A MULTI-STATION PROPRIOCEPTIVE EXERCISE PROGRAM IN PATIENTS WITH BILATERAL KNEE OSTEOARTHROSIS: FUNCTIONAL CAPACITY, PAIN AND SENSORIOMOTOR FUNCTION. A RANDOMIZED CONTROLLED TRIAL

We investigated the effects of a multi-station proprioceptive exercise program on functional capacity, perceived knee pain, and sensoriomotor function. Twenty-two patients (aged 41-75 years) with grade 2-3 bilateral knee osteoarthrosis were randomly assigned to two groups: treatment (TR; n = 12) and non-treatment (NONTR; n = 10). TR performed 11 different balance/coordination and proprioception exercises, twice a week for 6 weeks. Functional capacity and perceived knee pain during rest and physical activity was measured. Also knee position sense, kinaesthesia, postural control, isometric and isokinetic knee strength (at 60, 120 and 180°·s-1) measures were taken at baseline and after 6 weeks of training. There was no significant difference in any of the tested variables between TR and NONTR before the intervention period. In TR perceived knee pain during daily activities and functional tests was lessened following the exercise program (p < 0.05). Perceived knee pain was also lower in TR vs. NONTR after training (p < 0.05). The time for rising from a chair, stair climbing and descending improved in TR (p < 0.05) and these values were faster compared with NONTR after training (p < 0.05). Joint position sense (degrees) for active and passive tests and for weight bearing tests improved in TR (p < 0.05) and the values were lower compared with NONTR after training (p < 0.05). Postural control ('eyes closed') also improved for single leg and tandem tests in TR (p < 0.01) and these values were higher compared with NONTR after training. The isometric quadriceps strength of TR improved (p < 0.05) but the values were not significantly different compared with NONTR after training. There was no change in isokinetic strength for TR and NONTR after the training period. The results suggest that using a multi-station proprioceptive exercise program it is possible to improve postural control, functional capacity and decrease perceived knee pain in patients with bilateral knee osteoarthrosi

EFFECT OF TIME OF DAY ON THE RELATIONSHIP BETWEEN LACTATE AND VENTILATORY THRESHOLDS: A BRIEF REPORT

The purpose of this investigation was to study the effect of time of day on the relationship between lactate (LT) and ventilatory thresholds (VT) of pulmonary oxygen uptake (VO2). Seven moderately active male volunteers (26.3±3.0 years, 1.74±0.08 m, 76±5 kg) performed a maximal incremental test (increases of 30 W every 2 min) on a cycle ergometer on consecutive days at 0900 h, 1400h and 1900 h in a randomized fashion. The anaerobic threshold was determined using both ventilatory gas analysis and blood lactate measures. Each of the following variables was recorded both at VT and the LT; heart rate (HR, beats.min-1), minute ventilation (VE, L.min-1), respiratory exchange ratio (RER), time to threshold (Time, sec), oxygen uptake (VO2, ml.kg-1.min-1) and VO2 as a percentage of maximal oxygen uptake (%VO2max). The correlations between VT and LT variables analyzed by Pearson product moment correlations for each time of day. ANOVA was used to compare the data obtained at different times of the day. There were no significant differences for the data related to time of day either for ventilatory gas analysis or lactate measurements. The correlation coefficients between VT and LT variables were moderate to high (r=0.56-0.94) for time of day. However, the correlations for HR, VO2, and %VO2max (r=0.81-0.94) were slightly stronger compared with Time, VE and RER (r=0.56-0.88). It was concluded that, the data at VT and LT were not influenced by time of da

Effect of Upper-Extremity Strengthening Exercises on the Lumbar Strength, Disability and Pain of Patients with Chronic Low Back Pain: A Randomized Controlled Study

