Minimal clinically important difference and minimal detectable change of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) amongst patients with chronic musculoskeletal pain

Objectives: The aim of this study is to estimate a minimal clinically important difference (MCID) and a minimal detectable change (MDC) of the 12-item WHODAS 2.0 amongst patients with chronic musculoskeletal pain. Design: Cross-sectional cohort study. Setting: Outpatient Physical and Rehabilitation Medicine clinic. Subjects: A total of 1988 consecutive patients with musculoskeletal pain. Interventions: A distribution-based approach was employed to estimate a minimal clinically important difference, a minimal detectable change, and a minimal detectable percent change (MDC%). Results: The mean age of the patients was 48 years, and 65% were women. The average intensity of pain was 6,3 (2.0) po…

Effects of a Rehabilitation Program on Perceived Environmental Barriers in Older Patients Recovering from Hip Fracture: A Randomized Controlled Trial

Objectives. To study effects of a one-year multicomponent intervention on perceived environmental barriers in hip fracture patients.Design. Randomized controlled trial of a 12-month home-based rehabilitation aiming to improve mobility and function (ISRCTN53680197); secondary analyses.Subjects. Community-dwelling hip fracture patients on average 70 days after trauma (n=81).Methods. Assessments at baseline, 3, 6, and 12 months later included perceived entrance-related barriers (e.g., indoor/outdoor stairs, lighting, floor surfaces, and storage for mobility devices) and perceived barriers in the outdoor environment (poor street condition, hilly terrain, long-distances, and lack of resting plac…

Long-term leisure time physical activity and properties of bone: A twin study

Effects of physical activity on bone properties, when controlled for genetic effects, are not fully understood. We aimed to study the association between long-term leisure time physical activity (LTPA) and bone properties using twin pairs known to be discordant for leisure time physical activity for at least 30 yr. Volumetric BMD and geometric properties were measured at the tibia shaft and distal end using pQCT in 16 middle-aged (50-74 yr) same-sex twin pairs (seven monozygotic [MZ] and nine dizygotic [DZ] pairs) selected from a population-based cohort. Paired differences between active and inactive co-twins were studied. Active members of MZ twin pairs had larger cortical bone cross-secti…

Association between tibial subchondral bone structure from plain radiographs and cartilage composition from quantitative MRI in postmenopausal women with mild osteoarthritis

Differential Effects of Exercise on Tibial Shaft Marrow Density in Young Female Athletes

Increased mechanical loading can promote the preferential differentiation of bone marrow mesenchymal stem cells to osteoblastogenesis, but it is not known whether long-term bone strength-enhancing exercise in humans can reduce marrow adiposity.Our objective was to examine whether bone marrow density (MaD), as an estimate of marrow adiposity 1) differs between young female athletes with contrasting loading histories and bone strengths and 2) is an independent predictor of bone strength at the weight-bearing tibia.Mid-tibial MaD, cortical area (CoA), total area, medullary area, strength strain index (SSI), and cortical volumetric bone mineral density (vBMD) (total, endocortical, midcortical, …

Muscle cross-sectional area and structural bone strength share genetic and environmental effects in older women

The purpose of this study was to estimate to what extent muscle cross-sectional area of the lower leg (mCSA) and tibial structural strength are influenced by common and trait-specific genetic and environmental factors. pQCT scans were obtained from both members of 102 monozygotic (MZ) and 113 dizygotic (DZ) 63- to 76-yr-old female twin pairs to estimate the mCSA of the lower leg, structural bending strength of the tibial shaft (BSIbend), and compressive strength of the distal tibia (BSIcomp). Quantitative genetic models were used to decompose the phenotypic variances into common and trait-specific additive genetic (A), shared environmental (C), and individual environmental (E) effects. The …

Regular Strength and Sprint Training Counteracts Bone Aging: a 10- year Follow-up in Male Masters Athletes

According to cross-sectional and interventional studies, high-intensity strength and impact-type training provide a powerful osteogenic stimulus even in old age. Longitudinal evidence on the ability of high-intensity training to attenuate age-related bone deterioration is currently lacking, however. This follow-up study assessed the role of continued strength and sprint training on bone aging in 40- to 85-year-old male sprinters (n=69) with long-term training background. pQCT-derived bone structural, strength and densitometric parameters of the distal tibia (5% distal-proximal tibia length) and tibial midshaft (50% length) were assessed at baseline and after 10 years. The groups of well-tra…

Absence of an aging-related increase in fiber type grouping in athletes and non-athletes

The ageing-related loss of muscle mass is thought to be partly attributable to motor neuron loss and motor unit remodelling that result in fibre type grouping. We examined fibre type grouping in 19- to 85-year-old athletes and non-athletes and evaluated to which extent any observed grouping is explained by the fibre type composition of the muscle. Since regular physical activity may stimulate reinnervation, we hypothesised that fibre groups are larger in master athletes than in age-matched non-athletes. Fibre type grouping was assessed in m. vastus lateralis biopsies from 22 young (19-27 years) and 35 healthy older (66-82 years) non-athletes, and 14 young (20-29 years), 51 middle-aged (38%6…

Transmission of Vertical Whole Body Vibration to the Human Body

According to experimental studies, low-amplitude high-frequency vibration is anabolic to bone tissue, whereas in clinical trials, the bone effects have varied. Given the potential of whole body vibration in bone training, this study aimed at exploring the transmission of vertical sinusoidal vibration to the human body over a wide range of applicable amplitudes (from 0.05 to 3 mm) and frequencies (from 10 to 90 Hz). Vibration-induced accelerations were assessed with skin-mounted triaxial accelerometers at the ankle, knee, hip, and lumbar spine in four males standing on a high-performance vibration platform. Peak vertical accelerations of the platform covered a range from 0.04 to 19 in units …

Serum TRACP 5b Is a Useful Marker for Monitoring Alendronate Treatment: Comparison With Other Markers of Bone Turnover

We studied clinical performance of serum TRACP 5b and other bone turnover markers, including S-CTX, U-DPD, S-PINP, S-BALP, and S-OC, for monitoring alendronate treatment. TRACP 5b had higher clinical sensitivity, area under the ROC curve, and signal-to-noise ratio than the other markers. INTRODUCTION: The purpose of this study was to compare the clinical performance of serum TRACP 5b (S-TRACP5b) with that of other markers of bone turnover in the monitoring of alendronate treatment. MATERIALS AND METHODS: This double-blinded study included 148 healthy postmenopausal women that were randomly assigned into two groups: one receiving 5 mg alendronate daily (n=75) and the other receiving placebo …

Maintenance of aquatic training-induced benefits on mobility and lower-extremity muscles among persons with unilateral knee replacement.

Abstract Valtonen A, Poyhonen T, Sipila S, Heinonen A. Maintenance of aquatic training-induced benefits on mobility and lower-extremity muscles among persons with unilateral knee replacement. Objective To evaluate the maintenance of observed aquatic training-induced benefits at 12-month follow-up. Design Twelve-month follow-up of a randomized controlled study. Setting Research laboratory and hospital rehabilitation pool. Participants Population-based sample of 55 to 75-year-old women and men 4 to 18 months (on average 10mo) after unilateral knee replacement. Fifty people were willing to participate in the exercise trial and 42 people in the follow-up study. Intervention Twelve-month follow-…

Health-related quality of life and physical activity in persons at high risk for type 2 diabetes

The aim of this study was to compare the health-related quality of life (HRQOL) of persons at risk for type 2 diabetes to that of the Finnish general population. In addition, the associations between physical activity and HRQOL at-risk persons were studied.One hundred thirty-two at-risk persons were recruited from health care centres in Central Finland. Participants filled out questionnaires including demographic characteristics, HRQOL (SF-36), frequency of vigorous physical activity (or =2 times a week, once a week, less than once a week) and comorbidities.HRQOL of at-risk persons differed significantly from that of the Finnish population in four of the eight dimensions of SF-36. Compared …

Neuromuscular performance and body mass as indices of bone loading in premenopausal and postmenopausal women.

The strong association between body mass and skeletal robusticity has been attributed to increasing skeletal loading with increasing mass. However, it is unclear whether body mass is merely a coarse substitute for bone loading rather than a true independent predictor of bone strength. As indices of neuromuscular performance, impulse and peak power were determined from vertical ground reaction force during a maximal counter movement jump test in 221 premenopausal and 82 postmenopausal women. Bone compressive (BSI(d) g(2)/cm(4)) and bending (SSImax(mid) mm(3)) strength indices were measured with peripheral quantitative computed tomography (pQCT) at the distal ((d)) and midshaft ((mid)) sites …

Reproducibility of imaging human knee cartilage by delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) at 1.5 Tesla

Summary Objective The purpose of this study was to investigate the day-to-day reproducibility of the delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) measurement at different knee joint surfaces in healthy subjects at 1.5 Tesla (T). Methods The dGEMRIC experiment was repeated for 10 asymptomatic volunteers three times with an average interval of 5 days between scans. The measurement was performed from a single sagittal slice through the center of the lateral femoral condyle and from the center of the patella in the axial plane. Cartilage was manually segmented into superficial, deep and full-thickness regions of interests (ROIs) at different topographical locations of the femur, tibia…

Etäteknologian vaikuttavuus liikunnallisessa kuntoutuksessa : järjestelmällinen kirjallisuuskatsaus ja meta-analyysi

Acute injuries in Finnish junior floorball league players

Abstract Objectives To investigate the incidence and characteristics of acute time-loss injuries in Finnish junior floorball league players. Design Prospective cohort study with 3-year follow-up. Methods One hundred and eighty-six female and male players (mean age 16.6 ± 1.4) took part in the follow-up study (2011–2014). The training hours and games were recorded on a team diary. Floorball related acute injuries were registered and verified by a research physician. The injury incidence was expressed as the number of injuries per 1000 h of exposure. Incidence rate was calculated separately for games and practices, and for males and females. Results One hundred and forty-four acute time-loss …

Effectiveness of technology-based distance interventions promoting physical activity : Systematic review, meta-analysis and meta-regression

Objective: To determine the effectiveness of technology-based distance interventions for promoting physical activity, using systematic review and metaanalysis. Methods: A literature search of studies published between 2000 and 2015 was conducted in the following databases: CENTRAL, EMBASE, Ovid MEDLINE, CINAHL, PsycINFO, OTseeker, WOS and PEDro. Studies were selected according to the PICOS framework, as follows: P (population): adults; I (intervention): technology-based distance intervention for promoting physical activity; C (comparison) similar distance intervention without technology, O (outcomes) physical activity; S (study design) randomized controlled trial. Physical activity outcomes…

Physical activity and ability to meet different work requirements among adult working men with or without current depressive symptoms

Abstract Purpose To examine the relationship between leisure-time physical activity (LTPA) and ability to meet different work requirements among adult working men with or without current depressive symptoms. Methods We measured LTPA with the long version of the International Physical Activity Questionnaire (IPAQ). The Work Ability Index (WAI) and Beck Depression Inventory (BDI) were used to assess the work ability and depression of 921 Finnish employed male volunteers. Participants were divided into three groups according to the WAI for their work requirements: mental (MENT), physical (PHYS), and an equal amount of mental and physical work (BTH). Results When adjusted for age, BMI and emplo…

Gender-related differences in psychometric properties of WHO Disability Assessment Schedule 2.0

Objective of this study was to investigate the gender-related differential item function of 12-item WHODAS 2.0 amongst patients with chronic musculoskeletal pain. This was a cross-sectional survey study among 1,988 patients at a university Physical and Rehabilitation Medicine outpatient clinic. To assess DIF, WHODAS 2.0 items were dichotomized as `none’ rated by respondents as `0’ versus `any limitation’ rated as `1,2,3 or 4’. The item response theory analysis was used to define discrimination and difficulty parameters of a questionnaire. The probit logistic regression was used to test uniformity of DIF between gender groups. The results of DIF analysis were presented and evaluated graphica…

sj-docx-2-sph-10.1177_19417381211065443 ��� Supplemental material for Injury History and Perceived Knee Function as Risk Factors for Knee Injury in Youth Team-Sports Athletes

Supplemental material, sj-docx-2-sph-10.1177_19417381211065443 for Injury History and Perceived Knee Function as Risk Factors for Knee Injury in Youth Team-Sports Athletes by Jussi Hietamo, Anni Rantala, Jari Parkkari, Mari Lepp��nen, Marko Rossi, Ari Heinonen, Kathrin Steffen, Pekka Kannus, Ville Mattila and Kati Pasanen in Sports Health: A Multidisciplinary Approach

Walking and Running Require Greater Effort from the Ankle than the Knee Extensor Muscles.

