Effects of age on the reciprocal peak torque ratios during knee muscle contractions in elite soccer players

To investigate the effects of age on the reciprocal peak torque ratios during knee muscle contractions, 25 elite male soccer players, aged 22.3 +/- 3.8 yr (18-28), volunteered for the present study. The players were grouped as adult (> 21 years, n = 13) and young players (< or = 21 years, n = 12). Maximal concentric (CON) and eccentric (ECC) isokinetic thigh muscle strength was measured at angular velocities of 30 degrees, 180 degrees, 240 degrees and 300 degrees/s. ECC and CON peak torques of knee flexors (hamstring, HAM) and CON peak torques of knee extensors (quadriceps, QUA) in the dominant knee were greater (P < 0.05) in adult players than in young players at 180, 240 and 300 degrees/s. ECC HAM/CON QUA peak torque ratio at 300 degrees/s was greater (P < 0.05) for adult players compared to young players in the dominant knee but not in the nondominant knee. Furthermore, conventional HAM/QUA peak torque ratios of the dominant knee at all angular velocities for ECC contraction were higher (P < 0.05) in adult players than in young players. In conclusion, the findings of the present study indicate that the reciprocal torque ratio is influenced by age in the dominant knee of elite soccer players. Because there was no effect of age for the nondominant leg, the findings of the present study are more likely to be the result of the training background of the players than their age.     

Factors affecting running economy

Running economy, defined as the steady-state VO2 for a given running velocity, has been shown to account for a large and significant proportion of variation in distance-running performance among runners roughly comparable in VO2 max. Despite this recognition, relatively little is known regarding the potpourri of physiological, environmental, structural and mechanical factors potentially associated with a lower aerobic demand of running. Early attempts at quantifying the energy expenditure of exhaustive runs incorporated measurements of oxygen consumption before, during, and after exercise. The validity of this approach has been questioned, however, since recent evidence has demonstrated that only a moderate relationship exists between postexercise VO2 and anaerobic metabolism. The energy demands for submaximal running (i.e. running economy) can be quantified by calculating the steady-state VO2, expressed with respect to body mass and time, for a standardised, submaximal running speed. Since this variable represents the aerobic demand of running, the generation of energy must derive wholly from cell respiration and not from substantial protein catabolism. Research has indicated that at low to moderate work rates, the steady-state energy condition is attained in about 3 minutes. Trained individuals reach steady-state sooner than unfit subjects. While limited by methodological constraints, the existence of a steady-state has also been verified by the lack of blood lactate accumulation and the presence of a respiratory exchange ratio of less than 1.00. The ability of economy, either singly or in combination with VO2 max, to account for a substantial portion of performance variation among trained distance runners and untrained subjects of comparable ability and fitness level has been demonstrated in recent cross-sectional studies. Limited data from short and long term longitudinal research also suggests that endurance running success is linked to training and growth-related improvements in economy. Intraindividual variation in economy has been shown to vary between 2% and 11% for a given speed. Most of this variation can probably be attributed to biological error. While the majority of evidence does not support a gender difference in running economy, data from some studies suggest that males may be more economical than women. Prepubescent children are less economical than older children and adults, whereas older adults exhibit the same trend when compared to younger counterparts. Because of air and wind resistance, the aerobic demands of indoor treadmill running significantly underestimate the cost of overground running, especially at higher speeds.(ABSTRACT TRUNCATED AT 400 WORDS)     

Factors affecting radiographers' organizational commitment

CONTEXT: A variety of factors influence employees' attitudes toward their workplace and commitment to the organization that employs them. However, these factors have not been well documented among radiologic technologists. OBJECTIVE: To determine the predictive ability of selected organizational, leadership, work-role and demographic variables on organizational commitment for a national sample of radiographers. METHODS: Three thousand radiographers registered by the American Registry of Radiologic Technologists working full time in clinical settings were surveyed by mail regarding their commitment to their employers, leadership within the organization that employs them, employer support and demographic information. RESULTS: Overall, radiographers were found to have only a moderate level of commitment to their employers. Among the factors that significantly affected commitment were the radiographer's educational level, perceived level of organizational support, role clarity and organizational leadership. CONCLUSION: The results of this study could provide managers and supervisors with insights on how to empower and challenge radiographers and offer opportunities that will enhance radiographers' commitment to the organization, thus reducing costly turnover and improving employee performance.     

