Reliability of recovery heart rate variability measurements as part of the Lamberts Submaximal Cycle Test and the relationship with training status in trained to elite cyclists.

PURPOSE: To determine if post-exercise heart rate variability, in the form of logged transformed root mean square of successive differences of the R-R intervals (LnRMSSD) can be measured reliably during the recovery from a submaximal cycle test and what the relationship of LnRMSSD is with training status of the cyclists. METHODS: Fourteen male cyclists participated in the reliability part for the study, which included performing six Lamberts Submaximal Cycle Test (LSCT), during which recovery LnRMSSD was measured over 30 s (LnRMSSD30 s), 60 s LnRMSSD60 s)and 90 s LnRMSSD90 s). In addition, fifty male and twenty female cyclists completed a peak power output (PPO) test (including VO2peak) and 40 km time trial (40 km TT) before which they performed the LSCT as a standardized warm-up. Relationships between the LnRMSSD and PPO, VO2peak and 40 km TT time were studied. RESULTS: Due to the design of the LSCT, submaximal heart and breathing rate were similar at the end of stage 3 of the LSCT, as well as during the recovery periods. The highest reliability was found in LnRMSSD60 s (ICC: 0.97) with a typical error of the measurement (TEM: 5.8%). In line with this the strongest correlations were found between LnRMSSD60 s and PPO (r = 0.93[male]; 0.85[female]), VO2peak (r = 0.71[male]; 0.63[female];) and 40 km TT (r = - 0.83[male]; - 0.63[female]). CONCLUSIONS: LnRMSSD60 s can be measured reliably after the LSCT and can predict PPO, VO2peak and 40 km TT performance well in trained-to-elite cyclists. These findings suggest that recovery LnRMSSD can potentially play an important role in monitoring and fine-tuning training prescriptions in trained-to-elite cyclists.

Overhead throwing in cricketers: A biomechanical description and playing level considerations.

This study aimed to describe stationary overhead throwing biomechanics in South African cricketers, considering playing level, and relative to baseball. Kinematics and ground reaction forces were collected during throwing trials. Inverse dynamics was used to calculate joint kinetics. Inter-subject variability was calculated using the coefficient of variance. A one-dimensional statistical parametric mapping ANOVA was conducted to assess differences between the kinematic waveforms in elite and amateur cricketers (p < 0.05). Fifteen cricketers (elite = 8; amateur = 7) participated in this study. The basic parameters of a cricketer's throwing action are described. Substantial inter-subject variability was noted for all variables, except lumbopelvic movement. Cricketers presented with 74.9 ± 27.3° glenohumeral external rotation and 94.8 ± 23.7° elbow flexion, at maximum external rotation (MER). Amateur cricketers displayed decreased elbow flexion range of motion between 2-14% of the throwing cycle (F = 9.365;p = 0.01); greater shoulder (121.0vs85.9 N; F = 0.36,p = 0.021) and elbow compression (105.6vs72.8 N;F = 0.007,p = 0.043), and superior shoulder force (203.1vs115.5 N;F = 2.43,p = 0.022) at MER, when compared with elite cricketers. Cricketers display similarities to baseball pitchers when throwing overhead from a stationary position. The "preparatory arc" utilised is different to the wind-up noted for baseball. The forces exerted on the shoulder and elbow, in amateur cricketers specifically, are substantially greater at MER and may indicate the potential risk for injury.

Conceptualizing minimalist footwear: an objective definition.

Running has been plagued with an alarmingly high incidence of injury, which has resulted in the exploration of interventions aimed at reducing the risk of running-related injury. One such intervention is the introduction of footwear that mimics barefoot running. These have been termed minimalist shoes. Minimalist footwear aims to reduce the risk of injury by promoting adaptations in running biomechanics that have been linked to a reduction in both impact and joint forces. However, some studies have found that minimalist footwear may be beneficial to the runner as they promote favourable biomechanical adaptations, whilst other studies have found the opposite to be true. Reasons for these conflicting results could be attributed to the lack of a definition for minimalist footwear. The aim of this review article is to provide a structural definition for minimalist footwear based on studies that have examined the influence of footwear on biomechanical variables during running. Based on current literature, we define minimalist footwear as a shoe with a highly flexible sole and upper that weighs 200g or less, has a heel stack height of 20mm or less and a heel-toe differential of 7mm or less.

