Associations between Physical Fitness, Bone Mass, and Structure in Older People.

The main aim was to analyse the associations between several physical fitness variables and bone parameters in a sample of elderly people. 129 participants (94 females and 35 males, 76.2 ± 5.4 y) from the EXERNET cohort of Zaragoza (Spain) were included in the study. Physical fitness was assessed using the Senior Fitness Test Battery. Peripheral quantitative computed tomography (pQCT) at the tibia and dual-energy X-ray absorptiometry (DXA) at the hip and lumbar spine were used to assess bone and muscle parameters. Partial correlations were used to describe the associations between fitness and bone parameters. A stepwise regression analysis was used to determine the influence of fitness variables on bone parameters. In males, significant correlations were found between lower body strength and agility with bone total mineral density (Tt.BMD) (r = 0.41 and -0.50) and cortical thickness (r = 0.40 and -0.50, respectively) and walking speed with total and cortical density (r = -0.41 and -0.40, respectively), all measured at tibia (all p < 0.05). Regarding DXA, neck areal bone mineral density (aBMD) correlated with flexibility (r = -0.37) and walking speed (r = 0.39) and Ward's triangle with walking speed (r = 0.39). Agility predicted Tt.BMD and cortical thickness (r 2 change = 24.8% and 23.0%), while walking speed predicted cortical bone mineral density (r 2 change = 19.5%) (all p < 0.05). Females showed correlations between balance and total hip aBMD (r = 0.27) and trochanter aBMD (r = 0.25). Balance predicted trochanter (r 2 change = 4.2%) and total hip aBMD (r 2 change = 4.9%) (both p < 0.05). In conclusion, bone mass in elderly males seems to be more influenced by physical fitness than in females, being agility and walking speed the variables showing greater associations. Other variables should be taken into account in females for future research.

Does fitness attenuate the relationship between changes in sitting time and health-related quality of life over time in community-dwelling older adults? Evidence from the EXERNET multicenter longitudinal study.

OBJECTIVE: To assess the relationship between fitness levels and components, sitting time and health-related quality of life (HRQoL), over time among community-dwelling older adults. METHODS: Three different sitting trajectories were calculated: (i) no change; (ii) decrease; and (iii) increase in ST, between baseline and follow-up. Fitness was assessed using the aerobic capacity, upper and lower limb strength, and total fitness. Participants were classified into higher (75th percentile or above) or lower (below 75th percentile) fitness levels, using the fitness tests. HRQoL scores at follow-up were compared to the three different sitting time trajectories within and across both the higher and the lower fitness groups for each of the three fitness indexes. RESULTS: Greater HRQoL scores were observed in those participants that decreased their ST as compared with those increasing their sitting time over time for participants classified in the lower end of their aerobic capacity or total fitness index. No differences were detected in HRQoL scores in people classified in the higher fitness level group for any of the fitness indexes. Participants that increased or did not change their sitting time and who were classified in the higher fitness end of aerobic capacity and total fitness index self-reported higher HRQoL scores when compared with those in the lower fitness end. CONCLUSION: Increased sitting time over time is associated with poorer HRQoL in older adults. Higher fitness levels could help attenuate the negative impact of sitting over time.

The muscle-bone unit in adolescent swimmers.

Most researchers adjust bone by lean mass when comparing swimmers with controls. This adjustment is done under the assumption that lean affects bone similarly in both groups. Nonetheless, we found that the muscle-bone association is uncoupled in swimmers, and consequently, researchers should avoid this adjustment when evaluating swimmers' bone. INTRODUCTION: To examine the functional and structural muscle-bone unit in adolescent swimmers. METHODS: Sixty-five swimmers (34 girls/31 boys) and 119 controls (51 girls/68 boys) participated in the study. Muscle cross-sectional area (MCSA), bone mineral content (BMC), and polar strength-strain index (SSIPOL) were measured in the non-dominant radius by peripheral quantitative computed tomography (pQCT). Subtotal BMC and lean mass were evaluated with dual-energy X-ray absorptiometry (DXA). Handgrip and isometric knee extension (IKE) tests were performed to determine muscle force. The effect of MCSA, lean and force on SSIPOL, and BMC were tested, and the functional and structural muscle-bone ratios of swimmers and controls were compared. RESULTS: Both muscle size (MCSA and lean) and muscle force (handgrip and IKE) influenced BMC and SSIPOL in swimmers and controls similarly. Swimmers presented normal MCSA and lean values for their height, but when compared with controls, swimmers presented a higher amount of lean and MCSA for the same BMC or SSIPOL (structural muscle-bone unit). For the functional muscle-bone unit, different results were found for the lower and upper limbs, as no differences were found for the upper limbs, while for the lower limbs, swimmers presented higher muscle force for the same amount of BMC. CONCLUSIONS: The contradictory results regarding BMC in swimmers found in previous studies could partly be explained with the findings of the present study that reinforce the idea that swimming is not an effective sport to practice regarding bone mass and that the muscle-bone unit is different in swimmers than in controls.