Factors affecting radiologist inconsistency in screening mammography

RATIONALE AND OBJECTIVES: Although research has successfully documented variability in radiologists' interpretation of mammograms, it has failed to determine the relative contributions of case-specific features and reader inconsistency. Training interventions to improve consistency will be ineffectual if they do not target the principal determinants of disagreement among radiologists. The current study assessed the relative contributions of the case and the interpreter to the problem of inconsistent interpretation. MATERIALS AND METHODS: One hundred ten radiologists independently interpreted mammograms from the same 148 screening cases (43% with biopsy-proved cancers) and reported the presence or absence of calcifications, mass, architectural distortion, and asymmetric density in each of 296 breasts. The radiologists were blinded to disease status (established at biopsy or follow-up). RESULTS: Case-related differences accounted for a greater proportion of interpretation disagreement than did differences between interpreters. The presence of cancer was associated with increased disagreement, perhaps because of the multiplicity of findings. Patient age was also associated with increased disagreement in the reporting of calcifications. CONCLUSION: For screening mammography, increased consistency between radiologists in their recognition and reporting of clinically important findings will best be achieved by reducing disagreement in difficult cases. Current training in the United States addresses difficult cases only as they have been defined intuitively or experientially. The authors' population-based method provides an objective metric to measure case difficulty and basis from which to identify difficult cases for targeted training.     

Factors affecting performance in an ultraendurance triathlon

In the recent past, researchers have found many key physiological variables that correlate highly with endurance performance. These include maximal oxygen uptake (VO2max), anaerobic threshold (AT), economy of motion and the fractional utilisation of oxygen uptake (VO2). However, beyond typical endurance events such as the marathon, termed 'ultraendurance' (i.e. >4 hours), performance becomes harder to predict. The ultraendurance triathlon (UET) is a 3-sport event consisting of a 3.8 km swim and a 180 km cycle, followed by a 42.2 km marathon run. It has been hypothesised that these triathletes ride at approximately their ventilatory threshold (Tvent) during the UET cycling phase. However, laboratory assessments of cycling time to exhaustion at a subject's AT peak at 255 minutes. This suggests that the AT is too great an intensity to be maintained during a UET, and that other factors cause detriments in prolonged performance. Potential defeating factors include the provision of fuels and fluids due to finite gastric emptying rates causing changes in substrate utilisation, as well as fluid and electrolyte imbalances. Thus, an optimum ultraendurance intensity that may be relative to the AT intensity is needed to establish ultraendurance intensity guidelines. This optimal UET intensity could be referred to as the ultraendurance threshold.     

Factors affecting perception of pulmonary lesions

The authors review some of the factors that influence the perception of pulmonary lesions: the observer and his environment, the film or other image-recording and display media, the lesion and its qualities, and the technique or modality of examination used.     

Subscapularis muscle activity during selected rehabilitation exercises

BACKGROUND: The upper and lower portions of the subscapularis muscle are independently innervated and activated. HYPOTHESIS: Upper and lower portions of the subscapularis muscle demonstrate different activation levels and require different exercises for rehabilitation. STUDY DESIGN: Controlled laboratory study. METHODS: Fifteen healthy subjects performed seven shoulder-strengthening exercises. Electromyographic data were collected from the latissimus dorsi, teres major, pectoralis major, infraspinatus, supraspinatus, and upper and lower subscapularis muscles. RESULTS: Upper subscapularis muscle activity was greater than lower subscapularis muscle activity for all exercises except for internal rotation with 0 degrees of humeral abduction. The push-up plus and diagonal exercises consistently stressed the upper and lower subscapularis muscles to the greatest extent. CONCLUSIONS: Humeral abduction was found to have a strong influence on the selective activation of the upper versus the lower subscapularis muscle and thus supported the design of different exercise continuums. In addition, the push-up plus and diagonal exercises were found to be superior to traditional internal rotation exercises for activating both functional portions of the subscapularis muscle. CLINICAL RELEVANCE: Our results showing that the upper and lower portions of the subscapularis muscle are functionally independent may affect training or rehabilitation protocols for the rotator cuff muscles.     

