Salzburg Skiing for the Elderly Study: influence of alpine skiing on aerobic capacity, strength, power, and balance

Alpine skiing is a recreational sport with high demands on the cardiovascular and neuromuscular systems. It is assumed that skiing could have positive effects on the decline in aerobic capacity, strength, and balance ability of older individuals. In a 12-week intervention study, 47 elderly subjects (age 60-76 years) were randomized into an intervention group (IG) and a control group (CG). The IG averaged 28.5 days of guided skiing during 12 weeks. Aerobic capacity, leg power, and strength as well as postural stability were tested before, immediately after, and 10 weeks after the intervention phase. VO(2 max) improved by 7.2% from Pre to Post for the IG, without any change in the CG. Jump height increased on average by 6% over the 12 weeks for the IG, while jump height for the CG deteriorated by -11.7%. Dynamic maximal strength measured in both legs increased by 16% in the IG during the 12 weeks of skiing. In the CG, it increased by 7%, without being significant. In postural ability, no differences between groups or over time were noted. It appears that, in older individuals, 12 weeks of skiing leads to a significant increase in aerobic capacity, leg muscle power, and strength.     

Does a skiing intervention influence the psycho‐social characteristics of the elderly?

The purpose of this study was to assess whether a guided alpine skiing intervention lasting 12 weeks has an impact on psycho-social dimensions, measured by subjective assessments, of individuals who are 60+ years of age. A number of well-established questionnaires were used to measure well-being, life satisfaction, self-concept, health status, depression and self-efficacy. The physical self-concept in the domain "strength" increased significantly in the intervention group from pre- to post-test and remained stable through the retention test, whereas the control group demonstrated nearly no alteration. A similar effect was obtained in life satisfaction for the dimension "friends and relatives." On the contrary, psycho-social aspects of the elderly were not negatively influenced. The subjects of this study had very high pre-test scores that might reflect a ceiling effect which, in turn, can explain the marginal positive impact of the intervention. The findings of this study argue for recommending a guided alpine skiing intervention for individuals who are 60 years of age and older with high values in psycho-social variables.     

Salzburg Skiing for the Elderly Study: changes in cardiovascular risk factors through skiing in the elderly

Numerous studies have shown that treatment of the modifiable cardiovascular risk factors (CVRF) results in a decreased risk to suffer from stroke or myocardial infarction. Despite the fact that exercise training is a potent treatment choice for CVRF, this is the first randomized study to assess the effects of alpine skiing on CVRF in elderly skiers. Subjects (n=42) were randomized into an intervention group (IG; n=22; 12 males/10 females; age: 66.6 ± 2.1 years) completing 12 weeks of guided skiing or a control group (CG; n=20; 10 males/10 females; age: 67.3 ± 4.4 years). CVRF were assessed before and after the intervention period. No cardiovascular event occurred within a total of 795.1 h of skiing. A significant increase in exercise capacity in IG (ΔVO(2 max) : +2.0 mL/kg/min, P=0.005) but not in CG (ΔVO(2 max) : -0.1 mL/kg/min, P=0.858; IG vs CG: P=0.008) as well as a decrease in body fat mass [IG: -2.3%, P<0.0001; CG: ± 0.0%, P=0.866; IG vs CG: P<0.0001] was achieved. Blood pressure, blood lipids, heart rate and everyday physical activity remained essentially unchanged. Alpine skiing in the elderly is safe with respect to cardiovascular events, and improves some, but not all CVRF.     

