The validity and reliability of the Persian version of the Athlete Sleep Screening Questionnaire.

Background: Sleep as a biological phenomenon is effective in the performance and recovery of athletes. Questionnaires can be used as a cost-effective initial assessment tool for sleep. The Athlete Sleep Screening Questionnaire (ASSQ) demonstrated a clinically valid instrument for screening relevant sleep issues in athletic populations. Due to the lack of validated tools for adequate screening for sleep difficulties in the Iranian athlete population, the present study was conducted to evaluate the validity and reliability of the Persian version of the ASSQ. Materials and Methods: The translation process was performed using instructions by Beaton et al. Content validity was assessed by a panel of experts. Exploratory and confirmatory factor analysis was performed for two 5-item sleep difficulty scores (SDS) and a 4-item chronotype score. Internal consistency based on Cronbach's alpha and McDonald's omega and stability reliability were used to evaluate reliability. Results: The ASSQ achieved conceptual and semantic equivalence with the original scale. The item-level content validity index (I-CVI) of each item ranged from 0.87 to 1, and the averaging scale-level CVI/average was 0.95. In factor analysis, one factor for SDS and one factor for chronotype score were identified and confirmed. The internal consistency of the SDS scale (α =0.77, Ω =0.83) and chronotype (α =0.74, Ω =0.77) was acceptable. Stability reliability was confirmed for SDS scale (intra-class correlation [ICC] =0.87) and for chronotype (ICC = 0.83). Conclusion: Persian ASSQ has acceptable psychometric measurement properties as a screening tool to assess sleep in Iranian athletes.

Is ultrasound-measured abdominal fat thickness a reliable method for predicting metabolic diseases in obese and overweight women?

Background: Central fat deposition seems to be a risk factor for developing metabolic and cardiovascular diseases in overweight and obese individuals. Ultrasound is an accurate and non-invasive tool for measuring abdominal fat thickness and can precisely separate subcutaneous from visceral fat. This study was conducted to apply ultrasonography as a simple and reliable method to measure subcutaneous and visceral abdominal fat thickness and evaluate the relationship between this measured abdominal fat thickness and metabolic risk factors. Methods: A total of 80 overweight and obese women were included in this study. Anthropometric indices and abdominal fat thickness were measured using ultrasound. The association between abdominal fat thickness and metabolic risk factors with anthropometric indices was assessed using correlation coefficient. Results: The mean (± SD) of subcutaneous and visceral fat thickness was 2.71±0.92 and 5.46±1.88, respectively. There was a relationship between waist circumference and visceral and subcutaneous fat thickness. Also, there was a relationship between ultrasound- measured visceral fat thickness and fasting blood glucose and triglyceride. Conclusion: Ultrasonography is a simple and reliable method to measure abdominal fat thickness as an important predictor of metabolic diseases.

Treatment of knee osteoarthritis with platelet-rich plasma in comparison with transcutaneous electrical nerve stimulation plus exercise: a randomized clinical trial.

BACKGROUND: Osteoarthritis is a disabling musculoskeletal disease with no definite treatment. This study compared the effect of Platelet-rich plasma (PRP) and Transcutaneous Electrical Nerve Stimulation (TENS) plus exercise in the treatment of patients with knee joint osteoarthritis. METHODS: 54 eligible patients with knee osteoarthritis were randomly allocated into two groups. (IRCT2012110611382N) Group A (27 patients) received 2 injections of PRP (4 weeks apart) and group B (27 patients) received 10 sessions of TENS as well as exercise during the study period. Clinical outcome was evaluated using the Knee injury and Osteoarthritis Outcome Scores (KOOS) questionnaire before the treatment, 4 weeks, and 8 weeks after that the treatment. Pain was also assessed using a visual analog scale (VAS). Time to an intolerable knee pain during treadmill workout was also evaluated using an objective test. RESULTS: In the PRP group, the mean KOOS symptom score improved significantly from baseline to the end of study, while the change was not significant over this period for the group B. In both groups, significant reductions were observed in VAS scores from baseline till the end of study. The mean time to feel intolerable knee pain during treadmill work out of PRP group increased significantly from baseline to week 4, but no significant changes were found in this parameter over the time of study in the group B. CONCLUSION: Intraarticular injection of PRP is an effective, safe method for short-term treatment of patients with knee joint osteoarthritis.

