Performance of Eye Protectors for Squash and Racquetball

Although squash and racquetball eye protectors are available and many people wear them, eye injuries still exist. The authors studied the ability of the 13 eye protectors currently available in Canada to protect the players' eyes. The eye guards were mounted on a headform, and balls were thrown at it at speeds from 50 to 100 mph. This was recorded on high-speed film that was analyzed to determine ball speed, lens or frame deformation, and damage during impact. Eye contact with protectors having lenses was confirmed only once in 54 impacts. All 17 hits to the open eye guards produced ball-eye contact. The authors suggest that standards for eye protectors should be established.     

Paintball Popularity Explodes

IN BRIEF: Even mild-to-moderate elevations in blood pressure dramatically increase the risk of left ventricular hypertrophy, stroke, and renal disease. Although antihypertensive drugs can reduce blood pressure, their side effects and cost have stimulated a search for alternatives. Nonpharmocologic interventions can serve as definitive therapy for selected patients and as adjunctive therapy for many hypertensive patients. Patients with secondary hypertension should be treated directly and may not derive as much benefit from exercise. Low-to-moderate intensity aerobic exercise can help mildly hypertensive patients and reduce the drug dosage of those more severely affected. For active patients who require medication, regimens can be tailored to minimize adverse drug effects.     

Metabolic responses to submaximal treadmill walking and cycle ergometer pedalling in obese adolescents

Physical activity is essential in obesity management because of the impact of exercise‐related energy expenditure (EE) and fat oxidation (Fox) rate on a daily balance, but the specific physiological effects of different exercise modalities are scarcely known in obese individuals. The objective of the study was to compare the metabolic responses to treadmill (TM) and cycle ergometer (CE) exercise in obese adolescents. Gas exchange, heart rate (HR), blood lactate (LA) concentration, EE and Fox were determined at different intensity levels (up to about 85% of maximal oxygen uptake) during TM and CE in 14 pubertal (Tanner stage: >3) obese (BMI SDS: 2.15–3.86) male adolescents (age: 13–18 years). At comparable HR, oxygen uptake, EE and Fox were higher, and LA lower, during TM than CE (P<0.05–0.001), suggesting that cycling imposes a metabolic involvement at the level of the single active muscles greater than walking. Therefore, due to different physiological responses to TM and CE, walking was more convenient than cycling in obese adolescents, permitting to attain the same EE at lower HR, with lower blood LA concentration and with greater Fox. These conclusions seem clinically relevant when using exercise as a part of multidisciplinary treatment for juvenile obesity and amelioration of related metabolic disturbances.     

Assessing the psychosocial factors associated with adherence to exercise referral schemes: A systematic review

This paper aimed to systematically review the evidence base to uncover the key psychosocial factors that underpin adherence to an exercise referral scheme (ERS). Databases PsycINFO, MEDLINE, SPORTDiscus, Web of Science, PubMed, PsycARTICLES, Open Grey, and PsycEXTRA were systematically searched. A parallel results‐based convergent synthesis was performed by identifying key themes from quantitative and qualitative studies separately. After applying inclusion and exclusion criteria, the review included 24 eligible studies. Key findings showed intrinsic motivation, psychological need satisfaction, social support, and self‐efficacy to be the prominent psychosocial factors associated with ERS adherence. In addition, lower expectations for change when entering the scheme was associated with ERS adherence. This review should serve as a catalyst to provide evidence‐based ERS and as such ERS providers should seek to place an emphasis on participants’ expectations and beliefs when entering the scheme. Moreover, targeting the key factors of intrinsic motivation, psychological need satisfaction, social support, and self‐efficacy throughout the duration of an ERS should serve to facilitate adherence.     

