Asian Journal of Sports Medicine
Volume:6 Issue: 4, Dec 2015

Context: Hamstring acute muscle injuries are prevalent in several sports including AFL football (Australian Football League), sprinting and soccer, and are often associated with prolonged time away from sport.Evidence Acquisition: In response to this, research into prevention and management of hamstring injury has increased, but epidemiological data shows no decline in injury and re-injury rates, suggesting that rehabilitation programs and return to play (RTP) criteria have to be improved. There continues to be a lack of consensus regarding how to assess performance, recovery and readiness to RTP, following hamstring strain injury. The aim of this paper was to propose rehabilitation protocol for hamstring muscle injuries based on current basic science and research knowledge regarding injury demographics and management options. Criteria-based (subjective and objective) progression through the rehabilitation program will be outlined along with exercises for each phase, from initial injury to RTP.

Circulating levels of adiponectin and testosterone decrease in obese men and this increases risks of cardiovascular disease and diabetes. The purpose of this study was to survey changes of serum adiponectin and testosterone concentrations following twelve weeks resistance training in obese young men.Patients and In a semi-experimental study, twenty one obese young men were randomly placed in two groups: resistance training (26.5 ± 2.8 years) and control (27.4 ± 2.9 years). General characteristics of subjects and serum levels of adiponectin and testosterone were assessed before and after training. Resistance training protocol consisted of twelve weeks weight training (3 sessions per week, 10 exercises, 3 sets of 8 - 12 repetitions in each exercise, intensity 60% - 80% of one repetition maximum, rest between sets 1 minute and between exercises 2 minutes, duration of main training 20 - 40 minutes per each session). Resistance training had no significant effect on body weight and body mass index (P > 0.05), whereas it decreased body fat percent (P = 0.017). Also, serum adiponectin (8.1 ± 1.8 vs. 10.5 ± 2.3 μg/mL) and testosterone concentrations (6.9 ± 2.4 vs. 8.2 ± 1.7 ng/mL) were increased after resistance training (P = 0.033, P = 0.018 respectively), while there were no significant changes in serum levels of these hormones in control group (P > 0.05). Twelve weeks of resistance training increased serum concentrations of adiponectin and testosterone in obese young men. With respect to inverse associations between changes of adiponectin and testosterone with BFP and insulin level variations after resistance training, it is recommended that obese young men do resistance training to benefit useful decreasing/preventive effects of this type of training against the risks of cardiovascular diseases and diabetes.

Hypohydration can have significant implications on normal physiological functions of the body. This study aimed to determine the impact of agitation, storage temperature, and storage time on urine osmolality compared to the criterion control.Patients and We used a descriptive diagnostic validity test design. To investigate agitation, we recruited 75 healthy individuals (males = 41, females = 34; mean age = 22 ± 5 years; mean self-reported height = 172 ± 23 cm and mass = 77 ± 17 kg) who provided one or more samples (total = 81). The independent variables were agitation (vortex, hand shaken, no agitation) and temperature (room temperature, freezer, and refrigerator) type. Participants completed informed consent, a health questionnaire and were asked to provide a urine sample, which was split and labeled according to agitation type or storage temperature. Urine osmolality was used to determine hydration status at two time points (within 2 hours [control], 48 hours). We used t-tests to determine the difference between each condition and the control and calculated percent error for each condition. No significant differences for no agitation (t79 = -0.079, P = 0.937), hand shaken (t79 = 1.395, P = 0.167) or vortex mixed (t79 = -0.753, P = 0.453) were identified when compared to the criterion control. No significant differences for room temperature (t82 = -0.720, P = 0.474), refrigerator (t82 = -2.697, P = 0.008) or freezer (t82 = 2.576, P = 0.012) were identified when compared to the criterion control. Our findings suggest agitation of urine specimen is not necessary and samples do not require refrigeration or freezing if assessed within 48 hours. Analysis within two hours of collection is not necessary and samples can be stored for up to 48 hours without impacting the hydration status of the sample.