The knee and ankle extensors as human primary antigravity muscle groups are of utmost importance in a wide range of locomotor activities. Yet, we know surprisingly little about how these muscle groups work, and specifically, how close to their maximal capacities they function across different modes and intensity of locomotion. Therefore, to advance our understanding of locomotor constraints, we determined and compared relative operating efforts of the knee and ankle extensors during walking, running, and sprinting.Using an inverse dynamics biomechanical analysis, the muscle forces of the knee and ankle extensors during walking (1.6 m·s), running (4.1 m·s), and sprinting (9.3 m·s) were quant…

Construct and predictive validity of a self-reported measure of preclinical mobility limitation.

Abstract Manty M, Heinonen A, Leinonen R, Tormakangas T, Sakari-Rantala R, Hirvensalo M, von Bonsdorff MB, Rantanen T. Construct and predictive validity of a self-reported measure of preclinical mobility limitation. Objectives To validate self-reported preclinical mobility limitation concept and self-report assessment method against muscle power and walking speed, and to study the predictive validity of preclinical mobility limitation with respect to future risk of manifest mobility limitation. Design Observational prospective cohort study and cross-sectional analysis. Setting Research laboratory and community. Participants A total of 632 community-living (age range, 75−81y) women and men t…

Response to the comments on “Effects of high intensity aquatic resistance training on body composition and walking speed in women with mild knee osteoarthritis: a 4-month RCT with 12-month follow-up”

This article has no abstract. nonPeerReviewed

Effects of a progressive aquatic resistance exercise program on the biochemical composition and morphology of cartilage in women with mild knee osteoarthritis: protocol for a randomised controlled trial

Background Symptoms associated with osteoarthritis of the knee result in decreased function, loss of working capacity and extensive social and medical costs. There is a need to investigate and develop effective interventions to minimise the impact of and even prevent the progression of osteoarthritis. Aquatic exercise has been shown to be effective at reducing the impact of osteoarthritis. The purpose of this article is to describe the rationale, design and intervention of a study investigating the effect of an aquatic resistance exercise intervention on cartilage in postmenopausal women with mild knee osteoarthritis. Methods A minimum of 80 volunteers who meet the inclusion criteria will b…

Greater maintenance of bone mineral content in male than female athletes and in sprinting and jumping than endurance athletes: a longitudinal study of bone strength in elite masters athletes

Abstract Summary We investigated longitudinal changes in tibia bone strength in master power (jumping and sprinting) and endurance (distance) athletes of both sexes. Bone mass but not cross-sectional moment of inertia was better maintained in power than endurance athletes over time, particularly in men and independent of changes in performance. Objective Assessment of effects of sex and athletic discipline (lower limb power events, e.g. sprint running and jumping versus endurance running events) on longitudinal changes in bone strength in masters athletes. Methods We examined tibia and fibula bone properties at distal (4% distal-proximal tibia length) and proximal (66% length) sites using p…

Muscle deficits persist after unilateral knee replacement and have implications for rehabilitation.

BackgroundKnee joint arthritis causes pain, decreased range of motion, and mobility limitation. Knee replacement reduces pain effectively. However, people with knee replacement have decreases in muscle strength (“force-generating capacity”) of the involved leg and difficulties with walking and other physical activities.Objective and DesignThe aim of this cross-sectional study was to determine the extent of deficits in knee extensor and flexor muscle torque and power (ability to perform work over time) and in the extensor muscle cross-sectional area (CSA) after knee joint replacement. In addition, the association of lower-leg muscle deficits with mobility limitations was investigated.Methods…

Effects of physiotherapy interventions on balance in multiple sclerosis: A systematic review and meta-analysis of randomized controlled trials

Objective: to determine the effects of physiotherapy inter ­ ventions on balance in people with multiple sclerosis. Data sources: A systematic literature search was conducted in Medline, cinahl, embase, PeDro, both electronically and by manual search up to March 2011. Study selection: Randomized controlled trials of physiothe­ rapy interventions in people with multiple sclerosis, with an outcome measure linked to the International Classifica­ tion of Functioning, Disability and Health (icF) category of “changing and maintaining body position”, were included. Data extraction: the quality of studies was determined by the van tulder criteria. Meta­analyses were performed in subgroups according…

ASSOCIATION BETWEEN LEISURE TIME PHYSICAL ACTIVITY LEVEL AND ARTICULAR CARTILAGE IN POSTMENOPAUSAL WOMEN WITH MILD KNEE OSTEOARTHRITIS: A 12-MONTH FOLLOW-UP STUDY AFTER 4-MONTH INTERVENTION

Effectiveness of technology-based distance physical rehabilitation interventions on physical activity and walking in multiple sclerosis: a systematic review and meta-analysis of randomized controlled trials

Objective: To determine the effectiveness of technology-based distance physical rehabilitation interventions in multiple sclerosis (MS) on physical activity and walking. Data sources: A systematic literature search was conducted in seven databases from January 2000 to September 2016. Randomized controlled trials of technology-based distance physical rehabilitation interventions on physical activity and walking outcome measures were included. Methods: Methodological quality of the studies was determined and a meta-analysis was performed. In addition, a subanalysis of technologies and an additional analysis comparing to no treatment were conducted. Results: The meta-analysis consisted of 11 s…

Comments on the article titled ‘Component mode synthesis approach to estimate tibial strains in gait’,Journal of Medical Engineering & Technology, 33, pp. 488–495, 2009

In a recent article published in the Journal of Medical Engineering & Technology, Gaofeng et al. [1] claimed that they were the first to propose the flexible multibody simulation approach (i.e. flo...

Effectiveness of constraint-induced movement therapy on activity and participation after stroke: a systematic review and meta-analysis of randomized controlled trials

Objective: To examine the effect of constraint-induced movement therapy and modified constraint-induced movement therapy on activity and participation of patients with stroke (i.e. the effect of different treatment durations and frequency) by reviewing the results of randomized controlled trials. Data sources: A systematic literature search was conducted in MEDLINE, CINAHL, EMBASE, PEDro, OTSeeker, CENTRAL and by manual search. Review methods: Randomized controlled trials for patients over 18 years old with stroke and published in Finnish, Swedish, English or German were included. Studies were collected up to the first week in May 2011. The evidence was high, moderate, low or no evidence a…

Incidence and risk factors for back pain in young floorball and basketball players : A prospective study

The aim of this study was to investigate the incidence of back pain in young basketball and floorball players under 21 years of age. The secondary aim was to examine risk factors especially for low back pain (LBP). Nine basketball and nine floorball teams (n = 396) participated in this prospective follow‐up study (2011‐2014). Young athletes (mean age 15.8 ± 1.9) performed physical tests and completed a questionnaire at baseline. The follow‐up lasted 1‐3 years per player. During the follow‐up, back pain reported by the players was registered on a weekly basis and verified by a study physician. The exposure time (AE) on team practices and games was recorded by the coach. Altogether back pain …

Flexible multibody simulation approach in the analysis of tibial strain during walking.

Strains within the bone tissue play a major role in bone (re)modeling. These small strains can be assessed using experimental strain gage measurements, which are challenging and invasive. Further, the strain measurements are, in practise, limited to certain regions of superficial bones only, such as the anterior surface of the tibia. In this study, tibial strains occurring during walking were estimated using a numerical approach based on flexible multibody dynamics. In the introduced approach, a lower body musculoskeletal model was developed by employing motion capture data obtained from walking at a constant velocity. The motion capture data were used in inverse dynamics simulation to teac…

Relationships of leisure-time physical activity and work ability between different occupational physical demands in adult working men

Purpose: Leisure-time physical activity (LTPA) is known to be associated with positive health benefits, but the role of occupational physical demands remains inconsistent. The purpose of the current study was to assess the relationship between LTPA and work ability in different occupational physical activity (OPA) levels between young adult men. - Methods: We performed physical activity measurements in work and leisure time with the long version of International Physical Activity Questionnaire (IPAQ) and work ability with the Work Ability Index (WAI) in 921 Finnish employed male volunteer participants. The participants were divided into LTPA tertiles I ( 28 MET-h/week) and OPA tertiles I (0…

Low Back Pain in Young Basketball and Floorball Players

Objective The aim of the study was to investigate the prevalence and risk factors of low back pain (LBP) in young female and male basketball and floorball players. Design Cross-sectional study. Setting Nine basketball teams and 9 floorball teams from Tampere city district, Finland. Participants Four hundred one young female and male players (mean age: 15.8 ± 1.9 years). Assessment of risk factors Age, gender, sport, and family history of musculoskeletal disorders were assessed as risk factors for LBP. Adjustment was made on team level to avoid random effects associated with a team. Main outcome measures Information of players' background factors and LBP episodes was collected by a structure…

Predictors of lower extremity injuries in team sports (PROFITS-study): a study protocol.

Introduction Several intrinsic risk factors for lower extremity injuries have been proposed, including lack of proper knee and body control during landings and cutting manoeuvres, low muscular strength, reduced balance and increased ligament laxity, but there are still many unanswered questions. The overall aim of this research project is to investigate anatomical, biomechanical, neuromuscular, genetic and demographic risk factors for traumatic non-contact lower extremity injuries in young team sport athletes. Furthermore, the research project aims to develop clinically oriented screening tools for predicting future injury risk. Methods Young female and male players (n=508) from nine basket…

5 Frontal plane femoral adduction during single-leg landing and low back pain in young athletes: a prospective profits cohort study

Introduction Prospective studies investigating risk factors for low back pain (LBP) in young athletes are limited. The aim of this prospective cohort study was to investigate the association between LBP and selected biomechanical factors and postural stability during dynamic movement tasks in young athletes. Materials and methods 396 young floorball and basketball players (mean age 15.8±1.9) were included and followed prospectively for 1–3 years (2011–2014). In the beginning of every study year the players were tested. The physical tests included single-leg squat (SLS), single-leg vertical drop jump (SLVDJ), vertical drop jump (VDJ) and Star Reach Excursion Balance Test (SEBT). Individual e…

Health benefits of different sport disciplines for adults: systematic review of observational and intervention studies with meta-analysis

The aim was to assess the quality and strength of evidence for the health benefits of specific sport disciplines. Electronic search yielded 2194 records and the selection resulted in 69 eligible studies (47 cross-sectional, 9 cohort, 13 intervention studies). 105 comparisons between participation and non-participation groups in 26 different sport disciplines were reported. Moderately strong evidence showed that both running and football improve aerobic fitness and cardiovascular function at rest, and football reduces adiposity. Conditional evidence showed that running benefits metabolic fitness, adiposity and postural balance, and football improves metabolic fitness, muscular performance, p…

Bone Density, Structure and Strength, and Their Determinants in Aging Sprint Athletes

This study was undertaken to examine bone properties in masters sprinters of different ages and younger reference subjects. In addition, the association of sport-specific ground reaction force, muscle, training, and hormone characteristics with the bone parameters was evaluated in the athletes.Bone densitometric, structural, and strength parameters were assessed by peripheral quantitative computed tomography at the distal and midtibia in 83 male sprinters (40-85 yr) and 19 physically active referents (31-45 yr). Between-group differences were analyzed by ANCOVA with body mass and height as covariates.Bone values were generally greater in athletes than referents, the greatest differences bei…

High intensity aquatic exercise or daily physical activity for maintaining fat mass and walking ability for postmenopausal women with knee osteoarthritis?