Bone health in elite Kenyan runners.

Impact loading in athletes participating in various sports has been positively associated with increased bone mineral density (BMD), but this has not been investigated in elite Kenyan runners. Body composition and site-specific BMD measures quantified with dual x-ray absorptiometry were measured in 15 elite male Kenyan runners and 23 apparently healthy South African males of different ethnicities. Training load and biomechanical variables associated with impact loading, such as joint stiffness, were determined in the elite Kenyan runners. Greater proximal femur (PF) BMD (g · cm-2) was higher (P = 0.001, ES = 1.24) in the elite Kenyan runners compared with the controls. Six of the 15 (40%) Kenyan runners exhibited lumbar spine (LS) Z-Scores below -2.0 SD, whereas this was not found in the apparently healthy controls. PFBMD was associated with training load (r = 0.560, P = 0.003) and ankle (r = 0.710, P = 0.004) and knee (r = 0.546, P = 0.043) joint stiffness. Elite Kenyan runners exhibit greater PFBMD than healthy controls, which is associated with higher training load and higher joint stiffness. Our results reaffirm the benefits of impact loading on BMD at a weight-bearing site, while a high prevalence of low LSBMD in the elite Kenyan runners is hypothesised to be the result of a mismatch between energy intake and high training load. Future research investigating energy availability in Kenyan runners and the possible association with musculoskeletal injury should be investigated.

Race walking gait and its influence on race walking economy in world-class race walkers.

AIM: The aim of this study was to determine the relationships between biomechanical parameters of the gait cycle and race walking economy in world-class Olympic race walkers. METHODS: Twenty-One world-class race walkers possessing the Olympic qualifying standard participated in this study. Participants completed an incremental race walking test starting at 10 km·h-1, where race walking economy (ml·kg-1·km-1) and spatiotemporal gait variables were analysed at different speeds. RESULTS: 20-km race walking performance was related to race walking economy, being the fastest race walkers those displaying reduced oxygen cost at a given speed (R = 0.760, p < 0.001). Longer ground contact times, shorter flight times, longer midstance sub-phase and shorter propulsive sub-phase during stance were related to a better race walking economy (moderate effect, p < 0.05). CONCLUSION: According to the results of this study, the fastest race walkers were more economi cal than the lesser performers. Similarly, shorter flight times are associated with a more efficient race walking economy. Coaches and race walkers should avoid modifying their race walking style by increasing flight times, as it may not only impair economy, but also lead to disqualification.

Habitual Minimalist Shod Running Biomechanics and the Acute Response to Running Barefoot.

The aim of the study was to determine whether habitual minimalist shoe runners present with purported favorable running biomechanithat reduce running injury risk such as initial loading rate. Eighteen minimalist and 16 traditionally cushioned shod runners were assessed when running both in their preferred training shoe and barefoot. Ankle and knee joint kinetics and kinematics, initial rate of loading, and footstrike angle were measured. Sagittal ankle and knee joint stiffness were also calculated. Results of a two-factor ANOVA presented no group difference in initial rate of loading when participants were running either shod or barefoot; however, initial loading rate increased for both groups when running barefoot (p=0.008). Differences in footstrike angle were observed between groups when running shod, but not when barefoot (minimalist:8.71±8.99 vs. traditional: 17.32±11.48 degrees, p=0.002). Lower ankle joint stiffness was found in both groups when running barefoot (p=0.025). These findings illustrate that risk factors for injury potentially differ between the two groups. Shoe construction differences do change mechanical demands, however, once habituated to the demands of a given shoe condition, certain acute favorable or unfavorable responses may be moderated. The purported benefits of minimalist running shoes in mimicking habitual barefoot running is questioned, and risk of injury may not be attenuated.

Submaximal Markers of Fatigue and Overreaching; Implications for Monitoring Athletes.