Traditionally, stretching exercises are considered as basic components of warm up aiming to prepare the musculoskeletal system for performance and to prevent injuries. The purpose of this study was to examine the effects of different agonist and antagonist stretching arrangements within a pre-exercise warm-up on hip static (SROM) and dynamic range of motion (DROM). Sixty trained male subjects (Mean ± SD: height, 177.38 ± 6.92 cm; body mass, 68.4 ± 10.22 kg; age, 21.52 ± 1.17 years) volunteered to participate in this study. SROM was measured by V-sit test and DROM captured by a motion analysis system before and after (i) static stretching for both hip flexor and extensor muscles (SFSE), (ii) dynamic stretching for both hip flexor and extensor muscles (DFDE), (iii) static stretching for the hip flexors and dynamic stretching for hip extensors (SFDE), and (iv) dynamic stretching for the hip flexors and static stretching for hip extensors (DFSE). DFSE showed a significantly higher increase in DROM and SROM than the remainder of the stretching protocols (P < 0.05). There were significant differences between DFDE with SFSE and SFDE (P < 0.05) and SFSE showed significant increase as compared to SFDE (P < 0.05). In conclusion, DFSE is probably the best stretching arrangement due to producing more post activation potentiation on agonist muscles and less muscle stiffness in antagonist muscles.

A clinical outcome tool is needed for the assessment of young athletes with low back pain. To translate and culturally adapt the Micheli functional scale (MFS), a self-report questionnaire developed to evaluate young athletes with low back pain (LBP) into Persian language and examine the reliability and validity of the Persian MFS (PMFS). A cross-sectional study was conducted to assess the psychometric properties of the PMFS. The PMFS was cross-culturally adapted into Persian language adopting forward/backward translation, expert panel review, and pre-testing. The PMFS was administered to young athletes with and without LBP. Main outcome measures were Persian MFS, Persian functional rating Index (PFRI), and visual analogue scale (VAS). A sample of 100 young athletes with LBP with a mean age of 16.5 ± 2.5 years participated. Fifty young athletes without LBP completed the PMFS. There was no missing responses and floor or ceiling effects. There was a significant difference for the total PMFS scores between young athletes with and without LBP. A significant correlation was found between the total PMFS score and the VAS (r = 0.92) or the PFRI (r = 0.82; P < 0.001). A high internal consistency reliability (Cronbach α = 0.73), and excellent test-retest reliability (ICCagreement = 0.99, P < 0.001) were demonstrated for the PMFS. Factor analysis indicated a single-factor model for PMFS scores. The Persian MFS is valid and reliable for use in Persian-speaking young athletes with LBP.

It is well known that exercise training has positive effect on catecholamine response to a given work load. But in this regard, the effective method of training needs to be studied. The aim of this study was to compare the effects of 8 weeks endurance exercise with two overloading patterns on the left ventricular catecholamine levels. 29 male Wistar rats were randomly assigned to control (n = 9), daily sinusoidal overloading (n = 10) and weekly sinusoidal overloading (n = 10) groups. After the last exercise session, left ventricular blood samples were obtained immediately after lactate threshold test. Plasma concentrations of adrenaline and noradrenaline were measured by ELISA method. One way analysis of variance was used for analysis of the data. Immediately after lactate threshold test, adrenaline level was significantly (P < 0.05) lower in weekly loading group than in control and daily loading groups. Adrenaline was higher in the daily loading group compared with control group but did not reach the significant level. Noradrenaline levels were not significantly (P > 0.05) different between three study groups. The results showed 8 weeks of endurance exercise with weekly sinusoidal overloading pattern could induce a lower adrenal medulla activity (reflection of physical and physiological improvement) than daily sinusoidal loading pattern in response to the same absolute work load.