Knee extensor and flexor muscle power explains stair ascension time in patients with unilateral late-stage knee osteoarthritis: a cross-sectional study.

To determine the extent of asymmetrical deficits in knee extensor and flexor muscles, and to examine whether asymmetrical muscle deficits are associated with mobility limitations in persons with late-stage knee osteoarthritis (OA).Cross-sectional.Research laboratory.A clinical sample (N=56; age range, 50-75y) of eligible persons with late-stage knee OA awaiting knee replacement.Not applicable.Knee extensor and flexor power and torque assessed isokinetically; thigh muscle cross-sectional area (CSA) assessed by computed tomography; mobility limitation assessed by walking speed and stair ascension time; and pain assessed with the Western Ontario and McMaster Universities Osteoarthritis Index q…

Epidemiology of Overuse Injuries in Youth Team Sports: A 3-year Prospective Study

AbstractProspective studies on overuse injuries and their impact on athletic training among youth team sports are scarce. The purpose of this study was to investigate the incidence, severity and player related risk factors of overuse injuries among young (12–20 years) basketball and floorball players. A total of 387 players participated in a 3-year prospective study. Each player completed a baseline questionnaire regarding their background information. Overuse injuries that prevented players to fully or partly participate in their regular training were collected. In all, 204 overuse injuries were registered (injury incidence 1.51 injuries/1 000 h of exposure; 95% CI 1.35–1.78). Most of the …

Declining Physical Performance Associates with Serum FasL, miR-21, and miR-146a in Aging Sprinters.

Aging is associated with systemic inflammation and cellular apoptosis accelerating physiological dysfunctions. Whether physically active way of life affects these associations is unclear. This study measured the levels of serum inflammatory and apoptotic molecules, their change over 10 years, and their associations with physical performance in sprint-trained male athletes. HsCRP, cell counts, HGB, FasL, miR-21, and miR-146a were measured cross-sectionally (n=67, 18–90 yrs) and serum FasL, miR-21, and miR-146a and their aging-related associations with physical performance were assessed over a 10-year follow-up (n=49, 50–90 yrs). The cross-sectional study showed positive age correlations for …

Muscle Cross-Sectional Area and Structural Bone Strength Share Genetic and Environmental Effects in Older Women

The purpose of this study was to estimate to what extent muscle cross-sectional area of the lower leg (mCSA) and tibial structural strength are influenced by common and trait-specific genetic and environmental factors. pQCT scans were obtained from both members of 102 monozygotic (MZ) and 113 dizygotic (DZ) 63- to 76-yr-old female twin pairs to estimate the mCSA of the lower leg, structural bending strength of the tibial shaft (BSIbend), and compressive strength of the distal tibia (BSIcomp). Quantitative genetic models were used to decompose the phenotypic variances into common and trait-specific additive genetic (A), shared environmental (C), and individual environmental (E) effects. The …

Gaming for health across various areas of life

Lack of physical activity is mostly addressed by implementing programs to promote physical activity but seeing as the major cause for physical inactivity is that of technology. Few studies used the approach to use the very barrier as s mean to try and educate and breed good habits. This paper outlines the design and development of a project that will us various environments, home, gym and outdoors to promote physical activity by means of technology and more specifically games. peerReviewed

Absence of an aging‐related increase in fibre type grouping in athletes and non‐athletes

The ageing‐related loss of muscle mass is thought to be partly attributable to motor neuron loss and motor unit remodelling that result in fibre type grouping. We examined fibre type grouping in 19‐ to 85‐year‐old athletes and non‐athletes and evaluated to which extent any observed grouping is explained by the fibre type composition of the muscle. Since regular physical activity may stimulate reinnervation, we hypothesised that fibre groups are larger in master athletes than in age‐matched non‐athletes. Fibre type grouping was assessed in m. vastus lateralis biopsies from 22 young (19‐27 years) and 35 healthy older (66‐82 years) non‐athletes, and 14 young (20‐29 years), 51 middle‐aged (38‐6…

Physical Activity Is Related with Cartilage Quality in Women with Knee Osteoarthritis

Purpose To study the relationship between 12-month leisure-time physical activity (LTPA) level and changes in estimated biochemical composition of tibiofemoral cartilage in postmenopausal women with mild knee osteoarthritis (OA). Methods Originally, 87 volunteer postmenopausal women, age 60 to 68 yr, with mild knee OA (Kellgren Lawrence I/II and knee pain) participated in a randomized controlled, 4-month aquatic training trial (RCT), after which 76 completed the 12-month postintervention follow-up period. Self-reported LTPA was collected along the 12-month period using a diary from which MET task hours per month were calculated. Participants were divided into MET task hour tertiles: 1, lowe…

Effectiveness of Exergame Intervention on Walking in Older Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Abstract Objective The objective of this review was to systematically evaluate the effectiveness of exergaming on walking in older adults. In addition, the aim was to investigate the relationship between the exergaming effect and age, baseline walking performance, exercise traits, technology used, and the risk of bias. Methods A literature search was carried out in the databases MEDLINE, CINAHL, CENTRAL, EMBASE, WoS, PsycInfo, and PEDro up to January 10, 2020. Studies with a randomized controlled trial design, people ≥60 years of age without neurological disorders, comparison group with other exercise or no exercise, and walking-related outcomes were included. Cochrane RoB2, meta-analysis, …

Effects of a home-based, exergaming intervention on physical function and pain after total knee replacement in older adults : a randomised controlled trial

ObjectivesTo investigate the effects of 4 months of customised, home-based exergaming on physical function and pain after total knee replacement (TKR) compared with standard exercise protocol.MethodsIn this non-blinded randomised controlled trial, 52 individuals aged 60–75 years undergoing TKR were randomised into an exergaming (intervention group, IG) or a standard exercising group (control group, CG). Primary outcomes were physical function and pain measured before and after (2 months and 4 months) surgery using the Oxford Knee Score (OKS) and Timed Up and Go (TUG) test. Secondary outcomes included measures of the Visual Analogue Scale, 10m walking, short physical performance battery, iso…

Walking recovery after a hip fracture: A prospective follow-up study among community-dwelling over 60-year old men and women

Purpose. Recovery of walking outdoors after hip fracture is important for equal participation in the community. The causes of poor recovery are not fully understood. This study investigates recovery of walking outdoors and associated determinants after hip fracture.Methods. A prospective follow-up study, among clinical sample of 81 community-dwelling hip fracture patients over 60 years. Perceived difficulty in walking outdoors and 500 meters was assessed before fracture, at discharge to home (3.2 ± 2.2 weeks after surgery), and on average 6.0 ± 3.3 weeks after discharge. Potential determinants for walking recovery were assessed. Linear latent trajectory model was used to analyse changes dur…

Subgrouping and targeted exercise programmes for knee and hip osteoarthritis (STEER OA) individual participant data meta-analysis. Progress update and selection of potential moderators for analyses

Outdoor and indoor falls as predictors of mobility limitation in older women

Association between lower extremity muscle strength and acute ankle injury in youth team-sports athletes

Abstract Objectives To investigate lower extremity muscle strength as risk factor for an acute ankle injury in youth athletes. Design Cohort study. Setting Basketball and floorball clubs. Participants 188 youth (≤21) male and 174 female athletes. Main outcome measures 1RM leg press, maximal concentric isokinetic quadriceps and hamstrings as well as maximal isometric hip abductor strength were measured and athletes were followed for an acute ankle injury up to three years. Cox regression models were used in statistical analyses. Results In males, greater 1RM leg press and maximal quadriceps strength increased the risk of any type of acute ankle injury (Hazard ratio [HR] for 1 SD increase, 1.…

Virtual reality based robotic therapy for stroke rehabilitation: An initial study

The stroke rate will increase as the population ages. Lots of methods on stroke rehabilitation have been developed in the world. The therapy method based on the mirror box illusion helps the limb practice after stroke. Mirror therapy could be combined to virtual reality (VR) rehabilitation to enhance its effect, using robot to realize the position and force manipulation. Robotic device provide one way to regulate the amount and intensity of movement of the plegic limb and to focus more time on more task-specific and complex functional movements. The purpose of this study is to propose a robot assistant for stroke rehabilitation by utilizing virtual reality technology and sensory feedback, t…

Improved femoral neck BMD in older Finnish women between 2002 and 2010.

Abstract Purpose The number of hip fractures among Finns over 50-years of age rose constantly between 1970 and 1997, but since then, there has been a nationwide decline in incidence of hip fractures. One possible explanation, although not the only one, for the declining fracture rates, could be improved bone mineral density (BMD). The aim of this study was to evaluate differences in femoral neck BMD between older Finnish women born about a decade apart. Methods We compared the baseline data of two population-based samples of home-dwelling 70–80-year-old women who were initially recruited in exercise intervention studies ( N  = 216 in Cohort1, and N  = 389 in Cohort 2). Femoral neck BMD was …

Effects of high intensity resistance aquatic training on body composition and walking speed in women with mild knee osteoarthritis : a 4-month RCT with 12-month follow-up

Objective: To investigate the effects of 4-months intensive aquatic resistance training on body composition and walking speed in post-menopausal women with mild knee osteoarthritis (OA), immediately after intervention and after 12-months follow-up. Additionally, influence of leisure time physical activity (LTPA) will be investigated. Design: This randomised clinical trial assigned eighty-seven volunteer postmenopausal women into two study arms. The intervention group (n = 43) participated in 48 supervised intensive aquatic resistance training sessions over 4-months while the control group (n = 44) maintained normal physical activity. Eighty four participants continued into the 12-months' fo…

The effect of aquatic exercise on physical functioning in the older adult: a systematic review with meta-analysis

Background ageing and sedentary behaviour cause negative changes in the neuromuscular systems of healthy older adults resulting in a decrease in physical functioning. Exercising in water (aquatic exercise, AE) has been shown to be effective at improving physical functioning in this population; however, no systematic review with meta-analysis has been published. Purpose to investigate the effect of AE on physical functioning in healthy older adults compared to control or land-based exercise (LE) through a systematic review with meta-analysis of randomised controlled trials. Data sources Medline, Embase, Cinahl, PEDro, SPORTDiscus, Web of Science, Cochrane Library, published before 31st Decem…

Impaired geometric properties of tibia in older women with hip fracture history.

This study evaluated side-to-side differences in tibial mineral mass and geometry in women with previous hip fracture sustained on average 3.5 years earlier. Both tibial mineral mass and geometry were found to be reduced in the fractured leg. INTRODUCTION: The purpose of this study was to evaluate side-to-side differences in tibial mineral mass and geometry after hip fracture and to assess the determinants of such differences. METHODS: Thirty-eight 60- to 85-year-old women with a previous hip fracture and 22 same-aged control women without fractures participated in the study. Bone characteristics of the distal tibia and tibial shaft of both legs were assessed using pQCT in order to compare …

Effect of alendronate and exercise on bone and physical performance of postmenopausal women: a randomized controlled trial.

