The effects of basketball and soccer training on arterial stiffness / Efeitos do treinamento de basquetebol e futebol sobre a rigidez arterial / Efectos del entrenamiento de básquetbol y fútbol sobre la rigidez arterial

ABSTRACT Objective The purpose of this study was to examine arterial stiffness in elite basketball and soccer athletes by pulse wave velocity. Methods The cohort comprised 35 healthy male volunteers aged 17 to 26 years. All the subjects were either basketball players (n=9), soccer players (n=12) or sedentary controls (n=14). Arterial stiffness was measured by the Pulse Trace System (Micro Medical Ltd., Rochester, UK) and echocardiographic images were taken using a commercially available machine (Vivid 7 GE-Vingmed, Horten, Norway) with a 2.5 MHz transducer. Results The basketball players had significantly higher heights and body weights as compared to both the soccer players and the controls. The aortic elastic properties derived from the echocardiographic measurements did not differ between the groups. The peripheral pulse wave velocity measurements showed significantly lower values both in the basketball and soccer players compared to the controls, whereas the central pulse wave velocity measurement was significantly lower only in the basketball players as compared to the controls. No significant difference was seen between the basketball and soccer players. Conclusions The results of this study show that football and basketball exercises comprised of aerobic, anaerobic, endurance balance-coordination and sport-specific training play a role in reducing arterial stiffness. Level of evidence I; type of study: prognostic study.

RESUMO Objetivo O propósito deste estudo foi examinar a rigidez arterial em atletas de basquetebol e futebol medindo a velocidade da onda do pulso. Métodos A coorte foi composta por 35 voluntários saudáveis do sexo masculino, com idade entre 17 a 26 anos. Os participantes eram jogadores de basquetebol (n = 9), jogadores de futebol (n = 12) e controles sedentários (n = 14). A rigidez arterial foi medida com o Pulse Trace System (Micro Medical Ltd., Rochester, Reino Unido) e as imagens ecocardiográficas foram obtidas com um aparelho disponível no mercado, com transdutor de 2,5 MHz (Vivid 7 GE-Vingmed, Horten, Noruega). Resultados Os jogadores de basquetebol tinham estatura e peso corporal consideravelmente superiores aos dos jogadores de futebol e aos controles. As propriedades elásticas aórticas derivadas das medicas ecocardiográficas não diferiram entre os grupos. A velocidade da onda de pulso periférico foi significativamente menor nos jogadores de basquetebol e futebol em comparação com os controles, enquanto os jogadores de basquetebol tiveram velocidade da onda do pulso central consideravelmente menor que os controles. Não se observou diferença significativa entre os jogadores de basquetebol e os de futebol. Conclusões Os resultados deste estudo mostram que os exercícios de treinamento de futebol e basquetebol: aeróbicos, anaeróbicos, de resistência, de coordenação e equilíbrio e os treinamentos específicos de cada esporte têm um papel importante na redução da rigidez arterial. Nível de Evidência I, Estudo prognóstico.

RESUMEN Objetivo El propósito de este estudio fue examinar la rigidez arterial en atletas de básquetbol y fútbol midiendo la velocidad de onda de pulso. Métodos La cohorte fue compuesta por 35 voluntarios saludables del sexo masculino, con edad entre 17 y 26 años. Los participantes eran jugadores de básquetbol (n=9), jugadores de fútbol (n=12) y controles sedentarios (n=14). La rigidez arterial fue medida con Pulse Trace System (Micro Medical Ltd., Rochester, Reino Unido) y las imágenes ecocardiográficas fueron obtenidas con un aparato disponible en el mercado, con transductor de 2,5 MHz (Vivid 7 GE-Vingmed, Horten, Noruega). Resultados Los jugadores de básquetbol tenían estatura y peso corporal considerablemente superiores a los de los jugadores de fútbol y a los de los controles. Las propiedades elásticas aórticas derivadas de las medidas ecocardiográficas no difirieron entre los grupos. La velocidad de onda de pulso periférico fue significativamente menor en los jugadores de básquetbol y fútbol en comparación con los controles, mientras que los jugadores de básquetbol tuvieron velocidad de onda de pulso central considerablemente menor que los controles. No se observó diferencia significativa entre los jugadores de básquetbol y los de fútbol. Conclusiones Los resultados de este estudio muestran que los ejercicios de entrenamiento de fútbol y básquetbol: aeróbicos, anaeróbicos, de resistencia, de coordinación y equilibrio y los entrenamientos específicos de cada deporte tienen un papel importante en la reducción de la rigidez arterial. Nivel de Evidencia I, Estudio pronóstico.

