Effect of Chiropractic Manipulation on Vertical Jump Height in Young Female Athletes with Talocrural Joint Dysfunction: A Single-Blind Randomized Clinical Pilot Trial

Objective

The main objective of this pilot study was to explore the effect of chiropractic high-velocity, low-amplitude (HVLA) manipulation on vertical jump height in young female athletes with talocrural joint dysfunction.

Methods

This was a randomized assessor-blind clinical pilot trial. Twenty-two female handball players with talocrural joint dysfunction were randomized to receive either HVLA manipulation (n = 11) or sham treatment (n = 11) once a week during a 3-week period. The main outcome was change in vertical jump height from baseline to follow-up within and between groups after 3 weeks.

Results

Nineteen athletes completed the study. After 3 weeks, the group receiving HVLA manipulation (n = 11) had a statistically significant mean (SD) improvement in vertical jump height of 1.07 (1.23) cm (P = .017). The sham treatment group (n = 8) improved their vertical jump height by 0.59 (2.03) cm (P = .436). The between groups' change was 0.47 cm (95% confidence interval, − 1.31 to 2.26; P = .571) in favor of the group receiving HVLA manipulation. Blinding and sham procedures were feasible, and there were no reported adverse events.

Conclusion

The results of this pilot study show that a larger-scale study is feasible. Preliminary results suggest that chiropractic HVLA manipulation may increase vertical jump height in young female athletes with talocrural joint dysfunction. However, the clinical result in favor of HVLA manipulation compared with sham treatment needs statistical confirmation in a larger randomized clinical trial.     

Aerobic performance capacity in athletes

Summary Maximal oxygen uptake (max O₂) in leg and arm work, succinate dehydrogenase activity (SDH) and percentage of slow twitch fibers (%ST fibers) in M. vastus lateralis (VL), M. gastrocnemius c.l. (GL) and M. deltoideus (D) were studied in 89 athletes practising 11 different sport events. It was found that maximal oxygen uptake correlated positively with %ST fibers and SDH activity in M. VL. The SDH activity and %ST fibers in M. VL correlated also with one another. The results suggest that oxidative capacity of the muscles is not the limiting factor for maximal oxygen uptake. The role of the oxidative capacity of the muscles might be important during submaximal work of long duration and when a relatively small muscle mass is activated (long-distance running). Max O₂ might be the most important determinant of performance when large muscle mass is activated during maximal work of a duration from several minutes up to 1 h (cross-country skiing).     

Quantitative computed tomography for measuring bone mineral density in athletes

We studied the effect of different training patterns on vertebral trabecular and cortical bone mineral density (BMD) in male athletes using quantitative computed tomography. Vertebral trabecular (t) and cortical (c) BMDs of the first three lumbar vertebrae were measured using single energy quantitative computed tomography in 51 athletes including 10 weight lifters (mean age 20 years), 13 soccer players (mean age 27 years), 28 wrestlers (mean age 17 years), and 45 age-matched volunteers (mean age 21 years). Measured BMDs were correlated with age, body height and weight, training hours per week, sports years, and type of physical activity. Vertebral tBMDs were found to be 44%, 23%, and 24% higher in the weight lifters, soccer players, and wrestlers, respectively, compared with the volunteers. The corresponding cBMDs were 18%, 6%, and 11% higher than that of volunteers. There was significant correlation between the trabecular and cBMD, and height of the athletes, sports years, training hours per week, and physical activity. The most significant correlation with BMD was the type of physical activity. Both the height of the subjects and physical activity variables showed variations of 47% and 32% in trabecular and cBMD, respectively. According to the multiple analysis of variance (MANOVA) only the physical activity factor was effective, with a significance level ofP<0.01; the other factors and interactions were not effective (P>0.05) on trabecular and cBMD. Different training patterns have a different anabolic effect on both trabecular and cBMDs of the vertebrae, and this effect is more pronounced on the trabecular compartment. Weight lifting showed the highest anabolic effect on both trabecular and cBMDs compared with soccer playing and wrestling. Of the independent variables, physical activity showed the highest anabolic effect on the vertebrae. These results may have implications for devising exercise strategies to reduce the possibility of fracture in old age.     

Le questionnaire de surentraînement de la Société française de médecine du sport : reproductibilité à court termeOvertraining questionnaire of the Société française de médecine du sport (French Society of Sport Medicine): short term reproducibility

Purpose. – To assess the short-term stability, over time, of a slightly modified version of the overtraining questionnaire proposed by the SFMS.Methods. – Three or 7-day test–retest of the questionnaire was completed in 30 high level athletes. In a first stage analysis, the score obtained during the first test was compared to and correlated with that obtained during the second one. Then, in a second stage analysis, the individual reproducibility of each item was assessed using a similitude index: a value of 100% meant that all the athletes gave an identical response for the two trials.Results. – Scores were not different between the two tests and intra-class correlation coefficients were r = 0.82. Overall reproducibility of the similitude index was quite good even if six items of 52 displayed a lower similitude index (around 80%).Conclusion. – The short-term reproducibility of the overtraining questionnaire is quite good. This result reinforces its reliability and warrants its use in a longitudinal follow-up framework aimed to detect precociously an overtraining syndrome.     

