Health-related quality of life and flourishing in current and former recreational and elite cricketers.

BACKGROUND: Health related quality of life (HRQoL) and flourishing are constructs that encompasses a holistic representation of physical, psychological, and social health. The underlying psychological factors that can affect HRQoL and flourishing in sports participants is poorly understood. The purpose of this study was to i) evaluate HRQoL (physical and mental-components) and flourishing in recreational and elite and current and former cricketers; ii) determine the effect of resilience, playing-standard, and playing status on HRQoL and flourishing in cricketers. METHODS: The Cricket Health and Wellbeing Study (n = 2598 current and former cricketers, aged ≥18 years) collected cross-sectional questionnaire data including the Flourishing Scale, Short Form-8 (physical (PCS) and mental (MCS) component scores), resilience (European Social Survey), highest standard-of-play, and playing status. Multivariable linear regressions with fractional polynomials were utilised, adjusted for age, gender, total cricket-seasons, comorbidity, ≥ 4-week time-loss injury, and orthopaedic surgery. RESULTS: Two thousand two hundred eighty individuals (aged (mean (SD)) 51.7(14.7) years, 61% played recreationally, 37% former cricketers) were included in analyses. The median (IQR) PCS was 51.4(46.9-55.9), MCS was 54.3(50.0-58.6), and Flourishing Scale score was 48 [ (1-7)] .Greater resilience was associated with better PCS (effect (95% CI) 1.41(0.70-2.11)), MCS (4.78(4.09-5.48)), and flourishing (2.07(2.55-3.59)) compared to less resilience. Playing standard was not associated with HRQoL. Playing at an elite standard was associated with greater flourishing (1.21(0.68, 1.73)), compared with playing recreationally. Current cricket participation was associated with better PCS (3.61(2.92-4.30)) and flourishing scores (0.53(0.02-1.04)), compared to former cricket participation. CONCLUSION: Cricketers reported high levels of mental-components of HRQoL and flourishing, and this was similar in recreational, elite, current and former cricketers. Current cricket participation and a higher standard-of-play was associated with greater flourishing. Current cricket participation was also associated with better PCS, however playing-status was not related to MCS. Further research is needed to understand if cricket participation may have psychological benefits that persist beyond cricket retirement.

Playing sport injured is associated with osteoarthritis, joint pain and worse health-related quality of life: a cross-sectional study.

BACKGROUND: Sports participants are faced with the decision to continue or cease play when injured. The implications of playing sport while injured on joint health and health-related quality of life (HRQoL) has not been investigated. The purpose of this study was to investigate the relationship between having played sport while injured and HRQoL, osteoarthritis, and persistent joint pain; and compare findings in elite and recreational cricketers. METHODS: The Cricket Health and Wellbeing Study cohort was used for this study. Inclusion criteria were: age ≥ 18 years, played ≥1 cricket season. Questionnaire data collected included a history of playing sport injured, SF-8 (physical (PCS) and mental (MCS) component scores), physician-diagnosed osteoarthritis, and persistent joint pain (most days of the last month). Multivariable linear regressions and logistic regressions were performed. Continuous covariates were handled using fractional polynomials. Models were adjusted for age, sex, cricket-seasons played, playing status, joint injury, and orthopaedic surgery. All participants (n = 2233) were included in HRQoL analyses, only participants aged ≥30 years (n = 2071) were included in osteoarthritis/pain analyses. RESULTS: Of the 2233 current and former cricketers (mean age: 51.7 SD 14.7, played 30 IQR 24 cricket seasons, 60% were current cricketers, 62% played recreationally; median PCS: 51.4 IQR 9.0; MCS: 54.3 IQR 8.6) 1719 (77%) had played sport while injured. People who had played sport injured reported worse adjusted PCS (Effect(95% CI): - 1.78(- 2.62, - 0.93) and MCS (- 1.40(- 2.25, - 0.54), had greater odds of osteoarthritis (adjusted OR(95% CI): 1.86(1.39, 2.51) and persistent joint pain (2.34(1.85, 2.96)), compared to people who had not played sport injured. Similar relationships were observed regarding PCS, osteoarthritis and pain in elite and recreational subgroups. Playing injured was only related to worse MCS scores for elite cricketers (- 2.07(- 3.52, - 0.63)); no relationship was observed in recreational cricketers (- 0.70(- 1.79, 0.39)). CONCLUSION: Cricketers that had played sport injured had impaired HRQoL, increased odds of osteoarthritis and persistent joint pain, compared to those who had not played sport injured. Playing sport injured was only related to impaired mental-components of HRQoL in elite cricketers. The long-term impact of playing while injured on musculoskeletal health, should be considered when advising athletes on their ability to compete following injury.

Cricket related hand injury is associated with increased odds of hand pain and osteoarthritis.

