Balance test results in different hormonal statuses of the menstruation cycle. Are females more susceptible to lower extremities injuries on different days of their menstruation cycles?

BACKGROUND: The Star Excursion Balance Test (SEBT) and its modification(mSEBT) as dynamic tests have been shown to have high reliability and validity for the prediction of lower extremities injuries including ACL ones. No previous study has compared mSEBT performance measures in different hormonal statuses of the menstrual cycle in naturally menstruating women. So aim of the study was comparison of mSEBT performance measures in days of the menstruation cycle with the peak of estrogen and progesterone hormones in naturally menstruating women. METHODS: After a pilot study for estimation of sample size, mSEBT performance measures in a sample of 18 healthy women with regular menstrual cycles were compared two times in their cycles, first in the peak of estrogen (mid-cycle) and second in time of peak of progesterone (one week later). The test was performed 2 times using either the right or left leg as the stance and reach limb. FINDINGS: No significant difference between days with estrogen and progesterone peaks with right or left reach limb was seen for the percentage of reach in any direction or the composite reach on the mSEBT performance. CONCLUSION: It seems that there is the same risk for lower extremities injuries in estradiol and progesterone peak days of normal menstruating women.

Effects of Ramadan Fasting on Inspiratory Muscle Function.

BACKGROUND: Ramadan fasting is a major challenge for exercising Muslims especially in warm seasons. There is some evidence to indicate that Ramadan fasting causes higher subjective ratings of perceived exertion (RPE) in fasting Muslims. The mechanisms of this phenomenon are not known exactly. The role of respiratory muscle strength in this regard has not been studied yet. OBJECTIVES: The aim of this study was investigation of the effects of Ramadan fasting on respiratory muscle strength. PATIENTS AND METHODS: In a before-after study, from 35 fasting, apparently healthy, male adults who had fasted from the beginning of Ramadan, maximal inspiratory muscle pressure (MIP) and peak inspiratory flow (PIF) were measured in the last week of Ramadan month in summer. At the time of test, there was not any sleep problem in participants and all of them had good cooperation. Three months later, after exclusion of incompatible persons mainly because of change in their physical activity level, smoking behavior or drug consumption, the measurements were repeated in 12 individuals. RESULTS: Weight, MIP and PIF data had normal distribution (Kolmogorov-Smirnov Test). There was a significant increase in MIP (mean 8.3 cm H2O with 95% confidence interval of 2.2 - 14.3) and PIF (mean 0.55 lit/s with 95% confidence interval of 0.02 - 1.07) and weight (mean 3.4 Kg with 95% confidence interval of 2.2 - 4.5) after Ramadan (Paired t test with P < 0.05). When weight difference was used as a covariate in repeated measure ANOVA test, there was no further significant difference between MIP and PIF measurements. CONCLUSIONS: Ramadan fasting may cause reduction of respiratory muscle strength through reduction of body weight.

Stroke in a Young Swimmer.

INTRODUCTION: Arterial dissections are important causes of stroke in the young population. Dissection has been reported in association with some sports. It seems that this report is among the first ones of the cervical arterial dissection in a young swimmer. CASE PRESENTATION: A 30-year-old male professional swimmer with no history of any major disease suddenly complained of severe ataxia, moderate headache, neck pain, unilateral left facial weakness, and feelings of tingling and paresthesia on the left side of his body and face a few minutes following head and body stretching exercises in land. There was no history of major head or neck trauma, manipulation, and practicing diving skills in the past. Acute infarction of the left cerebellum was diagnosed after performing brain computed tomography and magnetic resonance imaging (with contrast) studies. Cervical magnetic resonance angiography confirmed left vertebral artery dissection as the cause of infarction. CONCLUSIONS: Important differential diagnoses of cervicocephalic arterial dissection include other vascular or neurological causes of head and neck pain and/or local neurological syndromes and other causes of brain ischemia such as cardiac emboli, atherosclerosis, and vasculopathy of brain vessels. It is important that sports medicine practitioners pay attention to this less-diagnosed cause of stroke in young athletes.