Obesity among urban primary schoolchildren

Three urban public primary schools in the district of Petaling, Selangor were surveyed for obesity amongst the schoolchildren and factors related to it. The prevalence of obesity amongst primary schoolchildren, with the mean age of 8.91 years was 9.5%. In addition, it was more prevalent among the boys (p<0.05) as compared to the girls. However, there was no difference with regards to ethnicity, being breastfed, physical activity, time spent watching television or fast food intake in relation to obesity among these primary schoolchildren. A larger community study is required to determine if other specific factors and dietary energy intake are associated with obesity amongst primary schoolchildren, especially in rural or less urbanised regions

Interventions for obesity among schoolchildren: a systematic review and meta­-analyses

Background: Childhood overweight and obesity has emerged as a major public health threat worldwide with challenges in its management. This review assessed the effectiveness of interventions for childhood overweight and obesity. Methods: A systematic literature search was conducted using CINAHL, EMBASE, Ovid MEDLINE, PsycINFO and SPORTDiscus databases to retrieve articles published from 1st January 2000 to 31st December 2017. Randomised controlled trials (RCTs) and quasi-experimental studies comparing different strategies in managing overweight and obesity among schoolchildren (6 to 12 years of age) were included. The main outcomes of interest were reductions in weight related variables included anthropometry and body composition measurements. All variables were analysed using random effects meta-analyses. Results: Fourteen studies were reviewed, 13 were RCTs and one was a quasi-experimental study. The risk of bias for randomisation was low risk for all of RCTs except for one, which was unclear. The risk of bias for randomisation was high for the quasi-experimental study. Most interventions incorporated lifestyle changes and behavioural strategies such as coping and problem solving skills with family involvement. The meta-analyses did not show significant effects of the intervention in reducing weight related outcomes when compared with controls. Conclusion: Meta-analyses of the selected studies did not show significant effects of the interventions on weight related outcomes among overweight and obese schoolchildren when compared with controls. The role of interdisciplinary team approaches with family involvement using behaviour and lifestyle strategies to curb obesity among schoolchildren is important

Patterns of injuries and illness among Malaysian athletes during the XVII Asian Games 2014

Although more Malaysians are taking part in International Multisport Games, these athletes well-being at such events have not been fully explored. The purpose of this study was to examine the pattern of injury and illness among Malaysian athletes during the XVII Asian Games 2014. Clinical and socio-demographic information of athletes diagnosed with injury or illness during the centralised training camp and at the Games were recorded in a standardised report form. Throughout the study period, 83 injuries and 64 illnesses were recorded from 276 athletes. Muscle strains and tears were the most common injury followed by ligamentous injury and soft tissues contusion. The number of injuries was highest among badminton players followed by hockey and rugby. Significantly higher incidence of injuries was observed among men than women hockey players. Athletes in individual events had higher proportion of more severe injury than those in team events. Respiratory tract infection was the most frequent illness diagnosed among athletes. Most injuries and illnesses diagnosed among athletes were minor and did not result in time away from participation. The incidence of injuries and illnesses among Malaysian athletes at the XVII Asian Games were comparable with those reported by previous authors. Injury and illness rate were influenced by gender and sports. Fortunately, majority of injuries and illnesses were minor and did not prevent athletes from participation

The short-term effects of progressive vs conventional core stability exercise in rehabilitation of nonspecific chronic low back pain

Core stability exercise programs are considered as a fundamental physical therapy treatment for chronic low back pain (LBP). However, it is still unclear which core stability program (progressive vs. conventional) is the most effective. A randomized controlled trial (RCT) was conducted to compare two core stability strategy strategies; progressive dynamic muscular stabilization technique (DMST) and conventional McGill Big 3 (MB3) in the rehabilitation of nonspecific chronic LBP. Thirty males diagnosed with nonspecific chronic LBP patients aged 33.57 ± 5.28 years were recruited and randomly assigned to; DMST and MGB3. All patients received additional conventional pain management treatment. The outcome measures were pain severity (motion, standing, sitting), functional disability, trunk endurance, lumbopelvic control, and body balance. All patients were assessed at baseline, 3rd week, and 6th week. A mixed design ANOVA showed both DMST and MGB3 improves all outcomes (p ≤ 0.05) specifically the pain severity and functional disability (p < 0.001, ηp2 = 0.81), trunk endurance (p < 0.001, ηp2 = 0.30), lumbopelvic control (p < 0.001, ηp2 = 0.242), and body balance (p = 0.003, ηp2 = 0.46) compared to baseline. However, no significant difference was found in all of the outcomes when comparing DMST and MBG3 (p > 0.05). In conclusion, both progressive DMST and conventional MGB3 core stability exercise programs are effective for nonspecific chronic LBP rehabilitation

