Investigating the relationship between pain level and grip and wrist muscles strength in individuals with lateral epicondylitis: is pain a barrier to strength assessment?

PURPOSE: This study was carried out to examine the relationship between rest, activity, and nighttime pain and grip and isokinetic muscle strength of the wrist muscles in individuals with lateral epicondylitis. METHODS: Fifty-six sedentary individuals aged between 18 and 65 years diagnosed with unilateral lateral epicondylitis volunteered to participate in the study. The level of rest, activity, and nighttime pain was evaluated with visual analog scale (VAS). The grip strengths of both arms were evaluated by averaging a maximum of three grip strength measurements using a hand dynamometer. The strength of both wrist flexor and extensor muscles were evaluated with isokinetic dynamometer at angular velocities of 60 and 180°/s with five and 15 concentric repetitions respectively. RESULTS: There was no significant relationship found between the affected side's grip strength and isokinetic muscle strength with rest, activity and nighttime pain (all P > 0.05). However, there was a difference observed between the affected and unaffected side in grip strength and isokinetic strength measurements of all wrist muscles (all P < 0.05); the unaffected side values were found to be higher. CONCLUSION: The result of this study found no correlation between the stated level of pain and the true muscle strength in the affected hand. In line with these findings, we think that assessments involving strength can be made in other musculoskeletal problems where pain is present. However, the findings may not reflect the true muscle strength which will tend to be underrated.

Visual or computer-based measurements: Which is important for the interpretation of an athlete's electrocardiography?

OBJECTIVE: Preparticipation screening of athletes by electrocardiography is the most crucial step in determining sudden cardiac death risk factors. Several electrocardiography interpretation software programs have been developed for physicians practicing in this field. Our study aimed to assess cardiopoint sudden death screening module by comparing its findings with two cardiologists using Seattle and International criteria. METHODS: A total of 303 licensed national athletes (37% females) were enrolled. electrocardiographies were examined by the cardiopoint sudden death screening module using Seattle criteria and cardiologists. The consistency between cardiologists and software was compared, and the confidence assessment of the module was tested. RESULTS: With regard to Seattle criteria, moderate consistency was found between the cardiopoint sudden death screening module and the 1st (κ=0.41) and 2nd cardiologist (κ=0.59). Consistency between two cardiologists was moderate (κ=0.55). When we applied International criteria, there was moderate consistency between the module and the 1st cardiologist (κ=0.42), and good consistency between the module and the 2nd cardiologist (κ=0.63). Consistency between the two cardiologists was good (κ=0.62). CONCLUSION: The cardiopoint sudden death screening module had similar agreement with cardiologists based on both criteria. However, the software needs to be updated according to International criteria. Using computer-based measurements for preparticipation screening will help to save time and provide standardization of electrocardiography interpretation.

Effect of contraction type at varying angular velocities on isokinetic muscle strength training.

The aim of this study is to determine whether concentric and eccentric isokinetic training performed at certain angular velocities in sedentary individuals is effective only in the angular velocities and contraction type where the training is performed, or at other angular velocities and contraction types that are not being trained. Twenty-eight sedentary individuals (matched according to weight, age and gender) volunteered to participate in this case study. The study was conducted on a total of 56 extremities belonging to 28 individuals (14 women, 14 men) aged between 24 and 60 years. Concentric and eccentric strength tests were performed at 30-60-90-120-150-180°/sec. The participants were randomly divided into two groups as concentric training group and eccentric training group, through stratified randomization matching. The training was done 3 days a week for a total of 6 weeks. At the end of the study, no difference was found between the pre- and posttraining measurements in the concentric training group (P>0.05). In the eccentric training group, the eccentric muscle strength of the knee flexors and extensors at angular velocity of 90°/sec, the eccentric strength of the knee extensors at angular velocity of 120°/sec, and the eccentric muscle strength of the knee flexors at angular velocity of 180°/sec were found to be different and an increase was seen after the training (P=0.032, P=0.049, P=0.041, P=0.032). These results demonstrate that eccentric training may be preferred in cases where muscle strength increase is needed in short time.