Glucose homeostasis and cardiovascular disease biomarkers in older alpine skiers

Alpine skiing and ski training involves elements of static and dynamic training, and may therefore improve insulin sensitivity. Healthy men and women who where beginners/intermediate level of alpine skiing, were studied before (Pre) and immediately after (Post) 12 weeks of alpine ski training. After an additional 8 weeks a third test (retention study, Ret) was performed. The subjects were randomized into an intervention group (IG, n=22, age=66.6 ± 0.4 years) or a control group (CG, n=20, age=67.0 ± 1.0 years). Plasma glucose decreased (P<0.05) in CG, but increased (P<0.05) again at Ret, while a continued decrease was seen in IG (Ret vs Post, P<0.05). Plasma insulin decreased (P<0.05) with training in IG, while no effect was seen in CG. HOMA2 index for insulin resistance decreased (P<0.05) from 0.80 ± 0.08 to 0.71 ± 0.09 in IG. The value at Ret (0.57 ± 0.08) tended (P=0.067) to be different from Post. In CG the corresponding values were 0.84 ± 0.09, 0.81 ± 0.12 and 0.70 ± 0.09, respectively. Total cholesterol and LDL decreased in both IC and CG, a result, interpreted as seasonal variation. Biomarkers for endothelial function and low-grade inflammation were not elevated and similar in IG and CG, and did not change. Alpine ski training improves glucose homeostasis and insulin sensitivity in healthy, elderly individuals.     

心理干预对高原新兵的心理状态的影响

目的：探索危机心理干预对进入高原新兵心理的影响。方法：792名入藏新兵为研究对象,随机分成干预组及对照组,在新兵入拉萨前后对干预组实施心理干预。填写SCL-90症状自评量表。结果;心理干预对入藏新兵的心理状态有改善作用。结论：危机心理干预法是防治进入高原人员心理疾病的重要方法。     

Skeletal muscle remodeling in response to alpine skiing training in older individuals

This study investigated whether regular alpine skiing could reverse sarcopenia and muscle weakness in older individuals. Twenty-two older men and women (67 ± 2 years) underwent 12 weeks of recreational skiing, two to three times a week, each session lasting ～ 3.5 h. An age-matched, inactive group (n=20, 67 ± 4 years) served as a control (CTRL). Before and after the training period, knee extensors muscle thickness (T(m) ), pennation angle (θ) and fascicle length (L(f) ) of the vastus lateralis muscle were measured by ultrasound. Maximum isokinetic knee extensor torque (MIT) at an angular velocity of 60°/s was measured by dynamometry. After the training, T(m) increased by 7.1% (P<0.001), L(f) by 5.4% (P<0.02) and θ by 3.4% (P<0.05). The increase in T(m) was matched by a significant gain in MIT (13.3%, P<0.001). No significant changes, except for a decrease in θ (2.1%, P<0.02), were found in the CTRL group. The gain in T(m) in the training group correlated significantly with an increase in the focal adhesion kinase content, pointing to a primary role of this mechano-sensitive protein in sarcomere remodeling with muscle hypertrophy. Overall, the results show that alpine skiing is an effective intervention for combating sarcopenia and weakness in old age.     

自控静脉镇痛对胸部创伤早期呼吸循环影响的初步探讨

目的观察自控静脉镇痛(PCIA)对胸部创伤患者早期呼吸循环功能的影响。方法选择2010年10月~2011年6月伤后12h急诊入住西南医院创伤急救中心的26例胸部闭合性创伤患者,随机分为两组,对照组11例,无镇痛措施;镇痛组15例,入院后予以自控静脉镇痛3d。对照组11例,男性10例,女性1例;年龄25~47岁,平均(36.65±8.40)岁;镇痛组15例,男性12例,女性3例;年龄23~48岁,平均(35.28±9.73)岁。分别测定入院时(0h)、24、48、72、96h及120h的动脉血气分析中p H值、动脉氧分压(PO2)、动脉二氧化碳分压(PCO2)、指氧饱和度(Sp O2)、氧合指数(Pa O2/FIO2),HR(心率)、肘部动脉收缩血压、心肌酶谱中谷草转氨酶(AST)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)、α-羟丁酸脱氢酶(α-HBDH),统计分析结果。结果两组在治疗24、48h时PO2和Pa O2/FIO2无明显改善,组间对比无明显差异(P0.05);72、96、120h时两组PO2和Pa O2/FIO2(对照组105.8±28.4/221.5±28.7,108.4±30.7/239.4±25.3,142.8±34.3/318.5±35.7;镇痛组131.8±27.5/285.5±32.7,153.4±32.4/328.1±30.6,170.8±20.7/350.2±34.9),组间对比差异明显(P0.05);p H值、PCO2、Sp O2行组间对比均无明显差异(P0.05);两组在镇痛后,心率在各时间点行组间对比差异明显(P0.05);收缩压及心肌酶谱检查结果,两组对比无统计学差异(P0.05)。结论镇痛对胸部创伤早期呼吸功能恢复有良好的治疗作用,可稳定心率,对血压及异常变化的心肌酶谱无明显影响。     

