Incidence and severity of reported acute sports injuries in 35 sports using insurance registry data.

Acute injuries in sport are still a problem where limited knowledge of incidence and severity in different sports at national level exists. In Sweden, 80% of the sports federations have their mandatory injury insurance for all athletes in the same insurance company and injury data are systematically kept in a national database. The aim of the study was to identify high-risk sports with respect to incidence of acute and severe injuries in 35 sports reported to the database. The number and incidences of injuries as well as injuries leading to permanent medical impairment (PMI) were calculated during 2008-2011. Each year approximately 12,000 injuries and 1,162,660 licensed athletes were eligible for analysis. Eighty-five percent of the injuries were reported in football, ice hockey, floorball, and handball. The highest injury incidence as well as PMI was in motorcycle, handball, skating, and ice hockey. Females had higher risk of a PMI compared with males in automobile sport, handball, floorball, and football. High-risk sports with numerous injuries and high incidence of PMI injuries were motorcycle, handball, ice hockey, football, floorball, and automobile sports. Thus, these sports ought to be the target of preventive actions at national level.

Positive short-term subjective effect of sports drink supplementation during recovery.

AIM: The aim of this study was to investigate the effects of a naturally composed sports drink containing proteins and carbohydrates used during recovery in competitive badminton players. The hypothesis was that the use of a recovery drink would lead to positive subjective effects, enhanced physical performance and less signs of overtraining. METHODS: During an in-door season 18 badminton players were instructed to drink at least 250 mL of a given sports drink immediately after each training or playing session. The study design was prospective double blind crossover with one active drink and one placebo. The active drink was based on natural products containing whey and orange juice, and the placebo was made of diluted apple juice. Evaluation of effects was done with laboratory tests, self-registered values and field tests. RESULTS: The players perceived statistically significant short-term subjective positive effects after using the active drink, compared with after using placebo. The blood hemoglobin concentration was also higher after the period with active drink. There were no other differences concerning other laboratory tests (leg strength, endurance, body fat percent, lean arm and leg masses), self-registered values (body weight, pulse, training amount and intensity) or field tests (speed, explosive effort, grip strength, endurance and POMS) between the periods with the different sports drinks. CONCLUSIONS: Supplementation with a sports drink during recovery showed a significant short-term subjective positive effect compared with placebo. However, no effects were seen on physical performance or signs of overtraining.

The use of dGPS and simultaneous metabolic measurements during orienteering.

PURPOSE: The Global Positioning System (GPS) is a satellite-based system for navigation. With this system, it is possible to pinpoint a subject's location on earth and to display the speed of movement. With the use of differentiation (dGPS), the accuracy of the GPS position and speed measurements can be improved. Our purpose was to investigate whether it would be possible to relate dGPS data with physiological variables in a field test and thus achieve a more controlled field test and hence improve the value of sport-specific testing. METHODS: 10 male orienteers were equipped with a portable metabolic gas analyzer and a differential Global Positioning System (dGPS). A field test was performed on a 4.3-km orienteering course. Oxygen uptake, carbon dioxide excretion, and heart rate were determined every 10 s. Speed was calculated by Doppler shift every 2 s and by differences in dGPS time and position. Validation of dGPS position, distance, and speed measurements was made on two fixed positions and on a 115-m straight asphalt road. RESULTS: The orienteers' route was visualized by the dGPS equipment. Detailed analysis of running speed in different sections of the course was made possible. Further, it was possible to relate each physiological data to the location of the subject. The correlation coefficient between speed measured by dGPS and speed measured by chronometry was r = 0.9995-0.9996. The mean errors of distance and position measurements were 0.04-0.7% and 1.94-2.13 m, respectively. CONCLUSION: dGPS was shown to be a method that could give detailed information about a subject's speed and position. It was further demonstrated that physiological variables could be related to dGPS data.

Heart rate variability in athletes: relationship with central and peripheral performance.