Frontal plane lower extremity alignment in adolescent athletes with chronic hip adductor-related groin injury symptoms: A case-control study.

OBJECTIVE: To compare trunk and lower extremity frontal plane projection angles (FPPA) during single leg squat (SLS) performance, perceived hip and groin function and symptoms, and isometric hip strength of adolescent athletes with chronic hip adductor-related groin injury (HARGI) symptoms and age, gender, and sport-matched healthy subjects. DESIGN: Case-control study. SETTING: Junior Olympic Development Training Centre. PARTICIPANTS: Twenty-six athletes at 59.1 ± 60 weeks (range = 12-208 weeks) post-index grade II HARGI injury who had continued sport training (injury group) and 26 control group subjects. MAIN OUTCOME MEASURES: SLS trunk, hip, and knee FPPA, isometric hip strength standardized to bodyweight, and Copenhagen Hip and Groin Outcome Scores (HAGOS). RESULTS: The injury group had greater bilateral knee FPPA, and greater injury side hip FPPA during maximum SLS. Injury group HAGOS subscale scores were lower than control group scores. Hip abductor, adductor, external rotator, and internal rotator strength was lower at the injury side of the injury group compared to the matched control group limb. Forward stepwise multiple regression analysis of the injury group found that 50% of injury side knee FPPA was predicted by hip internal rotator strength and time post-index HARGI; and 47% of injury side hip FPPA was predicted by other side hip flexor strength and the HAGOS function, sport and recreation subscale score (p = 0.002). CONCLUSIONS: Greater injury side hip and bilateral knee FPPA during maximum SLS, lower self-reported hip symptom and function scores, and less injury side hip abductor, adductor, external rotator and internal rotator strength suggests that adolescent athletes with chronic HARGI symptoms are at an increased risk for sustaining a non-contact knee injury. Impaired hip internal rotator strength at the side of the chronic HARGI was related to increased knee FPPA, and impaired hip flexor strength at the other side of the HARGI was related to increased hip FPPA. Findings support using SLS performance testing in this athlete group to help determine safe return to sport training readiness.

The immediate effect of simulating leg-length discrepancy on spinal posture and pelvic position: a cross-over designed study.

Leg-length discrepancy (LLD) is a common condition that may cause posture changes and clinical consequences. Rasterstereography is a valid and reliable method that analyzes posture without radiation exposure and invasive procedures. This study aimed to assess the immediate effect of artificial LLD on pelvic position and spinal posture in athletes. Twenty-four elite karate athletes (14 men, 10 women) were included in the study. Sagittal imbalance, coronal imbalance, pelvic obliquity, pelvic torsion angle, thoracic kyphosis angle and lumbar lordosis angle were measured at different artificial LLD heights (5 -10 -15 -20 mm). Statistical analysis was performed with One-Way ANOVA with repeated measures or Friedman test. In cases where there were significant differences, pairwise comparisons were performed with least significant differences (LSD) test or Wilcoxon signed rank test. There were statistically significant differences in pelvic obliquity (p = 0.001), pelvic torsion (p = 0.001) and lumbar lordosis (p = 0.001) with varying LLD. However, there was no significant difference in sagittal imbalance, coronal imbalance and thoracic kyphosis angle. It has been observed that even a 5-mm LLD causes pelvic position and spinal posture changes. Future studies detecting these changes in populations with LLD via rastersterography may prevent possible musculoskeletal disorders.

Which Body Density Equations Calculate Body Fat Percentage Better in Olympic Wrestlers?-Comparison Study with Air Displacement Plethysmography.

