold is surpassed, a systemic reaction takes place involving the “stress system” in the brain together with its peripheral components, the hypothalamic-pituitary-adrenal axis and autonomic sympathetic..
Stress induces an activation of the sympathetic nervous system (SNS) and the hypothalamic-pituitary-adrenal (HPA) axis. The purpose of this study was to investigate whether the SNS and the HPA axis would show parallel or divergent stress response patterns in a session of first parachute jump..
Patients and Activation of the SNS was evaluated by dosage of salivary alpha-amylase, galvanic skin responses, and heart rate in seven male novice parachutists. Activation of HPA axis was tested by dosage of cortisol. These variables were measured before and 1 minute and 90 minute after the jump..
All variables reached a peak at 1 minute post-jump. Salivary alpha-amylase, galvanic skin responses and heart rate did not return to basal value at 90 minutes post-jump, while cortisol returned to basal value at 90 minutes post-jump..
This evidence indicates that parachute jumping is accompanied by a dissociation of SNS and HPA response patterns in novice parachutists, showing a slower recovery in sympathetic activity than in cortisol secretion..

Carnosine is a dipeptide formed from the β-alanine and histidine amino acids and found in mainly in the brain and muscle, especially fast twitch muscle. Carnosine and creatine has an antioxidant effect and carnosine accounts for about 10% of the muscle's ability to buffer the H ions produced by exercise..
The aim of the study was to investigate the effects of beta alanine and/or creatine supplementation on oxidant and antioxidant status during repeated Wingate tests (WTs)..
Patients and Forty four sedentary males participated in the study. Participants performed three 30s WTs with 2 minutes rest between exercise bouts. After the first exercise session, the subjects were assigned to one of four groups: Placebo, Creatine, Beta-alanine and Beta-alanine plus creatine. Participants ingested twice per day for 22 consecutive days, then four times per day for the following 6 days. After the supplementation period the second exercise session was applied. Blood samples were taken before and immediately after the each exercise session for the analysis of oxidative stress and antioxidant markers..
Malondialdehyde levels and superoxide dismutase activities were affected by neither supplementation nor exercise. During the pre-supplementation session, protein carbonyl reduced and oxidized glutathione (GSH and GSSG) levels increased immediately after the exercise. However, during the post-supplementation session GSH and GSSG levels increased in beta-alanine and beta-alanine plus creatine groups immediately after the exercise compared to pre-exercise. In addition, during the post-supplementation session total antioxidant capacity increased in beta-alanine group immediately after the exercise..
Beta-alanine supplementation has limited antioxidant effect during the repeated WTs..

Exhausting physical exercise increases lipid peroxidation and causes important muscle damages. The human body tries to mitigate these adverse effects by mobilizing its antioxidant defenses..
This study aims to investigate the effect of a maximal versus supra-maximal race sustained until exhaustion on lipid peroxidation, antioxidant activity and muscle-damage biomarkers in trained (i.e. long-distance and middle-distance runners) and sedentary subjects..
The study has been carried out on 8 middle-distance runners (MDR), 9 long-distance runners (LDR), and 8 sedentary subjects (SS). Each subject has undergone two exhaustive running tests, the first one is an incremental event (VAMEVAL test), the second one is a constant supra-maximal intensity test (limited-time test). Blood samples were collected at rest and immediately after each test..
A significant increase in malondialdehyde (MDA) concentrations was observed in SS and MDR after the VAMEVAL test and in LDR after the Limited-Time test. A significant difference was also observed between LDR and the other two groups after the VAMEVAL test, and between LDR and MDR after the Limited-Time test. Significant modifications, notably, in myoglobin, CK, LDH, IL-6, TNF-α, and TAS were likewise noted but depending on the race-type and the sportive specialty..
Maximal and supra-maximal races induce a significant increase in lipid peroxidation and cause non-negligible inflammation and muscle damage. These effects were relatively related to the physical exercise type and the sportive specialty..

No previous research has analysed kinetic fatigue of elite adult players and elite youth players during the competitive period..
The aim of the present study was to analyse kinetic post-match fatigue in professional and youth soccer players during the competitive period..
resting heart rate (HRrest), post-effort recovery heart rate (HRrecovery), rate of perceived exertion fatigue (RPEf), muscle soreness and blood samples with creatine kinase (CK) and resting lactate (La) from nine professional soccer players were measured immediately before, 24 hour and 48 hour after two official French first league matches (Ligue 1) whereas RPEf, HRrest, and 20m speed performance (speed-20 m) were measured in ten U-17 elite players immediately before, 24 hour and 48h after a friendly match..
for professionals, a soccer match elevated all physiological markers during the next 24 hours (P Independent of their level, professional soccer players, need 48 hours to recover after an official match. Professionals gain more fatigue than young players after a match, but recover as fast. Thus, they recover more efficiently especially due to a better physical condition and fitness training. It is expected that the results showed in the study help elite soccer and fitness coaches to manage the training load of the team according to the match..