Anabolic-Androgenic Steroids and Prohibited Substances Misuse among Iranian Recreational Female Bodybuilders and its Associated Psycho-socio-demographic Factors.

BACKGROUND: The growing tendency to anabolic-androgenic steroids (AAS) and prohibited substances misuse by female athletes is a new public health concern. Epidemiological studies in this field are necessary to introduce an effective preventive drug control program in gyms. This study directed to evaluate the prevalence of AAS and other banned substances use and assess its association with some psycho-social and also demographic parameters among Iranian female recreational bodybuilders. METHODS: This study was done from January to March 2017 and 289 recreational female bodybuilders from 41 randomly-selected fitness and sports clubs in different geographic parts of Tehran, Iran, were included. Age, education level, months of sport involvement, frequency of sport participation in a week (hour), body image assessed by Multidimensional Body-Self Relations Questionnaire (MBSRQ), and history of AAS and substances intake as the psycho-socio-demographic parameters were recorded by interviews using questionnaires. FINDINGS: Subjects were all recreational female bodybuilders [mean and standard deviation (SD) of age: 26.3 ± 6.3, range: 15-52 years]. Self-report of AAS abuse was recorded in 70 bodybuilders (24.2%). Among prohibited substances, the use of stimulants (amphetamine or methamphetamine) and other illicit drugs was recorded in 10 (3.5%) and 95 (32.9%) athletes, respectively. 112 (38.8%) participants reported somatotropin use. Cigarette smoking, hookah use, and alcohol intake were reported by 42 (14.5%), 162 (56.1%), and 49 (17.0%) female bodybuilders, respectively. Among different evaluated parameters, merely the frequency of sport participation in a week and sport experience was inversely associated with AAS consumption. CONCLUSION: Based on the subjects' self-statement, AAS and substance misuse was surprisingly common in recreational female bodybuilders. Some factors including weekly frequency of sport participation and the duration of sport involvement may influence the prevalence of AAS abuse.

Comparison of three modes of aerobic exercise combined with resistance training on the pain and function of patients with knee osteoarthritis: A randomized controlled trial.

OBJECTIVES: To investigate the effects of three modes of aerobic exercise (lower limbs with and without weight bearing and upper limb) for knee osteoarthritis. DESIGN: Randomized controlled trial. SETTING: Sports medicine clinic. PARTICIPANTS: Seventy-eight patients with knee osteoarthritis were divided into 3 groups of resistance training combined with one of three programs of treadmill, cycle ergometer, or arm ergometer aerobic training. MAIN OUTCOME MEASURES: Pain (VAS), patients' opinion about knee status (KOOS questionnaire), and functional performance [6 min walk test (6MWT), timed up and go test (TUG) and chair stand test]. RESULTS: After 8 weeks, all groups showed significant improvement in the VAS, KOOS and functional tests. After adjusting for baseline characteristics, the change in VAS was significantly higher in arm ergometer than in treadmill group (P = 0.03). Change in TUG was significantly higher in treadmill than arm ergometer group (P = 0.02). Also, the change of function in sport and recreation (a KOOS dimension) was significantly higher in arm ergometer compared to treadmill group (P = 0.04). CONCLUSION: All modes of aerobic exercise combined with resistance training led to reduced pain and improved function. Nevertheless, arm ergometry may provide greater pain relief and sport performance; while treadmill may cause greater improvement in TUG.

The Activation Pattern of Trunk and Lower Limb Muscles in an Electromyographic Assessment; Comparison Between Ground and Treadmill Walking.

