Thyroid Stimulating Hormone as a Possible Additional COVID-19 Outcome Marker.

Background and Objectives: The interaction between thyroid and SARS-CoV-2 is complex and not yet fully understood. This study aimed to identify a predictive value of serum TSH levels on the short-term and middle-term outcomes of patients hospitalized for COVID-19. Materials and Methods: We retrospectively analyzed electronic records (ERs) data for hospitalized COVID-19 patients between March 2020 and June 2021 and their ERs during outpatient visits, 6-8 weeks post-discharge, in cases of known serum TSH levels and no previous thyroid disorder. The short-term (length of hospital stay, MSCT findings of lung involvement, required level of oxygen supplementation, admission to the ICU, and death) and middle-term outcomes after 6 to 8 weeks post-discharge (MSCT findings of lung involvement) were analyzed. Results: There were 580 patients included: 302 males and 278 females, average age of 66.39 ± 13.31 years, with no known thyroid disease (TSH mean 1.16 ± 1.8; median 0.80; no value higher than 6.0 mIU/L were included). Higher TSH was observed in patients with less severe outcomes and was associated with significantly higher SpO2 during hospitalization. Patients who required overall more oxygen supplementation or HFOT, mechanical ventilation, and patients who were more frequently admitted to the ICU or were more often treated with corticosteroids had lower TSH than those who did not show these indicators of disease severity. Lower TSH was also present in non-survivors when compared to survivors (all p < 0.01). Patients with low TSH during hospitalization more often had persistent lung involvement during the post-COVID-19 period (p = 0.028). In the post-COVID-19 period, there was an overall, statistically significant increase in the TSH levels when compared to TSH during hospitalization (p < 0.001). Conclusions: Low/suppressed serum TSH levels during acute COVID-19 may be an additional laboratory test that should be included in the prediction of unfavorable short- and middle-term outcomes.

DIFFERENCE IN PATIENT QUALITY OF LIFE AFTER HIP ARTHROPLASTY WITH A MINIMALLY INVASIVE APPROACH OR CLASSIC APPROACH.

The increasing rate of orthopedic procedures, hip arthroplasty in particular, requires improvement of surgical techniques, as well as of the respective rehabilitation protocols. The aim of the study was to assess differences in the quality of life and incidence of limping eight years after total hip arthroplasty performed with a minimally invasive or classic approach. This cross-sectional study included 68 patients, i.e. 32 operated with classic approach and 36 with minimally invasive approach during 2011. The following parameters were observed: anthropometric measurements, history of comorbidity, subjective assessment of limping, and SF-36 questionnaire (Short Form Survey Instrument). SF-36 testing, which consists of 8 domains, showed that 5 domains of the quality of life were statistically significantly better in the minimally invasive group (level of significance p<0.05). These domains were role of limitation due to physical health (p=0.01), energy (p=0.02), social functioning (p=0.02), pain (p=0.02) and general health (p=0.00). The minimally invasive group had a statistically significantly lower incidence of limping (p=0.032). Quality of life after hip replacement could be a decisive factor when choosing the type of orthopedic procedure. The higher number of limping patients in the classic approach group may have contributed to differences in the quality of life. In conclusion, the minimally invasive approach enables higher long-term quality of life and functional recovery.

High-intensity interval training changes the expression of muscle RING-finger protein-1 and muscle atrophy F-box proteins and proteins involved in the mechanistic target of rapamycin pathway and autophagy in rat skeletal muscle.