In this randomized, double-blind, placebo-controlled 12-month trial we evaluated effects of weight- bearing jumping exercise and oral alendronate, alone or in combination, on the mass and structure of bone, risk factors for falling (muscle strength and power, postural sway, and dynamic balance), and cardiorespiratory fitness in postmenopausal women. A total of 164 healthy, sedentary, early postmenopausal women were randomly assigned to one of four experimental groups: (1) 5 mg of alendronate daily plus progressive jumping exercise, (2) 5 mg alendronate, (3) placebo plus progressive jumping exercise, or (4) placebo. The primary endpoint was 12-month change in bone mass and geometry (measured…

Effects of resistance training on lower-extremity impairments in older people with hip fracture

Abstract Portegijs E, Kallinen M, Rantanen T, Heinonen A, Sihvonen S, Alen M, Kiviranta I, Sipila S. Effects of resistance training on lower-extremity impairments in older people with hip fracture. Objective To study the effects of resistance training on muscle strength parameters, mobility, and balance. Design Randomized controlled trial. Setting Research laboratory and senior gym. Participants Population-based sample of eligible 60- to 85-year-old community-dwelling men and women 0.5 to 7.0 years after hip fracture. Forty-six people had no contraindications and were willing to participate in the exercise trial. Intervention Twelve-week intensive progressive strength-power training (n=24),…

Sport injuries as the main cause of sport career termination among Finnish top-level athletes

Abstract Injuries are common among athletes, and are sometimes so severe that they affect an athlete's career in sport. As studies on sport career termination are few, we conducted a study to investigate the role of injuries as a reason for ending a sport career. The study group consisted of 574 male and female top-level cross-country skiers, swimmers, long-distance runners and soccer players who responded to a retrospective postal questionnaire in 2006. Twenty-seven athletes (4.9%, 27/548) reported ending their sport career because of injury. A follow-up interview was conducted by telephone in 2007 (n=20 volunteered to be interviewed) to confirm sport career termination and the reasons for…

Relationship between physical activity and predicted home presenteeism among participants with depressive symptoms with and without clinical depression : Findings from Finnish Depression and Metabolic Syndrome in Adults (FDMSA) study

Background and objectives Depression can pose a major threat to an individual’s ability to cope with daily activities. The aim of this study was to explore the relationship between physical activity (PA) and predicted home presenteeism (PHP) among depressive participants. The relationship between PHP and the severity of depressive symptoms was also investigated. Methods A total of 760 participants with depressive symptoms (DS) aged ≥35 years participated in this study. The study was conducted between 2008 and 2016 in municipalities within the Central Finland Hospital District. DS were determined with the 21-item Beck Depression Inventory (BDI-21) with a cutoff score ≥10, and psychiatric dia…

A Dynamic Simulation of a Human Gait Using the Hybrid Muscle Model and a QCT-Based Flexible Tibia

The flexible multibody simulation [9] approach can be used in a wide variety of engineering applications. In a previous study of authors [1], flexible multibody simulation approach was used to estimate strains during walking at tibial midshaft. In the previous study, simple muscle models were used in conjunction with a flexible tibia model based on magnetic resonance images (MRI). This study is an extension of the previous developments [1], [2] demonstrating the potential of model improvement by introducing hybrid muscle models, along with the flexible tibia based model on computed tomography (CT). The computed tomography technique allows for the accounting of inhomogeneous density and elas…

Which muscles compromise human locomotor performance with age?

Ageing leads to a progressive decline in human locomotor performance. However, it is not known whether this decline results from reduced joint moment and power generation of all lower limb muscle groups or just some of them. To further our understanding of age-related locomotor decline, we compare the amounts of joint moments and powers generated by lower limb muscles during walking (self-selected), running (4 m s −1 ) and sprinting (maximal speed) among young, middle-aged and old adults. We find that age-related deficit in ankle plantarflexor moment and power generation becomes more severe as locomotion change from walking to running to sprinting. As a result, old adults generate more pow…

Effects of Exercise on Patellar Cartilage in Women with Mild Knee Osteoarthritis

AB Purpose: This study aims to investigate the effects of exercise on patellar cartilage using T2 relaxation time mapping of magnetic resonance imaging in postmenopausal women with mild patellofemoral joint osteoarthritis (OA). Methods: Eighty postmenopausal women (mean age, 58 (SD, 4.2) yr) with mild knee OA were randomized to either a supervised progressive impact exercise program three times a week for 12 months (n = 40) or a nonintervention control group (n = 40). Biochemical properties of cartilage were estimated using T2 relaxation time mapping, a parameter sensitive to collagen integrity, collagen orientation, and tissue hydration. Leg muscle strength and power, aerobic capacity, and…

Inter- and intra-tester reliability of selected clinical tests in examining patients with early phase lumbar spine and sacroiliac joint pain and dysfunction

AbstractOf all patients with low back pain (LBP), 85% are diagnosed as “non-specific lumbar pain”. It has been postulated that the only reliable test is a straight leg raise test for detecting sciatic pain, and for other diagnostic subgroups, tests are of varying value. Only a few standardized tests exist to test function, inspection, mobility, pain, muscle flexibility or stability for patients with early phase lumbar spine and sacroiliac joint pain and dysfunction in the non-laboratory setting. The aim of this study was therefore to examine the inter- and intra-tester reliability of selected standardized clinical tests. Fifteen eligible, consecutive and voluntary LBP patients (aged 18–56 y…

Does hysterectomy with ovarian conservation affect bone metabolism and density?

We evaluated whether hysterectomy with ovarian conservation (HYX) has an effect on bone metabolism and density in 176 healthy Caucasian postmenopausal women aged 48-59 years. Bone properties of the hip, spine, radius, tibia, and calcaneus were measured using different bone assessment modalities. In addition, bone turnover was assessed using serum bone-specific alkaline phosphatase (BAP), osteocalcin (OC), and tartrate-resistant acid phosphatase (TRAP) 5b as biomarkers. Our results showed that women having HYX had a significantly lower level of OC ( P = 0.017) and a marginally lower level of TRAP 5b ( P = 0.051) and higher bone mineral density (BMD) of the femoral neck ( P = 0.037) and lumba…

The Added Value of Remote Technology in Cardiac Rehabilitation on Physical Function, Anthropometrics, and Quality of Life: Cluster Randomized Controlled Trial

Background Cardiovascular diseases (CVDs) cause most deaths globally and can reduce quality of life (QoL) of rehabilitees with cardiac disease. The risk factors of CVDs are physical inactivity and increased BMI. With physical activity, it is possible to prevent CVDs, improve QoL, and help maintain a healthy body mass. Current literature shows the possibilities of digitalization and advanced technology in supporting independent self-rehabilitation. However, the interpretation of the results is complicated owing to the studies’ high heterogeneity. In addition, the added value of this technology has not been studied well, especially in cardiac rehabilitation. Objective We aimed to examine the…

Diffusion capacity of the lung in young and old endurance athletes

Lung diffusion capacity (D LCO) declines with age. A significant proportion of older endurance athletes develop exercise-induced hypoxemia (SaO2<95%). We hypothesised that master endurance athletes have a lower D LCO than age-matched non-athletes. We recruited 33 control (16 young; 17 old) and 29 male endurance athletes (13 young; 16 old) during the World Masters Athletics Indoor Championships, 2012 (Jyvaskyla, Finland). To measure D LCO the participant exhaled to residual volume and then quickly inhaled to ≥ 90% total lung capacity from a gas source with 0.3% carbon monoxide. The D LCO and transfer coefficient (K CO) were corrected for the actual haemoglobin concentration. Spirometric func…

Association between frontal plane knee control and lower extremity injuries : a prospective study on young team sport athletes

Background/aimPoor frontal plane knee control can manifest as increased dynamic knee valgus during athletic tasks. The purpose of this study was to investigate the association between frontal plane knee control and the risk of acute lower extremity injuries. In addition, we wanted to study if the single-leg squat (SLS) test can be used as a screening tool to identify athletes with an increased injury risk.MethodsA total of 306 basketball and floorball players participated in the baseline SLS test and a 12-month injury registration follow-up. Acute lower extremity time-loss injuries were registered. Frontal plane knee projection angles (FPKPA) during the SLS were calculated using a two-dimen…

Relations between subdomains of physical activity, sedentary lifestyle, and quality of life in young adult men

Purpose To assess the relationship between physical activity (PA) in work, transport, domestic and leisure-time domains (with sitting time included) and health-related quality of life (HRQoL) among young adult men. Methods The long version of IPAQ and SF-36 Health Survey were used to assess PA and HRQoL, respectively, in 1425 voluntary 20 to 40 year old Finnish male participants. Participants were divided into tertiles (MET-h/week): Lowest tertile ( 100 MET-h/week). Results The IPAQ domain leisure-time PA predicted positively the Physical Component Summary (PCS) (β=0.11, 95% CI: 0.06 to 0.16) and Mental Component Summary (MCS) (β=0.11, 95% CI: 0.05 to 0.16) dimensions. Occupational PA predi…

Ankle and knee extensor muscle effort during locomotion in young and older athletes : Implications for understanding age-related locomotor decline

AbstractAge-related reduction in muscle force generation capacity is similarly evident across different lower limb muscle groups, yet decline in locomotor performance with age has been shown to depend primarily on reduced ankle extensor muscle function. To better understand why ageing has the largest detrimental effect on ankle joint function during locomotion, we examined maximal ankle and knee extensor force development during a two-leg hopping test in older and young men, and used these forces as a reference to calculate relative operating efforts for the knee and ankle extensors as participants walked, ran and sprinted. We found that, across locomotion modes in both age groups, ankle ex…

High ankle injury rate in adolescent basketball: A 3-year prospective follow-up study.

This prospective study investigated the incidence and pattern of acute time-loss injuries in young female and male basketball players. Eight basketball teams (n=201; mean age 14.85±1.5) participated in the follow-up study (2011-2014). The coaches recorded player participation in practices and games on a team diary. A study physician contacted the teams once a week to check new injuries and interviewed the injured players. In total, 158 injuries occurred. The overall rate of injury (per 1000 hours) was 2.64 (95% CI 2.23-3.05). Injury rate was 34.47 (95% CI 26.59-42.34) in basketball games and 1.51 (95% CI 1.19-1.82) in team practices. Incidence rate ratio (IRR) between game and practice was …

The effects of muscle strength and power training on mobility among older hip fracture patients

The incidence of hip fractures is growing in all Western societies. The mobility of hip fracture patients does not return to the pre-fracture level even 2 years after fracture. One reason for mobility limitation may be the persistent muscle weakness on the fractured leg. The purpose of this randomized controlled study was to examine whether 12-week muscle strength and power training twice a week has an effect on mobility in 60–85-year-old hip fracture patients. Forty-three persons were randomly assigned to an intervention (n=23) and a control (n=20) group. The intervention comprised 12-week supervised intensive progressive strength–power training twice per week. All the measurers were blind…

Effects of high-impact training and detraining on femoral neck structure in premenopausal women: a hip structural analysis of an 18-month randomized controlled exercise intervention with 3.5-year follow-up.

Purpose: This study evaluated the training effects of an 18-month exercise intervention and subsequent 3.5-year follow-up on femoral neck structure in premenopausal women. Methods: Of 98 women who participated in this randomized controlled study, 84 (39 trainees and 45 controls) completed the 18-month intervention. At both 18 months and 3.5 years, dual-energy X-ray absorptiometry data on 22 trainees and 22 control participants (ages 35–45 y) were available for hip structural analysis. The section modulus (Z), cross-sectional area (CSA), and subperiosteal width at the femoral neck were analyzed. Lower-leg explosive power and estimated maximal oxygen uptake (Vo2max) were assessed by vertical…

Combined resistance and balance-jumping exercise reduces older women's injurious falls and fractures: 5-year follow-up study

BACKGROUND AND OBJECTIVE: previously, a randomised controlled exercise intervention study (RCT) showed that combined resistance and balance-jumping training (COMB) improved physical functioning and bone strength. The purpose of this follow-up study was to assess whether this exercise intervention had long-lasting effects in reducing injurious falls and fractures. DESIGN: five-year health-care register-based follow-up study after a 1-year, four-arm RCT. SETTING: community-dwelling older women in Finland. SUBJECTS: one hundred and forty-five of the original 149 RCT participants; women aged 70-78 years at the beginning. METHODS: participants' health-care visits were collected from computerised…

Association between radiography-based subchondral bone structure and MRI-based cartilage composition in postmenopausal women with mild osteoarthritis

Summary Objective Our aim was to investigate the relation between radiograph-based subchondral bone structure and cartilage composition assessed with delayed gadolinium enhanced magnetic resonance imaging of cartilage (dGEMRIC) and T 2 relaxation time. Design Ninety-three postmenopausal women (Kellgren–Lawrence grade 0: n  = 13, 1: n  = 26, 2: n  = 54) were included. Radiograph-based bone structure was assessed using entropy of the Laplacian-based image ( E Lap ) and local binary patterns ( E LBP ), homogeneity indices of the local angles (HI Angles,mean , HI Angles,Perp , HI Angles,Paral ), and horizontal (FD Hor ) and vertical fractal dimensions (FD Ver ). Mean dGEMRIC index and T 2 relax…