QuikQuiz

Abstract

Aerobic exercise training and diet are recommended for the primary prevention of type 2 diabetes mellitus and cardiovascular disease. The American Diabetes Association (ADA) recommends that adults with prediabetes engage in ≥ 150 minutes per week of moderate activity and target a 7% weight loss. However, traditional moderate-intensity (MI) exercise training programs are often difficult to sustain for prediabetic adults; a commonly cited barrier to physical activity in this population is the “lack of time” to exercise. When matched for total energy expenditure, high-intensity (HI) exercise training has a lower overall time commitment compared with traditional low-intensity (LI) or MI exercise training. Several recent studies comparing HI exercise training with LI and MI exercise training reported that HI exercise training improves skeletal muscle metabolic control and cardiovascular function in a comparable and/or superior way relative to LI and MI exercise training. Although patients can accrue all exercise benefits by performing LI or MI activities such as walking, HI activities represent a time-efficient alternative to meeting physical activity guidelines. High-intensity exercise training is a potent tool for improving cardiometabolic risk for prediabetic patients with limited time and may be prescribed when appropriate.     

Short-term cessation of statin therapy does not alter aerobic exercise performance in physically active middle-aged adults

Objectives: Physically active adults may be especially vulnerable to the adverse muscular side effects of statins. We determined if short-term cessation of statin therapy would improve aerobic exercise performance in middle-aged adults engaged in regular aerobic exercise training. Methods: Physically active middle-aged adults on statin therapy ≥6 mo (n = 16; 58 ± 10 y) or not taking lipid-lowering medications (controls) (n = 19; 51 ± 9 y) completed a peak oxygen consumption (VO_2peak) and time to exhaustion test on a cycle ergometer 2-7 d apart. Tests were repeated following 1 mo of statin cessation or a 1 mo period for controls. Questionnaires were administered to assess exercise history and muscle complaints. Results: Statin users reported little or no muscle complaints and participation in aerobic exercise was similar between groups (p≥0.13). The lower VO_2peak (37.3 ± 9.0 vs. 43.1 ± 4.9 ml/kg/min; p = 0.02) and time to exhaustion (21.9 ± 4.4 vs. 26.0 ± 6.3 min; p = 0.04) in statin users versus controls did not persist after controlling for age (p≥0.08). Aerobic exercise performance did not change with 1 mo of statin cessation (p≥0.54). No changes were observed in controls when tests were repeated 1 mo later (p≥0.38). Conclusion: Short-term cessation of statin therapy does not alter maximal aerobic capacity or aerobic endurance in physically active middle-aged adults with few or no statin muscle complaints.     

Artificial Turf: Pros and Cons

A Forum for Our Readers

Forum is intended to provide a sounding board for our readers. Perhaps you have a special way to treat a common medical problem, or you may want to air your views on a controversial topic. You may object to an article that we have published, or you may want to support one. You may have a new trend to report, identified through an interesting case or a series of patients. Whatever your ideas, we invite you to send them to us. Illustrative figures are welcomed. Address correspondence to Forum, THE PHYSICIAN AND SPORTSMEDICINE, 4530 W 77th St, Minneapolis, MN 55435.     

Short‐term cycling restores endothelial dysfunction after resistance exercise

Resistance exercise impairs endothelial function. Therefore, it is of paramount importance to devise an effective strategy for restoring endothelial function after resistance exercise. Herein, we tested the hypothesis that resistance exercise‐induced endothelial dysfunction would be restored by low‐to‐moderate intensity cycling. Seventeen young healthy subjects completed two randomized experimental trials: (a) resistance exercise only trial; and (b) cycling after the resistance exercise trial. Following baseline brachial artery flow‐mediated dilation (FMD), subjects performed the resistance exercise. Following the resistance exercise, they were asked to rest in the supine position for the assessments of FMD. Subjects in the resistance exercise only trial maintained this supine position for 60 minutes, whereas those in the other trial cycled for 10 minutes after the resistance exercise trial. Subjects were again asked to rest in the supine position after cycling. Then FMD were repeated at 30 and 60 minutes after the resistance exercise in both trials. In the resistance exercise only trial, the increased blood flow and shear rate were disappeared after 1 hour of resting in the supine position, but were maintained in those in the cycling after the resistance trial due to subsequent cycling. Both trials caused a significant impairment in FMD at 10 minutes after the resistance exercise (P < 0.05). This decline was sustained for 60 minutes in the resistance exercise only trial. However, the impaired FMD was restored in the cycling after the resistance exercise trial. In conclusion, impaired endothelial function after the resistance exercise can be restored with 10 minutes of low‐to‐moderate intensity cycling.     