BACKGROUND: Due to biomechanical differences, various patterns of muscle contraction are expected to occur while walking over ground versus when walking on a treadmill. OBJECTIVES: This study aimed to compare amplitude and duration of activation of selected trunk and lower extremity muscles during over-ground and treadmill walking. MATERIALS AND METHODS: Through a simple sampling method, 19 sedentary healthy men within the age range of 20 - 40 were selected. Surface electromyography of rectus abdominis, external oblique, longissimus and multifidus muscles as the selected trunk muscles and vastus medialis, vastus lateralis and hamstrings as the selected lower limb muscles were recorded. RESULTS: In each gait cycle, there were no statistically significant differences in duration of selected trunk as well as lower limb muscles activity between treadmill and over-ground walking. However the mean amplitude of rectus abdominis (P = 0.005), longissimus (P = 0.018) and multifidus (P = 0.044) as the selected trunk muscles as well as the mean amplitude of vastus lateralis (P = 0.005) and vastus medialis (P < 0.001) as the lower limb muscles was greater on treadmill compared with over ground. CONCLUSIONS: Due to the stabilizing role of trunk and lower limb muscles during walking, these muscles seem to be active throughout the entire gait cycle. The increased muscle amplitude on treadmill can demonstrate that more motor units may be recruited during the contraction, which can be helpful in prescribing the appropriate type of exercise especially for patients with core muscle weakness.

The Prevalence of Selected Intrinsic Risk Factors for Ankle Sprain Among Elite Football and Basketball Players.

BACKGROUND: Lateral ankle sprains (LAS) are among the most common sports- related injuries and the reinjury rate is very high. OBJECTIVES: This study aimed to evaluate the prevalence of some intrinsic risk factors among professional football and basketball players with or without history of acute or recurrent ankle sprain. PATIENTS AND METHODS: One hundred and six professional football and basketball players who were referred for pre-participation examinations were recruited in this study. Prepared checklist was completed for each participant. Athletes were asked for any history of previous ankle sprain and the severity (based of self-description of signs and symptoms by the athlete), level and number of injuries in the last two years. All players were assessed for measures of foot posture index- 6, foot length and width, Beighton generalized joint laxity score, anterior drawer and talar tilt tests, star excursion and single leg balance tests and goniometric assessment of ankle plantarflexion, ankle dorsiflexion and first metatarsophalangeal dorsiflexion. RESULTS: Forty eight basketball players (45.3%) and 58 football players (54.7%) with mean (SD) age of 19.8 (4.5) years participated. About 58.5% and 14.2% of athletes had a history of ankle sprain and recurrent sprain in at least one extremity, respectively. Sprains were more prevalent in basketball players and in dominant leg. There was no significant difference in assessed risk factors between athletes with and without history of ankle sprain, except for positive single leg balance test which was more prevalent in athletes with history of ankle sprain and also for positive talar tilt test and decreased ankle plantarflexion range of motion in acute and recurrent injury of left ankle. CONCLUSIONS: Some intrinsic risk factors including lateral ankle ligaments laxity, balance and ankle plantarflexion seem to be related to acute or recurrent LAS in athletes. Further research is needed to reveal the role of different arthrokinematics following lateral ankle sprain.

The Misuse of Anabolic-Androgenic Steroids among Iranian Recreational Male Body-Builders and Their Related Psycho-Socio-Demographic factors.

BACKGROUND: The high prevalence and potential side effects of anabolic-androgenic steroids (AAS) misuse by athletes has made it a major public health concern. Epidemiological studies on the abuse of such drugs are mandatory for developing effective preventive drug control programs in sports community. This study aimed to investigate the prevalence of AAS abuse and their association with some psycho-socio-demographic factors in Iranian male recreational body-builders. METHODS: Between March and October 2011; 906 recreational male body-builders from 103 randomly selected bodybuilding clubs in Tehran, Iran were participated in this study. Some psycho-socio- demographic factors including age, job, average family income, family size, sport experience (months), weekly duration of the sporting activity (h), purpose of participation in sporting activity, mental health as well as body image (via General Health Questionnaire and Multidimensional Body-Self Relations Questionnaire, respectively), and history of AAS use were obtained by interviews using questionnaires. RESULTS: Participants were all recreational male body-builders [mean age (SD): 25.7 (7.1), ranging 14-56 yr]. Self-report of AAS abuse was registered in 150 body-builders (16.6%). Among different psycho-socio-demographic factors, only family income and sport experience were inversely associated with AAS abuse. CONCLUSION: Lifetime prevalence of AAS abuse is relatively high among recreational body-builders based on their self-report. Some psycho-socio-demographic factors including family income and sport experience may influence the prevalence of AAS abuse.

Injuries in iran futsal national teams: a comparative study of incidence and characteristics.