Outcome of drug-induced sleep endoscopy-directed surgery for persistent obstructive sleep apnea after adenotonsillar surgery.

PURPOSE: Drug-induced sleep endoscopy (DISE) is suitable for evaluating persistent obstructive sleep apnea syndrome (OSAS) after adenotonsillar surgery as a means to guide surgical intervention, yet few studies demonstrate its usefulness in resolving the syndrome. We describe our experience of DISE-directed surgery in children with persistent OSAS by analysing objective and subjective outcomes of this treatment. METHODS: Prospective study of 20 otherwise healthy 2-12 year-old children with OSAS persisting after adenotonsillar surgery. All patients underwent DISE-directed surgery and were followed up clinically and with a polysomnogram at 12 ±â€¯3 months. RESULTS: All 20 children had an apnea-hypopnea index (AHI) score ≥1 (mean: 6.1 ±â€¯4.9) and 75% had AHI>3 before surgery. We performed a total of 14 total tonsillectomies (70%), 7 with associated pharyngoplasties; 5 radiofrequency turbinate reductions (25%); 7 radiofrequency lingual tonsil reductions (35%); and 10 revision adenoidectomies (50%). No surgery-related complications were observed. AHI scores at follow-up were significantly lower than AHI scores before surgery (1.895 ±â€¯1.11 vs 6.143 ±â€¯4.88; p < 0.05) and, in 85% (n = 17) of patients, AHI was below 3. There was a significant reduction in the number of children with AHI>3 in follow-up at 12 ±â€¯3 months (15%; n = 3) compared to before surgery (75%; n = 15) (p < 0.005). CONCLUSION: DISE-directed surgery for otherwise healthy children with persistent OSAS is a useful and safe technique to decide a therapeutic strategy and to obtain good objective and subjective results regarding resolution of the syndrome.

Obstructive sleep apnea syndrome and growth failure.

Obstructive sleep apnea syndrome is a common problem among children and is recognized as a cause of significant medical morbidity. Since the 1980s, it has been suggested that obstructive sleep apnea syndrome is a risk factor for growth failure in children. In many cases, it has been shown that growth failure is reversible once the obstructive sleep apnea syndrome is resolved. The objectives of this study were to analyze and compare growth failure prevalence in a Mediterranean population of children with obstructive sleep apnea syndrome and healthy children matched in age and sex, and to assess the effectiveness of tonsillectomy and adenoidectomy in resolving growth retardation. We compared 172 children with obstructive sleep apnea syndrome (apnea-hypopnea index ≥ 3) who had undergone tonsillectomy and adenoidectomy with 172 healthy controls in terms of key anthropometric parameters. Most of the criteria used for growth failure were higher to a statistically significant degree in the study group vs the control group: height-for-age ≤ 3rd percentile (7.56% vs 2.91%; p = 0.044), weight-for-age ≤ 5th percentile (9.30% vs 2.33%; p = 0.005), weight-for-age ≤ 3rd percentile (8.14% vs 2.33%; p = 0.013) and height and/or weight for-age ≤ 5th percentile (13.95% vs 5.81%; p = 0.009). The height-for-age ≤ 5th percentile was almost at the limit of statistical significance (8.72% for the study group vs 4.65% for the control group; p = 0.097). At one-year post-surgery follow-up, 10 of 15 children with height-for-age ≤ 5th percentile had achieved catch-up growth (66.6%), and 14 of 24 children with height- and/or weight-for-age ≤ 5th percentile had normalized growth (58.33%). For children with failure to thrive or who have growth failure, physicians should consider the possibility of obstructive sleep apnea. A significant number of children with obstructive sleep apnea concurrent with growth failure could benefit from tonsillectomy and adenoidectomy to recover and normalize their growth rate.