The regular monitoring of athletes is important to fine-tune training and detect early symptoms of overreaching. Therefore the aim of this study was to determine if a noninvasive submaximal running test could reflect a state of overreaching. 14 trained runners completed a noninvasive Lamberts Submaximal Running Test, one week before and 2 days after finishing an ultramarathon, and delayed onset of muscle soreness and the daily analysis of life demands for athletes questionnaire were also captured. After the ultramarathon, submaximal heart rate was lower at 70% (-3 beats) and 85% of peak treadmill running speed (P<0.01). Ratings of perceived exertion were higher at 60% (2 units) and 85% (one unit) of peak treadmill running speed, while 60-second heart rate recovery was significantly faster (7 beats, P<0.001). Delayed Onset of Muscle Soreness scores and the number of symptoms of stress (Daily Analysis of Life Demands for Athletes) were also higher after the ultramarathon (P<0.01). The current study shows that the Lamberts Submaximal Running Test is able to reflect early symptoms of overreaching. Responses to acute fatigue and overreaching were characterized by counterintuitive responses, such as lower submaximal heart rates and faster heart rate recovery, while ratings of perceived exertion were higher.

Muscle co-activation and its influence on running performance and risk of injury in elite Kenyan runners.

The relationship between muscle co-activation and energy cost of transport and risk of injury (initial loading rate and joint stiffness) has not been jointly studied. Fourteen elite Kenyan male runners were tested at two speeds (12 and 20 km · h-1), where oxygen consumption, kinematic, kinetic and electromyography were recorded. Electromyography of seven lower limb muscles was recorded. Pre-activation and ground contact of agonist:antagonist co-activation was determined. All muscles displayed higher activity during pre-activation except rectus femoris (RF). Conversely, no differences were found during ground contact except for higher biceps femoris (BF) at 20 km · h-1. Knee stiffness was correlated to RF-BF co-activation during both pre-activation and ground contact at both running speeds. However, energy cost of transport was only positively correlated to the above-mentioned muscle pairs at 20 km · h-1 (r = 0620, P = 0.032; r = 0.682, P = 0.015, respectively). These findings emphasise the influence of neuromuscular control and performance and its support to musculoskeletal system to optimise function and modulate risk of injury. Further, neuromuscular activity during terminal swing is also important and necessary to execute and maintain performance.

Barefoot running: an evaluation of current hypothesis, future research and clinical applications.

Barefoot running has become a popular research topic, driven by the increasing prescription of barefoot running as a means of reducing injury risk. Proponents of barefoot running cite evolutionary theories that long-distance running ability was crucial for human survival, and proof of the benefits of natural running. Subsequently, runners have been advised to run barefoot as a treatment mode for injuries, strength and conditioning. The body of literature examining the mechanical, structural, clinical and performance implications of barefoot running is still in its infancy. Recent research has found significant differences associated with barefoot running relative to shod running, and these differences have been associated with factors that are thought to contribute to injury and performance. Crucially, long-term prospective studies have yet to be conducted and the link between barefoot running and injury or performance remains tenuous and speculative. The injury prevention potential of barefoot running is further complicated by the complexity of injury aetiology, with no single factor having been identified as causative for the most common running injuries. The aim of the present review was to critically evaluate the theory and evidence for barefoot running, drawing on both collected evidence as well as literature that have been used to argue in favour of barefoot running. We describe the factors driving the prescription of barefoot running, examine which of these factors may have merit, what the collected evidence suggests about the suitability of barefoot running for its purported uses and describe the necessary future research to confirm or refute the barefoot running hypotheses.

Stride angle as a novel indicator of running economy in well-trained runners.

The main purpose of this study was to investigate the relationship between a novel biomechanical variable, the stride angle, and running economy (RE) in a homogeneous group of long-distance athletes. Twenty-five well-trained male runners completed 4-minute running stages on a treadmill at different set velocities. During the test, biomechanical variables such as stride angle, swing time, ground contact time, stride length, stride frequency, and the different sub-phases of ground contact were recorded using an optical measurement system. VO2 values at velocities below the lactate threshold were measured to calculate RE. Stride angle was negatively correlated with RE at every speed (p < 0.001, large effect sizes). Running economy was also negatively correlated with swing phase and positively correlated with ground contact time and running performance according to the best 10-km race time (p ≤ 0.05, moderate and large effect sizes). Last, stride angle was correlated with ground contact time at every speed (p < 0.001, large effect sizes). In conclusion, it seems that optimal execution of stride angle allows runners to minimize contact time during ground contact, whereby facilitating a better RE. Coaches and/or athletes may find stride angle a useful and easily obtainable measure to track and make alterations to running technique, because changes in stride angle may influence the energy cost of running and lead to improved performance.