The effects of synthetic surfaces on the risk of injuries is still debated in literature and the majority of published data seems to be contradictory. For such reasons the understanding of injury incidence on such surfaces, especially in youth sport, is fundamental for injury prevention..
The aim of this study was to prospectively report the epidemiology of injuries in young football players, playing on artificial turfs, during a one sports season..
Patients and 80 young male football players (age 16.1 ± 3.7 years; height 174 ± 6.6 cm; weight 64.2 ± 6.3 kg) were enrolled in a prospective cohort study. The participants were then divided in two groups; the first included players age ranging from 17 to 19 (OP) whereas the second included players age ranging from 13 to 16 (YP). Injury incidence was recorded prospectively, according to the consensus statement for soccer..
A total of 107 injuries (35 from the OP and 72 from the YP) were recorded during an exposure time of 83.760 hours (incidence 1.28/1000 per player hours); 22 during matches (incidence 2.84/1000 per player hours, 20.5%) and 85 during training (incidence 1.15/1000 per player hours, 79.5%). Thigh and groin were the most common injury locations (33.6% and 21.5%, respectively) while muscle injuries such as contractures and strains were the most common injury typologies (68.23%). No statistical differences between groups were displayed, except for the rate of severe injuries during matches, with the OP displaying slightly higher rates compared to the YP. Severe injuries accounted for 10.28% of the total injuries reported. The average time lost due to injuries was 14 days. Re-injuries accounted for 4.67% of all injuries sustained during the season..
In professional youth soccer injury rates are reasonably low. Muscle injuries are the most common type of injuries while groin and thigh the most common locations. Artificial turf pitches don’t seem to contribute to injury incidence in young football players..

Previous studies have reported endothelial dysfunction and inflammatory cytokine in heart failure patients (HF)..
The purpose of this study was to determine the effects of creatine monohydrate and exercise on inflammatory and endothelial dysfunction markers among HF patients..
Patients and One hundred patients were prospectively randomized into two groups: Intervention group which received 5 grams/day creatine monohydrate and exercised for 8 weeks; and control group which did not receive any interventions. Interleukine-6 (IL-6), high sensitivity C reactive protein (hs-CRP), P-selectin, intercellular adhesion molecule-1 (ICAM-1), and vascular cell adhesion molecule 1 (VCAM-1) were measured at the start and end of the study for both groups..
In total, 100 patients including 50 controls and 50 intervention group (54% male, mean EF of 34.2 ± 10.5% and 52% male, mean EF of 35.6 ± 12.7%, respectively) were analyzed. The serum levels of hs-CRP and IL-6 increased at the end of the study in the control group compared to the baseline, (7.5 ± 1.5 mg/L vs. 6.9 ± 1.3 mg/L, P 0.05)..
Combination of creatine monohydrate and exercise attenuated inflammation and endothelial dysfunction markers among heart failure patients..

Infrared thermography (IRT) does not require contact with the skin, and it is a convenient, reliable and non-invasive technique that can be used for monitoring the skin temperature (TSK)..
The aim of this study was to monitor the variations in the regional TSK during exercise on 28 regions of interest (ROIs) (forehead, face, chest, abdomen, back, lumbar, anterior and posterior neck, and posterior and anterior views of the right and left hands, forearms, upper arms, thighs, and legs) with IRT..
Patients and 12 physically active young males were monitored with IRT during the following three phases: a) 30 minutes before exercise b) while performing one hour of moderate intensity exercise on a treadmill at 60% of the VO2max, and c) 60 minutes after exercise..
During pre-exercise, all TSK reached a steady-state (P ≤ 0.05), which ensured adequate thermal stabilisation. At the beginning of exercise, there was a significant reduction in the TSK in most ROIs after 10 minutes of activity, except for the lower limbs (legs and thighs). After one hour of recovery, in the anterior view of the hands and thighs and in the posterior view of the legs, there were significant increases in the TSK compared to pre-exercise..
There were significant distinctions in the skin temperature distribution during exercise according to the activity of the area under consideration during exercise, which may be important in the development of physiological models and heat flux analyses for different purposes..

