Volume of physical activity and injury occurrence in young basketball players

Participation in organised, competitive physical activity by young athletes is increasing rapidly. This is concurrent with an increase in sporting injuries in the young population. This pilot study aimed to compare the weekly volume and types of physical activity in young basketball players injured and not injured during the season. Detailed physical activity and injury data were prospectively collected in 46 school-level basketball players aged 14 to 18 years. Participants completed physical activity logs which documented the type of physical activity undertaken, what the activity consisted of (i.e. training, competition) and the level at which it was played on a daily basis. Allied health staff completed a weekly injury form. Results showed that injured and uninjured athletes participated in a similar volume of total weekly physical activity over the season. However, injured athletes (p = 0.04) and athletes who specifically sustained overuse injuries (p = 0.01) participated in a greater amount of basketball refereeing than uninjured athletes. Based on these findings it was concluded that greater participation in running-type physical activity such as refereeing, as an addition to training and competition, may predispose the young basketball player to increased injury risk. Future research using larger sample sizes are required to further investigate the role of participation volume and type on injury occurrence in adolescent athletes.<br /

The effects of a protein enriched diet with lean red meat combined with a multi-modal exercise program on muscle and cognitive health and function in older adults: study protocol for a randomised controlled trial

BACKGROUND: Age-related muscle wasting has been strongly implicated with falls and fractures in the elderly, but it has also been associated with cognitive decline and dementia. Progressive resistance training (PRT) and adequate dietary protein are recognised as important contributors to the maintenance of muscle health and function in older adults. However, both factors also have the potential to improve brain function and prevent cognitive decline via several pathways, including the regulation of various growth and neurotrophic factors [insulin-like growth factor-1 (IGF-1)]; brain-derived growth factor (BDNF)] and/or the modulation of systemic inflammation. The primary aim of this study is to investigate whether a modest increase in dietary protein achieved through the consumption of lean red meat three days per week, when combined with PRT, can enhance muscle mass, size and strength and cognitive function in community-dwelling older people. METHODS/DESIGN: The study design is a 48-week randomised controlled trial consisting of a 24-week intervention with a 24-week follow-up. Men and women (n=152) aged 65 years and over residing in the community will be randomly allocated to: 1) PRT and provided with 220 g (raw weight) of lean red meat to be cooked and divided into two 80 g servings on each of the three days that they complete their exercise session, or 2) control PRT in which participants will be provided with and advised to consume &ge;1 serving (~1/2 cup) of rice and/or pasta or 1 medium potato on each of the three training days. The primary outcome measures will be muscle mass, size and strength and cognitive function. Secondary outcomes will include changes in: muscle function, neural health (corticospinal excitability and inhibition and voluntary activation), serum IGF-1 and BDNF, adipokines and inflammatory markers, fat mass and inter-/intra-muscular fat, blood pressure, lipids and health-related quality of life. All outcome measures will be assessed at baseline and 24 weeks, with the exception of cognitive function and the various neurobiological and inflammatory markers which will also be assessed at week 12. DISCUSSION: The findings from this study will provide important new information on whether a modest increase in dietary protein achieved through the ingestion of lean red meat can enhance the effects of PRT on muscle mass, size and strength as well as cognitive function in community-dwelling older adults. If successful, the findings will form the basis for more precise exercise and nutrition guidelines for the management and prevention of age-related changes in muscle and neural health and cognitive function in the elderly. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry: ACTRN12613001153707 . Date registered 16(th) October, 2013

Implementation, mechanisms of impact and key contextual factors involved in outcomes of the Modification of Diet, Exercise and Lifestyle (MODEL) randomised controlled trial in Australian adults: Protocol for a mixed-method process evaluation