Although skinfold-derived equations seem to be practical for field application in estimating body fat percentage (BF%) and minimum body mass in Olympic wrestlers, prediction equations applied first need to be cross-validated in Olympic wrestlers to define the best prediction equation. This study aimed to evaluate the most accurate field method to predict BF% in Olympic wrestlers compared to BF% estimated by air displacement plethysmography (ADP). Sixty-one male (body mass 72.4 ± 13.5 kg; height 170.3 ± 7.0 cm; body mass index (BMI) 24.9 ± 3.5 kg.m-2; BF% 8.5 ± 4.9%) and twenty-five female wrestlers (body mass 60.3 ± 9.9 kg; height 161.3 ± 7.1 cm; BMI 23.1 ± 2.5 kg.m-2; BF% 18.7 ± 4.7%) undertook body composition assessments including ADP and nine-site skinfold measurements. Correlations, bias, limits of agreement, and standardized differences between alterations in BF% measured by ADP and other prediction equations were evaluated to validate measures, and multiple regression analyses to develop an Olympic wrestlers-specific prediction formula. The Stewart and Hannan equation for male wrestlers and the Durnin and Womersley equation for female wrestlers provided the most accurate BF% compared to the measured BF% by ADP, with the lowest bias and presented no significant differences between the measured and predicted BF%. A new prediction equation was developed using only abdominal skinfold and sex as variables, predicting 83.2% of the variance. The findings suggest the use of the new wrestler-specific prediction equation proposed in the study as a valid and accurate alternative to ADP to quantify BF% among Olympic wrestlers.

Determining the number of repetitions to establish isokinetic knee evaluation protocols specific to angular velocities of 60°/second and 180°/second.

INTRODUCTION: This study aims to develop a standard number of repetition at angular velocities of 60°/sec and 180°/sec and define the difference of number of repetitions between genders. METHOD: One hundred ninety-six athletes (judo, volleyball, Greco-Roman wrestling, runners, and gymnastics) were involved. Concentric-concentric isokinetic muscle strength of the knee flexor-extensor muscles of the athletes were performed with an ISOMED 2000 isokinetic dynamometer. The evaluation test protocol consisted of 10 repetition of knee flexion-extension at 60°/sec and 30 repetitions at 180°/sec. RESULTS: Athletes performed with maximal knee flexion strength at their second and third trial at 60°/sec and third-forth trial at 180°/sec. It was found that 2 repetitions and 2-3 repetitions were needed for knee extension peak torque at 60°/sec and 180°/sec respectively. The difference between the genders was significant at 60°/sec for knee flexion and extension on the dominant side; at 180°/sec for knee extension on the dominant and non-dominant side. It was determined that 3 repetitions for 60°/sec, 4 repetitions for 180°/sec were enough to determine peak torque values. DISCUSSION: Optimal number of repetitions is crucial so that athletes could have the opportunity to reach maximal strength without unnecessary workload or waste of time. CONCLUSIONS: Protocols involving 3 repetitions for 60°/sec, 4 repetitions for 180°/sec were enough to determine peak torque values. Gender of athletes should be considered when establishing isokinetic knee evaluation protocols.

The relationships between isometric muscle strength and respiratory functions of the Turkish National Paralympic Goalball Team.

Goalball is a unique sport for only blind and visually disabled people to prevent physical inactivity and its harmful consequences. Determining the profile of physical fitness parameters and their relationship is crucial for all sports discipline. The purpose of the study is to determine the characteristics and the relationship between isometric muscle strength and respiratory functions. A total of 14 (10 female, four male athletes) goalball athletes were included in the study. Upper-extremity, lower-extremity and trunk isometric muscle strength and pulmonary function tests measurements were performed to the athletes on two different days. The relationship between parameters was evaluated by Spearman correlation test. Strength and pulmonary function parameters were higher in male athletes (P<0.05). A medium/strong/very strong correlation was found between respiratory function and upper extremity isometric muscle strength (r=0.529-0.917, P<0.05). A moderate/strong correlation was found between lower extremity isometric muscle strength and respiratory function (r=0.534-0.867, P<0.05). A moderate correlation was found between trunk isometric muscle strength and respiratory function (r=0.538-0.640, P<0.05). It was seen that respiratory functions were associated with upper-lower extremity and trunk muscle strength. With this result, the idea arises that strength exercises can affect the improvement of respiratory function in individuals with disabilities, which is very important for both overall health and sports performance.

Current Predictive Resting Metabolic Rate Equations Are Not Sufficient to Determine Proper Resting Energy Expenditure in Olympic Young Adult National Team Athletes.