There is an interaction between oxidative equilibrium and anti-oxidants in oxidative stress. Therefore, oxidative stress has an effect on intercellular oxidation and causes atrophy and is an underlying factor in many diseases. The aim of this study was to investigate the effect of running downhill and the short-term effect of caffeine supplementation on oxidative stress in non-athletic men.Patients and Twenty men, aged 25 - 28 years, from Tabriz, Iran were been selected and divided in two homogeneous groups of 10 men: the supplementation group and the placebo group. In the next stage, groups received caffeine supplementation (caffeine capsules at a dose of 5 mg/kg of body weight daily for 14 days) or placebo (5 mg/kg of dextrose during supplementation) and ran downhill (30 minutes of treadmill running with a slope of −10 degrees with 65% maximal oxygen consumption); blood sampling was also performed. Anti-oxidant capacity by the ferric reducing ability of plasma (FRAP) techniques and serum malondialdehyde (MDA) were measured by the thiobarbituric acid (TBA) method, while the total number of thiol molecules (TTM) with Hu and DNA damage was evaluated using ELISA. The results of this study indicated that running downhill caused significant changes in all measured parameters, but the short-term caffeine supplementation did not have a significant effect on the indices of oxidative stress or DNA damage measured.

The body composition varies according to different life styles (i.e. intake calories and caloric expenditure). Therefore, it is wise to record military personnel’s body composition periodically and encourage those who abide to the regulations. Different methods have been introduced for body composition assessment: invasive and non-invasive. Amongst them, the Jackson and Pollock equation is most popular. The recommended anthropometric prediction equations for assessing men’s body composition were compared with dual-energy X-ray absorptiometry (DEXA) gold standard to develop a modified equation to assess body composition and obesity quantitatively among Iranian military men.Patients and A total of 101 military men aged 23 - 52 years old with a mean age of 35.5 years were recruited and evaluated in the present study (average height, 173.9 cm and weight, 81.5 kg). The body-fat percentages of subjects were assessed both with anthropometric assessment and DEXA scan. The data obtained from these two methods were then compared using multiple regression analysis. The mean and standard deviation of body fat percentage of the DEXA assessment was 21.2 ± 4.3 and body fat percentage obtained from three Jackson and Pollock 3-, 4- and 7-site equations were 21.1 ± 5.8, 22.2 ± 6.0 and 20.9 ± 5.7, respectively. There was a strong correlation between these three equations and DEXA (R² = 0.98). The mean percentage of body fat obtained from the three equations of Jackson and Pollock was very close to that of body fat obtained from DEXA; however, we suggest using a modified Jackson-Pollock 3-site equation for volunteer military men because the 3-site equation analysis method is simpler and faster than other methods.

It is well accepted that skeletal muscle conforms to exercise stimulus by increasing capillary density and angiogenesis, but there is less evidence regarding the effect of resistance training on capillary density in flexor hallucis longus (FHL) and soleus muscle. In this study, we evaluated the effect of resistance training on capillary density around soleus and FHL muscles in type 1 diabetic rats. Thirty-six male rats were divided into four groups: (1) control; (2) diabetic; (3) diabetic trained and (4) control trained (n = 9 each). A Single intraperitoneal injection of Streptozotocin at a dose of 55 mg/kg was used for induction of diabetes. The rats in the trained group undertook one training session per day for 3 days/week. Training was done with the use of a 1 meter high ladder inclined at 80°. After 4 weeks, the plasma nitrite concentrations were measured. Capillary/fiber ratio was determined around soleus and FHL muscles by immunohistochemistry. Plasma Nitric Oxide (NO) concentration was increased after resistance training in diabetic animals (P < 0.05). Capillary/fiber ratio around the soleus muscle of diabetic group was more than control rats. Resistance training did not alter capillary/fiber ratio in diabetic animals (1.00 ± 0.6 vs. 1.07 ± 0.07, respectively). Capillary/fiber ratio around FHL muscle was significantly different between diabetic and control and did not alter after exercise (diabetes: 1.1702 ± 0.09; diabetic trained: 1.1714 ± 0.08; control: 0.79 ± 0.08; control trained: 0.73 ± 0.03). There was a positive correlation between plasma NO concentration and capillary density in the soleus muscle (R2 = 0.65). Resistance training could not improve capillary/fiber ratio in soleus and FHL muscle of diabetic animals in spite of increase in some angiogenic factors including NO.