Irreversible bone loss in former amenorrheic athletes

Small gains in bone mineral density (BMD) have been reported in the first year following resumption of menses in amenorrheic athletes but there have been no long-term outcome studies. The purpose of this study was to determine whether the BMD of former oligomenorrheic or amenorrheic athletes normalizes following several years of normal menses or use of oral contraceptives. Twenty-nine athletes first studied in this laboratory 8.1 years (range 6–10 years) ago were available for follow-up. At recruitment (time 1) 29 athletes, mean age of 30.6 years, were non-smokers, exercised 4 or more days/week for at least 45 min, had not used oral contraceptives, and had no medical conditions affecting bone metabolism. At time 1, 9 women (R/R) had always menstruated regularly, 9 (R/O/A) had experienced intermittent oligo/amenorrhea as well as regular menses, and 11 (O/A) had never menstruated regularly. At follow-up (time 2) mean age of the women was 38.2 years and there were no significant changes in height, weight or activity patterns. BMD (g/cm²) was measured at the lumbar vertebrae (L1–4 and femoral neck by dual-energy X-ray absorptiometry and expressed as a percentage of R/R values. Vertebral BMD was significantly lower in the O/A group compared with the R/R group at both time 1 and time 2 (p<0.05). The R/O/A group had intermediate values and did not differ significantly from R/R or O/A at either time. Differences in technique between machines for determining femoral neck BMD made it difficult to detect the longitudinal effect of menstrual status at that site. Despite several years of normal menses or use of oral contraceptives, the mean vertebral BMD of former oligo-amenorrheic athletes remained low, being 84.4% of the R/R value compared to 84.8% at time 1. Those experiencing menstrual regularity with intermittent oligo/amenorrhea remained at an intermediate position of 94.7% of the R/R mean. Our results suggest early intervention is necessary to prevent irreversible vertebral bone loss in oligo/amenorrheic athletes     

Path integration: is there a difference between athletes and non-athletes?

The ability to estimate distance walked when blindfolded is associated with the vestibular, proprioceptive and (loco-)motor systems. In this study, we examined subjects’ ability to walk when blindfolded to a previously seen target. We examined whether there is a difference of performance in path integration between athletes and non-athletes. Two groups of healthy volunteers took part in this experiment: 21 athletes and 20 non-athletes. Subjects were asked to walk at three different velocities (slow, normal, fast) to a target (10 m in front of them) that they had seen before being blindfolded. Increase in velocity was associated with a decrease in the distance walked for both groups. Both groups were accurate at normal velocities. Athletes were also accurate at fast velocities whereas non-athletes undershot the target. In both groups, accuracy considerably decreased at slow velocities. It seems that our perceptual system can adapt to different velocities (normal, fast) but is most strongly disrupted at low velocity. When attempting to modify walking velocity, step length is also modified, playing a determining role in the estimation of distance.     

Effects of prolonged low doses of recombinant human erythropoietin during submaximal and maximal exercise

The aim of this study was to characterise the effect of prolonged low doses of recombinant erythropoietin (r-HuEPO) on the responses to submaximal and maximal exercise. Volunteer recreational athletes (n=21) were divided into three groups: r-HuEPO+intravenous iron (EPO+IV, n=7), r-HuEPO+oral iron (EPO+OR, n=9) and placebo (n=5). During the 12 week study, r-HuEPO or saline injections were given three times a week for the first 8 weeks and for the final 4 weeks the subjects were monitored but no injections were administered. The r-HuEPO doses were 50 IU·kg^–1 body mass for 3 weeks and 20 IU·kg^–1 body mass for the next 5 weeks. An exercise test comprising three submaximal intensities and then increments to elicit maximal aerobic power ( ) was conducted during weeks 0, 4, 8 and 12. During week 0, the mean intensity of the submaximal stages was 60%, 72% and 81% . Blood taken at rest was analysed twice a week for haematocrit (Hct). The relative increases in at weeks 4, 8 and 12 were 7.7%, 9.7% and 4.5%, respectively, for the EPO+IV group; 6.0%, 4.7% and 3.1% for the EPO+OR group; and –0.5%, –0.1% and –1.0% for the placebo group, where the improvements at week 12 for the EPO+IV and EPO+OR groups remained significantly above week 0 values. The Hct was significantly elevated by 0.06 and 0.07 units at week 3 in the EPO+IV and EPO+OR groups, respectively, and was stable during the 5 weeks of low-dose r-HuEPO. After 8 weeks of r-HuEPO use, plasma lactate concentration tended to be lower at exercise intensities ranging from 60% to 100% . This study confirmed the ability of low doses of r-HuEPO to maintain Hct and at elevated levels. Electronic Publication     