NEW FINDINGS: What is the central question of this study? What are the adaptations of protein synthesis and degradation that occur in skeletal muscle in response to high-intensity interval training (HIIT), and what are the magnitudes of the changes in response to HIIT, compared to moderate-intensity continuous training (MICT), and the mechanisms underlying these changes? What is the main finding and its importance? HIIT is more effective than MICT in altering the expression of muscle RING-finger protein-1 and muscle atrophy F-box, and enhancing the autophagic flux in rat soleus muscle. In addition, HIIT could activate the mechanistic target of rapamycin pathway. These findings suggest that HIIT might be an effective exercise strategy for health promotion in skeletal muscle. ABSTRACT: This study aimed to investigate the impact of high-intensity interval training (HIIT) on the proteins involved in protein synthesis, the ubiquitin-proteasome system (UPS) and autophagy in skeletal muscle of middle-aged rats. Nine-month-old male Wistar rats (n = 56) were randomly divided into three groups: a control (C) group, a moderate-intensity continuous training (MICT) group and a HIIT group. Rats in the training groups ran on treadmills 5 days per week for 8 weeks. The MICT group ran for 50 min at 60% V̇O2max , while the HIIT group ran for 3 min at 80% of V̇O2max six times separated by 3-min periods at 40% V̇O2max . Aerobic endurance, number of autophagosomes and expression of proteins involved in protein synthesis and degradation in the soleus muscle were measured at three time points: before training, after 4 weeks and after 8 weeks of training. Compared to the C group, HIIT and MICT increased the expression of phosphorylated mechanistic target of rapamycin (mTOR) after 8 weeks (P < 0.05 and P < 0.01, respectively). HIIT increased the expression of muscle RING-finger protein-1 (MuRF-1) after 4 weeks (P < 0.01), and decreased its expression after 8 weeks (P < 0.01). Both HIIT and MICT decreased the expression of muscle atrophy F-box (MAFbx) after 4 weeks (P < 0.05). HIIT improved the expression of microtubule-associated protein 1A/1B-light chain 3 (LC3)-II (P < 0.05), and decreased the P62 content (P < 0.01) after 4 weeks. The LC3II/LC3I ratio was increased after 8 weeks (P < 0.01). This study demonstrated that HIIT could activate the mTOR pathway, alter the expression of MuRF-1 and MAFbx proteins, and enhance autophagic flux in soleus muscle of middle-aged rats.

The acute effects of graded physiological strain on soccer kicking performance: a randomized, controlled cross-over study.

PURPOSE: The aim of the present study was to examine the acute effects of graded physiological strain on soccer kicking performance. METHODS: Twenty-eight semi-professional soccer players completed both experimental and control procedure. The experimental protocol incorporated repeated shooting trials combined with a progressive discontinuous maximal shuttle-run intervention. The initial running velocity was 8 km/h and increasing for 1 km/h every 3 min until exhaustion. The control protocol comprised only eight subsequent shooting trials. The soccer-specific kicking accuracy (KA; average distance from the ball-entry point to the goal center), kicking velocity (KV), and kicking quality (KQ; kicking accuracy divided by the time elapsed from hitting the ball to the point of entry) were evaluated via reproducible and valid test over five individually determined exercise intensity zones. RESULTS: Compared with baseline or exercise at intensities below the second lactate threshold (LT2), physiological exertion above the LT2 (blood lactate > 4 mmol/L) resulted in meaningful decrease in KA (11-13%; p < 0.05), KV (3-4%; p < 0.05), and overall KQ (13-15%; p < 0.01). The light and moderate-intensity exercise below the LT2 had no significant effect on soccer kicking performance. CONCLUSIONS: The results suggest that high-intensity physiological exertion above the player's LT2 impairs soccer kicking performance. In contrast, light to moderate physiological stress appears to be neither harmful nor beneficial for kicking performance.

Functional recovery after muscle sparing total hip arthroplasty in comparison to classic lateral approach - A three years follow-up study.