Predictive resting metabolic rate (RMR) equations are widely used to determine athletes' resting energy expenditure (REE). However, it remains unclear whether these predictive RMR equations accurately predict REE in the athletic populations. The purpose of the study was to compare 12 prediction equations (Harris-Benedict, Mifflin, Schofield, Cunningham, Owen, Liu's, De Lorenzo) with measured RMR in Turkish national team athletes and sedentary controls. A total of 97 participants, 49 athletes (24 females, 25 males), and 48 sedentary (28 females, 20 males), were recruited from Turkey National Olympic Teams at the Ministry of Youth and Sports. RMR was measured using a Fitmate GS (Cosmed, Italy). The results of each 12 prediction formulas were compared with the measured RMR using paired t-test. The Bland-Altman plot was performed to determine the mean bias and limits of agreement between measured and predicted RMRs. Stratification according to sex, the measured RMR was greater in athletes compared to controls. The closest equation to the RMR measured by Fitmate GS was the Harris-Benedict equation in male athletes (mean difference -8.9 (SD 257.5) kcal/day), and Liu's equation [mean difference -16.7 (SD 195.0) kcal/day] in female athletes. However, the intra-class coefficient (ICC) results indicated that all equations, including Harris-Benedict for male athletes (ICC = 0.524) and Liu's for female athletes (ICC = 0.575), had a moderate reliability compared to the measured RMR. In sedentary subjects, the closest equation to the measured RMR is the Nelson equation in males, with the lowest RMSE value of 118 kcal/day [mean difference: 10.1 (SD 117.2) kJ/day], whereas, in females, all equations differ significantly from the measured RMR. While Nelson (ICC = 0.790) had good and Owen (ICC = 0.722) and Mifflin (calculated using fat-free mass) (ICC = 0.700) had moderate reliability in males, all predictive equations showed poor reliability in females. The results indicate that the predictive RMR equations failed to accurately predict RMR levels in the participants. Therefore, it may not suitable to use them in determining total energy expenditure.

Investigation of sitting position of paralympic wheelchair basketball players.

PURPOSE: The aim of this study was to examine the sitting position (posture) of wheelchair basketball (WB) players who cannot walk and can walk in daily life and to compare them with the able-bodied sedentary individuals. METHODS: A total of 22 male individuals, including six WB players who could not walk in daily life, eight WB players who walked in daily life, and eight able-bodied sedentary individuals (control group) were included in the study. Posture analysis of individuals was evaluated using rastersterographic system DIERS formetric 4D device. Kruskal-Wallis test was used to compare the data obtained during posture analysis. The Mann-Whitney U-test was used to determine which group caused the difference in the data determined to be different. Statistical significance level was taken as P < 0.05. RESULTS: Trunk-length, sacrum-width, sagittal and coronal imbalance, trunk-torsion, pelvic-obliqueness, pelvic-torsion, pelvic-inclination and fleche-cervicale were found to be values similar in the three groups (P > 0.05). It was determined that the lumbar lordosis and thoracic kyphosis angles were different between the groups, and the lumbar lordosis and thoracic kyphosis angles of the WB players who could not walk in daily life were higher than those of the WB players who walked in daily life and the control group (P < 0.05). CONCLUSIONS: Based on the results of our study, we suggest evaluating the sitting postures of WB players and rehabilitating WB players, especially those who cannot walk in daily life, with posture corrective exercises aimed at reducing and normalizing thoracic kyphosis.

The Relationship Between Athletic Performance and Physiological Characteristics in Wheelchair Basketball Athletes.

Purpose: This study was aimed to investigate the relationship between athletic performance and physiological characteristics in wheelchair basketball (WB) athletes with different classification scores. Methods: Twenty-six (24 male and 2 female) WB athletes were involved into the study. The participants were divided into two functional categories (Category A:1.0-2.5 points, category B: 3.0-4.5 points) according to the IWBF rules. Shoulder internal (IR) and external rotation (ER) muscle strengths were evaluated with the ISOMED 2000® isokinetic dynamometer. Handgrip strength was evaluated with hydraulic hand dynamometer. Custom ramp protocol on treadmill was employed to measure aerobic capacity. Anaerobic capacity was evaluated with Wingate anaerobic power test in standard laboratory conditions. The athletic performance was assessed by 20 m Sprint test, Slalom Test, and Zone Shot tests. Results: Category B athletes achieved significantly better results in the measurements of shoulder IR and ER muscle strength, aerobic and anaerobic capacity, and athletic performance while the grip strength was found similar in the categories. There was a significant correlation between the athletic performance and shoulder IR and ER muscle strength, and aerobic and anaerobic capacities in two categories. There was no significant relationship between grip strength and athletic performance parameters in two categories. Conclusion: It was concluded that athletic performance in WB athletes with different classification scores is related to upper extremity muscle strength, aerobic, and anaerobic capacity. Additionally, upper limb muscle strength, athletic performance, aerobic and anaerobic capacity assessments to be made will contribute positively to the planning of individual training and exercise programs.