Physiotherapists’ experiences of direct access for clients with musculoskeletal pain and dysfunction: a qualitative study

Aims: The aim of this study was to qualitatively analyse physiotherapists’ experiences and perspectives for delivering services directly, without prescription or referral, for clients with musculoskeletal pain or dysfunction. Methods: This was a qualitative study where data were collected from questionnaires given to 34 physiotherapists, 18 of them being in direct access for 6 years and 16 for 6 months. There were 15 structured questions and 3 open-ended ones. The answers were analysed with quantitative and qualitative methods. Results: The data analysis of the open-ended questions showed that physiotherapists had positive experiences of direct access. This practice brought meaningfulness, …

INTERVENTIONS TO PREVENT SPORTS RELATED INJURIES: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMISED CONTROLLED TRIALS

The effects of methods to prevent injuries have been studied in several systematic reviews. However, no meta-analysis taking into account all randomised controlled intervention trials aiming at the prevention of sports injuries has been published.To summarise the effects of sports injury prevention interventions.Systematic review and meta-analysis of randomised controlled trials.PubMed, MEDLINE, SPORTDiscus, the Cochrane Central Register of Controlled Trials, CINAHL, PEDro, and Web of Science, searched in September 2013. The reference lists of retrieved articles and reviews were hand searched.To be selected articles had to examine the effects of any preventive intervention on sports injurie…

Effectiveness of Technology-Based Distance Physical Rehabilitation Interventions for Improving Physical Functioning in Stroke: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

OBJECTIVE: To study the effectiveness of technology-based distance physical rehabilitation interventions on physical functioning in stroke. DATA SOURCES: A systematic literature search was conducted in 6 databases from January 2000 to May 2018. STUDY SELECTION: Inclusion criteria applied the patient, intervention, comparison, outcome, study design framework as follows: (P) stroke; (I) technology-based distance physical rehabilitation interventions; (C) any comparison without the use of technology; (O) physical functioning; (S) randomized controlled trials (RCTs). The search identified in total 693 studies, and the screening of 162 full-text studies revealed 13 eligible studies. DATA EXTRACT…

Biomechanical loading in the triple jump

The triple jump is a demanding field event in which a jumper must tolerate extremely high impact forces while maintaining high horizontal speed. The present study was designed to clarify the mechanical loading characteristics and the role of neuromuscular function in the triple jump. Seven national triple jumpers (4 males, 3 females) volunteered to perform 3-6 jumps. The mean best performances were 14.32+/-0.45 m and 11.90+/-0.28 m for males and females, respectively. The three longest triple jumps for each jumper were selected for final analysis. The mean contact times were 0.139 s (hop), 0.157 s (step) and 0.177 s (jump). The largest ground reaction forces were observed in the step (15.2 …

Promoting mobility after hip fracture (ProMo): study protocol and selected baseline results of a year-long randomized controlled trial among community-dwelling older people

Abstract Background To cope at their homes, community-dwelling older people surviving a hip fracture need a sufficient amount of functional ability and mobility. There is a lack of evidence on the best practices supporting recovery after hip fracture. The purpose of this article is to describe the design, intervention and demographic baseline results of a study investigating the effects of a rehabilitation program aiming to restore mobility and functional capacity among community-dwelling participants after hip fracture. Methods/Design Population-based sample of over 60-year-old community-dwelling men and women operated for hip fracture (n = 81, mean age 79 years, 78% were women) participat…

Effects of High-Impact Training on Bone and Articular Cartilage: 12-Month Randomized Controlled Quantitative MRI Study

Osteoarthritis and osteoporosis often coexist in postmenopausal women. The simultaneous effect of bone-favorable high-impact training on these diseases is not well understood and is a topic of controversy. We evaluated the effects of high-impact exercise on bone mineral content (BMC) and the estimated biochemical composition of knee cartilage in postmenopausal women with mild knee osteoarthritis. Eighty women aged 50 to 66 years with mild knee osteoarthritis were randomly assigned to undergo supervised progressive exercise three times a week for 12 months (n = 40) or to a nonintervention control group (n = 40). BMC of the femoral neck, trochanter, and lumbar spine was measured by dual-energ…

Relationship between occupational and leisure-time physical activity and the need for recovery after work

Abstract Background Health benefits of physical activity are very well acknowledged but the role of both occupational physical activity (OPA) and leisure time physical activity (LTPA) in recovery after work is not thoroughly understood. The purpose of this study was to investigate the association between accelerometer-measured OPA and LTPA and the need for recovery after work (NFR) in early childhood education and care (ECEC) professionals. Methods The study participants were 217 female ECEC professionals aged 17–64. Physical activity was recorded with a three-axis accelerometer (ActiGraph GT9X Link, ActiGraph, USA) for seven consecutive days. Separate analyses were conducted for both OPA a…

Impact or No Impact for Women With Mild Knee Osteoarthritis: A Bayesian Meta‐Analysis of Two Randomized Controlled Trials With Contrasting Interventions

Objective We aim to predict the probability of a benefit from two contrasting exercise programs for a woman with a new diagnosis of mild knee osteoarthritis (OA). The short and long-term effects of aquatic resistance training (ART) and high-impact aerobic land training (HLT) compared with the control will be estimated. Methods Original data sets from two previously conducted randomised controlled trials (RCT) were combined and used in a Bayesian meta-analysis. Group differences in multiple response variables were estimated. Variables included cardiorespiratory fitness, dynamic maximum leg muscle power, maximal isometric knee extension and flexion force, pain, other symptoms and quality of l…

Comment on "Effects of Elastic Resistance Band Exercise on Postural Balance, Estrogen, Bone Metabolism Index, and Muscle Strength of Perimenopausal Period Women".

Effects of a 20-week high-intensity strength and sprint training program on tibial bone structure and strength in middle-aged and older male sprint athletes: a randomized controlled trial.

This randomized, controlled, high-intensity strength and sprint training trial in middle-aged and older male sprint athletes showed significant improvements in mid-tibial structure and strength. The study reveals the adaptability of aging bone, suggesting that through a novel, intensive training stimulus it is possible to strengthen bones during aging. High-load, high-speed and impact-type exercise may be an efficient way of improving bone strength even in old age. We evaluated the effects of combined strength and sprint training on indices of bone health in competitive masters athletes, who serve as a group of older people who are likely to be able to participate in vigorous exercise of th…

What Makes a 97-Year-Old Man Cycle 5,000 km a Year?

&lt;b&gt;&lt;i&gt;Background:&lt;/i&gt;&lt;/b&gt; The nature versus nurture debate is one of the oldest issues in the study of longevity, health and successful aging. &lt;b&gt;&lt;i&gt;Objective:&lt;/i&gt;&lt;/b&gt; We present a 97-year-old man (I.K.) as an example of the effects of habitual exercise on the aging process. &lt;b&gt;&lt;i&gt;Methods:&lt;/i&gt;&lt;/b&gt; Extensive assessments included medical examinations, interviews, musculoskeletal structure, performance characteristics, cognitive function and gut microbiota composition. &lt;b&gt;&lt;i&gt;Results:&lt;/i&gt;&lt;/b&gt; I.K. suffers from iatrogenic hypogonadism, prostate cancer, hypothyroidism and a history of deep popliteal th…

Effects of intensive strength-power training on sense of coherence among 60-85-year-old people with hip fracture: A randomized controlled trial

Background and aims: Older people with disabilities are at increased risk of psychological health decline. There are no earlier studies on the effects of resistance training on sense of coherence (SOC) among older people with a history of hip fracture. The aim of this study is to test the effects of intensive 12-week strength-power training on SOC among older adults after hip fracture. Methods: A clinical sample of 60-85-year-old community-dwelling men and women was studied, 0.5. to 7.0 years after hip fracture. Forty-six had no contraindications for participation and were randomized into training (n=24) and control groups (n=22). The training group participated in a 12-week, individually t…

Effects of Exercise on Health-Related Quality of Life and Fear of Falling in Home-Dwelling Older Women

This randomized, controlled trial evaluated the effects of exercise on health-related quality of life (HRQoL) and fear of falling (FoF) among 149 home-dwelling older women. The 12-mo exercise program was intended to reduce the risk of falls and fractures. HRQoL was assessed by the RAND-36 Survey, and FoF, with a visual analog scale, at baseline, 12 mo, and 24 mo. On all RAND-36 scales, the scores indicated better health and well-being. The exercise had hardly any effect on HRQoL; only the general health score improved slightly compared with controls at 12 mo (p = .019), but this gain was lost at 24 mo. FoF decreased in both groups during the intervention with no between-groups difference at…

Effectiveness of Distance Technology in Promoting Physical Activity in Cardiovascular Disease Rehabilitation : Cluster Randomized Controlled Trial, A Pilot Study

BackgroundPhysical activity is beneficial for cardiovascular rehabilitation. Digitalization suggests using technology in the promotion of physical activity and lifestyle changes. The effectiveness of distance technology interventions has previously been found to be similar to that of conventional treatment, but the added value of the technology has not been frequently studied. ObjectiveThe aim of this pilot study was to investigate whether additional distance technology intervention is more effective in promoting physical activity than non-technology–based treatment in 12 months of cardiac rehabilitation. MethodsThe cardiovascular disease rehabilitation intervention consisted of three 5-day…

Mineral mass, size, and estimated mechanical strength of triple jumpers’ lower limb

This study was designed to examine the anticipated strong influence of extreme impact loading on the mineral mass, size, and gross structural properties of triple jumpers' lower limb bones. We compared the bone data obtained with peripheral quantitative computed tomography (pQCT) and dual-energy X-ray absorptiometry (DXA) from 8 Finnish triple jumpers with corresponding data from gender-, age-, height-, and weight-matched nonathletic peers. The volumetric (trabecular) density was significantly higher in the jumpers than in controls (from an average 18% difference at the distal tibia to a 41% difference at the proximal tibia), whereas the cortical density did not differ between groups. The D…

Effects of a progressive aquatic resistance exercise program on the biomechanical composition and morphology of cartilage in women with mild knee osteoarthritis: protocol for a randomised controlled trial

Background. Symptoms associated with osteoarthritis of the knee result in decreased function, loss of working capacity and extensive social and medical costs. There is a need to investigate and develop effective interventions to minimise the impact of and even prevent the progression of osteoarthritis. Aquatic exercise has been shown to be effective at reducing the impact of osteoarthritis. The purpose of this article is to describe the rationale, design and intervention of a study investigating the effect of an aquatic resistance exercise intervention on cartilage in postmenopausal women with mild knee osteoarthritis. Methods. A minimum of 80 volunteers who meet the inclusion criteria will…

Effects of preoperative group-based aquatic training on health related quality of life in persons with late stage knee osteoarthritis

drainage is better than resistance training alone as far as improvement in lymphedema is concerned. Implications: Lymphedema has a substantial effect on the upper limb functioning, independence as well as quality of life post mastectomy. Manual lymphatic drainage can help these patients to achieve functional independence and thereby increase their life quality in a simple, cost effective and efficient way.

477 Injury risk in finnish youth floorball: a one-year prospective follow-up study

Background Floorball is a popular team sport in Finland. Previous studies have revealed that injuries are a significant problem in adult floorball. However, epidemiological studies of injuries in youth floorball are lacking. The aim of this study was to investigate the incidence, type, and severity of injuries in young floorball players. Methods One-hundred-fifty-six female (n = 57) and male players (n = 99) (mean age 17.1 ± 1.6 years) from nine floorball teams participated in the study. Injury data as well as practice and game exposures were collected over the 12-months period (from May 2013 to April 2014). An injury was defined as having occurred in an organised floorball practice or game…

From "Non-encounters" to autonomic agency. Conceptions of patients with low back pain about their encounters in the health care system.