BACKGROUND: The muscle sparing total hip arthroplasty had generated a distinguishable interest, in both the patients and the surgeons, but its benefits are still often questioned. The main idea of this study was to compare the functional clinical outcome of the patients operated by the anterolateral approach with a muscle-sparing technique (modified Watson-Jones approach), and the patients operated by modified direct lateral approach without the muscle-sparing technique (Bauer/Hardinge approach). METHODS: The patients (N = 130) were divided into two groups: 68 in a standard method group (STAND) and 62 patients in a muscle sparing surgery group (MSS). The hip flexibility, mobility, the strength of the hip abduction, the pain scale, Harris hip scores, the duration of the hospital stay and the overall satisfaction were measured seven days, three months, one year and three years (in 80 patients) after the surgery. There were no differences in any of the parameters between the groups prior to the procedure. RESULTS: The statistically significant differences in first three follow-ups (up to one year) were determined between the groups in passive and active hip flexion ability but the hip abduction strength, which is a crucial parameter for functional recovery, and 50 m walk test remained better in MSS group even after three years. Patients, who underwent MSS suffered also less pain, stayed in hospital shorter and were more satisfied with the operation outcome. CONCLUSIONS: The functional recovery in patients treated with muscle sparing method was faster than in patients operated with conventional lateral approach. Based on the results, we could recommend anterolateral muscle sparing approach for a total hip replacement for its faster and fuller functional recovery.

Reliability and Validity of the Inline Skating Skill Test.

This study aimed to examine the reliability and validity of the inline skating skill test. Based on previous skating experience forty-two skaters (26 female and 16 male) were randomized into two groups (competitive level vs. recreational level). They performed the test four times, with a recovery time of 45 minutes between sessions. Prior to testing, the participants rated their skating skill using a scale from 1 to 10. The protocol included performance time measurement through a course, combining different skating techniques. Trivial changes in performance time between the repeated sessions were determined in both competitive females/males and recreational females/males (-1.7% [95% CI: -5.8-2.6%] - 2.2% [95% CI: 0.0-4.5%]). In all four subgroups, the skill test had a low mean within-individual variation (1.6% [95% CI: 1.2-2.4%] - 2.7% [95% CI: 2.1-4.0%]) and high mean inter-session correlation (ICC = 0.97 [95% CI: 0.92-0.99] - 0.99 [95% CI: 0.98-1.00]). The comparison of detected typical errors and smallest worthwhile changes (calculated as standard deviations × 0.2) revealed that the skill test was able to track changes in skaters' performances. Competitive-level skaters needed shorter time (24.4-26.4%, all p < 0.01) to complete the test in comparison to recreational-level skaters. Moreover, moderate correlation (ρ = 0.80-0.82; all p < 0.01) was observed between the participant's self-rating and achieved performance times. In conclusion, the proposed test is a reliable and valid method to evaluate inline skating skills in amateur competitive and recreational level skaters. Further studies are needed to evaluate the reproducibility of this skill test in different populations including elite inline skaters.

Ultrasound-assisted calcaneoplasty.

PURPOSE: The endoscopic technique for resection of a postero-superior part of calcaneus served as a golden standard during the last 10 years, and it has mostly replaced the open techniques. In an effort to reduce the morbidity and the recovery time, we had introduced the ultrasound-assisted technique. METHODS: In the period of 1 year, 15 patients with the prominent postero-superior part of calcaneus and retrocalcaneal bursitis were operated through the single skin incision using the ultrasound-assisted technique. The prominent part of calcaneus was resected with a bone abrader under the ultrasound control to the point when there was no impingement between Achilles tendon and calcaneus in maximal dorsal flexion. The patients were evaluated preoperatively and postoperatively with the AOFAS score and Ogilvie-Harris score. The strength test of the muscle triceps surae, as well as the proprioceptive test, was also undertaken. RESULTS: Initially, the follow-up was meant to last 6 months, but there were no differences in results between 6 weeks and 3 months postoperatively, so it was concluded that the 3-month follow-up is sufficient and relevant. All 15 patients were available for follow-up. All measured variables significantly improved (AOFAS, Ogilvie-Harris), and all the patients were satisfied with the postoperative result. Only one minor complication occurred: superficial infection. CONCLUSION: The ultrasound-assisted calcaneoplasty enables a precise resection of the postero-superior part of calcaneus and removal of the retrocalcaneal impingement. This method could become clinically relevant as it enables effective treatment of Haglund deformity, and results of this study presented rapid functional recovery. LEVEL OF EVIDENCE: Case series with no comparison group, Level IV.