BACKGROUND: Futsal is a growing sport with lots of fans in many countries including Iran, but there are few papers in the literature which report injuries in top level futsal. OBJECTIVES: The aim of this study is to record and analyze the incidence and characteristics of injuries in Iran futsal national teams from March 2011 to September 2012. PATIENTS AND METHODS: 55 Iranian national futsal players participated in this prospective cohort study. Before entering the study, all players took part in Pre-Competition Medical Assessment (PCMA) in accordance with FIFA protocol. Team physicians recorded the injuries throughout the match and trainings in a special form which was designed for this purpose. Finally, data analysis was done with the SPSS software. RESULTS: The total exposure time for all players was 24326 hours (21138 hours during training and 3188 hours during matches). During the study period, 32 of the 55 national players (58.2%) incurred 54 injuries (incidence rate = 2.22 injuries per 1000 players-hours). The incidence rate of injury in female players was significantly higher than male players (P = 0.001). The majority of injuries (85.2%) were located on the lower extremities. The ankle was the most frequent injury location (40.7%) and sprain was the most frequent type of injury. CONCLUSIONS: Injuries are common among futsal players and female players are more prone to injuries than male players. The ankle is the most frequent site and sprain is the most frequent type of injury among futsal players.

Congenital Adrenal Hyperplasia in an Elite Female Soccer Player; What Sports Medicine Clinicians Should Know about This?

BACKGROUND: Congenital Adrenal Hyperplasia (CAH) refers to a group of congenital conditions characterized by disordered cortisol synthesis. The correlation between CAH and sports performance has been less studied before and there is very limited information regarding the impacts of this congenital disease on sports performance. Probably, there are some limitations for patients who suffer from CAH in sports, but at the same time, they may enjoy some advantage due to the probable effect of endogenous hyperandrogenism on their exercise performance. CASE PRESENTATION: The case is a 14 - year old girl with male phenotype who is a known case of congenital adrenal hyperplasia. She plays in the women's national soccer team of under 16. She has been in the first division league of indoor soccer for 4 years and was also selected in the preparation training camp of women's football team for Singapore's youth Olympic Games. Her illness and dependence on corticosteroid have caused some concerns for her participation in the international competitions of women. However, following consultations with the Therapeutic Use Exemption (TUE) Committee of games organization, she received TUE to use corticosteroid only within the games period. Despite all her problems, she is now playing in the Second Division League of indoor soccer. CONCLUSIONS: A female adolescent with CAH may compete at the high level of outdoor and indoor soccer. However, there are many questions regarding the advantages and disadvantages of this congenital disorder and its treatment on sports related issues.

Amphetamine use and its associated factors in body builders: a study from Tehran, Iran.

INTRODUCTION: Epidemiological studies on all types of illicit drug use among athletes are essential for both the sport community and drug control achievements. Here, we investigated the prevalence and associated factors of amphetamine use in body builders in Tehran, Iran, 2007. MATERIAL AND METHODS: This study is a secondary analysis of a substance use survey done in 103 randomly selected gymnasia in Tehran (capital city of Iran). The survey was conducted from November 2007 to January 2008 and included 843 randomly selected bodybuilders (aged 40 years or less). By interviews via questionnaires the following data were obtained: age, job, marital status, education level, housing status, average monthly family income, number of family members, gymnasium area (m(2)), number of trainers, number of gymnasium members, initiation time (months), weekly duration of the sporting activity (h), monthly cost of the sporting activity, purpose of participating in sporting activity, and history of anabolic steroid and amphetamine use. RESULTS: One hundred twenty (13.3%) body builders reported a history of amphetamine use. According to the results of regression analysis, being married (risk ratio - RR = 0.540), and participating in body building to enhance self-esteem (RR = 0.423) or to enhance sport performance (RR = 0.545) had protective effects on amphetamine use. However, having university qualifications (RR = 1.843), using anabolic steroids (RR = 1.803) and participating in sport to maintain fitness (RR = 2.472) were linked to increased risk of amphetamine use. CONCLUSIONS: Well-educated bodybuilders were more likely to use amphetamines, and why this is so needs to be discovered. If further studies show that they are not aware of the dangers associated with amphetamine use, providing them with information should be considered.