Peak oxygen uptake cut‐points to identify children at increased cardiometabolic risk – The PANIC Study

We aimed to develop cut‐points for directly measured peak oxygen uptake () to identify boys and girls at increased cardiometabolic risk using different scaling methods to control for body size and composition. Altogether 352 children (186 boys, 166 girls) aged 9‐11 years were included in the analyses. We measured V?O_2peak directly during a maximal cycle ergometer exercise test and lean body mass (LM) by bioelectrical impedance. We computed a sex‐ and age‐specific cardiometabolic risk score (CRS) by summing important cardiometabolic risk factors and defined increased cardiometabolic risk as >1 standard deviation above the mean of CRS. Receiver operating characteristics curves were used to detect V?O_2peak cut‐points for increased cardiometabolic risk. Boys with V?O_2peak <45.8 mL kg body mass (BM)^?1 min^?1 (95% confidence interval [CI] = 45.1 to 54.6, area under the curve [AUC] = 0.86, P < 0.001) and <63.2 mL kg LM^?1 min^?1 (95% CI =52.4 to 67.5, AUC = 0.65, P = 0.006) had an increased CRS. Girls with V?O_2peak <44.1 mL kg BM^?1 min^?1 (95% CI = 44.0 to 58.6, AUC = 0.67, P = 0.013) had an increased CRS. V?O_2peak scaled by BM^?0.49 and LM^?0.77 derived from log‐linear allometric modeling poorly predicted increased cardiometabolic risk in boys and girls. In conclusion, directly measured <45.8 mL kg BM^?1 min^?1 among boys and <44.1 mL kg BM^?1 min^?1 among girls were cut‐points to identify those at increased cardiometabolic risk. Appropriately controlling for body size and composition reduced the ability of cardiorespiratory fitness to identify children at increased cardiometabolic risk.     

有氧锻炼对久坐不动生活方式的健康人群最大摄氧量的影响:Meta分析

目的:评价有氧锻炼对最大摄氧量的影响和最有效锻炼强度,为有氧运动处方强度的制定提供依据。方法:以MEDLINE为文献主要来源,搜索1976年至2008年间公开发表的有氧锻炼对最大摄氧量影响的相关文献,根据纳入标准和排除标准选择合适的文献,并对其进行质量评估和相关数据提取。结果:(1)对35篇文献中889名受试者进行Meta分析:最大摄氧量加权均数差为3.61ml/kg/min,95%可信区间为2.96～4.25ml/kg/min,与锻炼前平均最大摄氧量数值(27.26ml/kg/min)相比,锻炼后增加了13.2%。(2)根据锻炼强度的不同进行亚组Meta分析,锻炼强度分别为70～80%最大摄氧量(VO2max)、71～80%最大心率(HRmax)和61～70%储备心率(HRR)时,最大摄氧量增加最多。结论:久坐不动生活方式的健康人群通过有氧锻炼可以提高其最大摄氧量水平,且本研究结果中最有效的锻炼强度为制定有氧运动处方强度提供一定的理论依据。     