PURPOSE: To investigate relationships between heart rate variability (HRV) and peripheral and central performance measures, 17 cross-country (X-C) skiers and seven canoeists were studied before and after a training period of 7 months. METHODS: For the skiers and canoeists respectively, leg and arm peak torque (Tq), time to peak torque (TiTq), and total work (Wrk) were measured in an isokinetic dynamometer. Maximal oxygen uptakes (VO(2max)) were obtained from treadmill tests. Power spectral analysis of HRV was performed on electrocardiographic recordings in the resting supine position and after a tilt to yield power in the low-frequency (0.04--0.15 Hz) and high-frequency (0.15--0.45 Hz) components of HRV. RESULTS: The change in normalized LF-variability in standing (Delta LFnT) correlated (P < 0.01) with the changes in TiTq (r = 0.63), max lactate (r = -0.63), and VO(2max) (r = -0.53). The change in absolute LFT was inversely correlated with the change in Tq. Subjects who improved VO(2max) were characterized by consistently higher high-frequency and total HRV than subjects with deteriorated aerobic capacity (P < 0.05). CONCLUSION: The results suggest that improved measures of both peripheral and central (aerobic) work capacities were associated with a reduction of low-frequency HRV in the tilted position. High-frequency and total HRV did not change in proportion with changes in muscle performance or aerobic capacity, but the ability to further improve VO(2max) with training in these already fit subjects seemed to depend on their average levels of these HRV measures, interpreted to reflect parasympathetic activity.

Cardiac autonomic imbalance in an overtrained athlete.

PURPOSE: In order to investigate overtraining-related adaptations in the autonomic nervous system, cardiac autonomic activity was examined in a junior cross-country skier who presented with reduced performance in competitions, early breathlessness during training sessions, and accumulated central fatigue. METHODS: Power spectral analysis of heart rate variability (HRV) was performed before, when overtrained (OT), and after recovery (Rec). RESULTS: In the overtrained state, high frequency (HF) and total powers in the lying position were higher compared with before and after. In normalized units, the increased HF in OT was even more prominent and clearly higher than in any control subject, and it was reversed in Rec. Resting heart rate was slightly reduced in OT and returned to baseline in Rec. CONCLUSIONS: The shift toward increased heart rate variability, particularly in the HF range, together with a reduced resting heart rate suggest a cardiac autonomic imbalance with extensive parasympathetic modulation in this athlete when overtrained.

Short-term overtraining: effects on performance, circulatory responses, and heart rate variability.

PURPOSE AND METHODS: Nine elite canoeists were investigated concerning changes in performance, heart rate variability (HRV), and blood-chemical parameters over a 6-d training camp. The training regimen consisted of cross-country skiing and strength training, in total 13.0+/-1.6 h, corresponding to a 50% increase in training load. RESULTS: Time to exhaustion (RunT) decreased from 19.1+/-1.0 to 18.0+/-1.2 min (P < 0.05). VO2max and max lactate (La(max)) both decreased significantly (P < 0.05) over the training period (4.99+/-0.97 to 4.74+/-0.98 L x min(-1) and from 10.08+/-1.25 to 8.98+/-1.03 mmol x L(-1) respectively). Heart rates (HR) decreased significantly at all workloads. Plasma volume increased by 7+/-7% (P < 0.05). Resting cortisol, decreased from 677+/-244 to 492+/-222 nmol x L(-1) (P < 0.05), whereas resting levels of adrenaline and noradrenaline remained unchanged. The change between tests in RunT correlated significantly with the change in HRmax (r = 0.79; P = 0.01). There were no group changes in high or low frequency HRV, neither at rest nor following a tilt. CONCLUSIONS: The reduced maximal performance indicates a state of fatigue/overreaching and peripheral factors are suggested to limit performance even though HRmax and La(max) both were reduced. The reduced submaximal heart rates are probably a result of increased plasma volume. HRV in this group didn't seem to be affected by short-term overtraining.

Physical training with and without oxygen in patients with chronic obstructive pulmonary disease and exercise-induced hypoxaemia.

A randomized, controlled, single-blind study was performed on 20 patients with chronic obstructive pulmonary disease and exercise-induced hypoxaemia. Ten patients each were randomly assigned to one of two groups, one training with air and the other training with oxygen. There were no significant differences between the groups regarding values measured prior to the study. The patients trained 3 times per week for 30 minutes each time for a duration of 8 weeks. The training consisted of interval walking on a treadmill (intensity set according to Borg ratings) with either air or oxygen administered through a nasal cannula at a rate of 5 l/min. Training significantly improved the 6-minute walking distance by 20% and 14% in the air and oxygen group, respectively, when the patients were tested on air. In the same test the air group significantly decreased Borg ratings for perceived exertion. Borg ratings for dyspnoea and perceived exertion significantly decreased in the oxygen group when they were tested on oxygen. It was concluded that oxygen supplementation did not further improve the training effect, compared with training with air, in patients with chronic obstructive pulmonary disease and exercise-induced hypoxaemia.