Electrocardiographic ECG characteristics among Malaysian athletes

The electrocardiogram (ECG) is a graphic representation of the heart’s electrical activity. Although it has some limitations as a diagnostic or prognostic tool, it contains a wealth of information necessary for the proper care of a patient with a potential cardiovascular disease. Understanding the ECG changes among athletes would allow medical practitioners to distinguish between normal physiological adaptations and abnormal changes. However, there is limited data on the ECG characteristics among multi-ethnic athletes such as in Malaysia. This study aimed to determine the ECG characteristics and its associated factors among Malaysian national athletes. Malaysian national athletes annual preparticipation medical records were retrieved. Information on sociodemographic, sports and medical history including the 12-lead resting ECG tracings were extracted. ECG were assessed and categorised into normal, physiological adaptation changes, and abnormal ECG using the standardised ‘Seattle criteria’. Differences in ECG characteristics between genders, ethnic background, and type of sports was investigated. Additionally, factors associated with the ECG characteristics were assessed using multiple logistic regression. Majority of Malaysian national athletes had physiological adaptation ECG changes (61%). The most frequent changes were early repolarization, sinus bradycardia and isolated left ventricular hypertrophy. We found significantly higher prevalence of physiological adaptation changes among men (χ2 (2,371) = 18.9; p = 0.001) and athletes of Chinese ethnicity (both genders) (χ2 (2,356) = 13.8; p = 0.002). Factors associated with physiological ECG changes were men (OR=2.67; 95% CI= 1.68, 4.27; p<0.001) and Chinese ethnicity (OR=2.92; 95% CI=1.68, 4.27; p=0.039). Most athletes had physiological adaptation ECG changes which were significantly associated with male gender and Chinese ethnicity. This information would facilitate the development of a specific guideline in interpreting ECG among Malaysian athletes

Electrocardiographic (ECG) characteristics among Malaysian athletes

The electrocardiogram (ECG) is a graphic representation of the heart’s electrical activity. Although it has some limitations as a diagnostic or prognostic tool, it contains a wealth of information necessary for the proper care of a patient with a potential cardiovascular disease. Understanding the ECG changes among athletes would allow medical practitioners to distinguish between normal physiological adaptations and abnormal changes. However, there is limited data on the ECG characteristics among multi-ethnic athletes such as in Malaysia. This study aimed to determine the ECG characteristics and its associated factors among Malaysian national athletes. Malaysian national athletes annual pre-participation medical records were retrieved. Information on sociodemographic, sports and medical history including the 12-lead resting ECG tracings were extracted. ECG were assessed and categorised into normal, physiological adaptation changes, and abnormal ECG using the standardised ‘Seattle criteria’. Differences in ECG characteristics between genders, ethnic background, and type of sports was investigated. Additionally, factors associated with the ECG characteristics were assessed using multiple logistic regression. Majority of Malaysian national athletes had physiological adaptation ECG changes (61%). The most frequent changes were early repolarization, sinus bradycardia and isolated left ventricular hypertrophy. We found significantly higher prevalence of physiological adaptation changes among men (χ2(2,371) = 18.9; p = 0.001) and athletes of Chinese ethnicity (both genders) (χ2(2,356) = 13.8; p = 0.002). Factors associated with physiological ECG changes were men (OR=2.67; 95% CI= 1.68, 4.27; p<0.001) and Chinese ethnicity (OR=2.92; 95% CI=1.68, 4.27; p=0.039). Most athletes had physiological adaptation ECG changes which were significantly associated with male gender and Chinese ethnicity. This information would facilitate the development of a specific guideline in interpreting ECG among Malaysian athletes

Effects of self-management program as adjunctive to usual rehabilitation exercise on pain and functional outcomes in knee osteoarthritis: a randomized controlled trial

Background:Home-basedexercise(HBE)andpatient education (EDU) have been reported asbeneficial additions to usual knee osteoarthritis (KOA) rehabilitation. However, previous trials mostly examined the effects of HBE and EDU separately. Thus, this study aimed to evaluate the effects of a structured combined HBE and EDU program in addition to usual KOA rehabilitation on pain score, functional mobility, and disability level. Study Design: A parallel-group, single-blinded randomized controlled trial. Methods: Eighty adults with KOA were randomly allocated to experimental (n=40) and control (n=40) groups. All participants underwent their usual physiotherapy care weekly for eight weeks. The experimental group received a structured HBE+EDU program to their usual care, while the control group performed home stretching exercises to equate treatment time. The Knee Injury and Osteoarthritis Outcome Score (KOOS) for the disability level, visual analogue scale (VAS) for pain, and timed up-and-go test (TUG) for mobility were measured pre-post intervention. Results: After eight weeks, the experimental group demonstrated significant improvements in the KOOS (all subscales), pain VAS, and TUG scores compared to baseline (P < 0.001); meanwhile, only KOOS (activities of daily living and sports subscales) was significant in the control group. Relative to the control, the experimental group presented higher improvements (P<0.001) by 22.2%, 44.1%, and 15.7% for KOOS, pain VAS, and TUG, respectively. Conclusion: Integrating the HBE+EDU program into usual KOA rehabilitation could reduce pain and disability, while it improved functional mobility. The finding of this study suggests a combination of a structured HBE and EDU program to be considered as part of mainstream KOA management