Radiographic osteoarthritis (OA) is most prevalent in the hand. The association of hand injury with pain or OA is unclear. The objective was to describe the relationship between hand injury and ipsilateral pain and OA in cricketers. Data from former and current cricketers aged ≥ 30 years was used. Data included history of cricket-related hand/finger injury leading to > 4 weeks of reduced exercise, hand/finger joint pain on most days of the last month, self-reported history of physician-diagnosed hand/finger OA. Logistic regression assessed the relationship between injury with hand pain (in former cricketers) and with OA (in all cricketers), adjusted for age, seasons played, playing standard. Of 1893 participants (844 former cricketers), 16.9% reported hand pain, 4.3% reported OA. A history of hand injury increased the odds of hand pain (OR (95% CI) 2.2, 1.4 to 3.6). A history of hand injury also had increased odds of hand OA (3.1, 2.1 to 4.7). Cricket-related hand injury was related to an increased odds of hand pain and OA. This highlights the importance of hand injury prevention strategies within cricket. The high prevalence of hand pain is concerning, and further research is needed to determine the impacts of hand pain.

The prevalence of hand and wrist osteoarthritis in elite former cricket and rugby union players.

OBJECTIVES: This study aimed to determine the prevalence of hand and wrist osteoarthritis in former elite cricket and rugby union players, by sport and playing position, and to define the prevalence of severe hand injury, and its association with hand osteoarthritis. DESIGN: Cross-sectional. METHODS: Data from cross-sectional studies of former elite male cricket and rugby players were used to determine the prevalence of hand pain, physician-diagnosed osteoarthritis, and previous severe injury. Multivariable logistic regression was used to determine the association of previous injury with pain and osteoarthritis. RESULTS: Data from 200 cricketers and 229 rugby players were available. Complete case analysis resulted in 127 cricketers and 140 rugby players. Hand pain was more prevalent amongst cricketers (19.7%) than rugby players (10.0%). The prevalence did not differ between cricket and rugby players for hand osteoarthritis (2.4% and 3.6%), wrist osteoarthritis (1.6% and 2.1%), or previous severe hand injury (36.2% and 31.4%). No significant association between previous hand injury and pain or osteoarthritis was identified in either sport. CONCLUSIONS: Former elite cricketers reported more hand pain than rugby players. No significant association was found between self-reported severe injury and hand osteoarthritis in either cohort, potentially indicating that risk factors aside from injury may be more prominent in the development of hand osteoarthritis.

Osteoarthritis and other long-term health conditions in former elite cricketers.

OBJECTIVES: This study aimed to describe the prevalence and risk of chronic conditions in former elite cricketers compared to a normal population, and describe wellbeing in former elite cricketers. DESIGN: Cross-sectional study. METHODS: Former elite cricketers, recruited from the Professional Cricketers' Association, completed a self-report cross-sectional questionnaire. The English Longitudinal Study of Ageing (ELSA) served as the normal population. The prevalence of self-reported, GP-diagnosed conditions (heart problems, hypertension, stroke, diabetes, asthma, dementia, osteoarthritis (OA), total hip replacement (THR), total knee replacement (TKR), anxiety, depression) were reported for both population samples. Standardised morbidity ratios (SMRs) compared chronic conditions in sex-, age- and BMI-matched former cricketers (n=113) and normal population (n=4496). RESULTS: Heart problems were reported by 13.3% of former cricketers, significantly lower than the normal population, SMR 0.55 (0.33-0.91). Former cricketers reported 31.9% hypertension, 1.8% stroke, 6.2% diabetes, 15.0% asthma, and no dementia, none significantly different to the normal population. OA, THR, and TKR were reported by 51.3%, 14.7% and 10.7% of former cricketers, respectively, significantly higher than the normal population, SMRs 3.64 (2.81-4.71), 3.99 (2.21-7.20) and 3.84 (1.92-7.68). Anxiety and depression were reported by 12.4% and 8.8% of former cricketers, respectively, SMRs 3.95 (2.34-6.67) and 2.22 (1.20-4.14). 97% of former cricketers reflected they would undertake their cricket career again, 98% agreed that cricket enriched their lives. CONCLUSIONS: Heart problems were significantly lower, while OA, THR, TKR, anxiety, and depression were significantly higher in the former cricketers compared to the normal population (ELSA). Most former cricketers reflected positively on their career.

A Catecholamine Precursor Does Not Influence Exercise Performance in Warm Conditions.

PURPOSE: Acute doses of Sinemet® (L-DOPA combined with carbidopa) previously failed to influence prolonged exercise performance in a temperate environment, but it is not known whether acute doses of L-DOPA timed to reach maximum plasma concentrations (Cmax) during exercise will improve prolonged cycling performance in warm conditions (30.2°C ± 0.2°C, 50% ± 1%). METHODS: Ten physically active men (age, 26 ± 4 yr; height, 1.76 ± 0.08 m; body mass, 76.3 ± 10.6 kg; V˙O2peak, 57 ± 8 mL·kg(-1)·min(-1)) were recruited for this study. Participants cycled for 1 h at 60% V˙O2peak followed by a 30-min exercise test, during which they were instructed to complete as much work as possible. Heart rate, skin and core temperatures, as well as RPE and thermal stress were recorded throughout the exercise, and blood samples were collected at rest, at 15-min intervals during the first hour of exercise, and at the end of the exercise test. Finger tapping tests at the beginning and end of the exercise were conducted to examine fine motor control. RESULTS: There was no significant difference in the work done on the placebo (314 ± 43 kJ) and L-DOPA trials (326 ± 48 kJ, P = 0.276). Prolactin concentrations were increased at the end of the exercise in all trials (P < 0.001), but this response was attenuated at the end of the exercise for the L-DOPA trial (11.4 ± 5.5 ng·mL(-1)) and placebo trials (20.8 ± 3.3 ng·mL(-1), P = 0.003). No differences between trials were found for any other measure. CONCLUSIONS: The results suggest that increasing central catecholamine availability inhibits the normal prolactin response to exercise in the heat but does not alter performance, thermoregulation, or sympathetic outflow.