Low back pain is a considerable health problem which affects people around the world, causing major healthcare costs. The use of qualitative research methods enables us to describe and understand patients' experience of, and attitudes to, healthcare. The aim of the present phenomenographic study was to identify and describe the contextual nature of the conceptions of patients with low back pain of their encounters in the HCS. Seventeen patients with chronic or episodic low back pain classified as "high risk" were interviewed in open recall interviews, using videos of patients' initial physiotherapy sessions that had been recorded previously. The data were analysed using the phenomenographic…

Effectiveness of Exergame Intervention on Walking in Older Adults : A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Objective. The objective of this review was to systematically evaluate the effectiveness of exergaming on walking in older adults. In addition, the aim was to investigate the relationship between the exergaming effect and age, baseline walking performance, exercise traits, technology used and the risk of bias. Methods. A literature search was carried out in the databases MEDLINE, CINAHL, CENTRAL, EMBASE, WoS, PsycInfo and PEDro up to January 10, 2020. Studies with a Randomized Controlled Trial (RCT) design, people ≥60 years of age without neurological disorders, comparison group with other exercise or no exercise, and walking related outcomes were included. Cochrane RoB2, meta-analysis, met…

Effects of preoperative aquatic resistance training on knee pain, mobility limitation and muscle impairments in people with late-stage knee osteoarthritis

Long-term effect of physical activity counseling on mobility limitation among older people: a randomized controlled study.

Background. Physical activity counseling increases physical activity among older people, but its effectiveness on mobility, that is, maintaining the ability to move independently, is unknown. We studied the effect of physical activity counseling on mobility among older people and evaluated whether counseling-induced benefi ts persist after cessation of the intervention. Methods. In a 2-year, single-blinded, randomized controlled study, 632 sedentary participants aged 75 – 81 years were randomly assigned into the intervention ( n = 318) or control ( n = 314) group. The intervention group received a single individualized physical activity counseling session with a supportive telephone contact…

Effects of progressive aquatic resistance training on symptoms and quality of life in women with knee osteoarthritis: A secondary analysis.

Abstract Objective: To conduct a secondary analysis to study the effects, those 4 months of aquatic resistance training have on self‐assessed symptoms and quality of life in post‐menopausal women with mild knee osteoarthritis (OA), after the intervention and after a 12‐month follow‐up period. Methods: A total of 87 post‐menopausal volunteer women, aged 60‐68 years, with mild knee OA were recruited in a randomized, controlled, 4‐month aquatic training trial (RCT) and randomly assigned to an intervention (n = 43) and a control (n = 44) group. The intervention group participated in 48 supervised aquatic resistance training sessions over 4 months while the control group maintained their usual l…

Balance confidence and functional balance are associated with physical disability after hip fracture.

Abstract Background This cross-sectional study investigated the associations between balance confidence, functional balance, and physical disability among older people after hip fracture. Material and methods The study utilizes baseline data of two randomized controlled trials (ISRCTN34271567 and ISRCTN53680197). The participants were 159 community-dwelling over 60-year-old people. Health, fracture status, the date and type of surgery, and contraindications for participation were assessed in a clinical examination. Balance confidence was assessed by the Activities-specific Balance Confidence Scale (ABC) and functional balance by the Berg Balance Scale. Physical disability was assessed by a …

Targeted exercise against osteoporosis: A systematic review and meta-analysis for optimising bone strength throughout life

Abstract Background Exercise is widely recommended to reduce osteoporosis, falls and related fragility fractures, but its effect on whole bone strength has remained inconclusive. The primary purpose of this systematic review and meta-analysis was to evaluate the effects of long-term supervised exercise (≥6 months) on estimates of lower-extremity bone strength from childhood to older age. Methods We searched four databases (PubMed, Sport Discus, Physical Education Index, and Embase) up to October 2009 and included 10 randomised controlled trials (RCTs) that assessed the effects of exercise training on whole bone strength. We analysed the results by age groups (childhood, adolescence, and you…

Effectiveness of Gamification in Knee Replacement Rehabilitation : Protocol for a Randomized Controlled Trial With a Qualitative Approach

Background: Exergames can provide encouraging exercise options. Currently, there is limited evidence regarding home-based exergaming in the postoperative phase of total knee replacement (TKR). Objective: This study aimed to investigate the effects of a 4-month postoperative home-based exergame intervention with an 8-month follow-up on physical function and symptoms among older persons undergoing TKR compared with home exercise using a standard protocol. In addition, a concurrent embedded design of a mixed methods study was used by including a qualitative component within a quantitative study of exergame effects. Methods: This was a dual-center, nonblinded, two-arm, parallel group randomized…

Prevention of Sports Injuries

Increased participation in sports has led to more sports injuries. Evidence-based methods to prevent sports injuries are needed. A systematic review was conducted of the effects of randomized controlled interventions to prevent sports injuries. A systematic search was performed of various databases and the reference lists of articles and reviews. Two reviewers independently extracted the data and assessed the methodological quality of the included trials. Thirty-two trials (24,931 participants) met the inclusion criteria. We found evidence of the preventive effect of 3 types of injury prevention interventions. In 5 trials including 6 different comparisons (2446 participants), custom-made or…

Injury History and Perceived Knee Function as Risk Factors for Knee Injury in Youth Team-Sports Athletes

Background: The identification of risk factors for sports injuries is essential before injury prevention strategies can be planned. Hypothesis: Previous acute knee injury and lower perceived knee function measured by Knee injury and Osteoarthritis Outcome Score (KOOS) will increase the risk of acute knee injury in youth team-sports athletes. Study Design: Prospective cohort study. Level of Evidence: Level 3. Methods: At baseline, youth (≤21 years old) male and female basketball and floorball athletes completed a questionnaire on previous acute knee injuries and perceived knee function (KOOS). A total of 211 male and 183 female athletes were followed for an acute knee injury up to 3 years. U…

Exercise loading and cortical bone distribution at the tibial shaft

Cortical bone is not a uniform tissue, and its apparent density [cortical volumetric density (vBMD)] varies around the bone cross-section as well as along the axial length of the bone. It is not yet known, whether the varying vBMD distribution is attributable to modulation in the predominant loads affecting bone. The aim of the present study was to compare the cortical bone mass distribution through the bone cortex (radial distribution) and around the center of mass (polar distribution) among 221 premenopausal women aged 17-40 years representing athletes involved in high impact, odd impact, high magnitude, repetitive low impact, repetitive non-impact sports and leisure time physical activit…

Association between lower extremity muscular strength and acute knee injuries in young team‐sports athletes

The purpose of this study was to investigate LE muscular strength variables as potential risk factors for all and non‐contact acute knee and ACL injuries in young athletes. A total of 188 young (≤21) male and 174 female basketball and floorball players participated in LE muscular strength tests and were followed up to three years. The strength test battery consisted of 1RM leg press, maximal concentric isokinetic (60°/s) quadriceps and hamstrings and maximal isometric hip abductor strength. The outcomes were a new acute knee or ACL injury and a new acute non‐contact knee or ACL injury. A total of 51 (17 in males and 34 in females) new acute knee injuries registered and 17 (one in males and …

Maximal voluntary isokinetic knee flexion torque is associated with femoral shaft bone strength indices in knee replacement patients.

It is currently unknown whether knee replacement-associated bone loss is modified by rehabilitation programs. Thus, a sample of 45 (18 men and 25 women) persons with unilateral knee replacement were recruited; age 66 years (sd 6), height 169 cm (sd 8), body mass 83 kg (sd 15), time since operation 10 months (sd 4) to explore the associations between maximal torque/power in knee extension/flexion and femoral mid-shaft bone traits (Cortical cross-sectional area (CoA, mm(2)), cortical volumetric bone mineral density (CoD, mg/mm(3)) and bone bending strength index (SSI, mm(3))). Bone traits were calculated from a single computed tomography slice from the femoral mid-shaft. Pain in the operated …

Efficacy of progressive aquatic resistance training for tibiofemoral cartilage in postmenopausal women with mild knee osteoarthritis : a randomised controlled trial

Objective: To study the efficacy of aquatic resistance training on biochemical composition of tibiofemoral cartilage in postmenopausal women with mild knee osteoarthritis (OA). Design: Eighty seven volunteer postmenopausal women, aged 60-68 years, with mild knee OA (Kellgren-Lawrence grades I/II and knee pain) were recruited and randomly assigned to an intervention (n = 43) and control (n = 44) group. The intervention group participated in 48 supervised aquatic resistance training sessions over 16 weeks while the control group maintained usual level of physical activity. The biochemical composition of the medial and lateral tibiofemoral cartilage was estimated using single-slice transverse …

Performance in dynamic movement tasks and occurrence of low back pain in youth floorball and basketball players

Abstract Background Prospective studies investigating risk factors for low back pain (LBP) in youth athletes are limited. The aim of this prospective study was to investigate the association between hip-pelvic kinematics and vertical ground reaction force (vGRF) during landing tasks and LBP in youth floorball and basketball players. Methods Three-hundred-and-eighty-three Finnish youth female and male floorball and basketball players (mean age 15.7 ± 1.8) participated and were followed up on for 3 years. At the beginning of every study year the players were tested with a single-leg vertical drop jump (SLVDJ) and a vertical drop jump (VDJ). Hip-pelvic kinematics, measured as femur-pelvic angl…

Exercise therapy for functional capacity in chronic diseases: an overview of meta-analyses of randomised controlled trials.

To summarise all meta-analyses of randomised controlled trials that have evaluated the effects of exercise therapy on functional capacity in patients with chronic diseases.Umbrella review of meta-analyses of randomised controlled trials.We systematically searched the CENTRAL, CINAHL, DARE, Medline, OTSeeker, PEDro, SPORTDiscus, ProQuest NursingAllied Health Database, Web of Science, Scopus, OpenGrey and BMC Proceedings from database inception to 1 September 2016.We included meta-analyses that compared the effects of exercise therapy with no treatment or usual care in adults with non-communicable chronic diseases and included outcomes related to functional capacity. We excluded meta-analyses…

The standing knee lift test is not a useful screening tool for time loss from low back pain in youth basketball and floorball players

Abstract Objectives The aim of this study was to investigate the association between pelvic kinematics during the standing knee lift (SKL) test and low back pain (LBP) in youth floorball and basketball players. Design A prospective cohort study. Setting Finnish elite youth floorball and basketball players. Participants Finnish elite youth female and male floorball and basketball players (n = 258, mean age 15.7 ± 1.8). Main outcome measures LBP resulting in time loss from practice and games was recorded over a 12-month period and verified by a study physician. Associations between LBP and sagittal plane pelvic tilt and frontal plane pelvic obliquity during the SKL test as measured at baselin…

Type of sport is related to injury profile: A study on cross country skiers, swimmers, long-distance runners and soccer players. A retrospective 12-month study

This 12-month retrospective questionnaire compared the occurrence of sports injuries in 149 cross country skiers, 154 swimmers, 143 long-distance runners and 128 soccer players aged 15-35 years. Soccer had significantly more injuries (5.1 injuries/1000 exposure hour) than other sports (2.1-2.8, P<0.001). More runners than soccer players reported overuse injuries (59% vs 42%, P=0.005), locating typically in the foot in runners, soccer players and skiers. Swimmers reported overuse injuries in the shoulder more commonly than skiers (40% vs 1%, P<0.001), who also intensively load shoulders. Acute injuries in skiers (80%) and in swimmers (58%), and overuse injuries in skiers (61%), occurred duri…

Age-Related Declines in Lower Limb Muscle Function are Similar in Power and Endurance Athletes of Both Sexes : A Longitudinal Study of Master Athletes

The age-related decline in muscle function, particularly muscle power, is associated with increased risk of important clinical outcomes. Physical activity is an important determinant of muscle function, and different types of physical activity e.g. power-based versus endurance-based exercise appear to have differential effects on muscle power. Cross-sectional studies suggest that participation in power-based exercise is associated with greater muscle power across adulthood but this has not been investigated longitudinally. We recruited eighty-nine male and female power and endurance master athletes (sprint and distance runners respectively, baseline age 35–90y). Using jumping mechanography,…