Platelet-rich plasma (PRP) for the treatment of muscle injury / Mohamad Shariff A Hamid

Muscle injury particularly the hamstring group is the most common type of sports related injury among athletes. Despite its frequent occurrence, the best treatment for hamstring injury is not known. Athletes affected by muscle injury often need considerable amount of time to recover. Recently autologous biological products are being used for treatment of soft tissue injury including that of muscles. Off recent, an autologous platelet-rich plasma (PRP) therapy is one of the ‘hot topics’ discussed in literatures. A systematic review of the available literatures on PRP therapy showed evidences to support PRP use for rotator cuff injury, lateral epicondylitis (tennis elbow), patellar tendinopathies and Achilles' tendinopathies. As clinical evidence to support its usefulness is limited, a randomised controlled trial is needed to examine the effect of PRP on muscle injury. Besides, current evidences were based on few laboratory animal studies and case reports. Since information on injury prevalence and management of muscle injury in the local settings is limited, a cross-sectional study was conducted to investigate the pattern of muscle injury among Malaysian athletes. Medical records of athletes diagnosed with muscle injury were examined and injury mechanisms, types, treatment and duration to return-to-play (DRP) recorded. The pattern of muscle injury among Malaysian athletes was comparable to those reported by earlier researchers. Surprisingly, the DRP of local athletes were considerably longer compared with other studies (7.4 versus 3.8 weeks). Further, duration before first consultation, recurrent hamstring injury and female athletes were significant predictors of DRP. The decision to allow return-to-play was based on athlete’s symptoms of pain and objective clinical assessments including muscle flexibility test. An active knee extension (AKE) test was designed for assessment of hamstring flexibility in the RCT. A preliminary study on 14 healthy individuals showed excellent interater and test-retest reliabilities with intraclass correlation coefficient ranges from 0.78 to 0.92. This findings support the inclusion of the AKE test in the RCT. Twenty-eight athletes diagnosed with grade-2 acute hamstring injury were recruited in an RCT to explore effect of PRP on DRP. Both intervention and control groups were prescribed with a standard rehabilitation program. Additionally patients in the PRP group received a single 3 ml injection of autologous PRP (approximately 5-fold increase in platelets and white blood cells) into the injured muscle. Significantly earlier DRP (p = 0.013) was noted among participants in the PRP (median 21.0 ± IQR 13.0 days) compared with control (median 34.0 ± IQR 37.3 days). In addition the PRP group has significantly (p ≤ 0.001) lower pain severity score (1.14 ± SE 0.19) than control at all time points (2.31 ± SE 0.23). Furthermore participants reported no severe adverse effect of PRP therapy. In conclusion the findings of this research suggest PRP therapy is a safe and effective treatment for muscle injury

Cost Effectiveness of a Platelet-rich Plasma Preparation Technique for Clinical Use

INTRODUCTION: Despite limited clinical evidence, platelet-rich plasma (PRP) is currently used for the treatment of various soft tissue injuries, but optimal use of PRP has yet to be determined. In many instances, PRP is prepared using commercial devices that lack standardized preparation techniques and consistent quality of the PRP produced. OBJECTIVE: The aim of this study is to explore a simple, easy, economical method of PRP preparation that is practical for clinical use. MATERIALS AND METHODS: This cross-sectional study was conducted at the Sports Medicine Clinic at the University of Malaya Medical Centre, Malaysia. Participants were healthy postgraduate students and staff at the Sports Medicine Department. The PRP was prepared using a single centrifugation technique. Leukocyte and platelet levels were compared with that of a whole blood baseline and a commercial preparation kit. RESULTS: The PRP produced using this technique contained significantly higher mean platelet (1725.0 vs. 273.9 x 109/L) and leukocyte (33.6 vs. 7.7 x 109/L) levels compared with whole blood. There was no significant difference in the mean platelet and leukocyte levels between the PRP produced in this study and by a commercial PRP system. CONCLUSIONS: A single-centrifugation protocol using readily available materials in a typical clinical setting could produce PRP of comparable quality to those of a commercial PRP production system