[Training and sports competition during pregnancy and after childbirth. Physical training is beneficial for mother and child]. / Träning och tävling under graviditet och efter barnafödande. Fysisk träning är bra för både mamman och barnet.

Physical training and activity during pregnancy is very common today, and many women even continue training after the 25th week of gestation. Irrespective of its level of intensity, training has not proved to be associated with manifest risk. Moderate training seems to be beneficial, by increasing the peripheral effect of insulin among those possibly at risk of gestational diabetes. Gravidae who train not only tend to be characterised by better health and self-esteem, and a lower incidence of depression during pregnancy, but also find delivery less strenuous. The offspring of women who train during pregnancy manifest fewer signs of stress during delivery, and are usually characterised by better general condition (e.g., higher Apgar scores).

Body composition and performance in cross-country skiing.

The purpose of this study was to investigate the relationships between body composition and performance in cross-country skiing. Ten male college-aged elite cross-country skiers (17.9 yrs; S 1.0 yrs) participated in a 5.6-km cross-country skiing time trial and in dual energy X-ray absorptiometry (DXA, Lunar DPX-L, Madison, WI, USA) body composition measurements. A differential global positioning system (dGPS, GPS 12 CX, Garmin Int. Inc., Olathe, KS, USA; RXMAR 2, Aztec SA, Strasbourg, France) was used to compute speed in different sections of the course. Spearman correlation analyses were applied. Total body weight and absolute lean body mass were significantly related to final time (r = - 0.721; p < 0.05 and - 0.830; p < 0.01, respectively). Absolute lean arm mass (kg) was negatively correlated to final time (r = - 0.648; p < 0.05) and the relative lean arm mass was significantly related to speed mainly in uphill sections (r = 0.636 to 0.867; p < 0.05 to p < 0.01). We suggest that large amounts of lean body mass, especially in the arms, seem to be of great importance for cross-country skiing performance.

Gender in ice hockey: women in a male territory.

This study investigates how female ice hockey players describe and explain their situation within as well as outside their sport. Information was obtained by semi-structured interviews with female ice hockey players. The results were analyzed in a gender perspective where the main starting point was the concepts of different levels of power relations in society developed by Harding and applied to sports by Kolnes (the symbolic, structural, and individual level). The study shows that the players appeared to share the traditional views of men and women. They also described gender differences in terms of financial and structural conditions as well as differences in ice hockey history. Even though the players described structural inequalities, they were quite content with their situation and the differences in conditions were not considered when they explained the gender differences in ice hockey performance. At the individual level, the players considered themselves different from other women and appeared to share the traditional views of femininity and masculinity. It has been suggested that performance of a sport traditionally associated with the other sex might alter the traditional view of men and women; however, our results lend little support to this suggestion.

Distribution, number and size of different types of fibres in whole cross-sections of female m tibialis anterior. An enzyme histochemical study.

The aim of the study was to determine the distribution, total number and size of different types of fibres in whole cross-sections of female m tibialis anterior and to compare these data with previous results obtained from male skeletal muscles as well as with data on female muscles obtained by biopsy technique. The distribution of fibre types varied within the muscle cross-sections, and the pattern was slightly different from that earlier described for male muscles (Henriksson-Larsén et al. 1983). No difference in mean fibre type occurrence was found between the left and right muscles of the females. The type 2 fibres varied in size in different muscle regions and were usually largest at the deep surface of the muscle. Both the total number and size of the muscle fibres were smaller in the female muscles than in the corresponding male muscles (Henriksson-Larsén et al. 1985a, b). This resulted in a 30-40% smaller value for the total muscle fibre area in the female muscles compared to the male muscles.

Mechanical output and electromyographic parameters in males and females during fatiguing knee-extensions.

The purpose of this study was to elucidate if the m. quadriceps femoris was fully activated during the first contractions of a series of repetitive maximal contractions and if there was any difference in the development of fatigue between sexes. To do this sixteen untrained subjects performed two series of contractions in an isokinetic dynamometer: one series of single maximum contractions and one series of repetitive maximum contractions. The EMG activity of m. vastus lateralis, m. vastus medialis and m. rectus femoris was recorded. The subjects were unable to perform maximum effort during the first repetitions of each trial, which might influence the results of fatigue studies, if these contractions are chosen as reference. We also found in contrast to other studies a decrease in RMS between the reference contraction and the fatigue level. We have not been able to display any difference between males and females during fatigue either in relative mechanical output nor in electromyographic parameters or experience in fatigue during isokinetic knee-extensions.