Russian current versus high voltage current with isokinetic training on the quadriceps muscle strength and endurance.

Electrotherapy modalities are one of the increasing ways of muscle strength and endurance. However, it is not clear which electrotherapy modalities are more effective. The purpose of this study is to compare the effect of Russian current (RC) and high voltage pulsed current (HVPC) on the strength and endurance of the quadriceps muscle. The study was performed on 10 volleyball athletes. The participants' extremities were divided into two groups as RC and HVPC. Muscle strength and endurance levels were assessed by an isokinetic device. Isokinetic training and 20-min electrotherapy were given in each treatment session. This training program consisted of a total of 12 sessions, scheduled twice a week for 6 weeks. After training, knee extensor peak torque values and endurance ratios have increased in both groups, but it was determined that this increase was only significant in terms of the endurance ratio (P<0.05). There was no significant difference between the muscle strength and the endurance ratio of the RC and HVPC groups (P>0.05). RC or HVPC have no advantages over each other, and therefore it has been determined that both currents can be used in order to strengthen muscles and increase muscular endurance. Additional studies whose longer-term effects will investigate are needed.

Total Dietary Antioxidant Intake Including Polyphenol Content: Is it Capable to Fight against Increased Oxidants within the Body of Ultra-Endurance Athletes?

The role of dietary antioxidants on exhaustive exercise-induced oxidative stress has been well investigated. However, the contribution of total dietary antioxidant capacity on exogenous antioxidant defense and exercise performance has commonly been disregarded. The aims of the present investigation were to examine (i) the effects of dietary total antioxidant intake on body antioxidant mechanisms, and (ii) an exhaustive exercise-induced oxidative damage in ultra-endurance athletes. The study included 24 ultra-marathon runners and long-distance triathletes (12 male and 12 female) who underwent an acute exhaustive exercise test (a cycle ergometer (45 min at 65% VO2max) immediately followed by a treadmill test (75% VO2max to exhaustion). Oxidative stress-related biomarkers (8-isoprostaglandin F2alpha (8-iso PGF2a), total oxidant status (TOS, total antioxidant status (TAS)) in plasma were collected before and after exercise. Oxidative stress index was calculated to assess the aspect of redox balance. Blood lactate concentrations and heart rate were measured at the 3rd and 6th min after exercise. Dietary antioxidant intake was calculated using the ferric reducing ability of plasma (FRAP) assay. Dietary total antioxidant intake of the subjects was negatively correlated with pre-exercise TOS concentrations (rs = -0.641 in male, and rs = -0.741 in females) and post- vs. pre- (∆) 8-iso PGF2a levels (rs = -0.702 in male; p = 0.016, and rs = -0.682 in females; p = 0.024), and positively correlated with ∆ TAS concentrations (rs = 0.893 in males; p = 0.001, and rs = 0.769 in females; p = 0.002) and post- exercise lactate concentrations (rs = 0.795 for males; p = 0.006, and rs = 0.642 for females; p = 0.024). A positive meaningful (p = 0.013) interaction was observed between time at exhaustion and dietary antioxidant intake (rs = 0.692) in males, but not in females. In conclusion, the determination of total dietary antioxidant intake in ultra-endurance athletes may be crucial for gaining a better perspective on body antioxidant defense against exhaustive exercise-induced oxidative stress. However, the effects of dietary antioxidant on exercise performance and recovery rate needs further investigation.