Evidence for the effectiveness of walking training on walking and self-care after stroke: A systematic review and meta-analysis of randomized controlled trials

Objective: To examine the effect of randomized controlled trials of walking training on walking and self-care in patients with stroke. Data sources: MEDLINE, CINAHL, Embase, PEDro, OTSeeker, Central, and manual search to the end of August 2012. Study selection: English, Finnish, Swedish, or German language walking training randomized controlled trials for patients over 18 years of age with stroke. Data synthesis: The meta-analyses included 38 randomized controlled trials from 44 reports. There was high evidence that in the subacute stage of stroke, specific walking training resulted in improved walking speed and distance compared with traditional walking training of the same intensity. In t…

sj-docx-1-sph-10.1177_19417381211065443 ��� Supplemental material for Injury History and Perceived Knee Function as Risk Factors for Knee Injury in Youth Team-Sports Athletes

Supplemental material, sj-docx-1-sph-10.1177_19417381211065443 for Injury History and Perceived Knee Function as Risk Factors for Knee Injury in Youth Team-Sports Athletes by Jussi Hietamo, Anni Rantala, Jari Parkkari, Mari Lepp��nen, Marko Rossi, Ari Heinonen, Kathrin Steffen, Pekka Kannus, Ville Mattila and Kati Pasanen in Sports Health: A Multidisciplinary Approach

Influence of long-term postmenopausal hormone-replacement therapy on estimated structural bone strength: A study in discordant monozygotic twins

Although postmenopausal hormone-replacement therapy (HRT) is known to prevent fractures, knowledge on the influence of long-term HRT on bone strength and its determinants other than areal bone mineral density is scarce. This study used a genetically controlled design with 24 monozygotic female twin pairs aged 54 to 72 years in which one cotwin was using HRT (mean duration 8 years) and the other had never used HRT. Estimated bone strength, cross-sectional area, volumetric bone mineral density, bone mineral mass, and cross-sectional density and mass distributions were assessed in the tibial shaft, distal tibia, and distal radius with peripheral computed tomography (pQCT). In the tibial shaft,…

Bone rigidity to neuromuscular performance ratio in young and elderly men.

Given the adaptation of bone to prevalent loading, bone loss should follow, but lag behind, the decline in physical performance during aging. Furthermore, bone responsiveness to load-induced strains is believed to decrease with aging. However, the relationship between bone and lean body ( approximately muscle) mass appears to remain rather constant throughout adulthood. The purpose of this study was to examine the association between age and bone to neuromuscular performance ratio. Young (N=20, age 24 SD+/-2 years, body mass 77+/-11 kg, height 178+/-6 cm) and elderly (N=25, 72+/-4 years, 75+/-9 kg, 172+/-5 cm) men served as subjects. Bone structural traits were measured at the right distal …

Effects of a Home-Based Physical Rehabilitation Program on Physical Disability After Hip Fracture: A Randomized Controlled Trial

Abstract Objective Fewer than half of the patients with hip fracture will regain the prefracture level of physical functioning. This secondary analysis of a randomized controlled trial investigated the effects of a multicomponent home-based rehabilitation program (ProMo) on physical disability after hip fracture. Design Randomized, controlled, parallel-group trial. Setting Rehabilitation in participants' homes; measurements in university-based laboratory and local hospital. Participants Population-based clinical sample of community-dwelling people older than 60 years (n = 81) operated for hip fracture were randomized into intervention and control groups. Intervention The year-long intervent…

Knowledge translation from continuing education to physiotherapy practice in classifying patients with low back pain

Physical therapists have used continuing education as a method of improving their skills in conducting clinical examination of patients with low back pain (LBP). The purpose of this study was to evaluate how well the pathoanatomical classification of patients in acute or subacute LBP can be learned and applied through a continuing education format. The patients were seen in a direct access setting.The study was carried out in a large health-care center in Finland. The analysis included a total of 57 patient evaluations generated by six physical therapists on patients with LBP. We analyzed the consistency and level of agreement of the six physiotherapists' (PTs) diagnostic decisions, who par…

Influence of long-term postmenopausal hormone replacement therapy on estimated structural bone strength: A study in discordant monozygotic twins.

Although postmenopausal hormone-replacement therapy (HRT) is known to prevent fractures, knowledge on the influence of long-term HRT on bone strength and its determinants other than areal bone mineral density is scarce. This study used a genetically controlled design with 24 monozygotic female twin pairs aged 54 to 72 years in which one cotwin was using HRT (mean duration 8 years) and the other had never used HRT. Estimated bone strength, cross-sectional area, volumetric bone mineral density, bone mineral mass, and cross-sectional density and mass distributions were assessed in the tibial shaft, distal tibia, and distal radius with peripheral computed tomography (pQCT). In the tibial shaft,…

Effects of progressive resistance training on physical disability among older community-dwelling people with history of hip fracture

Background and aims: Hip fracture is a common trauma in older people, and often leads to decreased muscle strength and increased physical disability. This randomized controlled trial examined whether three months of progressive resistance training (PRT) can reduce physical disability among older people with a history of hip fracture. Methods: A population-based sample of 60-85-year-old community-dwelling persons, with hip fractures sustained on average three years earlier, were enrolled in the study. Of 78 people participating in laboratory assessments, those without contraindications for participation in resistance training were randomly assigned to a training group (TG, n=22) or a control…

Leisure time physical activity and its relation to psychiatric comorbidities in depression. Findings from Finnish Depression and Metabolic Syndrome in Adults (FDMSA) study

Purpose: The study aim was to examine association between leisure time physical activity (LTPA) and psychiatric comorbidities among people with depression. Methods: Total 447 patients aged 35 years and older suffering from depressive symptoms (DS) and who were confirmed depression positive participated this study. The study was conducted between 2008 and 2011 in municipalities within Central Finland Hospital District. DS were determined with Beck Depression Inventory (BDI-21) with cutoff score >= 10 and psychiatric diagnoses were confirmed by Mini-International Neuropsychiatric Interview (M.I.N.I.). LTPA, other diseases as well as use of antidepressant were captured by self-reported questio…

Loading modalities and bone structures at nonweight-bearing upper extremity and weight-bearing lower extremity: a pQCT study of adult female athletes.

This cross-sectional study of adult female athletes assessed whether the apparent loading-related differences in bone structure are primarily associated with the loading type or the muscle performance-related joint moments. Several structural variables at shaft sites of the tibia, radius and humerus, and distal sites of the tibia and radius were measured with peripheral quantitative computed tomography (pQCT) among 113 female national level athletes (representing hurdling, volleyball, soccer, racket-sports and swimming) and their 30 nonathletic referents. For the weight-bearing lower extremities, the loading modalities of the above sports were classified into high-impact (hurdling, volleyba…

Does baseline leisure-time physical activity level predict future depressive symptoms or physical activity among depressive patients? Findings from a Finnish five-year cohort study

Objectives The aims of this study were to investigate whether baseline leisure-time physical activity (LTPA) is associated with future recovery from depression among patients with a depression diagnosis and whether baseline LTPA is associated with total physical activity after five years of follow-up. Methods A total of 258 patients aged >= 35 years with clinically confirmed depression at baseline participated. The study was conducted between 2008 and 2016 in municipalities within the Central Finland Hospital District. Depressive symptoms (DS) were determined with the Beck Depression Inventory (BDI) with a cutoff score >= 10, and depression diagnoses were confirmed by the Mini-International…

Both Resistance and Agility Training Increase Cortical Bone Density in 75- to 85-Year-Old Women With Low Bone Mass

A randomized, controlled, single-blinded 25-wk prospective study was conducted to compare the effects of group-based resistance and agility training on bone, as measured by both dual-energy X-ray absorptiometry (DXA) and peripheral quantitative computed tomography (pQCT), in older women with low bone mass. Ninety-eight community-dwelling women aged 75-85 yr were randomized to one of three experimental groups: resistance training (n = 32), agility training (n = 34), or stretching (sham exercise) (n = 32). Total hip, femoral neck, and trochanteric bone mineral density (BMD) were measured by DXA. Peripheral QCT measurements were performed at the tibia and radius. The pQCT outcome measures at t…

A full body musculoskeletal model based on flexible multibody simulation approach utilised in bone strain analysis during human locomotion

Load-induced strains applied to bone can stimulate its development and adaptation. In order to quantify the incident strains within the skeleton, in vivo implementation of strain gauges on the surfaces of bone is typically used. However, in vivo strain measurements require invasive methodology that is challenging and limited to certain regions of superficial bones only such as the anterior surface of the tibia. Based on our previous study [Al Nazer et al. (2008) J Biomech. 41:1036-1043], an alternative numerical approach to analyse in vivo strains based on the flexible multibody simulation approach was proposed. The purpose of this study was to extend the idea of using the flexible multibod…

sj-docx-2-sph-10.1177_19417381211065443 ��� Supplemental material for Injury History and Perceived Knee Function as Risk Factors for Knee Injury in Youth Team-Sports Athletes

Supplemental material, sj-docx-2-sph-10.1177_19417381211065443 for Injury History and Perceived Knee Function as Risk Factors for Knee Injury in Youth Team-Sports Athletes by Jussi Hietamo, Anni Rantala, Jari Parkkari, Mari Lepp��nen, Marko Rossi, Ari Heinonen, Kathrin Steffen, Pekka Kannus, Ville Mattila and Kati Pasanen in Sports Health: A Multidisciplinary Approach

Validation of Knee KL-classifying Deep Neural Network with Finnish Patient Data

Osteoarthritis (OA) is the most common form of joint disease in the world. The diagnosis of OA is currently made by human experts and suffers from subjectivity, but recently new promising detection algorithms have been developed. We validated the current state-of-the-art KL-classifying neural network model for knee OA using knee X-rays taken from postmenopausal women suffering from knee pain attributable to OA. The performance of the model on the clinical data was considerably lower compared to the previous results on population-based test data. This suggests that the performance of the current grading methods is not yet adequate to be applied in clinical settings. The present results also …

LOW BACK PAIN IN YOUNG TEAM SPORT PLAYERS: A RETROSPECTIVE STUDY

Background Low back pain (LBP) is a common complaint in general population affecting both genders and almost all age-groups. LBP is a common problem in sports as well, even in younger populations. LBP is prone to recur, thus there is a need for studies on the early phases of the problem in different sports. Objective To investigate the prevalence, nature, severity and risk factors of self-reported LBP in young team sport players. Design A retrospective cross-sectional study. Setting Finnish female and male basketball, floorball, ice hockey and volleyball teams. Participants This study is a part of an ongoing cohort study exploring risk factors for sports injuries. Players from 22 teams, a t…

Movement characteristics during customized exergames after total knee replacement in older adults

Introduction: There is limited understanding of how older adults can reach kinematic goals in rehabilitation while performing exergames and conventional exercises, and how similar or different the kinematics during exergaming are when compared with conventional therapeutic exercise with similar movement. The aim of this study was to describe the movement characteristics performed during exercise in custom-designed exergames and conventional therapeutic exercises among patients who have undergone unilateral total knee replacement (TKR). In addition, the secondary aim was to assess the relation of these exercise methods, and to assess participants' perceived exertion and knee pain during exer…

Progression of untreated mild thoracic Scheuermann's kyphosis – Radiographic and functional assessment after mean follow-up of 46 years

There is no data available on the radiographic development of the Scheuermann's deformity. Our purpose was to investigate radiographic deformity progression and the relation between kyphosis progression and clinical outcome in patients with untreated Scheuermann's kyphosis.Thoracic kyphosis (Th4-Th12) was measured from standing lateral radiographs in 19 patients at baseline and after mean 46-year follow-up. Mean age at baseline was 19.2 and at follow-up 64.7 years. At follow-up, height, weight, hand grip strength, and hamstring tightness were measured, and sit-to-stand and walking tests were performed. Additionally general health and quality of life questionnaires were administered.The mean…

Effects of aquatic resistance training on mobility limitation and lower-limb impairments after knee replacement.