Multiligamentous injuries of knee are a complex problem in orthopaedics. Combined ACL-PCL injuries are uncommon, usually associated with knee dislocations. Extremity vascular status is essential because of possible arterio-venous compromise. These complex injuries require a systematic evaluation and treatment. Single setting simultaneous arthroscopic ACL and PCL reconstruction or a staged approach can be adopted to treat these cases..
To evaluate functional outcome of simultaneous arthroscopic ACL and PCL reconstruction with hamstring tendon autograft in multiligamentous knee injuries..
Patients and This prospective study was performed on 20 patients with combined ACL-PCL injuries who underwent simultaneous arthroscopic ACL-PCL reconstruction with hamstring tendon. Evaluation of functional outcome was by IKDC and Lysholm-Tegner scores..
In 20 patients, mean age 34 years, return to full-time work and to full sports was 8 weeks and 6.2 months respectively. All patients had full range of motion except 2 patients with Simultaneous arthroscopic ACL and PCL reconstructions using hamstring tendon for combined ACL and PCL injuries is a clinically effective, safe, time saving and cost-effective procedure with better patient compliance and reproducible for a timely return of motion, strength, and function with favorable outcome..

The elite-level referee is exposed to similar physical demands to those placed on a midfield soccer player. They have an important responsibility to implement the rules of the game. So, good health and performance of soccer referees have a great importance..
The purpose of this study was to assess the cardiorespiratory fitness and body composition of all 78 soccer referees officiating at the Iranian Premier League and determine the correlation between these parameters and performance..
Patients and In a cross-sectional study, all referees selected for the competitions were enrolled. Participants underwent exercise stress test, pulmonary function test and body composition assessment. Then the weekly scores of each referee, assessed by qualified supervisors of national federation were obtained using the FIFA standard form throughout the season (34 weeks) and registered..
Among 78 participants (including 32 center and 46 side referees), mean and standard deviation of age, body mass index, percent of body fat, VO2max and performance scores were 37 ± 3.8, 23.6 ± 2.1, 20.7 ± 3.9, 59.9 ± 7.1 and 85.8 ± 0.25, respectively. No significant correlation between referees’ mean score and selected parameters were found..
It seems that the acquired scores of top-class referees may be influenced by multiple factors other than the laboratory findings of cardiopulmonary fitness and body composition..

Injury prevention programs have recently been created for various sports. However, a longitudinal study on badminton injuries, as assessed by a team’s dedicated medical staff, at the gymnasium has not been performed..
We aimed to perform the first such study to measure the injury incidence, severity and type as the first step in creating a badminton injury prevention program..
Patients and A prospective, longitudinal survey was conducted between April 2012 and March 2013 with 133 national tournament-level badminton players from junior high school to university in Japan with the teams’ physical therapists at the gymnasium. Injury incidence was measured as the injury rate (IR) for every 1,000 hour (1000 hour) and IR for every 1,000 athlete exposures (1000 AE). Severity was classified in 5 levels by the number of days the athlete was absent from practice or matches. Injury types were categorized as trauma or overuse..
Practice (IR) (1,000 hour) was significantly higher in female players than in male players; the rates increased with increasing age. IR (1,000 AE) was significantly higher in matches than in practice in both sexes of all ages, except for female junior high school students and injuries were most frequent for high school students in matches. The majority of the injuries were slight (83.8%); overuse injuries occurred approximately 3 times more than trauma..
This is the first study in which medical staff assessed injuries in badminton, providing value through benchmark data. Injury prevention programs are particularly necessary for female university students in practice and high school students in matches..

Exercise order affects repetition performance and acute hormonal responses to resistance training (RT) programs..
The purpose of this study was to compare the acute effects of two different resistance exercise orders (REO) on number of repetitions and serum Insulin-like Growth Factor-1 (IGF-1), testosterone and cortisol levels in normal-weight and obese men..
25 untrained college-aged men were assigned to either obese (n = 11) or normal-weight (n = 15) groups. Subjects performed two REO protocols in 2 exercise groups. In the first group subjects began with large-muscle group and progressed to small-muscle group (Protocol A), while in the other group subjects performed the same exercise but in reverse sequence (Protocol B). Each activity was performed in 3 consecutive sets of 10 repetitions maximum to near fatigue..
REOs did not affect number of repetitions in none of the groups. The average rating of perceived exertion was higher for protocol B in both groups. IGF-1 and testosterone increased immediately post exercise for both protocols and in both groups, however immediately post exercise increase in IGF-1 and testosterone were lower in obese group. Cortisol response to REO was weaker in obese group..
Performing large muscle group exercises first in RE training and progressing to small muscle group produced greater anabolic hormonal response relative to reverse sequence in normal-weight young adult men. Anabolic hormonal response to REOs was blunted in the obese group..