Finite element investigation of the effect of a bifid arch on loading of the vertebral isthmus.

BACKGROUND: The biomechanical effect of a bifid arch as seen in spina bifida occulta and following a midline laminectomy is poorly understood. PURPOSE: To test the hypothesis that fatigue failure limits will be exceeded in the case of a bifid arch, but not in the intact case, when the segment is subjected to complex loading corresponding to normal sporting activities. STUDY DESIGN: Finite element analysis. METHODS: Finite element model of an intact L4-S1 human lumbar motion segment including ligaments was used. A section of the L5 vertebral arch and spinous process was removed to create the model with a midline defect. The models were loaded axially to 1 kN and then combined with axial rotation of 3°. Bilateral stresses, alternating stresses, and shear fatigue failure on both models were assessed and compared. RESULTS: Under 1 kN axial load, the von Mises stresses observed in midline defect case and in the intact case were very similar (differences <5 MPa) having a maximum at the ventral end of the isthmus that decreases monotonically to the dorsal end. However, under 1 kN axial load and rotation, the maximum von Mises stresses observed in the ipsilateral L5 isthmus in the midline defect case (31 MPa) was much higher than the intact case (24.2 MPa), indicating a lack of load sharing across the vertebral arch in the midline defect case. When assessing the equivalent alternating shear stress amplitude, this was found to be 22.6 MPa for the midline defect case and 13.6 MPa for the intact case. From this, it is estimated that shear fatigue failure will occur in less than 70,000 cycles, under repetitive axial load and rotation conditions in the midline defect case, whereas for the intact case, fatigue failure will occur only after more than 10 million cycles. CONCLUSIONS: A bifid arch predisposes the isthmus to early fatigue fracture by generating increased stresses across the inferior isthmus of the inferior articular process, specifically in combined axial rotation and anteroposterior shear.

Exercise with low muscle glycogen augments TCA cycle anaplerosis but impairs oxidative energy provision in humans.

We tested the hypotheses that: (i) exercise with low muscle glycogen would reduce pyruvate flux through the alanine aminotransferase (AAT) reaction and attenuate the increase in tricarboxylic acid (TCA) cycle intermediates, and (ii) attenuation of tricarboxylic acid cycle intermediate (TCAI) pool expansion would limit TCA cycle flux, thereby accelerating phosphocreatine (PCr) degradation. Eight men cycled for 10 min at 70 % of their (VO(2,max) on two occasions: (i) following their normal diet (CON) and (ii) after cycling to exhaustion and consuming a low carbohydrate diet for approximately 2 days (LG). Biopsies (m. vastus lateralis) confirmed that [glycogen] was lower in LG vs. CON at rest (257 +/- 18 vs. 611 +/- 54 mmol (kg dry mass)(-1); P 0.05); however, net glycogenolysis was not different after 1 or 10 min of exercise. PCr degradation from rest to 1 min was approximately 26 % higher in LG vs. CON (38 +/- 4 vs. 28 +/- 4 mmol (kg dry mass)(-1); P< or =0.05). The sum of five measured TCAIs (approximately 90 % of total pool) was not different between trials at rest and after 1 min, but was higher after 10 min in LG vs. CON (5.51 +/- 0.43 vs. 4.45 +/- 0.49 mmol (kg dry mass)(-1); P 0.05). Pyruvate dehydrogenase complex (PDC) activity was lower during exercise in LG vs. CON (2.2 +/- 0.2 vs. 1.4 +/- 0.2 mmol min(-1) (kg wet weight)(-1) after 10 min; P< or =0.05), and acetylcarnitine was approximately threefold less, implying increased pyruvate availability for flux through AAT. Resting muscle [glutamate] was higher in LG vs. CON (16.1 +/- 0.8 vs. 11.8 +/- 0.4 mmol (kg dry mass)(-1); P< or =0.05) and the net decrease in [glutamate] during exercise was approximately 30 % greater in LG vs. CON. These findings suggest that: (i) contrary to our hypotheses, LG increased anaplerosis by decreasing PDC flux and/or increasing the conversion of glutamate carbon to TCAIs, and (ii) accelerating the rate of muscle TCAI expansion did not affect oxidative energy provision during the initial phase of contraction, since changes in [TCAI] were not temporally related to PCr degradation.