Force irradiation effect of kinesiotaping on contralateral muscle activation.

We aimed to determine the force irradiation effect of kinesiotaping (KT) on contralateral muscle activity during unilateral muscle contraction. Forty healthy (26 females, 14 males) subjects were divided into two groups: KT and control groups. KT was applied on the biceps brachii at the contralateral limb (non-dominant limb) in the KT group, whereas no taping was applied to the control group. All participants performed unilateral isometric, concentric, and eccentric contractions with their dominant upper limbs (exercised limb) by means of an isokinetic dynamometer, while the contralateral limb was in the resting condition, neutral position, and motionless during the testing procedure. During the exercise, contralateral biceps brachii muscle activity was recorded by surface electromyography (EMG). To quantify the muscle activation, EMG signals were expressed as a percentage of the maximal isometric voluntary contraction, which is referred to as %EMGmax. The KT group showed significantly higher %EMGmax in the biceps brachii compared to the control group at the contralateral limb during the isometric, concentric, and eccentric contractions (p = 0.035, p = 0.046, and p = 0.002, respectively) The median values of the contralateral muscle activity were 2.74 %EMGmax and 6.62 %EMGmax during the isometric contraction for the control and KT groups, respectively (p = 0.035). During the concentric contraction, the median values of the contralateral muscle activity were 1.61 %EMGmax and 9.39 %EMGmax for the control and KT groups, respectively (p = 0.046). The median values of the contralateral muscle activity were 4.49 %EMGmax and 22.89 %EMGmax for the eccentric contraction for the control and KT groups, respectively (p = 0.002). In conclusion, KT application on the contralateral limb increased the contralateral muscle activation in the biceps brachii during the unilateral isometric, concentric, and eccentric contractions.

Acute phase protein increase in high altitude mountaineers / Aumento da proteína de fase aguda em montanhistas de grandes altitudes / Aumento de la proteína de fase aguda en montañeros de gran altitud

ABSTRACT Introduction: Many middle-aged Turks go hiking in mountains to breathe some fresh air or to maintain fitness. Objective: This study investigated the effects of regular high altitude mountain climbing on the metabolic and hematological responses of mountaineers. Methods: Hematological and biochemical parameters were studied, as well as some hormonal values of 21 mountaineers and 16 healthy age-matched sedentary volunteers. Results: The neutrophil to lymphocyte ratio (NLR) was significantly lower (p<0.04) in mountaineers compared with the sedentary group. Total protein (p<0.001) and albumin (p<0.001) were lower, while the levels of ferritin (p<0.04), creatine (p<0.03) and creatine phosphokinase (p<0.01) were higher in mountaineers. Other hematological and biochemical parameters, i.e., erythrocytes, leukocytes, hemoglobin and hematocrit, did not change significantly. Conclusion: Our results show that regular exposure to high altitude increased the serum levels of some acute phase proteins with anti-inflammatory properties.

RESUMO Introdução: Muitos turcos de meia-idade fazem caminhadas em montanhas para respirar ar puro ou manter a boa forma física. Objetivo: Este estudo pesquisou os efeitos da escalada regular em grandes altitudes sobre as respostas metabólicas e hematológicas dos montanhistas. Métodos: Foram estudados parâmetros hematológicos e bioquímicos, assim como alguns valores hormonais de 21 montanhistas e 16 voluntários sedentários de mesma idade. Resultados: A razão entre neutrófilos e linfócitos (RNL) foi significantemente menor (p<0,04) nos montanhistas, em comparação com o grupo sedentário. A proteína total (p<0,001) e a albumina (p<0,001) foram mais baixas, enquanto os níveis de ferritina (p<0,04), creatina (p<0,03) e creatina fosfoquinase (p<0,01) foram mais altos nos montanhistas. Outros parâmetros hematológicos e bioquímicos, isto é, eritrócitos, leucócitos, hemoglobina e hematócrito não tiveram mudanças significantes. Conclusão: Nossos resultados mostram que a exposição regular a grandes altitudes aumentou os níveis séricos de algumas proteínas de fase aguda com propriedades anti-inflamatórias.