Abstract Valtonen A, Poyhonen T, Sipila S, Heinonen A. Effects of aquatic resistance training on mobility limitation and lower-limb impairments after knee replacement. Objective To study the effects of aquatic resistance training on mobility, muscle power, and cross-sectional area. Design Randomized controlled trial. Setting Research laboratory and hospital rehabilitation pool. Participants Population-based sample (N=50) of eligible women and men 55 to 75 years old 4 to 18 months after unilateral knee replacement with no contraindications who were willing to participate in the trial. Interventions Twelve-week progressive aquatic resistance training (n=26) or no intervention (n=24). Main Out…

Lower-Limb Pain, Disease, and Injury Burden as Determinants of Muscle Strength Deficit After Hip Fracture

Background: Hip fracture may result in an asymmetrical lower-limb strength deficit. The deficit may be related to the trauma, surgical treatment, pain, or disuse of the fractured limb. However, disease and injury burden or musculoskeletal pain in the other limb may reduce muscle strength on that side, reducing the asymmetrical deficit. The aim of our study was to explore the asymmetrical strength deficit and to determine the potential underlying factors in patients from six months to seven years after a hip fracture. Methods: The asymmetrical deficit was calculated ([fractured limb/sum of both lower limbs] x 100%) for isometric knee extension torque, rate of force development during isometr…

Physical activity and health

Advances in Physiotherapy is an international scientific journal on physiotherapy. Its Volume 9 is published in this year. This current number is a special issue on Physical Activity and Health for...

Sense of coherence: effect on adherence and response to resistance training in older people with hip fracture history.

Our aim was to study the effects of sense of coherence (SOC) on training adherence and interindividual changes in muscle strength, mobility, and balance after resistance training in older people with hip fracture history. These are secondary analyses of a 12-week randomized controlled trial of progressive resistance training in 60- to 85-year-old community-dwelling people 0.5–7 years after hip fracture (n = 45; ISRCTN34271567). Pre- and posttrial assessments included SOC, knee extension strength, walking speed, timed up-and-go (TUG), and Berg Balance Scale (BBS). Group-by-SOC interaction effects (repeated-measures ANOVA) were statistically significant for TUG (p = .005) and BBS (p = .040), …

Genetic and Environmental Influence on Structural Strength of Weight-Bearing and Non-Weight-Bearing Bone: A Twin Study

A bivariate genetic analysis among 217 older female twin pairs showed that, although the structural strength of tibia and radius are mainly regulated by same genetic and environmental factors, the tibia is more affected by environment. Introduction: The habitual loading environment of the bone may modulate the relative contribution of genetic and environmental factors to bone structure. The purpose of this study was to estimate the contribution of the common and site-specific genetic and environmental factors to interindividual variation in compressive structural strength of the weight-bearing tibia and non–weight-bearing radius. Materials and Methods: pQCT scans were obtained from both mem…

Whole body frontal plane mechanics across walking, running, and sprinting in young and older adults

This study investigated the whole body frontal plane mechanics among young (26 ± 6 years), early old (61 ± 5 years), and old (78 ± 4 years) adults during walking, running, and sprinting. The age-groups had similar walking (1.6 m/s) and running (4.0 m/s) speeds, but different maximal sprinting speed (young 9.3 m/s, early old 7.9 m/s, and old 6.6 m/s). Surprisingly, although the old group exerted much lower vertical ground reaction force during running and sprinting, the hip frontal plane moment did not differ between the age-groups. Kinematic analysis demonstrated increased hip adduction and pelvis drop, as well as reduced trunk lateral flexion among old adults, especially during sprinting. …

Outcome comparison among working adults with centralizing low back pain: Secondary analysis of a randomized controlled trial with 1-year follow-up

Our purpose was to examine if adults with centralizing pain might achieve better treatment outcomes when treated by individually designed therapy than “given advice only to stay active”. One hundred and nineteen working adults with first or a recurrent episode of low back pain (LBP) were classified as centralizers and were randomly allocated to orthopaedic manual therapy (OMT; n=42), the McKenzie (n=48) or “advice only to stay active” (Advice-only; n=29) groups. Back and leg pain were assessed by the visual analogue scale, disability with the Roland–Morris questionnaire and functional status with an activities of daily living (ADL) index. Immediately after the treatment period, LBP decrease…

Effectiveness of physical activity promoting technology-based distance interventions compared to usual care. Systematic review, meta-analysis and meta-regression.

Introduction Technology has been thought to have strong potential for promoting physical activity, but the evidence has remained unclear. The aim of this study was to examine whether a technology-based distance intervention promoting physical activity is more effective than a physical activity intervention without the use of technology. This systematic review is registered in Prospero (CRD42016035831). Evidence acquisition A systematic literature search of studies published between January 2000 to December 2015 was conducted in CENTRAL, EMBASE, Ovid MEDLINE, CINAHL, PsycINFO, OT-Seeker, WOS and PEDro. Studies were selected by two independent authors applying the following PICOS criteria P) …

Counselling for physical activity, life-space mobility and falls prevention in old age (COSMOS): protocol of a randomised controlled trial.

IntroductionThe most promising way to promote active life years in old age is to promote regular participation in physical activity (PA). Maintaining lower extremity muscle function with good balance has been associated with fewer falls and the need of help from others. This article describes the design and intervention of a randomised controlled trial (RCT) investigating the effectiveness of a health and PA counselling programme on life-space mobility and falls rates in community-dwelling older adults at the Health Kiosk and/or Service Centre.Methods and analysisCommunity-dwelling men and women (n=450) aged 65 years and over with early phase mobility limitation will be recruited to a 24-mo…

Physical function and lean body mass as predictors of bone loss after hip fracture: a prospective follow-up study

Abstract Background: Predictors of bone deterioration after hip fracture have not been well characterized. The aim of this study was to examine the associations of physical function and lean body mass (LBM) with loss of bone density and strength in older people recovering from a hip fracture. Methods: A total of 81 over 60-year-old, community-dwelling men and women operated for a hip fracture participated in this 1-year prospective follow-up study. Distal tibia total volumetric bone mineral density (vBMDTOT, mg/cm³) and compressive strength index (BSI, g²/cm⁴) and mid-tibia cortical vBMD (vBMDCO, mg/cm³) and bending strength index (SSI, mm³) were assessed in both legs by peripheral quantita…

Effect of Therapeutic Aquatic Exercise on Symptoms and Function Associated With Lower Limb Osteoarthritis: Systematic Review With Meta-Analysis

BackgroundCurrent management of osteoarthritis (OA) focuses on pain control and maintaining physical function through pharmacological, nonpharmacological, and surgical treatments. Exercise, including therapeutic aquatic exercise (TAE), is considered one of the most important management options. Nevertheless, there is no up-to-date systematic review describing the effect of TAE on symptoms and function associated with lower limb OA.PurposeThe purpose of this study was to conduct a systematic review with meta-analysis to determine the effect of TAE on symptoms and function associated with lower limb OA.Data SourcesThe data sources used in this study were: MEDLINE, PubMed, EMBASE, CINAHL, PEDr…

Impact or No Impact for Women With Mild Knee Osteoarthritis : A Bayesian Meta-Analysis of Two Randomized Controlled Trials With Contrasting Interventions

Objective: We aim to predict the probability of a benefit from two contrasting exercise programs for a woman with a new diagnosis of mild knee osteoarthritis (OA). The short and long-term effects of aquatic resistance training (ART) and high-impact aerobic land training (HLT) compared with the control will be estimated. Methods: Original data sets from two previously conducted randomised controlled trials (RCT) were combined and used in a Bayesian meta-analysis. Group differences in multiple response variables were estimated. Variables included cardiorespiratory fitness, dynamic maximum leg muscle power, maximal isometric knee extension and flexion force, pain, other symptoms and quality of…

Orthopaedic manual therapy, McKenzie method or advice only for low back pain in working adults: a randomized controlled trial with one year follow-up.

OBJECTIVE: To examine the effects of 2 manual therapy methods compared with one counselling session with a physiotherapist with "advice-only to stay active" for treating low back pain/leg pain and disability. DESIGN: A randomized, controlled trial with a 1-year follow-up. SUBJECTS: A total of 134 subjects with low back disorders. METHODS: Participants with acute to chronic first or recurrent low back pain, excluding those with "red flag" criteria, were assigned randomly to one of the 3 intervention groups: an orthopaedic manual therapy group (n=45), a McKenzie method group (n=52), and an "advice only to be active" group (advice-only) (n=37). Data on leg and low back pain intensity and disab…

Floor and ceiling effects of the World Health Organization Disability Assessment Schedule 2.0 among patients with chronic musculoskeletal pain

The aim of this study was to investigate the floor and ceiling effects of 12-item World Health Organization Disability Assessment Schedule 2.0 (WHODAS). This was a cross-sectional survey study at a university’s physical and rehabilitation medicine outpatient clinic of 1988 patients with chronic musculoskeletal pain. Floor and ceiling effects were calculated as relative frequencies of the lowest or the highest possible scores for each item. The probit plotting method was used to detect the non-normality of distribution of the total score graphically. A significant floor effect of 15–79% was observed in all 12 WHODAS 2.0 items. A substantial floor effect for total score was also detected grap…

Altered hip control during a standing knee-lift test is associated with increased risk of knee injuries

Few prospective studies have investigated hip and pelvic control as a risk factor for lower extremity (LE) injuries. The purpose of this study was to investigate whether deficits in hip and lumbopelvic control during standing knee lift test are associated with increased risk of acute knee and LE injuries in youth team sports. At baseline, 258 basketball and floorball players (aged 12‒21 y.) participated in a standing knee lift test using 3‐dimensional motion analysis. Two trials per leg were recorded from each participant. Peak sagittal plane pelvic tilt and frontal plane pelvic drop/hike were measured. Both continuous and categorical variables were analysed. New non‐contact LE injuries, an…

Does level of leisure time physical activity, in a sample of patients with depression, predict health care utilization over a subsequent 5-year period? Findings from a Finnish cohort study

Objectives: The main aim of this study was to investigate the association between leisure time physical activity (LTPA) and health care utilization (HCU) and furthermore, socio-demographic and clinical factors according to LTPA level among depressed patients based on data drawn from the Finnish Depression and Metabolic Syndrome in Adults (FDMSA)-study (2009-2016). Methods: 447 depressed patients aged 35-65 from municipalities within the Central Finland Hospital District participated in this study. Depressive symptoms (DS) were determined with the Beck Depression Inventory (a 10 points) and the psychiatric diagnosis confirmed with a diagnostic interview (M.I.N.I.). Severity of depression was…

Effects of a Home‐Based Physical Rehabilitation Program on Tibial Bone Structure, Density, and Strength After Hip Fracture: A Secondary Analysis of a Randomized Controlled Trial

Abstract Weight‐bearing physical activity may decrease or prevent bone deterioration after hip fracture. This study investigated the effects of a home‐based physical rehabilitation program on tibial bone traits in older hip fracture patients. A population‐based clinical sample of men and women operated for hip fracture (mean age 80 years, 78% women) was randomly assigned into an intervention (n = 40) and a standard care control group (n = 41) on average 10 weeks postfracture. The intervention group participated in a 12‐month home‐based rehabilitation intervention, including evaluation and modification of environmental hazards, guidance for safe walking, nonpharmacological pain management, m…

Targeted exercise against osteoporosis: A systematic review and meta-analysis for optimising bone strength throughout life

Background. Exercise is widely recommended to reduce osteoporosis, falls and related fragility fractures, but its effect on whole bone strength has remained inconclusive. The primary purpose of this systematic review and meta-analysis was to evaluate the effects of long-term supervised exercise (≥6 months) on estimates of lower-extremity bone strength from childhood to older age. Methods. We searched four databases (PubMed, Sport Discus, Physical Education Index, and Embase) up to October 2009 and included 10 randomised controlled trials (RCTs) that assessed the effects of exercise training on whole bone strength. We analysed the results by age groups (childhood, adolescence, and young and …