Spinal reflex plasticity in response to alpine skiing in the elderly

The present study was designed to assess the influence of 12 weeks (28.5 ± 2.6 skiing days) of alpine skiing on spinal reflex plasticity, strength and postural control in senior citizens. Therefore, soleus H-reflexes and postural stability were measured during bipedal quiet and unstable stance in 22 (12 male and 10 female) elderly subjects aged 66.6 ± 1 years. Furthermore, the maximal isometric force was determined in a leg press. The results showed an increased H-reflex excitability after the training (+39%; P<0.05) while no changes occurred in the background EMG. The postural sway decreased after training (-6.6 cm; P ≤ 0.05) and the maximal force increased (+16.1%; P<0.05). No adaptations in any parameter could be observed in the control group. The present study demonstrated that skiing training was effective to alter the spinal reflex activity in elderly individuals. The increased H-reflexes correspond to adaptations known from strength training in young subjects. It may be assumed that alpine skiing induced a functional adaptation in that subjects have learned to integrate Ia afferent feedback more efficiently to ensure adequate motoneuron output.     

Effect of a skiing intervention on the psycho-physiological reactivity and recovery in the elderly

This study determined the effects of a skiing intervention lasting 12 weeks on the psycho-physiological reactivity to and recovery from mental stressors in individuals who are 60+ years of age. In accordance with the cross-stressor hypothesis, it was assumed that a skiing intervention optimizes psycho-physiological pre-conditions for coping with stress. A cognitive task was used to investigate stress-induced changes (reactivity) in the high-frequency (HF) component of the heart rate variability (HRV) and in the skin conductance level (SCL) as well as recovery from this stressor. The intervention group demonstrated a significant increase in maximal oxygen consumption that was not accompanied by alterations in HRV at rest. In comparison with the control group, there was no difference in the alteration of the reactivity and recovery in the HF component and in the SCL after completing the training. The findings indicate that neither the psycho-physiological reactivity nor the recovery was influenced by the skiing intervention. It may be speculated that the intensity of the skiing intervention was too low to induce such adaptations. Therefore, further studies are encouraged to enhance the duration and intensity of the exercises to achieve adaptations of the autonomous nervous system of elderly individuals.     

Alpine skiing and the mature athlete.

Alpine skiing is a popular sport enjoyed by millions of Americans annually. As the average age of the world population increases, so does the average age of the skier. The ever-increasing older group of skiers adds a new dimension to both the prevention and treatment of ski injuries. Several injuries, if not unique to the older skier, are more common in this group, and familiarity with the causes, treatments, risks, and avoidance of these injuries is essential for proper treatment. It is possible that with proper education, prevention, and physical training, the incidence of these injuries can be decreased to the level of the general population, and skiing will not be more hazardous to the older athlete.     

The Harstad injury prevention study: the epidemiology of sports injuries. An 8 year study.

OBJECTIVE--To describe the epidemiology of sports injuries occurring in a community during 8 years and to evaluate the outcome of an intervention implemented against injuries occurring in downhill skiing. METHODS--Hospital treated sports injuries occurring in Harstad, Norway (population 22 600) were recorded prospectively during an 8 year period. A prevention programme targeting downhill skiing injuries was evaluated. RESULTS--2234 sports injuries accounted for 17.2% of recorded unintentional injuries. Two out of three injuries occurred in team sports. Soccer accounted for 44.8% of all sports injuries. Downhill skiing injuries had higher mean score on the abbreviated injury scale than all other sports analysed combined (P < 0.01). Postintervention injury rates for downhill skiing were reduced by 15% when adjusting for exposure (P = 0.24). Further observations are needed for assessing the effectiveness of the downhill skiing safety programme. CONCLUSIONS--Strategies for future sports injury prevention include community involvement, particularly sports organisations. Local data analysis seems to justify some priorities, for example, promotion of helmet use in downhill skiing for young adolescents and prevention of lower limb fractures in male soccer players 15+ years old. Prospective hospital recording of injuries provides a tool for the design and outcome evaluation of sports injury intervention research.     