RESUMEN Introducción: Muchos turcos de mediana edad hacen caminatas en montaña para respirar aire puro o mantener la buena forma física. Objetivo: Este estudio ha investigado los efectos de la escalada regular en gran altitud sobre las respuestas metabólicas y hematológicas de los montañeros. Métodos: Se estudiaron parámetros hematológicos y bioquímicos, así como algunos valores hormonales de 21 montañistas y 16 voluntarios sedentarios de la misma edad. Resultados: El índice neutrófilo/linfocito (INL) fue significativamente menor (p<0,04) en los montañeros, en comparación con el grupo sedentario. La proteína total (p<0,001) y la albúmina (p<0,001) fueron más bajas, mientras que los niveles de ferritina (p<0,04), creatina (p<0,03) y creatina fosfoquinasa (p<0,01) fueron más altos en los montañistas. Otros parámetros hematológicos y bioquímicos, es decir, eritrocitos, leucocitos, hemoglobina y hematocrito no cambiaron significativamente. Conclusión: Nuestros resultados muestran que la exposición regular a grandes altitudes aumentó los niveles séricos de algunas proteínas de fase aguda con propiedades anti-inflamatorias.

Psychiatric and functional evaluation of professional athletes following anterior cruciate ligament reconstruction.

OBJECTIVE: The aim of this study is to evaluate early phase depression and anxiety in the proffessional athletes who underwent anterior cruciate ligament (ACL) reconstruction and compare them with the functional improvement of knee. METHODS: Thirty-eight patients (35 males, 3 females; mean age±SD: 26.84±8.03) were included in this study. Measurements were obtained immediately following the operation and at Week 6 of postoperative rehabilitation. Depression and anxiety symptoms were evaluated by the Hospital Anxiety and Depression Scale (HADS), and knee function was evaluated by Lysholm Knee Scoring Scale (LKSS). RESULTS: Change in total LKSS scores from the time of admission (56.4±20.2) to the end of the sixth week (78.7±13.8) was significant (t=-8.21, p<0.001). Neither the HADS depression nor the HADS anxiety scores were above the cutoff values in the 2 assessments. Significant difference was noted in HADS anxiety scores between the time of admission (6.21±3.50) and at the sixth week (5.33±3.33) (t=2.02, p=0.05). However, HADS depression scores were not statistically different between the 2 evaluations (5.95±3.68 and 5.35±3.50 at admission and Week 6 week, respectively) (t=1.07, p=0.29). Changes between the 2 LKSS and HADS anxiety assessments were negatively correlated (r=-0.49, p=0.002), but there no correlation was detected between the total LKSS and HADS score changes. CONCLUSION: The decline of the signs of anxiety and depression at the sixth week of rehabilitation indicate that proper rehabilitation positively affects the emotional status of ACL reconstruction patients.

The effect of prophylactic migraine treatment on arterial stiffness.

BACKGROUND: Migraine is a common type of primary headache predominantly seen in women. This study aimed to evaluate endothelial function in patients with migraine using pulse wave velocity (PWV). METHODS: The study included 73 patients with newly diagnosed migraine and 80 healthy subjects. All patients and controls underwent baseline transthoracic echocardiography and PWV measurements. Patients were randomized to three groups to receive propranolol, flunarizine or topiramate, and the measurements were repeated at the end of 1 month. RESULTS: The newly diagnosed migraine patients and the control group exhibited no differences in baseline clinical characteristics, and the measurements showed that PWV was 7.4 ± 1.0 m/s in the patient group and 6.0 ± 1.0 m/s in the control group (p < 0.001). The same measurements were repeated during a control visit at the end of 1 month. Following treatment, a significant decrease was observed in PWV in all patient groups compared to baseline (p < 0.001). Subgroup analysis showed significantly decreased PWV in all drug groups, with the most prominent decrease in the topiramate group. CONCLUSIONS: The increased PWV demonstrated in migraine patients in this study stands out as an additional parameter elucidating endothelial dysfunction in these patients. Decreasing the number of migraine attacks with prophylactic treatment may reduce PWV and decrease cardiovascular risk in long-term follow-up.

Principles of postoperative anterior cruciate ligament rehabilitation.

It is known that anterior cruciate ligament (ACL) reconstruction needs to be combined with detailed postoperative rehabilitation in order for patients to return to their pre-injury activity levels, and that the rehabilitation process is as important as the reconstruction surgery. Literature studies focus on how early in the postoperative ACL rehabilitation period rehabilitation modalities can be initiated. Despite the sheer number of studies on this topic, postoperative ACL rehabilitation protocols have not been standardized yet. Could common, "ossified" knowledge or modalities really prove themselves in the literature? Could questions such as "is postoperative brace use really necessary?", "what are the benefits of early restoration of the range of motion (ROM)?", "to what extent is neuromuscular electrical stimulation (NMES) effective in the protection from muscular atrophy?", "how early can proprioception training and open chain exercises begin?", "should strengthening training start in the immediate postoperative period?" be answered for sure? My aim is to review postoperative brace use, early ROM restoration, NMES, proprioception, open/closed chain exercises and early strengthening, which are common modalities in the very comprehensive theme of postoperative ACL rehabilitation, on the basis of several studies (Level of Evidence 1 and 2) and to present the commonly accepted ways they are presently used. Moreover, I have presented the objectives of postoperative ACL rehabilitation in tables and recent miscellaneous studies in the last chapter of the paper.