Do the fibre-type proportion and the angular velocity influence the mean power frequency of the electromyogram?

The dependence of the mean-power frequency and the signal amplitude of the electromyogram (EMG) on the angular velocity and the fiber-type proportion were investigated in nine female volunteers. The subjects were required to perform maximum knee extensions using an isokinetic dynamometer at different angular velocities; 0.57, 1.05, 1.57, 2.09 and 3.14 rad s-1. Electromyographic signals were obtained from the vastus lateralis, vastus medialis and the rectus femoris muscles. The angle and the torque signals were recorded simultaneously with the three EMG signals on a tape-recorder. From the EMG recordings the mean power frequency (MPF) and the signal amplitude were determined. Muscle biopsies were later obtained from the right vastus lateralis and stained for alkaline and acid mATPase for the determination of fibre-type proportions and areas. Neither the signal amplitude nor the MPF of the EMG of the three muscles were dependent on the angular velocity. The MPF of the vastus lateralis correlated significantly (r = -0.93) with the type 1 fibre proportion at 1.57 rad s-1. However, there was no significant correlation between the areas of the fibre types, alone or together, and the MPF. In conclusion the fibre-type proportion was the major factor behind the MPF irrespective of angular velocity.

Muscular fatigue during repeated isokinetic shoulder forward flexions in young females.

Peak torque, work, mean power and electromyographic (EMG) activity were recorded for each of 150 repeated isokinetic maximal shoulder flexions (45 degrees-90 degrees) in 23 healthy females. From the EMG signals of trapezius, deltoid, infraspinatus and biceps brachii the mean power frequency and the signal amplitude were determined in real time. The mechanical output showed a steep decrease during the first 40 contractions, followed by a plateau maintained until the end. In all muscles, except the biceps brachii, significant decreases in mean power frequency occurred during the first 40 contractions, showing a tendency to stabilize around the same absolute frequency value. Signal amplitude increased in the trapezius, the deltoid and the infraspinatus, but was constant in the biceps brachii. For some individuals rather high EMG activity was recorded in the muscles during the time the arm was supposed to be passively extended to the starting position, and this was found to be associated with lower strength and endurance levels. Longitudinal analyses showed that the mean power frequencies correlated better than the signal amplitudes with the three mechanical variables. The results suggest that the initial steep decrease in mechanical performance and mean power frequency is caused by fatiguing of type 2 motor units.

Pre- and post-season heart rate variability in adolescent cross-country skiers.

To investigate the effects on cardiac autonomic control after a competitive cross-country skiing season, 9 females and 8 males, 16-19 years old, performed tilt-table heart rate variability (HRV) recordings and incremental treadmill tests before (August), and after (April the following year) the most intensive period of training and competition. Spectral analysis of HRV showed increased total variability at rest and reduced low frequency variability in the tilted position (LFtilt) at the second test (P<0.05). The female subgroup showed consistently higher high frequency (HF) and total heart rate variability than males. Total run time (RunT) increased from 18.5+/-1.9 min to 19.4+/-1.7 min (mean+/-SD) in the entire group (P<0.05), while VO2max only showed a non-significant increase (0.05

Inter-relationship between muscle morphology, mechanical output and electromyographic activity during fatiguing dynamic knee-extensions in untrained females.

Changes in mechanical performance and electromyographic activity during fatiguing dynamic knee-extensions were evaluated with respect to muscle fibre type composition of the vastus lateralis muscle in nine sedentary female [23 (3) years] volunteers. The subjects performed 150 repetitive maximum knee-extensions using a Cybex dynamometer at 1.57 rad x s(-1). EMG activity was recorded from the vastus lateralis, the vastus medialis and the rectus femoris muscles. For each contraction, mean power frequency (MPF) and the root mean square (RMS) of the EMG were calculated, simultaneously with the peak torque (PT), contractional work (CW) and the mean power (MP). The MPF showed an initial decrease followed by a stable phase. The RMS increased during the initial seven contractions, after which a period of variability was displayed until about the 60th contraction. At the plateau level (last 50 contractions) the relative RMS values were not significantly different from the initial values. The PT, CW and MP increased during the initial five to ten contractions, after which a two-phase pattern was displayed, with a gradual decline followed by a stable phase. The absolute plateau level of MPF for the vastus lateralis muscle showed a significant negative correlation with the area percentage of type-1 fibres (r = -0.71). Significant correlations were also demonstrated to occur between the absolute plateau levels of PT, CW and MP and the relative proportion of type-1 fibres (r = 0.80, r = 0.82 and r = 0.82 respectively). Thus, in female subjects the mechanical performance and the MPF during fatigue are at least partly determined by muscle morphology.