Does exercise reduce brain oxidative stress? A systematic review

The aim of the present systematic review was to investigate the influence of different exercise programs on brain oxidative stress. A search of the literature was conducted up to 1 December 2012 across five databases: PUBMED, SCOPUS, SPORTS DISCUS, Web of Science, and The Cochrane Library. The search strategy used in the electronic databases mentioned was established as: (swim* OR exercise OR training) AND (“oxidative stress” AND brain) for each database. A methodological quality assessment valuation/estimation was additionally carried out in the final sample of studies. Of 1553 potentially eligible papers, 19 were included after inclusion and exclusion criteria. The methodological quality assessment showed a total score in the Quality Index between 40% and 80%, with a mean quality of 56.8%. Overall, regular moderate aerobic exercise appears to promote antioxidant capacity on brain. In contrast, anaerobic or high‐intensity exercise, aerobic‐exhausted exercise, or the combination of both types of training could deteriorate the antioxidant response. Future investigations should be focused on establishing a standardized exercise protocol, depending on the exercise metabolism wanted to test, which could enhance the objective knowledge in this topic.     

Self‐reported health‐enhancing physical activity recommendation adherence among 64,380 finnish adults

The Finnish recommendations for health‐enhancing physical activity (PA) for adults (≥18 years) recommend: (i) ≥150 minutes of moderate‐to‐vigorous‐intensity physical activity (MVPA) and (ii) activities that develop muscle strength and balance ≥2 days/week. However, adherence to these recommendations among the Finnish adults is currently unknown. This study reports on the self‐reported adherence to the PA recommendations and associations with sociodemographic factors among Finnish adults. Data were used from the Finnish “Regional Health and Well‐being Study.” In 2013‐2014, postal questionnaires were sent to 132,560 persons, with 69,032 responding (response rate =52.1%). The weighted proportions adhering to the: (i) MVPA recommendation, (ii) sufficient muscle‐strengthening activity (≥2 days/week), (iii) sufficient balance training (≥2 days/week), and (iv) Finnish health‐enhancing PA recommendations (Finnish recommendations) were calculated. Associations with sociodemographic variables (eg, age, education level, self‐rated health) were assessed using multiple logistic regression analyses. Of 69,032 respondents, 92.6% (n=64,380, response rate =48.6%, 18‐98 years) reported on their physical activity levels. A total of 31.2% (95% CI: 30.8%‐31.6%) met the aerobic MVPA recommendation, 17.2% (95% CI: 16.9%‐17.6%) reported sufficient muscle‐strengthening activity, 6.7% (95% CI: 6.4%‐6.9%) reported sufficient balance training, and 10.8% (95% CI: 10.5%‐11.1%) met the Finnish recommendations. In the adjusted analysis, those with poorer self‐rated health, older age, lower education levels, and those classified overweight or obese were independently associated with lower odds of meeting the Finnish recommendations. The vast majority of Finnish adults do not meet the full PA recommendations. Public health action is needed to increase PA in Finland.     

The relationship between physical activity and health-related quality of life: a systematic review of current evidence

The objective of this review was to update the relationship between physical activity (PA) and health-related quality of life (HRQL). A systematical search was performed in MEDLINE and PsychINFO between 2000 and 2007, for HRQL- and PA-related keywords in titles, abstracts, or indexing fields. From over 600 retrieved references, 35 citations were judged to require further evaluation. Finally, 10 studies were retained for data extraction and analysis; five were cross-sectional studies, four were cohort and randomized-controlled trails (RCT) studies, and one used a combined cross-sectional and longitudinal design. Cross-sectional studies showed a consistently positive association between self-reported PA and HRQL. The largest cross-sectional study reported an adjusted odds ratio of "having 14 or more unhealthy days" during the previous month to be 0.40 (95% confidence interval 0.36–0.45) for those meeting recommended levels of PA compared with inactive subjects. Cohort studies and RCT tended to show a positive effect of PA on HRQL, but similar to the cross-sectional studies, had methodological limitations. Cross-sectional data showed a consistently positive association between PA level and HRQL. Limited evidence from RCT and cohort studies precludes a definitive statement about the nature of this association.     

The Iditarod: Alaskan Challenge

In brief A rugby player who had a spleen injury was sent home after initial evaluation because he was hemo-dynamically stable. But the next day he reported to the emergency department after a near-syncopal episode. This case illustrates the need for careful observation of athletes who have abdominal injuries and the importance of preparticipation screening.