Neurogenic bladder in patients with traumatic spinal cord injury: Treatment and follow-up

Study design:Multi-center, cross-sectional study.Objectives:Our aim was to evaluate the treatment methods and follow-up of neurogenic bladder in patients with traumatic spinal cord injury retrospectively using a questionnaire.Setting: Turkey.Methods:Three hundred and thirty-seven patients who had spinal cord injury for at least 2 years were enrolled from six centers in the neurogenic bladder study group. They were asked to fill-out a questionnaire about treatments they received and techniques they used for bladder management.Results:The study included 246 male and 91 female patients with a mean age of 42±14 years. Intermittent catheterization ( IC) was performed in 77.9% of the patients, 3.8% had indwelling catheters, 13.8% had normal spontaneous micturition, 2.6% performed voiding maneuvers, 1.3% used diapers and 0.6% used condom catheters. No gender difference was found regarding the techniques used in bladder rehabilitation ( P>0.05). Overall, 63.2% of patients used anticholinergic drugs; anticholinergic drug use was similar between genders ( P>0.05). The most common anticholinergic drug used was oxybutynin ( 40.3%), followed by trospium ( 32.6%), tolterodine ( 19.3%) darifenacin ( 3.3%), propiverine ( 3.3%) and solifenacin ( 1.1%). The specialties of the physicians who first prescribed the anticholinergic drug were physiatrists ( 76.2%), urologists ( 22.1%) and neurologists ( 1.7%). Only four patients had previously received injections of botulinum-toxin-A into the detrusor muscle and three of them stated that their symptoms showed improvement. Most of the patients ( 77%) had regular follow-up examinations, including urine cultures, urinary system ultrasound and urodynamic tests, when necessary; the reasons for not having regular control visits were living distant from hospital ( 15.3%) and monetary problems ( 7.7%). Of the patients, 42.7% did not experience urinary tract infections ( UTI), 36.4% had bacteriuria but no UTI episodes with fever, 15.9% had 1-2 clinical UTI episodes per year and 5% had ≥3 clinical UTIs. The clinical characteristics of patients with and without UTI ( at least one symptomatic UTI during 1 year) were similar ( P>0.05). The frequency of symptomatic UTI was similar in patients using different bladder management techniques ( P>0.05).Conclusion:The most frequently used technique for bladder rehabilitation in patients with SCI was IC ( 77.9%). In all, 63.2% of patients used anticholinergic drugs, oxybutynin being the most commonly used drug. Also, 77% of patients had regular control visits for neurogenic bladder; 42.7% did not experience any UTIs. © 2014 International Spinal Cord Society

Intermittent catheterization in patients with traumatic spinal cord injury: Obstacles, worries, level of satisfaction

Objectives: The aim of this study is to examine the obstacles in people with traumatic spinal cord injury (SCI) face performing intermittent catheterization (IC), also their worries and level of satisfaction. Methods: Two hundred sixty-nine patients performing IC for at least 3 months were asked to fill-out a questionnaire about their opinions on IC. Results: In total, 69.5% of patients performed IC themselves, 10.4% had performed by their mothers, 7.8% by another caregiver and 7.4% by their spouse. For the 72 (26%) patients unable to apply IC, reasons were insufficient hand function (56.1%), being unable to sit appropriately (35.4%) and spasticity (8.5%). In all, 70% of male patients had insufficient hand function, 20% could not sit and 10% had spasticity while 56.3% of female patients could not sit, 37.5% had insufficient hand function and 63% had spasticity. Difference between sexes was found to be statistically significant (P<0.05). Worries patients had when starting IC were fear of being dependent on IC (50.2%), accidentally injuring self (43.8%), embarrassment (43.2%), causing an infection (40.2%), bleeding (32.7%), fear of feeling pain (30.2%) and hygiene (24.7%). More women felt embarrassment; other items were similar in both sexes. In all, 46.9% of patients had urinary incontinence in intervals. Conclusion: In total, 69.5% of patients performed IC themselves. Men's most common obstacle was insufficient hand function while women's was being unable to sit appropriately. Patients' most common worries were being dependent on IC for life. In all, 46.9% had incontinence in intervals; 47.9% said IC improved their life quality; and 97.4% preferred IC over continuous catheterization. © 2014 International Spinal Cord Society All rights reserved

A Comparison of Incremental Running Field and Treadmill Tests in Young Soccer Players.