Effects of aerobic and anaerobic training on freedivers' performance.

BACKGROUND: Freediving is a sport that could be defined as both aerobic and anaerobic. Therefore, this study aimed to evaluate the effect of aerobic-anaerobic training on the performance of moderate and elite freedivers. METHODS: The sample of participants included 26 freedivers (9 females) (average age of 26.62±3.34 years, body height of 178.95±9.19 cm, and body mass of 74.64±11.97 kg). The sample of variables included: anthropometric indices, relative maximal oxygen consumption (rVO2max), Diving anaerobic sprint test (DAST), Swimming anaerobic sprint test (SAST), 100-meter crawl sprint test (100 m), maximal dynamic apnea with monofin (DYN), maximal swimming length for 2 minutes (2 min). The study procedure included a 5-month aerobic-anaerobic training intervention. This intervention was conducted during a 4-phase (5-week each) training period. RESULTS: The results showed that moderate group showed a significant decrease in 100 m (final 83.94±15.68; initial 88.29±16.73; P<0.00), DASTmax (final 10.91±1.46; initial 12.01±1.38; P<0.00), DAST (final 70.29±8.95; initial 79.40±10.25; P<0.00), SASTmax (final 16.81±2.24; initial 18.01±2.69; P<0.00), SAST(final 112.87±19.19; initial 122.65±21.55; P<0.00), and increase in 2 min (final 140.56±21.53; initial 128.68±19.33; P<0.00), and DYN (final 130.48±26.89; initial 91.65; P<0.00). Similarly, the elite group experienced a decrease in 100 m (final 72.18±9.77; initial 75.00±11.36; P=0.02), DASTmax (final 10.14±0.95; initial 10.88±0.99; P=0.03), DAST (final 65.55±6.50; initial 71.24±7.32; P=0.02), SASTmax (final 14.82±1.84; initial 15.76±1.80; P=0.03), and increase in DYN (final 194.94±27.70; initial 161.11±27.70; P<0.00). CONCLUSIONS: The results of this study demonstrate that dynamic apnea, as a main performance factor, had increase in all phases of procedure, with highest increase during anaerobic phases.

Evaluating Intraocular Pressure Alterations during Large Muscle Group Isometric Exercises with Varying Head and Body Positions.

Performing physical exercise affects intraocular pressure, and its elevation and fluctuations are the main risk factors for glaucoma development or progression. The aim of this study was to examine the acute alterations in intraocular pressure (IOP) during four unweighted isometric exercises and to determine whether the different head and body positions taken during exercise additionally affect IOP. Twelve healthy volunteers between the ages of 25 and 33 performed four isometric exercises: wall sit in neutral head and body position, elbow plank in prone head and body position, reverse plank in supine head and body position for 1 min, and right-side plank in lateral head and body position for 30 s. Intraocular pressure was measured by applanation portable tonometry, before performing the exercise, immediately after exercise completion, and after five minutes of rest. A significant acute increase in intraocular pressure was found as a response to the performance of the elbow plank (p < 0.01), the reverse plank (p < 0.001), and the right-side plank (p < 0.001). The wall sit exercise did not reveal a statistically significant IOP elevation (p = 0.232). Different head and body positions had no significant additional influence on IOP (F (3,33) = 0.611; p = 0.613), even though the alteration in IOP was found to be greater in exercises with a lower head and body position. Our data revealed that IOP elevation seems to be affected by the performance of the elbow plank, the reverse plank, and the right-side plank; and not by the wall sit exercise. More different isometric exercises should be examined to find ones that are safe to perform for glaucoma patients.

Validation of the Sensewear Armband during recreational in-line skating.

