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Long-distance race car drivers are classified as athletes. The sport is physically and mentally demanding, requiring long hours of practice. Therefore, optimal dietary intake is essential for health and performance of the athlete. The aim of the study was to evaluate dietary intake and to compare the data with dietary recommendations for athletes and for the general adult population according to the German Nutrition Society (DGE). A 24-h dietary recall during a competition preparation phase was obtained from 16 male race car drivers (28.3 ± 6.1 years, body mass index (BMI) of 22.9 ± 2.3 kg/m2). The mean intake of energy, nutrients, water and alcohol was recorded. The mean energy, vitamin B2, vitamin E, folate, fiber, calcium, water and alcohol intake were 2124 ± 814 kcal/day, 1.3 ± 0.5 mg/day, 12.5 ± 9.5 mg/day, 231.0 ± 90.9 ug/day, 21.4 ± 9.4 g/day, 1104 ± 764 mg/day, 3309 ± 1522 mL/day and 0.8 ± 2.5 mL/day respectively. Our study indicated that many of the nutrients studied, including energy and carbohydrate, were below the recommended dietary intake for both athletes and the DGE.
Long-distance race car drivers are classified as athletes. The sport is physically and mentally demanding, requiring long hours of practice. Therefore, optimal dietary intake is essential for health and performance of the athlete. The aim of the study was to evaluate dietary intake and to compare the data with dietary recommendations for athletes and for the general adult population according to the German Nutrition Society (DGE). A 24-h dietary recall during a competition preparation phase was obtained from 16 male race car drivers (28.3 ± 6.1 years, body mass index (BMI) of 22.9 ± 2.3 kg/m2). The mean intake of energy, nutrients, water and alcohol was recorded. The mean energy, vitamin B2, vitamin E, folate, fiber, calcium, water and alcohol intake were 2124 ± 814 kcal/day, 1.3 ± 0.5 mg/day, 12.5 ± 9.5 mg/day, 231.0 ± 90.9 ug/day, 21.4 ± 9.4 g/day, 1104 ± 764 mg/day, 3309 ± 1522 mL/day and 0.8 ± 2.5 mL/day respectively. Our study indicated that many of the nutrients studied, including energy and carbohydrate, were below the recommended dietary intake for both athletes and the DGE.
Static (one-legged stance) and dynamic (star excursion balance) postural control tests were performed by 14 adolescent athletes with and 17 without back pain to determine reproducibility. The total displacement, mediolateral and anterior-posterior displacements of the centre of pressure in mm for the static, and the normalized and composite reach distances for the dynamic tests were analysed. Intraclass correlation coefficients, 95% confidence intervals, and a Bland-Altman analysis were calculated for reproducibility. Intraclass correlation coefficients for subjects with (0.54 to 0.65), (0.61 to 0.69) and without (0.45 to 0.49), (0.52 to 0.60) back pain were obtained on the static test for right and left legs, respectively. Likewise, (0.79 to 0.88), (0.75 to 0.93) for subjects with and (0.61 to 0.82), (0.60 to 0.85) for those without back pain were obtained on the dynamic test for the right and left legs, respectively. Systematic bias was not observed between test and retest of subjects on both static and dynamic tests. The one-legged stance and star excursion balance tests have fair to excellent reliabilities on measures of postural control in adolescent athletes with and without back pain. They can be used as measures of postural control in adolescent athletes with and without back pain.
Static (one-legged stance) and dynamic (star excursion balance) postural control tests were performed by 14 adolescent athletes with and 17 without back pain to determine reproducibility. The total displacement, mediolateral and anterior-posterior displacements of the centre of pressure in mm for the static, and the normalized and composite reach distances for the dynamic tests were analysed. Intraclass correlation coefficients, 95% confidence intervals, and a Bland-Altman analysis were calculated for reproducibility. Intraclass correlation coefficients for subjects with (0.54 to 0.65), (0.61 to 0.69) and without (0.45 to 0.49), (0.52 to 0.60) back pain were obtained on the static test for right and left legs, respectively. Likewise, (0.79 to 0.88), (0.75 to 0.93) for subjects with and (0.61 to 0.82), (0.60 to 0.85) for those without back pain were obtained on the dynamic test for the right and left legs, respectively. Systematic bias was not observed between test and retest of subjects on both static and dynamic tests. The one-legged stance and star excursion balance tests have fair to excellent reliabilities on measures of postural control in adolescent athletes with and without back pain. They can be used as measures of postural control in adolescent athletes with and without back pain.