Improved arterial stiffness in mitral stenosis after successful percutaneous balloon valvuloplasty.

BACKGROUND: Rheumatic mitral stenosis (MS) is still a common disease in developing countries with high morbidity and mortality rates. The purpose of the study was to evaluate arterial stiffness in severe MS before and after percutaneous mitral balloon valvuloplasty (PMBV). METHODS: Thirty patients with MS in sinus rhythm requiring PMBV and 20 age-gender matched healthy volunteers. The analyze of pulse wave velocities (PWV) were performed using of the carotid artery at the femoral by PWV technique on patients at baseline and a week after PMBV. RESULTS: The values of PWV were significantly decreased after successful PMBW in MS patients. Mitral mean gradients and systolic pulmonary artery pressures (sPAP) both on echocardiography and catheterization also had a significant decrease after PMBW. The mitral valve areas were significantly increased after PMBW. There was a highly significant negative correlation between mitral valve areas and PWV values. A highly significant positive correlation was seen between mitral mean gradient on catheterization and PWV (r = 0.830, p 〈 0.001). There was also a significant correlation between sPAP on catheterization and PWV values (r = 0.639, p 〈 0.001). Echocardiographic mitral mean gradients and PWV were highly positive correlated with each other (r = 0.841, p 〈 0.001). The sPAP on echocardiography had also a highly positive correlation with PWV (r = 0.681, p 〈 0.001). CONCLUSIONS: Mitral stenosis is a cause of impaired arterial stiffness and after the enlargened mitral valve area arterial stiffness improved in patients with MS.

The effects of significant coronary stenosis and percutaneous coronary intervention on aortic stiffness.

OBJECTIVES: Although aortic stiffness (AS) is a strong predictor of cardiovascular events, its value is unknown in patients who have coronary stenosis and undergo percutaneous coronary intervention (PCI). Our hypothesis was that AS might provide additional information about coronary hemodynamic status. In this context, we investigated the effects of coronary stenosis and PCI on AS. STUDY DESIGN: The study included 107 patients undergoing coronary angiography. The patients were divided into three groups based on the angiographic results: 39 patients with significant lesions (≥50%) formed the 'critical group' and 38 patients with nonsignificant lesions (<50%) formed the 'noncritical group'. The control group (30 patients) had normal angiograms. Aortic stiffness was determined using the carotid-femoral aortic pulse wave velocity (PWV) method. All patients in the critical group underwent successful PCI and repeat PWV measurements. RESULTS: All baseline characteristics were similar in the three groups except for the mean PWV, which was significantly higher (9.4±2.2 m/sec) in the critical group compared to the control group (5.7±1.1 m/sec) and the noncritical group (5.8±1.1 m/sec) (p<0.0001). The latter two groups had similar PWV values (p=0.6). After PCI, the mean PWV decreased significantly by 24.4% to 7.1±2.0 m/sec (p=0.002); however, it was still significantly higher than that of the control group (p<0.0001). In correlation analysis, PWV showed significant correlations with age (r=0.412, p=0.01), systolic blood pressure (r=0.342, p<0.01), and hemoglobin (r=-0.370, p=0.02). Multiple logistic regression analysis showed that PWV was a predictor for significant stenosis [Exp(B) 3.960, 95% CI 2.014-7.786]. CONCLUSION: Our findings suggest that significant coronary stenosis is associated with significantly increased AS and successful PCI improves AS to some extent.

Rigorous bicycling does not increase serum levels of total and free prostate-specific antigen (PSA), the free/total PSA ratio, gonadotropin levels, or uroflowmetric parameters.