Decrease in peak heart rate with acute hypoxia in relation to sea level VO(2max)

The aim of this study was to evaluate the influence of arterial oxygen saturation (SaO₂) on maximal heart rate during maximal exercise under conditions of acute hypoxia compared with normoxia. Forty-six males were divided into three groups depending on their sea level maximal oxygen consumption (O_2max): high [GH, O_2max=64.2 (3.3) ml.min^–1.kg^–1], medium [GM, 50.8 (3.9) ml.min^–1.kg^–1] and low [GL, 41.0 (1.9) ml.min^–1.kg^–1]. All subjects performed a maximal exercise test in two conditions of inspired oxygen tension (PIO₂, (149 mmHg and 70 mmHg). Among the GM group, seven subjects performed five supplementary incremental exercise tests at PIO₂ 136, 118, 104, 92, and 80 mmHg. Measurements of O_2max and SaO₂ using an ear-oxymeter were carried out at all levels of PIO₂. The decrease in SaO₂ and peak heart rate (HR_peak) with PIO₂ became significant from 104 and 92 mmHg. SaO₂ correlated with the decrease in HR_peak. For PIO₂=70 mmHg, the decrease in O_2max, SaO₂ and HR_peak was, respectively, 44%, 62%, and 17.0 bpm for GH, 38%, 68%, and 14.7 bpm for GM, and 34%, 68%, and 11.8 bpm for GL. During maximal exercise in hypoxia, SaO₂ was lower for GH than GM and GL (p<0.01). Among subjects in GH, five presented exercise-induced hypoxemia (EIH) when exercising in normoxia. The EIH group exhibited a greater decrement in HR_peak than the non-EIH group at maximal hypoxic exercise (21.2 bpm vs. 15.0 bpm; p<0.05). When subjects are exposed to acute hypoxia, the lower SaO₂, due either to lower PIO₂ or to training status, is associated with lower HR_peak.     

Sleep disturbance at simulated altitude indicated by stratified respiratory disturbance index but not hypoxic ventilatory response

At high altitudes, the clinically defined respiratory disturbance index (RDI) and high hypoxic ventilatory response (HVR) have been associated with diminished sleep quality. Increased RDI has also been observed in some athletes sleeping at simulated moderate altitude. In this study, we investigated relationships between the HVR of 14 trained male endurance cyclists with variable RDI and sleep quality responses to simulated moderate altitude. Blood oxygen saturation (SpO₂%), heart rate, RDI, arousal rate, awakenings, sleep efficiency, rapid eye movement (REM) sleep, non-REM sleep stages 1, 2 and slow wave sleep as percentages of total sleep time (%TST) were measured for two nights at normoxia of 600 m and one night at a simulated altitude of 2,650 m. HVR and RDI were not significantly correlated with sleep stage, arousal rate or awakening response to nocturnal simulated altitude. SpO₂ was inversely correlated with total RDI (r=–0.69, P=0.004) at simulated altitude and with the change in arousal rate from normoxia (r=–0.65, P=0.02). REM sleep response to simulated altitude correlated with the change, relative to normoxia, in arousal (r=–0.63, P=0.04) and heart rate (r=–0.61, P=0.04). When stratified, those athletes at altitude with RDI >20 h^–1 (n=4) and those with <10 h^–1 (n=10) exhibited no difference in HVR but the former had larger falls in SpO₂ (P=0.05) and more arousals (P=0.03). Neither RDI (without stratification) nor HVR were sufficiently sensitive to explain any deterioration in REM sleep or arousal increase. However, the stratified RDI provides a basis for determining potential sleep disturbance in athletes at simulated moderate altitude.     

等速肌力测试膝、踝关节及腰背肌力量的评价

背景：等速肌力测试已普遍用来作为运动员肌肉系统的机能状态和运动损伤的治疗效果评定的一种客观指标。 目的：探讨作为足球运动专项肌群的腰背肌、膝关节以及踝关节肌力特征。 方法：运用Cybex-Norm等速肌力测试与训练系统评价足球运动员在不同角速度下的膝、踝关节及腰背肌群屈伸肌峰力矩、相对峰力矩以及耐力水平。 结果与结论：运动员膝、踝关节左右两侧肌力发展较为均衡(< 5%),膝关节伸肌峰力矩和相对峰力矩偏低,屈肌峰力矩和相对峰力矩偏高,左侧膝关节表现尤为突出,不利于比赛时有效地控球、踢球和纵跳等动作的完成;腰背肌群相对峰力矩值相对较弱,容易在运动过程中发生损伤,引起下背痛类疾病;膝、踝关节以及腰背肌群的速度耐力水平均有较大提高空间。 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程