Assessing spring-mass similarity in elite and recreational runners.

The dynamic complexity and individualization of running biomechanics has challenged the development of objective and comparative gait measures. Here, we present and explore several novel biomechanical metrics for running that are informed by a canonical inter-species gait template-the spring-mass model. The measures assess running mechanics systemically against the template via quantifying characteristics of a runner's kinetics relative to the energy-conserving elastic system-i.e., their "spring-mass similarity". Applying these metrics in a retrospective cohort investigation, we studied the overground kinetics of two heterogenous populations of runners in two footwear conditions: elite and recreational athletes in shod and barefoot conditions. Across all measures and within foot strike types, the elite runners exhibited mechanics that were more similar to those of the ideally elastic spring-mass template. The elite runners had more symmetric bounces, less discrepancy (i.e., greater coordination) between horizontal and vertical kinetic changes, and better fit to a spring-mass vertical ground reaction force time series. Barefoot running elicited greater kinetic coordination in the recreational runners. At a faster speed, the elites further improved their similarity to the template. Overall, the more economical elite group exhibited greater likeness to the linearly elastic, energy-conserving spring-mass system than their recreational counterparts. This study introduces novel biomechanical measures related to performance in distance running. More broadly, it provides new, approachable metrics for systemic quantification of gait biomechanics in runners across all demographics. These metrics may be applied to assess a runner's global biomechanical response to a variety of interventions, including training adaptations, rehabilitation programs, and footwear conditions.

Overhead throwing biomechanics in cricketers: The effect of a run-up approach.

Overhead throwing by cricketers when fielding with different approaches has been described using two-dimensional analysis. Currently, the three-dimensional kinematic and kinetic characteristics of an overhead throw performed by cricketers following a run-up are unknown. Fifteen South African cricketers performed six overhead throws, from a stationary position and with a run-up over 15-20 m prior to fielding a ball, respectively. Kinematic data and ground reaction forces were collected throughout the throwing trials. Joint kinetics were calculated using inverse dynamics. An independent t-test or Mann-Whitney U-test was used to determine joint kinetic differences between throwing approaches. Differences between the kinematic waveforms for stationary and run-up throwing approaches were assessed using one-dimensional statistical parametric mapping ANOVA (P < 0.05). The shoulder, elbow and thoraco-lumbar joints displayed similar kinematics between throwing approaches. The run-up approach displayed increased hip flexion between 0-34% and 57-100% (F(1, 28) = 6.726; P = 0.01) of the throwing cycle; and lumbo-pelvic flexion between 57 and 65% (F(1, 28) = 6.823; P = 0.02) of the throwing cycle; greater shoulder compression (F(1, 28) = 1.036; P = 0.02) and posterior force (F(1, 28) = 1.052; P = 0.009) at maximum external rotation; yet less superior shoulder force (F(1, 28) = 1.744; P = 0.005) and elbow compression (F(1, 28) = 4.331; P = 0.03), superior (F(1, 28) = 1.212; P = 0.002) and medial (F(1, 28) = 1.370; P = 0.03) elbow forces at ball release, when compared to a stationary position. Cricketers maintain similar upper limb kinematics between overhead throwing approaches. However, throwing with a run-up approximately doubles the forces exerted on the shoulder at maximum external rotation, which is most likely caused by the greater dominant hip and lumbo-pelvic flexion noted. This may amplify the potential risk for shoulder injury when throwing.HighlightsThrowing arm motion is similar irrespective of the approach used by cricketers to throw.Throwing with a run-up produced increased angles of lumbo-pelvic and dominant hip flexion in various phases of the throwing cycle.Throwing with a run-up resulted in greater shoulder compression and posterior force at maximum external rotation.