Racquet sports, especially lawn tennis and badminton have been gaining popularity in Asian countries like India. With this increase in popularity, the injury rate in the sport has also increased. The study will help detect the presence of gleno-humeral movement dysfunction and scapular resting position abnormality in asymptomatic racquet players, thus providing basis for screening the players and allow the clinician to determine if the asymmetry is a normal adaptation in the player or an abnormal change associated with injury. 46 asymptomatic professional players were divided into a study group of 23 players (16 tennis and 7 badminton) and control group of 23 football players. Assessment of passive gleno-humeral range of motion and distance of spine and inferior angle of scapula from corresponding spinous process were measured bilaterally and between groups. There was statistically significant reduction in range of internal rotation (62.17 ± 8.09), extension (39.78 ± 4.12) and an increase in the external rotation (106.95 ± 7.49) of dominant compared to non-dominant arm of racquet players and a statistically significant decrease in internal rotation (78.69 ± 10.24), extension (44.78 ± 3.19), adduction (37.39 ± 6.54) and an increase in external rotation (102.6 ± 5.19) of dominant arm of racquet players compared to football players. Study also showed statistically significant increase in the spino-scapular distance at the level of inferior angle of scapula (10.23 ± 1.43) on dominant side compared to non-dominant. The dominant side scapula of asymptomatic racquet players showed increased external rotation and elevation as compared to the non-dominant side. Also, reduced shoulder internal rotation, extension and adduction and gain in shoulder external rotation was observed on the dominant side of racquet players when compared to the control group.

The cardiac parasympathetic reactivation is currently used in soccer with a daily or weekly monitoring. However, previous studies have not investigated how this cardiac parasympathetic reactivation is in elite soccer players along different types of traditional high-intensity training exercise and specific tests. In this context, the present study aim to analyse it and to determine the interests and limits of this type of physiological information. The present study aims to examine how different traditional training exercise modes affect the cardiac parasympathetic reactivation function in elite soccer players. Twenty-two international soccer players participating in UEFA Champion’s League took part in this study (age: 24.3 ± 4.2 years; height: 178.1 ± 6.2 cm; body mass: 80.3 ± 5.7 kg). Players performed different training methods including: short-duration intermittent exercises (INT) in-line and with changes of direction (COD) (10 - 10 seconds, 15 - 15 seconds, 30 - 30 seconds, e.g. an alternance of 10 - 10 seconds is 10 seconds of running according to the maximal aerobic speed (MAS) and 10-sec of recovery), INT including agility and technical skills (8 - 24-seconds), small-sided-games (SSGs) with and without goalkeepers (2 vs. 2, 3 vs. 3, 4 vs. 4), and repeated sprint ability (RSA) efforts (10 × 20 m, 10 × 30 m, 15 × 20 m). Heart rate (HR) decline was recorded 3 minutes after each exercise. HR declines were greater after the RSA compared to SSGs (P < 0.001) and INT (P < 0.01), especially at 1 min post-exercise. In addition, when the analysis focused on each type of exercise, greater HR declines were observed in on-field players at 1 minute when there was: inclusion of goalkeepers in SSGs (for 2 vs. 2 and 3 vs. 3, P < 0.01); increase of sprint distances or number of sprint repetitions in RSA (P < 0.01); increase of intensity (% of maximal aerobic speed), and the use of COD or inclusion of technical skills during INT, especially for the 30 - 30-seconds. This study revealed that cardiac parasympathetic reactivation function varied after INT, RSA and SSG, but also according to the rules manipulation. Therefore, this study provides interesting information for the training monitoring and players’ recovery profile, with the aim of facilitating a more efficient planning and manipulation of training recovery strategies according to their fitness markers.