The present study aimed to analyze the impacts of a low back rehabilitation program accompanied with neck, shoulder and upper back exercises on pain, disability, and physical characteristics of patients with chronic low back pain. Twenty sedentary male patients with chronic low back pain participated in the study on a voluntary basis. The patients were randomly allocated into two groups: a conventional low back exercise group (CE) and a supported exercise group (SE; CE plus upper back, neck, and shoulder exercises). The Modified Oswestry Disability Questionnaire (MODQ) was used to evaluate the disability status and the Visual Analog Scale (VAS) was used to identify the pain states of the patients. In addition, neck, lumbar and shoulder isokinetic and isometric strengths of the patients were evaluated. The CE group performed lumbar stretching, mobilization and stabilization exercises in addition to low-back and abdominal isometric and concentric strengthening exercises. The SE group performed static stretching and isotonic exercises for the neck, upper-back, and shoulder muscles, in addition to the exercises performed in CE group. The exercises were implemented 3 days a week for 6 weeks in both groups. Following the 6-week exercise periods in both groups, statistically significant (p < 0.01) improvements were observed in the patients’ levels of pain and the scores of MODQ reflecting an easing of disability. With respect to the levels of pain and disability, the improvements observed in the SE group was significantly (p < 0.01) greater than the improvement observed in the CE group. Based on the findings of this study, we can conclude that a low back exercise program used in combination with neck, shoulder and upper back exercises reduces the level of pain and disability in patients with chronic low back pain more prominently than conventional low back exercises

Effects of Static and Dynamic Stretching on the Isokinetic Peak Torques and Electromyographic Activities of the Antagonist Muscles

The aim of this study was to investigate if static and dynamic stretching exercises of the knee muscles (quadriceps and hamstring muscles) have any effects on concentric and eccentric isokinetic peak torques and electromyographic amplitudes (EMG) of the antagonist muscles. Twenty healthy male athletes (age between 18-30 years) voluntarily participated in this study. All of the subjects visited the laboratory to complete the following intervention in a randomized order on 5 separate days; (a) non-stretching (control), (b) static stretching of the quadriceps muscles, (c) static stretching of the hamstring muscles, (d) dynamic stretching of the quadriceps muscles, and (e) dynamic stretching of the hamstring muscles. Static stretching exercises either for the quadriceps or the hamstring muscles were carried out at the standing and sitting positions. Subjects performed four successive repetitions of each stretching exercises for 30 seconds in both stretching positions. Similar to static stretching exercises two different stretching modes were designed for dynamic stretching exercises. Concentric and eccentric isokinetic peak torque for the non-stretched antagonist quadriceps or hamstring muscles at angular velocities of 60°/sec and 240°/sec and their concurrent electromyographic (EMG) activities were measured before and immediately after the intervention. Isokinetic peak torques of the non-stretched agonist hamstring and quadriceps muscles did not represent any significant (p > 0.05) differences following static and dynamic stretching of the antagonist quadriceps and hamstring muscles, respectively. Similarly, the EMG activities of the agonist muscles exhibited no significant alterations (p > 0.05) following both stretching exercises of the antagonist muscles. According to the results of the present study it is possible to state that antagonist stretching exercises either in the static or dynamic modes do not affect the isokinetic peak torques and the EMG activities of the non-stretched agonist quadriceps or hamstring muscles

MYOCARDIAL PERFORMANCE AND AORTIC ELASTIC PROPERTIES IN ELITE BASKETBALL AND SOCCER PLAYERS: RELATIONSHIP WITH AEROBIC AND ANAEROBIC CAPACITY