Factors affecting levels of physical activity in adults

A large proportion of adults in Western cultures are physically inactive, despite several decades of warnings about the potentially negative health consequences of a sedentary lifestyle. Efforts to promote physical activity have focused on identifying its determinants and designing interventions that might effectively promote regular physical activity. The multitude of factors that induce adults to initiate and maintain programmes of physical activity have been divided into those that are invariable (age, gender, race, ethnicity) and those that are presumed to be modifiable (behavioural and personality characteristics, environmental circumstances and community settings). The lack of consistency in the design, analysis and reporting of interventions in the lives of inactive or sedentary individuals has produced equivocal results. However, several social and environmental factors have systematically emerged as determinants of physical activity in adults. In ethnic minorities, the removal of barriers such as unaffordable facilities and unavailable childcare, high crime rates, fear for personal safety and culturally inappropriate activities are of primary importance. Social support from family, peers, communities and healthcare providers has resulted in modest improvements across cultures, ages and genders in selected settings, but the definition of specific interventions and their outcomes deserve additional attention. Longitudinal studies indicate that components of physical fitness are relatively transitory, with low to modest correlations between physical activity and measures of physical fitness in childhood and adolescence and in adulthood. Attempts to explain the activity behaviour of adults by applying various theories in programmes of intervention have also produced mixed results. Successful interventions tailor programmes to individual needs, account for personal levels of fitness, allow for personal control of the activity and its outcomes, and provide for social support by family, peers and communities. The initiation and maintenance of regular physical activity in adults depends on a multitude of biological and sociocultural variables that demand attention across the lifespan.     

Factors affecting running economy in trained distance runners

Running economy (RE) is typically defined as the energy demand for a given velocity of submaximal running, and is determined by measuring the steady-state consumption of oxygen (VO2) and the respiratory exchange ratio. Taking body mass (BM) into consideration, runners with good RE use less energy and therefore less oxygen than runners with poor RE at the same velocity. There is a strong association between RE and distance running performance, with RE being a better predictor of performance than maximal oxygen uptake (VO2max) in elite runners who have a similar VO2max). RE is traditionally measured by running on a treadmill in standard laboratory conditions, and, although this is not the same as overground running, it gives a good indication of how economical a runner is and how RE changes over time. In order to determine whether changes in RE are real or not, careful standardisation of footwear, time of test and nutritional status are required to limit typical error of measurement. Under controlled conditions, RE is a stable test capable of detecting relatively small changes elicited by training or other interventions. When tracking RE between or within groups it is important to account for BM. As VO2 during submaximal exercise does not, in general, increase linearly with BM, reporting RE with respect to the 0.75 power of BM has been recommended. A number of physiological and biomechanical factors appear to influence RE in highly trained or elite runners. These include metabolic adaptations within the muscle such as increased mitochondria and oxidative enzymes, the ability of the muscles to store and release elastic energy by increasing the stiffness of the muscles, and more efficient mechanics leading to less energy wasted on braking forces and excessive vertical oscillation. Interventions to improve RE are constantly sought after by athletes, coaches and sport scientists. Two interventions that have received recent widespread attention are strength training and altitude training. Strength training allows the muscles to utilise more elastic energy and reduce the amount of energy wasted in braking forces. Altitude exposure enhances discrete metabolic aspects of skeletal muscle, which facilitate more efficient use of oxygen. The importance of RE to successful distance running is well established, and future research should focus on identifying methods to improve RE. Interventions that are easily incorporated into an athlete's training are desirable.     

Factors affecting a fatal outcome in road accidents

The North Report mentioned the question of whether charges and/or sentencing should be modified by fatal outcome following offences involving bad driving. This note classifies factors relating to the accident, the casualty and medical care which may, often fortuitously, determine a fatal outcome. It is suggested that these should be borne in mind in deciding offences and sentencing.     

Physeal-sparing intraarticular anterior cruciate ligament reconstruction in preadolescents

BACKGROUND: In the very young patient in need of anterior cruciate ligament reconstruction, the option of reconstruction with physeal-sparing techniques is valid because it is not known what percentage of physeal transgression causes adverse growth consequences. PURPOSE: To report our experience with an intraarticular technique for anterior cruciate ligament reconstruction that spares the open femoral and tibial physes yet allows soft tissue graft fixation in the femoral and tibial tunnels. METHODS: Eight preadolescents underwent physeal-sparing intraarticular reconstruction for anterior cruciate ligament insufficiency with the use of semitendinosus and gracilis tendon grafts. All eight patients were in Tanner stage 1 with an average chronologic age of 11.15 years and average bone age of 10.9 years. Preoperative prediction of lower limb growth averaged 10.8 cm. RESULTS: Five of the eight patients had reached skeletal maturity at follow-up, which was at an average of 69.2 months postoperatively. For these five, the Orthopadische Arbeitsgruppe Knie (OAK) score averaged 97 and the average KT-2000 arthrometer difference was 1.8 mm. Average growth in total height from surgery to final follow-up was 21.7 cm. No patient had a leg-length discrepancy or angular deformity, as verified by clinical or teleroentgenogram measurements. CONCLUSIONS: The technique presented in this study provided graft isometry and stability without adverse physeal consequences. Additional research is needed to determine the threshold percentage of physeal transgression for avoiding growth disturbances in humans.     