Changes in total body water content during running races of 21.1 km and 56 km in athletes drinking ad libitum.

OBJECTIVE: To measure changes in body mass (BM), total body water (TBW), fluid intake, and blood biochemistry in athletes during 21.1-km and 56-km foot races. DESIGN: Observational study. SETTING: 2009 Two Oceans Marathon, South Africa. PARTICIPANTS: Twenty-one (21.1 km) and 12 (56 km) participants were advised to drink according to thirst or their own race drink plan (ad libitum). MAIN OUTCOME MEASURES: Body mass, TBW, plasma osmolality, plasma sodium (p[Na]), and plasma total protein ([TP]) concentrations were measured before and after race. Fluid intake was recorded from recall after race. RESULTS: Significant BM loss occurred in both races (21.1 km; -1.4 ± 0.6 kg; P < 0.000 and 56 km; -2.5 ± 1.1 kg; P < 0.000). Total body water was reduced in the 56-km race (-1.4 ± 1.1 kg; P < 0.001). A negative linear relationship was found between percentage change (%Δ) in TBW and %Δ in BM in the 56-km runners (r = 0.6; P < 0.01). Plasma osmolality and [TP] increased significantly in the 56-km runners (6.8 ± 8.2 mOsm/kg H2O; P < 0.05 and 5.4 ± 4.4 g/L; P < 0.01, respectively), but all other biochemical measures were within the normal range. CONCLUSIONS: Although TBW decreased in the 56-km race and was maintained in the 21.1-km race, the change in TBW over both races was less than the BM, suggesting that not all BM lost during endurance exercise is a result purely of an equivalent reduction in TBW. These findings support the interpretation that the body primarily defends p[Na] and not BM during exercise and that a reduction in BM can occur without an equivalent reduction in TBW during prolonged exercise. Furthermore, these data support that drinking without controlling for BM loss may allow athletes to complete these events.

The association between gird and overhead throwing biomechanics in cricket.

The development of GIRD is a well-documented adaptation associated with repetitive overhead throwing in numerous sports. In occurrence with total rotational range of motion deficit, GIRD is considered pathological and increases shoulder injury risk. While cricketers demonstrate these deficits in rotational range; the association between GIRD and overhead throwing has yet to be explored. Therefore, the aim of this study was to determine the relationship between GIRD and overhead throwing biomechanics in cricketers. Passive shoulder rotational range of motion was measured in 15 cricketers (elite = 8, amateur = 7). Kinetic and kinematic data were obtained during overhead throws from a stationary and run-up approach. Linear regression was used to determine potential relationships between GIRD and discrete shoulder kinetics for both throwing approaches. One-dimensional statistical parametric mapping regression was conducted to assess relationships between GIRD and throwing kinematics. When throwing overhead from a stationary position, GIRD was associated with reduced hip abduction during the preparatory arc (p = 0.002); superior shoulder (p = 0.003) and elbow compressive (p = 0.009) forces, at cocking. In addition, GIRD was associated with increased posterior shoulder force during arm deceleration for both stationary (p = 0.013) and run-up approaches (p = 0.03) to overhead throwing. Cricketers with GIRD utilise a shorter stride, creating early pelvic rotation and a slow throwing arm with an associated reduction in forces about the shoulder and elbow at cocking, when throwing from a stationary position. Further, overload of the posterior shoulder occurs during arm deceleration, irrespective of throwing approach. These findings highlight potential shoulder injury risk.

Incidence and impact of time loss and non-time-loss shoulder injury in elite South African cricketers: A one-season, prospective cohort study.