The effect of different neural mobilization exercises on hamstring flexibility and functional flexibility in wrestlers.

This study aimed to compare the short-term effects of sciatic nerve neural sliding and neural stretching exercises on hamstring muscle length and functional flexibility in wrestlers. The study participants included 74 wrestlers. The athletes were randomly divided into two groups: neural sliding and neural stretching groups. The hamstring flexibility and the functional flexibility were assessed using the active knee extension limitation (AKEL) angle and the sit and reach (SR) test one day before and immediately after the neural mobilization exercises, respectively. A three-way repeated measures analysis of variance was conducted that examined the effect of mobilization type, time, and gender on interest in AKEL right leg, AKEL left leg, and SR test. There is not a significant difference between the effect of two different mobilizations on AKEL right and left leg, and SR test (P>0.05). It was determined there is statistically significant differences between premobilization and post-mobilization outcome measures for AKEL right leg (F=59.886, P=0.001), AKEL left leg (F=31.896, P=0.001), and SR test (F=22.630, P=0.001). There is not a statistically significant difference between males and females by these three measures neural sliding and neural stretching exercises to the sciatic nerve in wrestlers were effective in increasing hamstring flexibility and functional flexibility and not superior to each other.

Stabilization training versus equilibrium training in karate athletes with deafness.

The aim of this study is to compare the effect of stabilization and equilibrium training on hip muscle strength and balance performance of karate athletes with deafness. Twenty-seven athletes from the National Deaf Karate Team (18 males, nine females) with an average age of 24.53±3.62 (18-43) years were included in this study. The athletes were randomly assigned to either stabilization or equilibrium training group. Both training programs lasted 6 weeks with once per day and 5 days per week sessions. The assessment of muscle strength and balance performance was done before and after the training. The muscle strength and balance have improved in both training groups (P<0.05), but while there was no difference in the results of muscle strength between the groups (P>0.05), balance performance was better in the equilibrium training group (P<0.05). In conclusion, stabilization and equilibrium training have helped the karate athletes with deafness to improve their muscle strength and balance performance.

The effect of deafness on the physical fitness parameters of elite athletes.

The purpose of this study is to determine the health-related physical fitness parameters of athletes, who are deaf. The study group consisted of 137 deaf athletes (52 females and 85 males with a mean age of 23.99±6.56 years) who have participated in the 2017 Deaflympics games. The assessed parameters included the isokinetic muscle strength, core endurance, balance assessments, grip strength, and body composition. At the end of the study, the following results were obtained. Hamstring/quadriceps ratio was in the range of 53%-54%, which was within 50%-60% of the normal limit. Endurance of the anterior and posterior core muscles was low as compared to the normative data. The athletes' balance was better with their eyes open than closed; and the grip strength was low as compared to the normative data in the literature. Also, the body fat percentage of deaf female athletes were similar to ones in healthy individuals with sedentary lifestyle, whereas male ones had slightly lower body fat mass percentage. These results can be used as the initial reference parameters to define the training program requirements of deaf athletes.

The relationship between peripheral muscle strength and respiratory function and respiratory muscle strength in athletes.

The aim of this study is to determine the relationship between peripheral muscle strength, respiratory function and respiratory muscle strength in athletes. The study included a total of 150 elite athletes (judo, rowing, gymnastics) (age, 16.94±2.37 years; length, 167.70±12.23 cm; body weight, 62.87±17.33 kg; body mass index, 21.95±2.92 kg/m2). Isomed 2000 isokinetic dynamometer was used to assess peripheral muscle strength. The strength of the dominant side knee flexor and extensor muscles was evaluated at 60°/sec and 180°/sec. At the end of the evaluation; knee flexion and extension peak torque (PT) values and flexion and extension PT values rates were obtained at 60°/sec and 180°/sec. Respiratory function and respiratory muscle strength of the athletes were evaluated using a digital spirometer. To assess respiratory function, forced vital capacity maneuver and maximal minute ventilation test; to assess the strength of the respiratory muscles, maximum inspiratory pressure and maximal expiratory pressure tests were performed. There was a strong relationship between muscle strength of knee flex-or and extensor muscles and respiratory function (r=-0.268/0.813, P<0.05). There was a strong moderate correlation between knee flexor and extensor muscle strength and all parameters of respiratory muscle strength (r=0.206/0.411, P<0.05). The knee flexor and extensor muscle strength, respiratory function and respiratory muscle strength develops parallel to each other and the codevelopment of these parameters together with special exercises to increase respiratory muscle strength will improve the performance of the athletes.