Introduction The Modification of Diet, Exercise and Lifestyle (MODEL) study aims to examine the impact of providing visualisation and pictorial representation of advanced structural vascular disease (abdominal aortic calcification), on ‘healthful’ improvements to diet and lifestyle. This paper reports the protocol for the process evaluation for the MODEL study. Methods and analysis The overall aim of the process evaluation is to understand the processes that took place during participation in the MODEL study trial and which elements were effective or ineffective for influencing ‘healthful’ behavioural change, and possible ways of improvement to inform wider implementation strategies. A mixed-method approach will be employed with the use of structured questionnaires and semistructured in-depth interviews. All 200 participants enrolled in the trial will undertake the quantitative component of the study and maximum variation sampling will be used to select a subsample for the qualitative component. The sample size for the qualitative component will be determined based on analytical saturation. Interviews will be digitally recorded and transcribed verbatim. Qualitative data will be analysed thematically and reported according to the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. Ethics and dissemination The MODEL study process evaluation has received approval from Edith Cowan University Human Research Ethics Committee (Project Number: 20513 HODGSON). Written informed consent will be obtained from all participants before they are included in the study. The study results will be shared with the individuals and institutions associated with this study as well as academic audiences through peer-reviewed publication and probable presentation at conferences

Modification of diet, exercise and lifestyle (MODEL) study: a randomised controlled trial protocol

Introduction: Most cardiovascular disease (CVD)-related events could be prevented or substantially delayed with improved diet and lifestyle. Providing information on structural vascular disease may improve CVD risk factor management, but its impact on lifestyle change remains unclear. This study aims to determine whether providing visualisation and pictorial representation of structural vascular disease (abdominal aortic calcification (AAC)) can result in healthful diet and lifestyle change. Methods and analysis: This study, including men and women aged 60–80 years, is a 12-week, two-arm, multisite randomised controlled trial. At baseline, all participants will have AAC assessed from a lateral spine image captured using a bone densitometer. Participants will then be randomised to receive their AAC results at baseline (intervention group) or a usual care control group that will receive their results at 12 weeks. All participants will receive information about routinely assessed CVD risk factors and standardised (video) diet and lifestyle advice with three simple goals: (1) increase fruit and vegetable (FV) intake by at least one serve per day, (2) improve other aspects of the diet and (3) reduce sitting time and increase physical activity. Clinical assessments will be performed at baseline and 12 weeks. Outcomes: The primary outcome is a change in serum carotenoid concentrations as an objective measure of FV intake. The study design, procedures and treatment of data will adhere to Standard Protocol Items for Randomized Trials guidelines. Ethics and dissemination: Ethics approval for this study has been granted by the Edith Cowan University and the Deakin University Human Research Ethics Committees (Project Numbers: 20513 HODGSON and 2019-220, respectively). Results of this study will be published in peer-reviewed academic journals and presented in scientific meetings and conferences. Information regarding consent, confidentiality, access to data, ancillary and post-trial care and dissemination policy has been disclosed in the participant information form

Osteo-cise: Strong Bones for Life: protocol for a community-based randomised controlled trial of a multi-modal exercise and osteoporosis education program for older adults at risk of falls and fractures

Background : Osteoporosis affects over 220 million people worldwide, and currently there is no \u27cure\u27 for the disease. Thus, there is a need to develop evidence-based, safe and acceptable prevention strategies at the population level that target multiple risk factors for fragility fractures to reduce the health and economic burden of the condition. Methods : The \u27Osteo-cise: Strong Bones for Life\u27 study will investigate the effectiveness and feasibility of a multi-component targeted exercise, osteoporosis education/awareness and behavioural change program for improving bone health and muscle function, and reducing falls risk in community-dwelling older adults at an increased risk of fracture. Men and women aged 60 years or above will participate in an 18-month randomised controlled trial comprising a 12-month structured and supervised community-based program and a 6-month \u27research to practise\u27 translational phase. Participants will be randomly assigned to either the \u27Osteo-cise\u27 intervention or a self-management control group. The intervention will comprise a multi-modal exercise program incorporating high velocity progressive resistance training, moderate impact weight-bearing exercise and high challenging balance exercises performed three times weekly at local community-based fitness centres. A behavioural change program will be used to enhance exercise adoption and adherence to the program. Community-based osteoporosis education seminars will be conducted to improve participant knowledge and understanding of the risk factors and preventative measures for osteoporosis, falls and fractures. The primary outcomes measures, to be collected at baseline, 6, 12, and 18 months, will include DXA-derived hip and spine bone mineral density measurements and functional muscle power (timed stair-climb test). Secondary outcomes measures include: MRI-assessed distal femur and proximal tibia trabecular bone micro-architecture, lower limb and back maximal muscle strength, balance and function (four square step test, functional reach test, timed up-and-go test and 30-second sit-to-stand), falls incidence and health-related quality of life. Cost-effectiveness will also be assessed. Discussion : The findings from the Osteo-cise: Strong Bones for Life study will provide new information on the efficacy of a targeted multi-modal community-based exercise program incorporating high velocity resistance training, together with an osteoporosis education and behavioural change program for improving multiple risk factors for falls and fracture in older adults at risk of fragility fracture.<br /