Factors affecting human tolerance to sustained acceleration

Linear increases in G tolerance with increases in anti-G suit (AGS) bladder inflation pressure occurred when relaxed subjects were exposed to acceleration plateaus while riding a centrifuge and were either seated upright, (15 degrees seat back angle or SBA) or supine (60 degrees SBA). Supine G tolerance with AGS bladder inflation decreased as G onset time was increased by factors of two and four. Changing the mode of operation of a new servo-controlled anti-G valve regulating AGS bladder pressure had no effect on G tolerance nor on AGS comfort scores. Comfort was unaffected by G onset time and reduced with high AGS bladder pressures. Results support the hypotheses that G protection provided by simultaneously applied anti-G techniques is additive and that the simple hydrostatic model of the circulatory system can adequately account for AGS bladder pressure changes required for G protection when body position is changed.     

Serratus anterior muscle activity during selected rehabilitation exercises

The purpose of this study was to document the electromyographic activity and applied resistance associated with eight scapulohumeral exercises performed below shoulder height. We used this information to design a continuum of serratus anterior muscle exercises for progressive rehabilitation or training. Five muscles in 20 healthy subjects were studied with surface electrodes for the following exercises: shoulder extension, forward punch, serratus anterior punch, dynamic hug, scaption (with external rotation), press-up, push-up plus, and knee push-up plus. Electromyographic data were collected from the middle serratus anterior, upper and middle trapezius, and anterior and posterior deltoid muscles. Each exercise was partitioned into phases of increasing and decreasing force and analyzed for average and peak electromyographic amplitude. Resistance was provided by body weight, an elastic cord, or dumbbells. The serratus anterior punch, scaption, dynamic hug, knee push-up plus, and push-up plus exercises consistently elicited serratus anterior muscle activity greater than 20% maximal voluntary contraction. The exercises that maintained an upwardly rotated scapula while accentuating scapular protraction, such as the push-up plus and the newly designed dynamic hug, elicited the greatest electromyographic activity from the serratus anterior muscle.     

Factors affecting the prognosis of meniscectomy in soccer players

Meniscectomy is a frequent surgical procedure in young soccer players but the results are unpredictable. A long-term survey was carried out to assess certain fundamental features and to establish the predictive factors which affect the prognosis after meniscectomy.     

Factors affecting bone mineral density in renal transplant patients

Bone disease is a major cause of morbidity in end stage renal failure. This study is aimed to assess the prevalence of abnormal bone mineral density (BMD), measured by dual photon absorptiometry (DPA) in the renal transplant population. Subjects consisted of 110 patients followed up after transplantation for between 1 and 17 years. Variables analyzed included age, sex, ethic origin, years and type of dialysis prior to transplantation, date of transplant, total steroid dose, number of rejection episodes, use of Cyclosporin, and biochemical/hormonal variables such as serum calcium, phosphate, magnesium, alkaline phosphatase, creatinine, FSH, LH and PTH. Analysis of variance and chi square tests were performed to assess the differences between groups and Pearson correlation coefficients were obtained. The total steroid dose, year of birth, PTH level and duration since transplantation were correlated with BMD (p < 0.05). Despite the statistical significance, the degree of variability indicated by each of these variables was low revealed by multiple regression analysis. We conclude that although steroid therapy is a major contributor to the increase in osteoporosis in renal transplant patients, about two thirds of the parameters that can influence bone metabolism remain unexplained.     

Factors affecting 39K NMR detectability in rat tissue

In this study we have found that NMR detectability of 39K in rat thigh muscle may be substantially higher (up to 100% of total tissue potassium) than values previously reported of around 40%. The signal was found to consist of two superimposed components, one broad and one narrow, of approximately equal area. Investigations involving improvements in spectral parameters such as signal-to-noise ratio and baseline roll, together with computer simulations of spectra, show that the quality of the spectra has a major effect on the amount of signal detected, which is largely due to the loss of detectability of the broad signal component. In particular, lower-field spectrometers using conventional probes and detection methods generally have poorer signal-to-noise and worse baseline roll artifacts, which make detection of a broad component of the muscle signal difficult.