The purpose of this study was to compare the incremental running tests performed by young soccer players on a treadmill (Tr) and in the field (FT(cod): 100 m change of direction and FT(cir): 100 m circle). Nineteen players (average age 17.4 ± 1.1 years; body height 172.0 ± 5.7 cm; body mass 68.9 ± 6.7 kg) volunteered to perform incremental Tr , FT(cod) and FT(cir) running tests. In all three tests, players ran for 3 min at 8, 10, 12 and 14 km∙h(-1) and were given a 1 min rest interval between subsequent stages. Blood lactate concentrations (La(-)) were measured at 1 min rest intervals and the heart rate (HR) responses of players were recorded during the tests. After a 5 min recovery period, the second part of the test started; players ran at 15 km∙h(-1) with velocity increments of 1 km∙h(-1) every 1 min until exhaustion. This part was performed to determine maximum HR, maximum La(-) and the players' final velocities. The results showed that players had significantly lower La(-) (F = 6.93, p = 0.07, η(2) = 0.46, 95%CI((TR-FTcir)) = -1.91/-0.34, 95%CI((TR-FTcod)) = -1.59/-0.05) and HR (F = 9.08, p = 0.02, η(2) = 0.53, 95%CI((TR-FTcir)) = -6.98/-1.68, 95%CI((TR-FTcod)) = -7.19/1.08) responses in the Tr test than in the FT(cir) and FT(cod) tests at 14 km∙h(-1). It was also found that players completed the Tr test (F = 58.22, p = 0.00, η(2) = 0.87) at higher final running velocities than the FT(cir) (95%CI((TR-FTcir)) = 1.67/2.78) and FT(cod) (95%CI((TR-FTcod)) = 1.69/2.85) tests. In conclusion, when coaches or sports scientists plan to train at higher running velocities or according to the final velocity in the test, it is advisable to carry out testing in the circumstances under which training will be carried out (in the field or on a treadmill)

Accuracy and reliability of SPI ProX global positioning system devices for measuring movement demands of team sports.

AIM: The aim of this study was to determine the accuracy and reliability of SPI ProX global positioning system (GPS) devices for measuring movement at various speeds and movement patterns as evident in team sport demands. METHODS: Eleven amateur soccer players performed a 40 m straight sprint test (with 10-20-30 m split times), a zigzag test, 30 m walking, jogging and moderate intensity runs. RESULTS: Results indicated that the SPI ProX GPS measurements showed acceptable accuracy for all movement patterns for distance (coefficient of variation [CV]=0.14% to 3.73%; 95% ratio limits of agreement [95% ratio LOA]=0.97 x / ÷ 1.09 to 1.00 x / ÷ 1.05) and speed (CV=4.22% to 9.52%; 95%LOA=-0.17 ± 1.70 km h-1 to 2.30 ± 1.17 km h-1) compared with the measured distance and speed determined from timing gates, respectively. Furthermore, acceptable reliability of SPI ProX GPS measures for distance (CV=0.34% to 3.81%; 95%LOA=-0.09 ± 0.23 m to -0.34 ± 2.31 m) and speed (CV=3.19% to 6.95%; 95%LOA=-0.05 ± 3.90 km h-1 to 0.42 ± 3.68 km h-1) were also evident. CONCLUSION: Whilst SPI ProX GPS devices were within acceptable ranges of reliability, they remained significantly different to criterion measures of team sport movement demands

The acute effect of different stretching methods on sprint performance in taekwondo practitioners.