Osteo-cise: Strong Bones for Life: a multi-component, community-based exercise, falls prevention and osteoporosis education program, an 18-month RCT

© 2012 Dr. Jenny GianoudisMulti-component exercise programs incorporating high-intensity progressive resistance training (PRT), moderate-to-high impact weight-bearing activities and high-challenge balance training are recommended for optimising the bone and falls-related risk factors for fracture. However, few studies have evaluated their combined effectiveness in a ‘real world’ community setting. Furthermore recent evidence suggests that high velocity (power) training may be more effective for improving physical function and bone health than traditional slow-speed PRT, and thus should be the key focus of fracture prevention programs. Within this thesis, three studies were conducted. The first cross-sectional study investigated the relationship between lifetime loading activity and trabecular bone microarchitecture and condylar size at the proximal tibia assessed by 3-Tesla Magnetic Resonance Imaging. Increasing age was significantly associated with a deterioration in trabecular microarchitecture, but no association between loading activity and any bone parameter was observed at this site. Studies 2 and 3 are described below. Study 2: Osteo-cise: Strong Bones for Life: A 12-month multi-faceted community-based exercise, osteoporosis education and behavioural change program on bone mineral density and risk factors for falls Aims: To investigate the effects of a multi-component exercise and osteoporosis education program on bone density (aBMD), body composition, functional power and performance, and falls in older adults at risk of falls and fracture. Methods: 162 men and women aged 66.9 ± 6.0 (mean ± standard deviation) years were randomised to the: 1) Osteo-cise program (n=81) or 2) control group (n=81). Exercise comprised high velocity PRT, weight-bearing (60-180 impacts/session) and balance training 3 days per week for 12 months. Dual energy X-ray absorptiometry (DXA) was used to assess total body, arm and leg lean and fat mass and aBMD at the hip and spine at baseline and 12 months. Leg and back 1-RM muscle strength and functional power (Timed Stair Climb) and performance (Four Square Step test [FSST], Functional Reach, Timed Up and Go, 30 Second Sit to Stand [30-STS]) were assessed at baseline, 6 and 12 months. Results: 93% of participants completed the study and groups were matched at baseline. Exercise attendance averaged 59%. Exercise resulted in a significant 1-1.1% net gain in femoral neck and lumbar spine aBMD vs. controls. There were significant exercise-induced net gains in back (13% [95% CI 6, 20]) and leg (10% [3, 16]) muscle strength, stair climbing power (5% [95% CI 1, 9]), 30-STS performance (16% [9, 22]) and dynamic balance (FSST) (-6% [-10, -1]), but no differences between groups in weight, total body or regional (arm and leg) lean mass or fat mass or falls. Conclusion: This multi-component intervention program was effective for improving aBMD, functional muscle power and performance in older adults at risk of fracture. Study 3: Osteo-cise: Strong Bones for Life. An 18-month multi-faceted community-based exercise, osteoporosis education and behavioural change program on musculoskeletal health and risk factors for falls: Translating research into practise Aims and Methods: As per Study 2. The final 6 months of the program was a ‘translation’ phase, whereby the program continued to be carried out by the health and fitness centres with minimal input from research staff to assess the feasibility of the program in the ‘real-world’. Results: Exercise compliance average 45% during the last 6 months and 55% over 18 months. From 12 to 18 months, the Osteo-cise group maintained aBMD at the lumbar spine and femoral neck aBMD, while the control group significantly lost aBMD at the femoral neck (1.3% over 18 months). The Osteo-cise group also maintained their net gain in muscle strength, arm lean mass, functional muscle power and performance while no significant differences in falls rates were observed. Conclusion: Exercise-induced gains in aBMD, functional muscle power and performance were maintained at 18 months providing support for the viability of this program in the ‘real world’ community setting