The study investigated the incidence of Achilles and patellar tendinopathy in adolescent elite athletes and non-athletic controls. Furthermore, predictive and associated factors for tendinopathy development were analyzed. The prospective study consisted of two measurement days (M1/M2) with an interval of 3.2 +/- 0.9 years. 157 athletes (12.1 +/- 0.7 years) and 25 controls (13.3 +/- 0.6 years) without Achilles/patellar tendinopathy were included at Ml. Clinical and ultrasound examinations of both Achilles (AT) and patellar tendons (PT) were performed. Main outcome measures were incidence tendinopathy and structural intratendinous alterations (hypo-/hyperechogenicity, vascularization) at M2 [%]. Incidence of Achilles tendinopathy was 1% in athletes and 0% in controls. Patellar tendinopathy was more frequent in athletes (13 %)than in controls (4%). Incidence of intratendinous alterations in ATs was 1-2% in athletes and 0 % in controls, whereas in PTs it was 4-6 % in both groups (p >0.05). Intratendinous alterations at M2 were associated with patellar tendinopathy in athletes (p <= 0.01). Intratendinous alterations at M1, anthropometric data, training amount, sports or sex did not predict tendinopathy development (p>0.05). Incidence often dinopathy and intratendinous alterations in adolescent athletes is low in ATs and more common in PTs. Development of intratendinous alterations in PT is associated with tend in opathy. However, predictive factors could not be identified.
Low back pain (LBP) is a leading cause of activity limitation. Objective assessment of the spinal motion plays a key role in diagnosis and treatment of LBP. We propose a method that facilitates clinical assessment of lower back motions by means of a wireless inertial sensor network. The sensor units are attached to the right and left side of the lumbar region, the pelvis and the thighs, respectively. Since magnetometers are known to be unreliable in indoor environments, we use only 3D accelerometer and 3D gyroscope readings. Compensation of integration drift in the horizontal plane is achieved by estimating the gyroscope biases from automatically detected initial rest phases. For the estimation of sensor orientations, both a smoothing algorithm and a filtering algorithm are presented. From these orientations, we determine three-dimensional joint angles between the thighs and the pelvis and between the pelvis and the lumbar region. We compare the orientations and joint angles to measurements of an optical motion tracking system that tracks each skin-mounted sensor by means of reflective markers. Eight subjects perform a neutral initial pose, then flexion/extension, lateral flexion, and rotation of the trunk. The root mean square deviation between inertial and optical angles is about one degree for angles in the frontal and sagittal plane and about two degrees for angles in the transverse plane (both values averaged over all trials). We choose five features that characterize the initial pose and the three motions. Interindividual differences of all features are found to be clearly larger than the observed measurement deviations. These results indicate that the proposed inertial sensor-based method is a promising tool for lower back motion assessment.