笑气清醒镇静对肠镜检查的有效性和安全性评价

 目的 研究笑气（N 2O）清醒镇静在肠镜检查中的安全性和有效性。 方法 将 2011-04至2011-12在我院行笑气清醒 镇静肠镜检查的330例患者作为A组,同期常规肠镜检查300例患者作为B组,对其HR、SpO 2、反应情况及镇静效果等进行研 究分析。 结果 A组术中不适反应明显低于B组。A组中,术中HR低于术前［（74.90±13.65）次/min vs （79.16±14.67）次/min, P ＜0.05］,但术中HR在正常安全范围内;术中SpO 2高于与术前［99.64±1.04）% vs （99.14±1.35）%, P ＜0.05］。B组中,术中HR高于术前［（89.80±13.52） vs (79.77±13.35), P ＜0.05］ ;术中SpO 2稍低于与术前［（99.42± 1.07 ）% vs (99.53±1.12)%］,但差异无统计学意义。 结论 笑气清醒镇静肠镜检查提高了肠镜检查的舒适度,安全、可行。     

Heart rate monitoring as a reliable tool for assessing energy expenditure in obese individuals

Previous studies have suggested the use of the FlexHR method for predicting daily energy expenditure in various populations. We investigated the stability of the relation between oxygen consumption (VO2) and heart rate (HR) in obese subjects undergoing a fitness and weight reduction program. Eleven obese (BMI>30) healthy subjects (6 males, 5 females) were recruited from a Wellness program. Subjects performed a laboratory calibration procedure between HR and VO2 in resting and exercising conditions, before starting the Wellness program (Stage I) and after reducing 10% of their initial body weights (BW) within 6 months (Stage II). Mean BW, BMI and % body fat were reduced by 13.1±4.4 kg, 4.2±1.4 kg.m-2 and 6.8±4.1%, respectively, for all parameters (P<0.001). Mean peak VO2 increased from 31.3±7.1 at the beginning to 37.2±7.3 mL.kg-1.min-1 at the end of the intervention period (P<0.01). The mean flex HR point changed from 96±14 to 86±15 beats.min-1 (P<0.05). There were no significant individual differences in the HR-VO2 prediction equations derived from the laboratory calibrations in either stage. In conclusion, the relationship between HR and VO2 consumption remains stable during a time period of weight reduction. The use of the FlexHR method for predicting energy expenditure by heart rate monitoring is recommended for subjects undergoing a weight-reduction program. It should be taken in account, however, that an increase in aerobic capacity, in parallel to changes in body weight and composition, might cause a decrease in the flex point.     

The self selected speed of running in recreational long distance runners.

The aim of this study was to test the hypothesis that the self selected speed in running (vss) is dependent upon the same factors that determine maximal speed in endurance events (e. g. the anaerobic threshold). Experiments were carried out on 8 recreational long distance runners (42.1 +/- 8.6 years of age, 70.1 +/- 10.6 kg of body mass, 1.74 +/- 0.06 m of body height) while they were participating in a 14 day relay race. During the "race" the subjects were not requested to perform maximally but only to cover their running turn (1 hour per day) at their preferred pace. The relationships between heart rate (HR), perceived exertion (RPE), blood lactate concentration ([La]b) and speed (v) were determined in each subject, before the race, during an incremental running test. From these relationships the speed corresponding to a 4 mM concentration of lactate in blood (v4mM) was calculated and found to be 14.3 +/- 1.8 km x h(-1) (n = 8). At this speed the RPE and HR values were 13.6 +/- 1.4 and 156.4 +/- 12.8 bpm, respectively. The average values of speed (vss, 13.4 +/- 0.6 km x h(-1)), RPE (13.5 +/- 1.4) and HR (154.4 +/- 7.6 bpm) measured during the race (n = 47) were not significantly different from those measured at the lactate threshold (v4mM, RPE4mM and v4mM). However, vss and the average HR during the race showed significantly lower variances than v4mM and HR4mM suggesting that, besides the need of avoiding lactate accumulation in blood, other factors must be involved in the choice of speed in running.     