Effects of a multinutrient-fortified milk drink combined with exercise on functional performance, muscle strength, body composition, inflammation, and oxidative stress in middle-aged women: a 4-month, double-blind, placebo-controlled, randomized trial

Background Multinutrient protein-enriched supplements are promoted to augment the effects of exercise on muscle mass and strength, but their effectiveness in middle-aged women, or whether there are any additional benefits to physical function, remains uncertain. Objectives We aimed to evaluate whether a multinutrient-fortified milk drink (MFMD) could enhance the effects of exercise on functional muscle power (stair climbing) in middle-aged women. Secondary aims were to evaluate the intervention effects on physical function, muscle strength, lean mass (LM), fat mass (FM), bone mineral content (BMC), muscle cross-sectional area (CSA), muscle density, balance, flexibility, aerobic fitness, inflammation, oxidative stress, bone and cartilage turnover, blood pressure, and blood lipids. Methods In this 4-mo, double-blind, placebo-controlled, randomized trial, 244 women (45&ndash;65 y) participated in a multimodal resistance-type exercise program 3 d/wk, with random allocation to a twice-daily MFMD containing added protein, vitamin D, calcium, milk fat globule membrane (phospholipids and other bioactives), and other micronutrients (Ex&nbsp;+&nbsp;MFMD, n&nbsp;=&nbsp;123) or an energy-matched placebo (Ex&nbsp;+&nbsp;placebo, n&nbsp;=&nbsp;121). Results A total of 216 women (89%) completed the study. After 4 mo, both groups experienced similar 3.6%&ndash;4.3% improvements in the primary outcomes of fast-pace 5- and 10-step stair ascent power. In contrast, Ex&nbsp;+&nbsp;MFMD experienced greater improvements in 5-step regular-pace stair descent time [net difference (95% CI): &minus;0.09 s (&minus;0.18, 0.00 s), P&nbsp;=&nbsp;0.045], countermovement jump height [0.5 cm (0.04, 1.0 cm), P&nbsp;=&nbsp;0.038], total body LM [0.3 kg (0.04, 0.60 kg), P&nbsp;=&nbsp;0.020], FM [&minus;0.6 kg (&minus;1.0, &minus;0.2 kg), P&nbsp;=&nbsp;0.004], BMC [0.4% (0.1%, 0.6%), P&nbsp;=&nbsp;0.020], muscle CSA [thigh: 1.8% (0.6%, 2.9%), P&nbsp;=&nbsp;0.003; lower leg: 0.9% (0.3%, 1.6%), P&nbsp;=&nbsp;0.005], balance eyes closed [3.3 s (1.1, 5.4 s), P&nbsp;=&nbsp;0.005], 2-min step performance [8 steps (3, 12 steps), P&nbsp;=&nbsp;0.003], and sit-and-reach flexibility [1.4 cm (0.6, 2.2 cm), P&nbsp;=&nbsp;0.026]. MFMD did not enhance the effects of exercise on any measures of muscle strength, gait speed, dynamic balance, reaction time, or blood lipids, and there was no effect of either intervention on blood pressure, markers of inflammation, or cartilage turnover. Ex&nbsp;+&nbsp;placebo had a greater improvement in the oxidative stress marker protein carbonyls (P&nbsp;&lt;&nbsp;0.01).Conclusions In middle-aged women, daily consumption of an MFMD did not enhance the effects of a multimodal exercise program on the primary outcome of stair climbing ascent power, but did elicit greater improvements in multiple secondary outcomes including various other measures of functional performance, LM, muscle size, FM, balance, aerobic capacity, flexibility, and bone metabolism.This trial was registered at www.anzctr.org.au as ACTRN12617000383369