Multi-sensor body monitors that combine accelerometry with other physiological data are designed to overcome drawbacks of accelerometers in assessing activities with little or no vertical movement. One of such devices is the Sensewear Armband (SWA) which has been extensively validated during various activities. However, very few of the validation studies included activities other than walking and running. The aim of this investigation was to assess the validity of the SWA during recreational in-line skating. Nineteen participants (11 females and 8 males), 28 (±6) years of age, performed in-line skating exercise on a circular track at a self-selected pace. Energy expenditure was measured with the SWA and the Cosmed K4b(2) breath-by-breath portable metabolic unit. The mean (SD) energy expenditure during in-line skating estimated by the SWA [25.5 (5.8) kJ/min] was significantly lower compared with indirect calorimetry [44.2 (9.7) kJ/min, P < 0.001]. Similarly, the mean (SD) MET values recorded by the SWA were also lower compared with IC [5.3 (1.0) METs vs. 9.1 (1.6) METs, P < 0.001]. The ratio limits of agreement suggest that in 95% of cases the SWA will underestimate the energy expenditure and MET values during in-line skating by as much as 24-56% compared with indirect calorimetry. In conclusion, the results of the present study indicate that the SWA is not able to overcome the drawbacks of accelerometry in assessing activities with limited vertical movement.

The Influence of Protective Headgear on the Visual Field of Recreational-Level Skiers.

The benefit of protective headgear for recreational skiers is an ongoing debate in the snow sports industry, and there are a lot of opposing opinions. Due to the dynamic conditions in which winter sports are performed, athletes demand rapid and constant processing of visual information. A sufficient level of anticipation helps athletes to properly position themselves to reduce the forces transferred to the head or even move to avoid a collision. To objectively identify the impact of protective headgear on the visual field when skiing, it is necessary to conduct suitable measurements. The sample consisted of 43 recreational-level skiers (27 M, 16 F; age 31.6 ± 8.23 years). A predefined testing protocol on an ortoreter was used to assess the visual field for three conditions of wearing protective headgear. Differences in perceived visual stimuli between the three conditions were evaluated by repeated measures analysis of variance (ANOVA). Based on the observed results, it can be concluded that the combination of wearing a ski helmet and ski goggles significantly negatively influences visual performance in a way that the visual field is narrowed, for both helmet users and non-users, only when comparing the tested conditions. When comparing helmet users and non-users, there are no differences in the amount of visual impairment; therefore, the habit of wearing a helmet does not influence the ability of perceiving visual stimuli.

Postoperative blood loss management in total knee arthroplasty: a comparison of four different methods.

PURPOSE: As the blood loss after the total knee arthroplasty (TKA) is not only a potentially serious medical problem but also an economical concern, the purpose of the study was to investigate the effectiveness of different combinations of knee positioning and the applied wound dressings on blood saving after TKA. METHODS: A randomized controlled trial including 147 TKA-operated patients was conducted. The subjects were assigned to one of the four groups; Group 1-controls, Group 2-flexion, Group 3-flexion and compression, Group 4-compression. The main outcome measures of the study were the blood loss volumes during the procedure and in the intensive care rooms and the decreases in haemoglobin, haemotocrit and red blood cells on the first and the second postoperative day. RESULTS: The MANOVA results showed no differences between the groups in any of the observed parameters. The post-hoc comparisons of the each group to the control group also revealed no influence of any of the proposed blood saving techniques on the actual blood loss. CONCLUSION: No significant differences among the four proposed blood saving methods were determined.

New "L value" parameter simplifies and enhances hip ultrasound interpretation in the detection of developmental dysplasia of the hip.