Comparison of muscular strength and balance in athletes with visual impairment and hearing impairment.

This study was conducted to compare muscular strength and balance of athletes with visual and hearing impairment. The study was carried out with 20 athletes of national Olympic level sports goalball team and 20 athletes of national Olympic level sports hearing-impaired karate team. Isokinetic muscular strength was assessed by IsoMed 2000 device as concentric-concentric at 60°/sec and 240°/sec. Balance assessment was carried out with the Human Body Equilibrium 360 device. There was no significant difference between groups regarding age, height, weight and body mass index (P>0.05). There were no differences between the dominant and nondominant knee flexion and extension peak torque (PT), % of flexion/extension PT ratio, % of dominant/nondominant PT differences at 60°/sec and 240°/sec velocities (P>0.05). There was no difference between the groups regarding of both leg static balance (P>0.05). However, single leg standing balance was significantly different between groups in favor of athletes with hearing impairment (P<0.001). As a result of our study it was determined that muscular strength and static balance of athletes with visual and hearing impairment were similar, but athletes with visual problems are likely to have lower levels of single leg balance. Strategies to promote single leg balance in athletes with visual impairments are warranted.

Determination of the relationship between core endurance and isokinetic muscle strength of elite athletes.

Muscle strength and core endurance are both factors contributing to athletes' performance and prevalence of injuries. There are no studies indicating the relationship between muscle strength around the shoulder and knee joints and core endurance. The aim of our study is to determine the relationship between core endurance and isokinetic muscle strength of knees and shoulders of elite athletes. Seventy-one elite athletes (weight lifting, boxing, taekwondo, biathlon, and ice skating) (age, 18.13±2.9 years) were included in the study. Isokinetic muscle strength of shoulder internal-external rotation and knee flexion-extension were determined by using an Isomed 2000 device. Core endurance of athletes was assessed using the Mcgill Core Endurance Tests. There was a relationship between the shoulder internal rotation and external rotation peak torque/body weight (PT/W) and all endurance tests except extension endurance tests. There was also a relationship between knee flexion PT/W and all core endurance tests. While there was a relationship between knee extension PT/W and extension endurance and the lateral bridge test, this relationship was not found with the flexor endurance test. These results indicate that the upper and lower extremity muscle strength and core endurance of athletes are related with each other and must be evaluated and trained as a whole with each other.

Characteristics of upper extremity's muscle strength in Turkish national wheelchair basketball players team.

The objective of this study was to reveal characteristics of muscle strength of upper extremities of wheelchair (WC) basketball players and to ensure more-specific training program preparation. Isokinetic muscle strength of 12 WC basketball players were assessed by ISOMED 2000 device. The assessment protocol was evaluated at 60°/sec velocity with 5 times repeated force and at 240°/sec with 15 times repeated force. This protocol was carried out individually for shoulder flexion-extension and wrist flexion-extension movements at the right and left extremities. The flexion/extension ratio was determined to be outside of the ratios accepted as normal for primarily shoulder joint and for wrist joint. The extension movement was stronger than flexion movement in the shoulders at both velocities and the flexion movement was stronger than ex-tension movement in the wrist. The repeat times where the peak torque occurred were 2-3 repeats at 60°/sec velocity during flexion and extension movements for the wrist and shoulders, and the peak torque occurred at an average of 5-6 repeats in the shoulders at 240°/sec velocity and it occurred at 3-4 repeats in the wrist. The angles where the peak torque of the shoulder flexion and extension occurred varied between 80°-115° at both velocities, and it varied between 5°-30° angles for the wrist. As this study revealed, determination of muscle strength characteristics of WC athletes and especially using objective isokinetic devices will guide the planning of the appropriate training and exercise programs and preventing sports injuries in long term.