Differences in neuromuscular activity of ankle stabilizing muscles during postural disturbances
(2018)
The purpose was to examine gender differences in ankle stabilizing muscle activation during postural disturbances. Seventeen participants (9 females: 27 +/- 2yrs., 1.69 +/- 0.1 m, 63 +/- 7 kg; 8 males: 29 +/- 2yrs., 1.81 +/- 0.1 m; 83 +/- 7 kg) were included in the study. After familiarization on a split-belt-treadmill, participants walked (1 m/s) while 15 right-sided perturbations were randomly applied 200 ms after initial heel contact. Muscle activity of M. tibialis anterior (TA), peroneus longus (PL) and gastrocnemius medialis (GM) was recorded during unperturbed and perturbed walking. The root mean square (RMS; [%]) was analyzed within 200 ms after perturbation. Co-activation was quantified as ratio of antagonist (GM)/agonist (TA) EMG-RMS during unperturbed and perturbed walking. Time to onset was calculated (ms). Data were analyzed descriptively (mean +/- SD) followed by three-way-ANOVA (gender/condition/muscle; alpha= 0.05). Perturbed walking elicited higher EMG activity compared to normal walking for TA and PL in both genders (p < 0.000). RMS amplitude gender comparisons revealed an interaction between gender and condition (F = 4.6, p = 0.049) and, a triple interaction among gender, condition and muscle (F = 4.7, p = 0.02). Women presented significantly higher EMG-RMS [%] PL amplitude than men during perturbed walking (mean difference = 209.6%, 95% confidence interval = -367.0 to -52.2%, p < 0.000). Co-activation showed significant lower values for perturbed compared to normal walking (p < 0.000), without significant gender differences for both walking conditions. GM activated significantly earlier than TA and PL (p < 0.01) without significant differences between the muscle activation onsets of men and women (p = 0.7). The results reflect that activation strategies of the ankle encompassing muscles differ between genders. In provoked stumbling, higher PL EMG activity in women compared to men is present. Future studies should aim to elucidate if this specific behavior has any relationship with ankle injury occurrence between genders.
Background: Core-specific sensorimotor exercises are proven to enhance neuromuscular activity of the trunk, improve athletic performance and prevent back pain. However, the dose-response relationship and, therefore, the dose required to improve trunk function is still under debate. The purpose of the present trial will be to compare four different intervention strategies of sensorimotor exercises that will result in improved trunk function.
Methods/design: A single-blind, four-armed, randomized controlled trial with a 3-week (home-based) intervention phase and two measurement days pre and post intervention (M1/M2) is designed. Experimental procedures on both measurement days will include evaluation of maximum isokinetic and isometric trunk strength (extension/flexion, rotation) including perturbations, as well as neuromuscular trunk activity while performing strength testing. The primary outcome is trunk strength (peak torque). Neuromuscular activity (amplitude, latencies as a response to perturbation) serves as secondary outcome. The control group will perform a standardized exercise program of four sensorimotor exercises (three sets of 10 repetitions) in each of six training sessions (30 min duration) over 3 weeks. The intervention groups’ programs differ in the number of exercises, sets per exercise and, therefore, overall training amount (group I: six sessions, three exercises, two sets; group II: six sessions, two exercises, two sets; group III: six sessions, one exercise, three sets). The intervention programs of groups I, II and III include additional perturbations for all exercises to increase both the difficulty and the efficacy of the exercises performed. Statistical analysis will be performed after examining the underlying assumptions for parametric and non-parametric testing.
Discussion: The results of the study will be clinically relevant, not only for researchers but also for (sports) therapists, physicians, coaches, athletes and the general population who have the aim of improving trunk function.
The aim of this study was to investigate the effect of a 6-week sensorimotor or resistance training on maximum trunk strength and response to sudden, high-intensity loading in athletes. Interventions showed no significant difference for maximum strength in concentric and eccentric testing (p>0.05). For perturbation compensation, higher peak torque response following SMT (Extension: +24Nm 95%CI +/- 19Nm; Rotation: + 19Nm 95%CI +/- 13Nm) and RT (Extension: +35Nm 95%CI +/- 16Nm; Rotation: +5Nm 95%CI +/- 4Nm) compared to CG (Extension: -4Nm 95%CI +/- 16Nm; Rotation: -2Nm 95%CI +/- 4Nm) was present (p<0.05).