PURPOSE: The purpose of this study was to simplify and enhance the ultrasound (US) analysis of the infant's hip by introducing a novel parameter named "L value" into the widely used Graf method. METHODS: We analysed 508 ultrasonographic images of the hips in infants aged three months. The images were first evaluated using the Graf measurements. On the same images, two additional measurements were performed in order to define the new parameter that was named L value. The threshold values of the new L value were identified based on the highest specificity as well as sensitivity for discrimination between the Graf groups. Those values were then used in order to reclassify the hips into three simplified groups. Inter-observer agreement was estimated by Cohen's kappa coefficient. RESULTS: The threshold values for the L value between Graf groups Ia and Ib was 0.46, between Ib and IIb was 0.68 and between IIb and IIc was 0.92. Correlation analysis between Graf's classification and the values of the L value was performed and was proved to be statistically significant, r = 0.49; p < 0.001. After simplifying the classification into three newly defined groups of patients depending on the degree of hip development, the correlation coefficient was much higher, r = 0.94, r (2) = 0.88 for p < 0.001. Inter-observer agreement for the L value was substantial. CONCLUSIONS: The new L value parameter in Graf's ultrasound hip evaluation enables a faster, simpler, more reliable and more unbiased classification for developmental dysplasia of the hip as the L value changes proportionally with the hip maturity.

Risk-taking behavior in skiing among helmet wearers and nonwearers.

OBJECTIVE: To examine differences in on-the-snow ski behavior between helmet wearers and nonwearers. METHODS: The data were collected using a survey. Several tourist agencies helped in administrating the survey to the skiers during the 2008-2009 and 2009-2010 seasons. The survey consisted of multiple-choice questions. The subjects were asked to choose answers most suitable for their skiing style and preferred skiing technique, volume of off-piste skiing, readiness to use time measuring systems on the slopes, and group-skiing preferences, such as leading the group, beside the group, away from the group, etc. The Risk Index was then calculated for each subject. RESULTS: The answers of 710 skiers (mean age 35.5, range 16-81 years) were analyzed. The predictive power for risk-taking behavior was tested for gender, age, educational level, level of skiing, years of skiing, and helmet usage. Younger age, male gender, higher skiing level, and helmet usage were used as independent predictors for the overall Risk Index (Power [1-ß err prob] = 0.942). Significantly higher risk was assessed for the male helmet wearers while the results were not significant for the female helmet wearers. The male occasional helmet wearers were found to be the most prone to risky behavior. In female nonhelmet wearers, there was a significant decrease in risk-taking behavior with age but this was not true for female helmet wearers. CONCLUSIONS: For males under 35 years of age, helmet use is one of the factors influencing risk-taking on the slopes. This is demonstrated for occasional helmet wearers in particular.

Women in sports: the applicability of common national reference intervals for inflammatory and coagulation biomarkers (HemSter Study).

INTRODUCTION: Intensive physical activity causes functional and metabolic changes in the athlete's organism. The study aimed to verify the common national available reference intervals (RIs) for common inflammatory and screening coagulation tests in a population of healthy young female athletes. MATERIALS AND METHODS: One hundred and twenty-one female athletes (age range: 16-34), from various sports disciplines (water polo, handball, volleyball, football, basketball), were included in the study. All participants completed the international physical activity short-form questionnaire. Blood samples were collected between 8-10 am, after an overnight fast, before any physical activity. Reference intervals were determined according to Clinical & Laboratory Standards Institute EP28-A3C Guidelines. RESULTS: Calculated RIs for white blood cell count (WBC), prothrombin time (PT), and activated partial thromboplastin time (APTT) ratio were in accordance with the common national RIs. Calculated RI for C-reactive protein (CRP) was lower (< 2.9 mg/L) than the proposed cut-off for a healthy population (< 5.0 mg/L). Reference interval for fibrinogen was higher (1.9-4.4 g/L), than the available RIs (1.8-3.5 g/L). D-dimer cut-off value was set at 852 µg/L fibrinogen equivalent units (FEU), higher than the proposed 500 µg/L FEU for venous thromboembolism (VTE) exclusion. CONCLUSIONS: The applicability of the available RIs for WBC count, PT, and APTT-ratio was confirmed. However, RIs for CRP and fibrinogen differed significantly than the available common national RIs for the healthy non-athletes' population. A higher cut-off for D-dimers should be extensively verified before implementation for VTE diagnosis exclusion in a group of healthy young female athletes.