BACKGROUND: The purpose of this study was to compare the acute effects of different stretching types on sprint performance in taekwondo practitioners. METHODS: Twelve male taekwondo practitioners performed stretching exercises using different types (ballistic, proprioceptive neuromuscular facilitation [PNF], static stretching) in a random order at three-day intervals; there was also a control condition involving no stretching exercises. The subjects performed 2 maximal 20-m sprints (with 10-m split times also recorded) with a recovery period of 1 minute immediately post stretching and at 5, 10, 15 and 20 minutes after stretching. They also performed these sprints before doing the stretching exercises. RESULTS: The study results showed that sprint times significantly increased after static stretching (10-m pre =1.84±0.07 s, 10-m post =1.89±0.08 s; 20-m pre =3.33±0.19 s, 20-m post= 3.38±0.2 s), PNF stretching (10-m pre =1.84±0.07 s, 10-m post =1.89±0.08 s; 20-m pre =3.33±0.19 s, 20-m post =3.38±0.20 s) and ballistic stretching (pre =1.84±0.08 s, post =1.86±0.07 s; 20-m pre =3.33±0.20 s, 20-m post =3.35±0.21 s) (P<0.05). In the static stretching condition, 10-m and 20-m sprint performance had fully returned to normal at 15 minutes after stretching. In the PNF stretching condition, 20-m sprint performance returned to normal levels at 15 minutes after stretching, while 10-m performance took 20 minutes to recover fully. In the ballistic stretching method, both 10-m and 20-m sprint performances had fully recovered at 5 minutes after stretching. CONCLUSIONS: It is therefore concluded that the acute effects of static, PNF and ballistic stretching may negatively affect sprint performance, although sprint performance is less affected after ballistic stretching than after the other stretching types. Therefore, it is not advisable to perform PNF or static stretching immediately before sprint performance

Public Health Rep

A survey of physicians, consumers, journalists, and experts on osteoporosis showed that the level of awareness, particularly among consumers and physicians, regarding osteoporosis and calcium supplementation is high. Professionals and consumers alike agree that osteoporosis is a serious disease. Most think that the disease is preventable, although serious. Most women are aware that osteoporosis may begin years before symptoms become evident, and that they may be subject to the disease. Most consumers and professionals believe that the ideal time to begin osteoporosis prevention is adolescence. If prevention does not begin during that age, some physicians suggest that any steps toward prevention taken premenopausally are beneficial. Nearly all of those surveyed believe that calcium as well as exercise helps prevent osteoporosis. Although about 90 percent of the physicians surveyed agreed that estrogen replacement therapy (ERT) alleviates osteoporosis; only 48 percent of postmenopausal women believe that ERT is helpful. The majority of the professionals who responded believe that most women do not get enough calcium in their diets, and that most women do not exercise enough. Although in most instances the consumers responding to this study were slightly less informed about the risks and factors associated with osteoporosis than were the professionals, the opinions of the four groups surveyed were similar for most of the topics discussed.2517709PMCnul

Effect of different recovery durations between bouts in 3-a-side games on youth soccer players\u27 physiological responses and technical activities

The aim of this study was to investigate the effects of the length of recovery durations between bouts in 4x4min 3-a-side small-sided games (SSG) on time-motion analysis, technical actions and physiological responses of players.Twelve young soccer players participated in 4 different 3-a-side games in which the recovery durations between bouts were different (R1: 1 min, R2: 2 min, R3: 3 min, and R4: 4 min). Heart rate (HR), total distance covered in different speed zones, and technical performance were monitored during all SSGs, whereas the rating of perceived exertion (RPE, CR-10) and venous blood lactate were determined at the end of the last bout of each SSG.Results showed that SSGs-R1 induced higher %HRreserve and lower successful passes (vs. R3 and R4 conditions, P\u3c0.05), lower total passes (vs. R4 conditions, P\u3c0.05), and greater distance covered in walking zone (0-6.9 km.h⁻¹) (vs. other 3 conditions, P\u3c0.05). In addition, during the SSG-R3 players covered greater distances in high-intensity running zone (\u3e18 km.h-1), performed more tackles (vs. R1 condition, P\u3c0.05) and had more ball contacts (vs. R1 and R2 conditions, P\u3c0.05).According to these results, it is thought that R1 and R2 are suitable for inducing higher physiological responses, while R3 and R4 are more appropriate for training aim to improve technical skills in 4x4min 3-a-side SSGs among young soccer players. These findings provide evidence for coaches to justify the selection of recovery duration between bouts in 3-a-side SSGs among young soccer players