Accuracy of training recommendations based on a treadmill multistage incremental exercise test
(2018)
Competitive runners will occasionally undergo exercise in a laboratory setting to obtain predictive and prescriptive information regarding their performance. The present research aimed to assess whether the physiological demands of lab-based treadmill running (TM) can simulate that of over-ground (OG) running using a commonly used protocol. Fifteen healthy volunteers with a weekly mileage of ≥ 20 km over the past 6 months and treadmill experience participated in this cross-sectional study. Two stepwise incremental tests until volitional exhaustion was performed in a fixed order within one week in an Outpatient Clinic research laboratory and outdoor athletic track. Running velocity (IATspeed), heart rate (IATHR) and lactate concentration at the individual anaerobic threshold (IATbLa) were primary endpoints. Additionally, distance covered (DIST), maximal heart rate (HRmax), maximal blood lactate concentration (bLamax) and rate of perceived exertion (RPE) at IATspeed were analyzed. IATspeed, DIST and HRmax were not statistically significantly different between conditions, whereas bLamax and RPE at IATspeed showed statistical significance (p < 0.05). Apart from RPE at IATspeed, IATspeed, DIST, HRmax and bLamax strongly correlate between conditions (r = 0.815–0.988). High reliability between conditions provides strong evidence to suggest that running on a treadmill are physiologically comparable to that of OG and that training recommendations and be made with assurance.
Accuracy of training recommendations based on a treadmill multistage incremental exercise test
(2018)
Competitive runners will occasionally undergo exercise in a laboratory setting to obtain predictive and prescriptive information regarding their performance. The present research aimed to assess whether the physiological demands of lab-based treadmill running (TM) can simulate that of over-ground (OG) running using a commonly used protocol. Fifteen healthy volunteers with a weekly mileage of ≥ 20 km over the past 6 months and treadmill experience participated in this cross-sectional study. Two stepwise incremental tests until volitional exhaustion was performed in a fixed order within one week in an Outpatient Clinic research laboratory and outdoor athletic track. Running velocity (IATspeed), heart rate (IATHR) and lactate concentration at the individual anaerobic threshold (IATbLa) were primary endpoints. Additionally, distance covered (DIST), maximal heart rate (HRmax), maximal blood lactate concentration (bLamax) and rate of perceived exertion (RPE) at IATspeed were analyzed. IATspeed, DIST and HRmax were not statistically significantly different between conditions, whereas bLamax and RPE at IATspeed showed statistical significance (p < 0.05). Apart from RPE at IATspeed, IATspeed, DIST, HRmax and bLamax strongly correlate between conditions (r = 0.815–0.988). High reliability between conditions provides strong evidence to suggest that running on a treadmill are physiologically comparable to that of OG and that training recommendations and be made with assurance.
Introduction
Annually, 2 million sports-related injuries are reported in Germany of which athletes contribute to a large proportion. Multiple sport injury prevention programs designed to decrease acute and overuse injuries in athletes have been proven effective. Yet, the programs’ components, general or sports-specific, that led to these positive effects are uncertain. Despite not knowing about the superiority of sports-specific injury prevention programs, coaches and athletes alike prefer more specialized rather than generalized exercise programs. Therefore, this systematic review aimed to present the available evidence on how general and sports-specific prevention programs affect injury rates in athletes.
Methods
PubMed and Web of Science were electronically searched throughout April 2018. The inclusion criteria were publication dates Jan 2006–Dec 2017, athletes (11–45 years), exercise-based injury prevention programs and injury incidence. The methodological quality was assessed with the Cochrane Collaboration assessment tools.
Results
Of the initial 6619 findings, 15 studies met the inclusion criteria. In addition, 13 studies were added from reference lists and external sources making a total of 28 studies. Of which, one used sports-specific, seven general and 20 mixed prevention strategies. Twenty-four studies revealed reduced injury rates. Of the four ineffective programs, one was general and three mixed.
Conclusion
The general and mixed programs positively affect injury rates. Sports-specific programs are uninvestigated and despite wide discussion regarding the definition, no consensus was reached. Defining such terminology and investigating the true effectiveness of such IPPs is a potential avenue for future research.
Introduction
Annually, 2 million sports-related injuries are reported in Germany of which athletes contribute to a large proportion. Multiple sport injury prevention programs designed to decrease acute and overuse injuries in athletes have been proven effective. Yet, the programs’ components, general or sports-specific, that led to these positive effects are uncertain. Despite not knowing about the superiority of sports-specific injury prevention programs, coaches and athletes alike prefer more specialized rather than generalized exercise programs. Therefore, this systematic review aimed to present the available evidence on how general and sports-specific prevention programs affect injury rates in athletes.