Epidemiological data on the occurrence of time-loss injuries over several A-League seasons remains lacking, while the effect of the mandatory implementation of ‘Minimum Medical Standards’ as a part of the collective bargaining agreement (CBA) needs to be explored..
To explore the 5 year evolution of hamstring, groin, knee, ankle and total time-loss injuries among professional footballers in the A-League; to evaluate the consequences of these time-loss injuries in terms of total matches missed and costs incurred; and to explore whether the mandatory implementation of ‘Minimum Medical Standards’ in the A-League had led to a decrease in the occurrence of total time-loss injuries and total matches missed..
Patients and An observational prospective study has been carried out since 2008. Data were collected weekly during the seasons 2008 - 2009 to 2012 - 2013 through official match previews/reviews, official media releases, official websites and/or self-reports by players. Total and specific (hamstring, groin, knee and ankle) numbers of time-loss injuries and matches missed were obtained for each season and the related financial costs calculated..
The total number of time-loss injuries and matches missed rose from 129 and 506 respectively in 2008 - 2009 to 202 and 1110 in 2010 - 2011. Following the introduction of ‘Minimum Medical Standards’, both categories decreased (significantly for matches missed). These time-loss injuries and matches missed led to high costs of up to AUD$ 37,317,029.29 (2012 - 2013 season). The same trend was found for knee injuries, while hamstring and ankle injuries remained almost the same. However, time-loss due to groin injuries increased despite the introduction of “Minimum Medical Standards”..
The introduction of “Minimum Medical Standards” in the A-League had a favorable effect on the number of total, hamstring, knee and ankle injuries and on the number of matches missed due to these injuries, but not on the number of groin injuries. The costs related to time-loss injuries and related matches missed remained high..

Headache is certainly one of the most common medical complaints of general population and one of the important causes of consumption of drugs. Despite its high overall prevalence, the epidemiology of exertional headache is not clear enough..
To determine the prevalence of headache in athletic and non-athletic university students and also estimating its variation between different sports fields including concussion prone sports..
This cross-sectional study comprised 739 subjects (367 athletes and 372 non-athletes). The present study was carried out on athletic and non-athletic university students aging between 18 to 28 years. An athlete was defined as a person who had at least one year of experience in sports including football, volleyball, basketball, wrestling, boxing, martial arts, track and field, chess, handball and swimming for three sessions a week each lasting at least 2 hours. The random selection of these participants was done by an independent statistical consultant. A questionnaire was used for data collection which was then analyzed by statistical methods..
Our study comprised 739 subjects (367 athletes and 372 non-athletes). Among athletic university students, 152 (41.2%) participants complained of headache. Such a complaint was present in 217 (58.3%) non-athletic university students. This lower prevalence of headache in athletes was statistically significant (P value The prevalence of headache is seemingly lower in athletic university students than non-athletic ones. In addition, among athletes, those who are participating in concussion prone sports especially wrestling experience headache more than athletes of other fields..

Professional sports injuries are usually all dealt with at one single operation to return the player to the sport after appropriate rehabilitation. We questioned the assumption that rotator cuff tears must be repaired concurrently with instability syndromes, and aimed to allow a professional rugby league player to achieve career goals by NOT correcting all pathology at one surgery..
A professional rugby league player presented with acute shoulder instability on a setting of a chronic full thickness rotator cuff tear. We performed an “in season” arthroscopic stabilization on an elite rugby league player, leaving a previously diagnosed large full thickness rotator cuff tear untreated. This allowed aggressive rehabilitation and return to contact competition at 12 weeks post-surgery. The player achieved a long held career goal of winning a premiership ring before undertaking rotator cuff repair at the end of the season. Latest follow up at seven years (still at elite level) demonstrated an asymptomatic shoulder..
The assumption that all pathology found at surgical exploration requires correction to play at elite level is not universally correct. We postulate that whilst rotator cuff deficiency has severe long-term sequelae, it is shoulder instability alone that prevents high level contact sports participation. Career goal management is an important part of managing elite level athletes. We have demonstrated that by careful management of the specific pathology preventing participation can allow elite athletes to achieve career goals without compromising long-term health..