OBJECTIVES: To determine the incidence, prevalence and impact of shoulder injury in elite South African cricketers. DESIGN: Prospective longitudinal cohort study. METHODS: One hundred and six senior national/franchise cricketers completed a pre-season Kerlan-Jobe Orthopaedic Clinic shoulder and elbow (KJOC) score. All injuries sustained during the 2016/2017 season were captured on an injury reporting system. Injuries were verified by the respective squad physiotherapist at the end of the season and post-season KJOC score was obtained from all the players. RESULTS: Eighteen percent (95% CI: 11-25%) of cricketers sustained a shoulder injury, at a rate of 0.19 injuries per player per year. Annual injury prevalence was 1.1%. Shoulder injury occurred primarily while throwing (58%). Fielding performance was maintained by adapting throwing technique (58%) or fielding position (21%). Thirty-two percent of shoulder injuries resulted in time lost to matches and/or training. A history of shoulder injury increased the risk of sustaining another injury by 1.91 times (95% CI: 1.73-2.15). Irrespective of injury, cricketers demonstrated consistently low pre- (78.5 ±â€¯15.6) and post-season (81.2 ±â€¯17.1) KJOC scores. Pre-season KJOC scores were significantly lower (r2 = 0.106, p = 0.001) in those cricketers with a history of shoulder injury. Cricketers who sustained a seasonal shoulder injury had significantly lower (r2 = 0.112, p < 0.001) post-season KJOC scores, indicating persistent shoulder pain or dysfunction. CONCLUSION: This is the first study to report both time- and non-time-loss shoulder injury in elite South African cricketers. All non-time-loss shoulder injuries compromised primary skill, while some resulted in changes to throwing technique and fielding position. Thus shoulder injury, whether it results in time loss or not, potentially impacts match performance.

Heat dissipating upper body compression garment: Thermoregulatory, cardiovascular, and perceptual responses.

PURPOSE: The aim of the present study was to determine the effects of an upper body compression garment (UBCG) on thermoregulatory responses during cycling in a controlled laboratory thermoneutral environment (~23°C). A secondary aim was to determine the cardiovascular and perceptual responses when wearing the garment. METHODS: Sixteen untrained participants (age: 21.3 ± 5.7 years; peak oxygen consumption (VO2peak): 50.88 ± 8.00 mL/min/kg; mean ± SD) performed 2 cycling trials in a thermoneutral environment (~23°C) wearing either UBCG or control (Con) garment. Testing consisted of a 5-min rest on a cycle ergometer, followed by 4 bouts of cycling for 14-min at ~50%VO2peak, with 1-min rest between each bout. At the end of these bouts there was 10-min of passive recovery. During the entire protocol rectal temperature (T rec), skin temperature (T skin), mean body temperature (T body), and heat storage (HS) were measured. Heart rate (HR), VO2, pH, hematocrit (Hct), plasma electrolytes, weight loss (W loss), and perceptual responses were also measured. RESULTS: There were no significant differences between garments for T skin, HS, HR, VO2, pH, Hct, plasma electrolyte concentration, W loss, and perceptual responses during the trial. T rec did not differ between garment conditions during rest, exercise, or recovery although a greater reduction in T rec wearing UBCG (p = 0.01) was observed during recovery. Lower T body during recovery was found when wearing UBCG (36.82°C ± 0.30°C vs. 36.99°C ± 0.24°C). CONCLUSION: Wearing a UBCG did not benefit thermoregulatory, cardiovascular, and perceptual responses during exercise although it was found to lower Tbody during recovery, which suggests that it could be used as a recovery tool after exercise.

The cricketer's shoulder: Not a classic throwing shoulder.

OBJECTIVES: To describe the musculoskeletal adaptations inherent to the cricketers' shoulder and determine potential predictors of shoulder injury in elite South African cricketers. DESIGN: Prospective longitudinal cohort study; SETTING: Non-clinical, at national cricket indoor training venues. PARTICIPANTS: One hundred and six elite cricketers, representing 82% of the South African national and franchise teams, consent. A total of 105 cricketers (27 ±â€¯4 years) were eligible for participation in this study. MAIN OUTCOME MEASURES: A pre-season shoulder screening battery including a shoulder function questionnaire, two ultrasonographic shoulder measurements and 14 musculoskeletal tests including pain provocation, range of motion, strength and flexibility was assessed. Non-contact dominant shoulder injuries were documented throughout the 2016/2017 season. RESULTS: The musculoskeletal profile of a cricketer's shoulder is described. 17% (95%CI: 9-24%) of cricketers sustained an injury during the 2016/2017 season. Two of the 17 screening tests predicted seasonal dominant shoulder injury (p < 0.05): a dominant supraspinatus tendon thickness ≥5.85 mm (sensitivity: 72%, specificity: 63%) and non-dominant pectoralis minor length ≤12.85 cm (sensitivity: 83%, specificity: 55%). CONCLUSION: The musculoskeletal adaptations inherent to cricketing shoulders are distinctly different to the classic "thrower's shoulder" described in baseball. A thickened dominant supraspinatus tendon and a shortened non-dominant pectoralis minor muscle are risk factors for developing shoulder injury in this group. This identifies the need to investigate preventative strategies (strengthening/flexibility) and throwing workload management in cricketers with shoulder injury.