The aims of the present study were to examine the myocardial performance index and aortic elastic properties of athletes engaged in ball sports and to determine their relationships with aerobic and anaerobic characteristics. Standard M-mode and Doppler echocardiography, maximal oxygen uptake and 30 sec Wingate tests were performed for 32 elite male athletes (12 basketball and 20 soccer players) and 12 healthy sedentary volunteers. Data were analyzed by ANOVA and partial correlation coefficient tests. Absolute values of left ventricular internal diameter, left ventricular posterior wall and interventricular septum thicknesses in diastole were significantly (p < 0.05-0.01) greater in athletes than in controls. The left ventricular internal diameter corrected by body surface area was also greater (p < 0.05-0.01) in the athletes compared with the controls. Absolute and body surface area corrected left ventricular mass were significantly greater (p < 0.05-0.001) in athletes than in controls. Isovolumetric relaxation time was higher (p < 0.01) in soccer players than in controls. There were no significant differences among the groups for myocardial performance index and aortic elastic properties. Left ventricular mass index was poorly correlated (p < 0.01) with VO2max (r = 0.410), peak power (r = 0.439) and average power (r = 0.464) in the athletes. Poor correlations (r = 0.333-0.350, p < 0.05) were also observed between aortic elastic properties and average power in athletes. Myocardial performance index and aortic elastic properties are not different in athletes involved in this study compared with sedentary subjects. Aerobic and anaerobic capacities of the athletes used in this study are poorly explained by these resting echocardiographic finding

PEAK AND END RANGE ECCENTRIC EVERTOR/CONCENTRIC INVERTOR MUSCLE STRENGTH RATIOS IN CHRONICALLY UNSTABLE ANKLES: COMPARISON WITH HEALTHY INDIVIDUALS

The aim of this study was to evaluate the alterations in eccentric evertor/concentric invertor strength ratio and their importance in the chronically unstable ankle. Eight patients with chronic ankle instability (CAI) and nine healthy individuals participated in this study. Isokinetic concentric and eccentric invertor and evertor muscle strength measurement was carried out at an angular velocity of 120°·sec-1 by measuring maximal force moments (torque) during isokinetic ankle inversion and eversion movements. Functionally, evertor/invertor muscle strength ratios (E/I strength ratio) were calculated separately based on peak moment and angle-specific moments obtained at 0°, 5°, 10°, 15°, 20° ankle joint angles. Peak and angle-specific eccentric evertor strength values at 0°, 5°, 10°, 15°, 20° were significantly lower in the chronic ankle instability (CAI) group. In spite of this, no differences were obtained for peak and angle-specific concentric invertor torque values. Eccentric evertor/concentric invertor strength (Eecc/Icon) ratios were also significantly lower in the CAI group, but only at 15° and 20°. Eccentric evertor muscle torque and end range (15°-20°) Eecc/Icon strength ratio for the chronically unstable ankle were significantly different from those for the healthy ankle. For this reason, measurements of end range eccentric/concentric strength ratios are more valuable in monitoring chronic ankle injuries and rehabilitation should include not only concentric muscle strengthening but also eccentric muscle strengthening, particularly for the evertor muscle

The Association Between Snoring, Daytime Sleepiness And Obesity In Professional Wrestlers

Aim: To investigate the prevalence of snoring, excessive daytime sleepiness and other sleep symptoms in a group of professional wrestlers and to identify the risk factors of snoring in these subjects. Methods: A questionnaire was administered to 55 professional wrestlers and 44 age matched men. All subjects answered nine questions about their sleep and snoring habits and self-graded on a scale of 0 to 4. The questions were also related to demographic characteristics, Epworth sleepiness scale (ESS) and general medical history. Results: There were no significant differences in age, smoking and alcohol intake between wrestlers and control subjects. Obesity (p=0.004) was significantly more common and neck circumference (p=0.004) significantly higher in wrestlers than in control subjects. Bed time were significantly early (p=0.006), wake time significantly late (p=0.014), total sleep time significantly higher (p<0.001) in wrestlers when compared to control subjects. Habitual snoring rated was reported by 9.1% of wrestlers and by 6.8% of control subjects (p>0.05). The prevalence of excessive daytime sleepiness, witnessed apnea, morning headache, restless leg, insomnia, sleep talking, sleep walking and mean ESS were not significantly different in wrestlers when compared to control subjects. Conclusion: There were no significant differences with respect to habitual snoring, daytime sleepiness and ESS between wrestlers and control subjects. However, obesity and large neck circumference were much more common among wrestlers