Ski helmets could attenuate the sounds of danger.

OBJECTIVE: To determine whether a ski helmet reduces skiers' hearing particularly sounds that can warn skiers of potentially dangerous situations. DESIGN: Randomized repeated measures (first part), environmental field measurements (second part). SETTING: Audiology Centre of Rijeka Medical School, ski slopes at Platak resort. PARTICIPANTS: Thirty healthy subjects not used to wearing a helmet each served as their own control. INTERVENTION: Ski cap, ski helmet, and no intervention in randomized order. MAIN OUTCOME MEASUREMENTS: Laboratory open-field audiometric testing: bareheaded, ski cap, and ski helmet (0.125-8 kHz protocol), and environmental A-weighted sound measurements on the slope for potentially dangerous situations like snowboarder breaking or skier passing by. In both parts of the study, the sound pressure levels (dB) and sound spectrum frequencies were analyzed. RESULTS: First part-No differences were found between bare head and wearing only a ski cap. Significant sound attenuation characteristics of the helmet were determined for frequencies 2, 4, and 8 kHz (P < 0.001). Second part-High sound pressure levels were found for all the danger sounds measured on the slope, especially at frequencies that were most affected by helmet sound attenuation (2-8 kHz) in previously conducted laboratory tests. CONCLUSIONS: Helmets could influence the level of the hearing threshold in frequencies between 2 and 8 KHz. The spectrum of danger sounds on the slope has high pressure levels at frequencies that were most affected by helmet sound attenuation characteristics (2-8 kHz), so the helmet wearers might misinterpret the sounds of potentially dangerous situations because the sound might be distorted.

The influence of test repetition on bipodal visually controlled static and dynamic balance.

This study explores the influence of test repetition on bipodal visually controlled balance, both static and dynamic. Our goal was to get an insight into the pattern of changes in posture maintenance results during repeated balance tests. Fifteen young, healthy male recreational athletes were tested for static and for dynamic balance using KAT 2000 balance platform. The subjects first performed three trial tests of static and dynamic balance to get used to the platform followed by seven repetitions of static as well as dynamic test which were recorded. During the repeated tests we could not determine any significant improvements of static balance test resulting from number of test repetitions neither in static nor in dynamic balance (Friedman ANOVA: Static balance p = 0.497, Dynamic balance p = 0.393). Correlating static and dynamic balance results we found that only one third of the dynamic balance was related to static balance abilities (r2 = 0.36). Possible patterns in front-back and left-right directions were analyzed as well, however, none of these balance scores were found to be related to the number of repetitions. In conclusion, this study found no significant influence of limited number of repetitions (seven) on test results in static and dynamic posture. However, as large number of repetitions might still influence test results we discourage the use of KAT 2000 as a training tool in patients in which it will be used as an instrument to validate postoperative rehabilitation or investigation results.

Women in sports: The applicability of reference intervals for 6 commercially available testosterone immunoassays (HemSter Study).

BACKGROUND: Testosterone levels in female athletes are increased due to their physical activity and correlate with their exercise volume. We therefore hypothesized that the reference intervals (RIs) derived from the general population are not applicable for female athletes. The aim of this study was to evaluate the applicability of the given RIs for 6 commercially available testosterone immunoassays in a group of female athletes. METHODS: Our study included 121 female athletes from various sporting disciplines (water polo, handball, volleyball, football, and basketball). The physical activity score was assessed by the Short Form of the International Physical Activity Questionnaire. Total testosterone was measured in serum samples by the reference LC-MS/MS method and six different immunoassays (Abbott Architect 2nd Generation Testosterone, Beckman Coulter Access Testosterone, Roche Elecsys Testosterone II, Siemens Atellica® IM Testosterone II (TSTII), Siemens IMMULITE 2000 Total Testosterone, and Snibe MAGLUMI™ Testosterone). RESULTS: There were statistically significant differences in age (P = 0.042), weight (P = 0.001), height (P < 0.001), and BMI (P < 0.001) between athletes across different sports. Their quantitative measurements of physical activity and testosterone concentration did not differ significantly between subgroups of various sports, P = 0.167 and P = 0.181, respectively. All immunoassays had a positive absolute and relative bias, in comparison with the LC-MS/MS. The manufacturer's RI was not verified for Abbott Architect, Beckman Coulter Access, and Roche Elecsys Testosterone methods, with the highest percentage of athletes above RI for Beckman Coulter (30%). CONCLUSIONS: We demonstrated that the upper reference limit provided was too low for some young female athletes. Clinical laboratories should consider implementation of the new proposed RIs.