Gait Pattern of Adults with Cerebral Palsy and Spastic Diplegia More Than 15 Years after Being Treated with an Interval Surgery Approach: Implications for Low-Resource Settings.

BACKGROUND: Single-event multilevel surgery (SEMLS) approach is regarded as the golden standard in developed countries to improve gait and functional mobility in children with cerebral palsy (CP). However, this approach is not always feasible in developing countries. Therefore, orthopedic surgery based on an interval surgery approach (ISA) is still commonly used in developing countries, although little is known about the long term outcomes of an ISA. Therefore, the aim of this study was to describe the gait patterns of adults with CP, who have been treated with ISA, which started more than 15 years ago. MATERIALS AND METHODS: Thirty adults with CP and spastic diplegia, who received ISA treatment 21.6-33.7 years ago, were recruited for this study and participated in three-dimensional gait analysis. Twenty kinematic and nondimensional temporal-distance parameters were captured, while the overall gait deviation index (GDI) was also calculated. Data of the adults with CP were compared to normative data of typically developing (TD) adults. RESULTS: Although all adults with CP were still ambulant, their gait parameters significantly differed from TD adults, with a lower GDI in the adults with CP. The CP gait patterns were characterized by excessive hip flexion and hip internal rotation as well as a stiff-knee gait. CONCLUSION: Although different to TD adults, the gait patterns observed in the adult with CP treated with ISA is in line with other studies. Gait patterns suggest that derotation osteotomies potentially could have improved the long term gait patterns. Although SEMLS might be the preferred treatment method, potentially resulting in better outcomes, ISA can also be used to treat children with CP in developing countries as India and South Africa, where a SEMLS approach is not always feasible.

Anthropometric characteristics of top-class Olympic race walkers.

BACKGROUND: Typical training programmes in elite race walkers involve high training volumes at low and moderate intensities, which have been reported to induce functional and structural adaptations at an anthropometric level. Since anthropometrical variables are closely related to movement efficiency and performance in endurance events, the aim of this study was to describe the anthropometric profile of world-class race walkers. METHODS: Twenty-nine world-class race walkers (21 men and 8 women) participated in this study. Anthropometric characteristics, including height, body mass, eight skinfolds, five girths and four bone breadths were measured. Body composition, somatotype, somatotype dispersion mean, somatotype attitudinal mean and height to weight ratio, as well as skinfolds extremity to trunk ratio were also calculated. RESULTS: Mean height, body mass and body mass index were 177.1±7.1 cm, 66.4±5.8 kg, and 21.2±1.3 kg·m2 for men and 165.6±4.5 cm, 53.6±3.7 kg, and 19.6±1.6 kg· m2 for women, respectively. Women presented greater body fat content (6.7±0.6 vs. 12.2±0.8%; very large effect), less muscle mass (65.6±4.6 vs. 61.6±2.6 kg; large effect), and were more endomorphic (large effect) than men. Men specialists in 20-km showed greater muscle mass (66.7±4.9 vs. 64.4±4.3 kg; moderate effect), and slightly higher skinfolds, girths, body fat content and were more mesomorphic than 50-km specialists (moderate effect). CONCLUSIONS: The present study expands the limited knowledge on the anthropometric characteristics and somatotype elements of elite top-class race walkers. The characterisation of the morphology of elite race walkers provides coaches a reference values to control the training development of the race walker, as well as providing reference values to improve talent identification.