In the field of vertical jump diagnostics, force plates (FP) are the reference standard. Recently, despite a lack of evidence, jump mats have been used increasingly. Important factors in favor of jumping mats are their low cost and portability. This validity study compared the Haynl-Elektronik jump mat (HE jump mat) with the reference standard force plate. Ten healthy volunteers participated and each participant completed three series of five drop jumps (DJ). The parameters ground contact time (GCT) and vertical jump height (VJH) from the HE jump mat and the FP were used to evaluate the concurrent validity. The following statistical calculations were performed: Pearson's correlation (r), Bland-Altman plots (standard and for adjusted trend), and regression equations. The Bland-Altman plots suggest that the HE jump mat measures shorter contact times and higher jump heights than the FP. The trend-adjusted Bland-Altman plot shows higher mean differences and wider wing-spreads of confidence limits during longer GCT. During the VJH the mean differences and the wing-spreads of the confidence limits throughout the range present as relatively constant. The following regression equations were created, as close as possible to the true value: GCT = 5.920385 + 1.072293 × [value HE jump mat] and VJH = -1.73777 + 1.011156 × [value HE jump mat]. The HE jump mat can be recommended in relation to the validity of constraints. In this study, only a part of the quality criteria were examined. For the final recommendation it is advised to examine the HE jump mat on the other quality criteria (test-retest reliability, sensitivity change).

Sleep hygiene is important for sleep quality and optimal performance during the day. However, it is not always possible to follow sleep hygiene requirements. In multiday relay events, athletes have to sleep immediately after physical exertion and sometimes against their biological clock. In this pilot study we investigated the effect of having to sleep at an abnormal circadian time on sleep duration.Patients and Eight runners and two cyclists performing a 500 km relay race were followed. They were divided into two groups that took turns in running and resting. Each group ran four times for approximately five hours while the other group slept. As a result, sleep times varied between normal and abnormal times. All athletes wore actigraphs to record the duration and onset of sleep. Linear mixed model analyses showed that athletes slept on average 43 minutes longer when they slept during usual (night) times than during abnormal (day) times. In general, sleep duration decreased during the race with on average 18 minutes per period. This pilot study shows that, even under extreme violation of sleep hygiene rules, there still is an apparent effect of circadian rhythm on sleep duration in relay race athletes.

Chronic obstructive pulmonary disease (COPD) is accompanied by several extra-pulmonary consequences, such as skeletal muscle weakness and atrophy which will have a negative impact on daily life in patients and lead to their debilitation; therefore, when treating COPD patients, protocols should be taken into account to improve function and quality of life (QoL). The case was a 71- year-old woman suffering from chronic bronchitis and bronchiectasis for 30 years that has been faced with increased musculoskeletal disorders in recent months. The case was managed by downhill treadmill walking for four months with the aim of improving her functional ability and QoL. Functional tests, thigh girth measurement and St. george’s respiratory questionnaire (SGRQ) were used to assess the physical status and QoL of the patient. The outcomes measures confirmed the improvement of the studied case. The improvements continued three months after the beginning of the treatment. The eccentric exercise therapy in the form of downhill walking had positive effects on functions and QoL of studied case, especially had an augmenting effect on the thigh muscles size.

Consumption of codeine can lead to positive urine test for morphine in athletes. Morphine is classified as a prohibited doping drug while Codeine is not. Morphine/codeine ratio is used in forensic medicine to distinguish the consumption of codeine from abuse of morphine and other narcotics. We present an athlete with positive urine test for morphine with a history of consumption of codeine. The disciplinary committee came to conclusion that the athlete had not consumed morphine and did not violate doping code based on morphine/codeine ratio. Analysis of codeine to morphine metabolism rate is needed when we are using morphine/codeine ratio to rule out abuse of narcotics. WADA should consider analysis for the CYP2D6 alleles (main metabolizer of codeine) in case of including morphine/codeine ratio in future prohibited list. The possibility of ultra-rapid CYP2D6 cannot be ruled out in certain results of morphine/codeine near the cut point.