Distribution of fibre sizes in human skeletal muscle. An enzyme histochemical study in m tibialis anterior.

The aim of the study was to determine the fibre size distribution within the human m tibialis anterior. Ten-micron thick cross-sections of the whole muscle were enzyme histochemically stained for myofibrillar ATPase at pH 9.4. The cross-sectional area of 100 fibres with low (type 1) ATPase and high (type 2) ATPase activity was measured in three different regions (superficial, central and deep). Both the type 1 and type 2 fibres were found to be larger in the deep region than in the central or superficial regions. The variation in fibre size could not be explained by the cryofixation or cryo-embedding techniques used. The data suggest that muscle adaptation to physical demands may not only occur by means of variation in types and number of muscle fibres, but also by variation in fibre size over the muscle cross-section.

Distribution of different fibre types in human skeletal muscles. I. Method for the preparation and analysis of cross-sections of whole tibialis anterior.

The aim of this study was to examine whether small biopsy specimens are representative of the whole human skeletal muscle or whether the different fibre types are unevenly distributed at different depths of the muscle. Ten micrometre thick cross-sections of whole human tibialis anterior were prepared using LKB PMV Cryo-Microtomes with a stroke length of 160 to 480 mm and the sections were stained for myofibrillar ATPase according to a modified procedure. The total and relative number of different fibres (Types 1 and 2) was determined in every 9th mm2 of the section. The data obtained were analysed by means of a computer program, which allowed assessment of bivariate data in the form of contour plots. The total number of fibres varied greatly between individuals (from 96 000 to 162 000; five individuals). The relative number of different fibres varied systematically in all individuals as a function of depth in the muscle. There was a gradual, often dramatic, relative increase in Type 2 fibre occurrence from the surface of the muscle (about 10--25%) towards the deeper regions (30--50%), the maximum being approximately along a line slightly posterior to the middle of the muscle. Additionally, superficial peaks were seen in places. In conclusion, the fibre type distribution in the tibialis anterior is not random. These results point to the importance of defining biopsy depth.

Distribution of different fiber types in human skeletal muscles: effects of aging studied in whole muscle cross sections.

The effects of aging on the total number and size of fibers, and the proportion and distribution of type 1 (slow twitch) and type 2 (fast twitch) fibers were studied in cross sections (15 mu thick) of autopsied whole m. vastus lateralis from two age groups. Each group consisted of six, previously physically healthy males (mean age 72 +/- 1 years and 30 +/- 6 years, respectively). The size of the muscles of the older individuals was 18% smaller (P less than 0.01) and the total number of fibers was 25% lower (P less than 0.01) than those of the young individuals (mean number 364,000 +/- 50,000 vs 478,000 +/- 56,000). There was, however, no significant difference in the mean fiber size (indirectly determined) or the proportion of the two fiber types, though a preferential reduction in type 2 fiber number in the aged individuals was seen. The relative occurrence of the fiber types at various depths in the aged muscles was found to be more even than in muscles from the young individuals. The results suggest that the aging atrophy in m. vastus lateralis, at least up to the age of 70, is primarily the result of a loss of fibers.

Distribution of different fibre types in human skeletal muscles. 2. A study of cross-sections of whole m. vastus lateralis.

In order to determine the total number of fibres and the extent to which the relative occurrence of different fibre types varies within m. vastus lateralis, 15 micrometers thick cross-sections of whole muscles were prepared. The total number of type 1 and type 2 fibres was determined in every 48th square millimetre of the section, and the results thus obtained were analysed using a computer program allowing an assessment of bivariate data in the form of contour plots. The total number of fibres varied both in proximal to distal direction in the same muscle and between individuals. No obvious correlation existed between the mean fibre area and the muscle cross-sectional area. The proportion of type 1 fibres in the whole muscle varied between individuals (from 44% to 57%) with a mean value for all five of 52%. The distribution of different fibre types varied within the muscle, mainly as a function of depth, with a predominance to type 2 fibres at the surface and type 1 fibres in deeper regions of the muscle. Thus, the fibre type distribution in m. vastus lateralis is not random. This must be taken into consideration when data on fibre type composition are compared with functional variables.