OBJECTIVES: To determine whether cycling has an effect on serum PSA, gonadotropins, and uroflowmetric parameters. METHODS: A total of 34 healthy male athletes from the National Cycling Team and 24 healthy male student volunteers from University and medical staff were prospectively enrolled in the study. Blood samples for serum total prostate-specific antigen (tPSA), free PSA (fPSA, fPSA/tPSA, follicle-stimulating hormone (FSH), luteinizing hormone (LH), and testosterone determinations were obtained before and after cyclists completed 300 km bicycle ride and with each cyclist seated without changing posture and with minimal movement for 10 minutes before blood collection. The cyclists also performed uroflowmetric and postvoid residual urine volume analysis before, and 1 hour after cycling course. Blood samples from the control group were drawn for serum hormones. They also underwent uroflowmetric and postvoid residual analysis. RESULTS: The athletes and the control group were well matched by age. There was no significant difference between the 2 groups in terms of serum tPSA, fPSA, f/t PSA values, FSH, LH, and testosterone levels and uroflowmetric parameters (P >.05). The differences between pre- and postcycling values for tPSA, fPSA, f/t PSA, FSH, LH, and uroflowmetric parameters were not statistically significant. The postcycling serum testosterone level was significantly lower than precycling levels (mean, 603.6 ng/dL [range, 300-949] vs 424.8 ng/dL [range, 193-723], P = .001]. There was no correlation between body mass index values, postcycling serum FSH, LH levels, age, and testosterone levels. CONCLUSIONS: There is no effect of professional bicycle riding on serum total and fPSA levels and uroflowmetric parameters.

Difference in the magnitude of muscle damage between elbow flexors and knee extensors eccentric exercises.

The aim of this study was to investigate the difference in the magnitude of muscle damage between maximal eccentric exercises of the elbow flexors (EF) and knee extensors (KE). Twelve sedentary male volunteers participated in the study. Range of motion (ROM), isometric peak torque (IPT), delayed onset of muscle soreness (DOMS), creatine kinase activity (CK), and myoglobin concentration (Mb) were evaluated before, immediately after, and on the 1(st) , 2(nd), 3(rd) , and 7(th) days following exercise. Total work (TW) during exercises was recorded and corrected by muscle volume (TWc). TWc was greater (p < 0.01) for EF [24 (2) joule·cm-3] than for KE [7 (0.4) joule·cm(-3)]. Increases in CK on the 2(nd) , 3(rd) , and 7(th) days (p < 0.01) and increases in Mb on the 1(st) , 2(nd) , 3(rd) , and 7(th) days were significantly (p<0.01) larger for EF than for KE. The decline in IPT was greater (p < 0.05- 0.01) for EF at all test occasions compared with KE. The results of this study demonstrate that the magnitude of muscle damage is greater and the recovery is slower following maximal eccentric exercise of the EF than of the KE for sedentary males. Key pointsThe magnitude of muscle damage is greater and the recovery is slower following maximal eccentric exercise of the EF than of the KE for sedentary males.This may be because of the higher total eccentric work per muscle unit in elbow flexors.

Soccer related sudden deaths in Turkey.

Regular physical exercise is recommended by the medical community, because it offers the potential to reduce the incidence of coronary events. On the other hand, vigorous exertion may act as a trigger of acute myocardial infarction and sudden cardiac death in susceptible individuals. Death during sports activities differs among sports disciplines and countries. In Turkey, soccer attracts more spectators than any other sports activity and the attention of the press and media, and is preferred over other sports by many young and middle-aged individuals. As autopsy-based studies are infrequent in literature and there is a lack of data detailing sudden death during physical activity in Turkey, we present a Turkish series of sudden deaths that occurred during soccer games based on data provided by the Morgue Specialization Department of the Council of Forensic Medicine. We identified 15 male cases of soccer-related sudden death aged from 10 to 48 years. Coronary artery disease was identified as the cause of sudden death in 11 cases. Key pointsThis study is one of the largest series of soccer related SD with reported 15 cases.In our series, CAD is the most common cause of SCD also in very young athletes in contrast with international literature.In autopsy, detailed cardio-vascular system evaluation and toxicological analysis including doping agents are essential to determine precise cause of exercise induced SD.Medical screening is important for all people interested in sport, not only for athletes, as a powerful means of prevention.

Exertional rhabdomyolysis of the bilateral adductor magnus.

We present a case study of a person (63 year-old man), who has been using statins for 18 years, with rhabdomyolysis of the bilateral adductor muscles associated with strenuous and prolonged eccentric exercises (hiking) in a hot environment. Clinical examination showed predominantly on the right side muscle swelling and palpational pain of the bilateral adductor muscle groups and bilateral tibial edema. His serum creatine kinase (CK) level was 12218 IU/L. T2-weighted magnetic resonance (MR) images showed a high signal intensity in the bilateral adductor muscles of the hip. The patient did not develop complications and returned to his previous performance level in 30 days following adequate hydration and resting of the affected muscles. Strenuous eccentric exercise should be avoided during the course of statin use and clinicians should be aware of present observations when considering the significance of acute CK elevations in patients on statin treatment. Key pointsStatin use can be one of the causes of the rhabdomyolysis following a strenuous eccentric exercise.Elevated CK levels and MRI imaging are important for the diagnosis.The treatment consists of complete rest and adequate hydration.