High volume-low intensity exercise camp and glycemic control in diabetic children.

AIM: To evaluate the effects of the designed regime encompassing high volume-low intensity physical activity programme on glycemic control in diabetic children, 20 subjects (age 12.81 +/- 2.14) spent 2 weeks in a controlled environment of a summer camp. METHODS: An exercise physiologist and a kinesiology specialist programme and conducted the three exercise sessions a day. Total daily caloric intake was controlled and the blood glucose was monitored four times a day with special concern for hypoglycaemia episodes. Short and long-term effects (HbA1c) of the summer camp were evaluated 10 days and 2 months following programme completion. The insulin dosage was not lowered at the beginning of the camp for everyone, but it was individually modified according to the blood glucose monitoring. RESULTS: Initial HbA1c was 8.28 +/- 1.3% and decreased to 7.92 +/- 1.42% measured 10 days after the camp (P = 0.023) while the number of children with the satisfactory HbA1c level lower than 7.5% doubled. HbA1c increased again 2 months following the camp. The average blood glucose concentrations decreased in the last days of the camp when compared with the first day in three out of four daily measurements (P < 0.05). There were only two clinically manifested hypoglycaemia episodes recorded. CONCLUSION: With a low rate of hypoglycaemia crisis and better glycemic control the proposed programme was found to be satisfactory but the downside was that the duration of the effects was too short. With no participation in organised exercise programmes and with absence of controlled nutrition, the beneficial effects of the camp disappeared within 2 months after the camp.

Predicting the 1000m rowing ergometer performance in 12-13-year-old rowers: the basis for selection process?

Performance-predictive parameters have been established for rowers representing different quality levels, sexes, weight categories and classifications, but none have been designed for very young rowers (age <14). The objective of this study was to predict 1000-m rowing ergometer performance based on 12 anthropometric and six physiological variables in 48 male rowers (age range 12.0-13.9 year; mean+/-S.D. 12.94+/-0.61) and to determine the key parameters that would perhaps provide a scientific basis for talent identification and the selection process in rowing. The subjects completed an incremental maximal treadmill test. Their body height (r=-0.79), body mass (r=-0.60), lean body mass (r=-0.82), leg length (r=-0.72), arm length (r=-0.71), bicristal diameter (r=-0.63), biacromial diameter (r=-0.73), upper arm girth (r=-0.34), forearm girth (r=-0.63), thigh girth (r=-0.29), calf girth (r=-0.54), maximal oxygen uptake (in L/min, r=-0.89; and in mL/kg/min, r=-0.36), maximal ventilation (r=-0.77), and oxygen uptake at ventilatory anaerobic threshold (r=-0.87) correlated with 1000-m time (p<0.05), while percent body fat, percent of maximal oxygen uptake at ventilatory anaerobic threshold and maximal lactate did not. Performance correlated significantly with age (r=-0.46; p<0.01), so it was important to consider this effect in the resulting regression models. Multiple regression procedures indicated that the model comprising anthropometric and physiological variables combined best predicts performance (R(2)=0.85), followed by models that comprised physiological (R(2)=0.80) and anthropometric (R(2)=0.76) variables alone. In conclusion, in rowers aged 12-13 year a higher aerobic capacity (as measured by maximal oxygen uptake in L/min), and a larger body size are beneficial for performance over 1000-m rowing ergometer distance.