不同时段介入治疗对心肌梗死室壁瘤患者心室收缩同步性及血浆脑钠肽的影响

目的对比经皮冠状动脉介入（PCI）治疗对急性心肌梗死（AMI）后左心室室壁瘤（LVA）形成、心室收缩同步性及血浆脑钠肽（BNP）的影响。方法选择2001年1月至2004年7月收治的首次急性前壁心肌梗死及左心室造影（LVG）确定合并室壁瘤者共326例,根据PCI施行的时间分为4组：A组32例（〈3h）、B组89例（≥3h且〈6h）、C组129例（≥6h且〈12h）、D组76例（AMI后1周）,4组患者于PCI后1周时行平衡法核素心室显像（ERNA）,测定左室整体和局部收缩功能、舒张功能和收缩同步性功能参数及反常室壁容积指数（PVI）;AMI后6个月随访时重复测定上述参数,并随访3年,记录主要恶性心脏事件（MACE）的发生率。所有患者于发病后18h,第5天及24周测定血浆BNP质量浓度。对数据行方差分析和,检验。结果AMI后6个月随访时,A、B、C3组左心室射血分数（LVEF）较D组明显增高（F=5．81,P〈0．05）,而相角程（PS）、半高宽（FWHM）明显降低（F=5．90和6．80,P均〈0．05）;A组反常容积消失病例数明显高于B、C、D组,且A组PVI明显低于B、C、D组[分别为（12．08±2．07）％、（15．43±2．39）％、（16．49±2．47）％、（20．41±3．68）％,F=4．32,P〈0．05]。D组发病后18h、第5天和第24周血浆BNP质量浓度均明显高于A组[（12．30±2．24）彬L与（9．85±2．60）μg／L,（9．47±1．95）μg／L与（6．65±1．56）μg／L,（5．36±1．43）μg／L与（3．27±1．12）μg／L,F=5．19,P〈0．05],B、C组差异无统计学意义（F=5．19,P〈0．05）,但均低于D组。住院期间及术后3年随访A,B,C3组梗死后心绞痛发生率和3年随访时死亡率[6．25％（2／32）与3．12％（1／32）,8．99％（8／89）与5．62％（5／89）,9．30％（12／129）与7．76％（10／129]均低于D组[21．05％（16／76）与17．11％（13／76）]∥分别为91．3和10．05,P均〈0．05。结论对AMI患者梗死相关动脉开通越早、越充分,才能越有效地抑制并逆转LVA的形成,提高左心室功能,最终改善患者预后。     

Efficacy of Nordic walking in obesity management

The effects of a Nordic walking (NW) program compared to those of a walking (W) program on physiological and perceptual variables in obese middle-aged women were investigated. Subjects (n=12 NW group, n=11 W group) trained over 12 weeks 3 times.week (-1). Body mass, body mass index (BMI), body fat, heart rate (HR), resting blood pressure, peak oxygen consumption (V˙O (2peak)) were measured before and after the training period. Moreover, HR, rating of perceived exertion (RPE) and adherence were recorded during all training sessions. After the training period body mass, body fat and diastolic blood pressure decreased in both groups (P<0.05) whereas V˙O (2peak) increased in the NW group (+3.7?ml.min (-1).kg (-1); P=0.005). During the training sessions, mean HR (P=0.021), HR at preferred walking speed (P=0.020) and % of time at high intensity (P=0.031) were higher in NW than in the W group. Finally, RPE was not influenced by the modality of exercise and NW group showed a higher rate of adherence (91±19% vs. 81±29%; P=0.011). To conclude, NW activity in obese women allows an increase in exercise intensity and adherence to a training program without increasing the perception of effort leading to enhanced aerobic capacity.     