Methods
PubMed and Web of Science were electronically searched throughout April 2018. The inclusion criteria were publication dates Jan 2006–Dec 2017, athletes (11–45 years), exercise-based injury prevention programs and injury incidence. The methodological quality was assessed with the Cochrane Collaboration assessment tools.
Results
Of the initial 6619 findings, 15 studies met the inclusion criteria. In addition, 13 studies were added from reference lists and external sources making a total of 28 studies. Of which, one used sports-specific, seven general and 20 mixed prevention strategies. Twenty-four studies revealed reduced injury rates. Of the four ineffective programs, one was general and three mixed.
Conclusion
The general and mixed programs positively affect injury rates. Sports-specific programs are uninvestigated and despite wide discussion regarding the definition, no consensus was reached. Defining such terminology and investigating the true effectiveness of such IPPs is a potential avenue for future research.
Background: Core-specific sensorimotor exercises are proven to enhance neuromuscular activity of the trunk, improve athletic performance and prevent back pain. However, the dose-response relationship and, therefore, the dose required to improve trunk function is still under debate. The purpose of the present trial will be to compare four different intervention strategies of sensorimotor exercises that will result in improved trunk function. Discussion: The results of the study will be clinically relevant, not only for researchers but also for (sports) therapists, physicians, coaches, athletes and the general population who have the aim of improving trunk function.
Research question: This study aimed to establish reference values in 1-14 year old healthy children and to implement FPA-percentile curves for daily clinical use. Methods: 5910 healthy children performed at least 3 repetitions of barefoot walking over an instrumented walkway using a pressure measurement platform. The FPA [degrees] was extracted and analyzed by age and gender (mean +/- standard deviation; median with percentiles, MANOVA (age, gender) and Wilcoxon-Signed-Rank test for intra-individual side differences (alpha = 0.05). Results: FPA maximum was observed in 2-year-old children and diminished significant until the age of 4 to moderate out-toeing. For ages 5-14, no statistically significant differences in FPA values were present (p > 0.05). MANOVA confirmed age (p < 0.001) and gender (p < 0.001) as significant FPA influencing factors, without combined effect (p > 0.05). In every age group, right feet showed significantly greater out-toeing (p < 0.05). Significance: Percentile values indicate a wide FPA range in children. FPA development in young children shows a spontaneous shift towards moderate external rotation (age 2-4), whereby in-toeing <= 1-5 degrees can be present, but can return to normal. Bilateral in-toeing after the age of four and unilateral in-toeing after the age of seven should be monitored.
Background Low back pain (LBP) is a common pain syndrome in athletes, responsible for 28% of missed training days/year. Psychosocial factors contribute to chronic pain development. This study aims to investigate the transferability of psychosocial screening tools developed in the general population to athletes and to define athlete-specific thresholds.
Methods Data from a prospective multicentre study on LBP were collected at baseline and 1-year follow-up (n=52 athletes, n=289 recreational athletes and n=246 non-athletes). Pain was assessed using the Chronic Pain Grade questionnaire. The psychosocial Risk Stratification Index (RSI) was used to obtain prognostic information regarding the risk of chronic LBP (CLBP). Individual psychosocial risk profile was gained with the Risk Prevention Index – Social (RPI-S). Differences between groups were calculated using general linear models and planned contrasts. Discrimination thresholds for athletes were defined with receiver operating characteristics (ROC) curves.
Results Athletes and recreational athletes showed significantly lower psychosocial risk profiles and prognostic risk for CLBP than non-athletes. ROC curves suggested discrimination thresholds for athletes were different compared with non-athletes. Both screenings demonstrated very good sensitivity (RSI=100%; RPI-S: 75%–100%) and specificity (RSI: 76%–93%; RPI-S: 71%–93%). RSI revealed two risk classes for pain intensity (area under the curve (AUC) 0.92(95% CI 0.85 to 1.0)) and pain disability (AUC 0.88(95% CI 0.71 to 1.0)).
Conclusions Both screening tools can be used for athletes. Athlete-specific thresholds will improve physicians’ decision making and allow stratified treatment and prevention.