Cross‐country skiing is associated with lower all‐cause mortality: A population‐based follow‐up study

The prospective relationship between leisure‐time cross‐country skiing and any fatal events is uncertain. We aimed to assess the associations of leisure‐time cross‐country skiing habits with the risk of all‐cause mortality in a general population. A 12‐month physical activity questionnaire was used at baseline to assess the frequency, average duration, and intensity of cross‐country skiing in a prospective population‐based cohort of 2087 middle‐aged men from eastern Finland. Hazard ratios (HR s; 95% confidence intervals) were calculated for all‐cause mortality. During a median (interquartile range) follow‐up of 26.1 (18.7‐28.0) years, 1028 all‐cause mortality outcomes were recorded. In analyses adjusted for several established risk factors and other potential confounders, when compared to men who did not do any cross‐country skiing, the HR s (95% CI s) of all‐cause mortality were 0.84 (0.73‐0.97) and 0.80 (0.67‐0.96) for men who did 1‐200 and >200 metabolic equivalent‐hours per year of cross‐country skiing, respectively. Similarly, compared to men who did not do any cross‐country skiing, the corresponding adjusted HR s (95% CI s) for all‐cause mortality were 0.84 (0.72‐0.97) and 0.82 (0.69‐0.97) for men who did 1‐60 min/wk and >60 min/wk of cross‐country skiing, respectively. The associations were similar across several subgroups, except for evidence of effect modification by body mass index and history of diabetes. Total volume as well as duration of leisure‐time cross‐country skiing is each inversely and independently associated with all‐cause mortality in a middle‐aged Caucasian male population.     

Effect of alpine skiing training on tendon mechanical properties in older men and women

Strain is one of the parameters determining tendon adaptation to mechanical stimuli. The aim of this study was to test whether the patellar tendon strain induced during recreational alpine skiing would affect tendon mechanical properties in older individuals. Twenty-two older males and females (67 ± 2 years) were assigned to a 12-week guided skiing programme (IG) and 20 aged-matched volunteers served as controls (CG). Patellar tendon mechanical properties and cross-sectional area (CSA) were measured before and after training, with combined dynamometry and ultrasonography scanning. None of the variables changed significantly in the CG after training. In the IG, tendon stiffness and Young's modulus were increased (respectively, 14% and 12%, P<0.01), without any significant change in tendon CSA. In addition, changes in tendon stiffness were blunted in women (9%) compared with men (19%). Serum IGF-1 concentration tended to be lower in women (-19%, P=0.07). These results demonstrate that the mechanical stimulus induced by alpine skiing is sufficient to elicit adaptive changes in patellar tendon mechanical and material properties in older subjects. Furthermore, the present sex-specific adaptations are consistent with previous reports of lower collagen metabolic responsiveness in women and may be underpinned by anthropometric and metabolic differences.     

A comparison of three skating techniques and the diagonal stride on heart rate responses and speed in cross-country skiing

The purpose of this study was to compare the heart rate responses and the speed of three different skating techniques and the diagonal stride in cross-country skiing. The subjects were ten elite male cross-country ski racers, 16 to 25 years of age. They skied a 3.04-km loop of various terrain four separate times, using a different technique for each trial. A thirty-minute recovery period was allowed between each trial. Heart rate and skiing velocities were analyzed over a flat, an uphill, and a downhill section, as well as for the total loop. No significant differences (p greater than 0.05) were found in heart rate values between the four techniques on all sections of the course, while heart rates were significantly different over the three different sections. Skiing velocities were significantly different (p less than 0.05) between the diagonal stride and all skating techniques, the diagonal stride being the slowest technique, and this, for all sections. Energy costs while skiing were estimated on the basis of individual HR/VO2 curve determined under laboratory conditions. Since no differences in HR were found between the four techniques, no differences in energy costs were found. These energy costs represented between 69 and 73% of max VO2, and between 87 and 89% of max HR for the 3.04-km loop. Thus, for the same estimated energy expenditure, greater speeds (16%) were achieved with the skating techniques than with the diagonal stride.