Grado de conocimiento del idioma guaraní en estudiantes de medicina en un hospital universitario de Paraguay / Knowledge of the Guarani language in medical students at a university hospital in Paraguay

INTRODUCCIÓN: Paraguay es un país bilingüe, y el conocimiento del idioma guaraní constituye una herramienta importante de comunicación en la relación médico-paciente. OBJETIVO: Dar cuenta del grado y los factores que determinan el conocimiento del idioma guaraní, en estudiantes de medicina de último año en un hospital universitario de Paraguay. MÉTODOS: Estudio observacional, transversal y analítico. En él se aplicó una encuesta anónima con cuestionario a los alumnos de último año de medicina de un hospital universitario de Paraguay. Se realizó un estudio descriptivo de las características basales de los estudiantes de medicina y de su grado de conocimiento del idioma guaraní. Se efectuó la prueba de Chi-cuadrado para comparar variables categóricas, y se aplicó un estudio de regresión logística para determinar factores que determinan el grado de conocimiento del idioma. RESULTADOS: Fueron encuestados 264 estudiantes. El 82% provenía de la capital, 72% realizó sus estudios preuniversitarios en Asunción. El 92% estudió guaraní en la educación primaria y secundaria; 67,9% no lo interpreta correctamente. El 8,5% entienden y se expresan totalmente en guaraní; de ellos el 86% refirió que su mayor aprendizaje del idioma fue en el hogar familiar. El 75,2% de los encuestados consideró que la educación primaria y secundaria no ayudó en el aprendizaje. El grado de conocimiento del idioma (habla y entiende el idioma guaraní correctamente), varía si el estudiante proviene del interior o de la capital (31,25% versus 2,5%; OR ajustado: 0,24, intervalo de confianza 95% de 0,06 a 0,92; p=0,003); y según la localidad de la escuela primaria y secundaria: interior versus capital (25,6 y 1% respectivamente; OR ajustado: 0,08; intervalo de confianza 95% de 0,01 a 0,53; p=0,009). CONCLUSIONES: El grado de conocimiento de los estudiantes del guaraní es menor, comparado con población general. Los que mejor se expresan y comprenden el idioma, nacieron o lo estudiaron en el interior del país. La mayoría considera de poco aporte la educación primaria y secundaria para el aprendizaje del guaraní. Siendo el idioma una herramienta importante de comunicación en la relación médico­paciente, y sabiendo que el guaraní es el idioma más hablado del país; se deberían implementar estrategias para su aprendizaje.

INTRODUCTION: Paraguay is a bilingual country and knowledge of the guarani language is an important communication tool for the doctor- patient relationship. OBJECTIVE: To determine the degree of and the factors that influence the knowledge of the Guaraní language in medical students at a University Hospital in Paraguay METHODS: Observational, cross-sectional, analytical study in which an anonymous questionnaire was applied to the final year medical students of a University Hospital of Paraguay. The baseline characteristics of the medical students and their degree of knowledge of the Guarani language were described. The association between the characteristics of the students and the degree of knowledge of the Guarani language was evaluated with the Chi square association test and the logistic regression model. RESULTS: We included 264 students in the survey. Eighty two percent come from the capital, 72% made their pre-university studies in the capital; 92% studied Guaraní in primary and secondary education; 67.9% do not interpret Guarani correctly; 8.5% understand and express themselves totally in Guaraní. Of these, 86% refer to have the greater learning of the language in their home; 75.2% of respondents believe that primary and secondary education did not help in learning the language. The degree of knowledge of the language (speaks and understands the Guarani language correctly) varies according to: the origin of the student, the inland regions or the capital (31.25% vs. 2.5%, adjusted OR = 0.24, 95% confidence interval: 0.06 to 0.92, p = 0.003); the location of primary and secondary school: inland versus capital (25.6% vs. 1%, adjusted OR: 0.08, 95% confidence interval: 0.01 to 0.53, p = 0.009). CONCLUSIONS: The degree of knowledge of the Guaraní language of the students is lower compared to the general population; those who best understand and express themselves were born or studied in the interior of the country. The majority considers that primary and secondary education contribute little in the learning of Guaraní. Since language is an important communication tool in the patient-doctor relationship and knowing that Guarani is the most spoken language in the country, strategies for its learning should be implemented.

Do 6 months of whole-body vibration training improve lean mass and bone mass acquisition of adolescent swimmers?

Swimming has little effect on bone mass. Therefore, adolescent swimmers should complement their water training with a short and intense weight-bearing training, aiming to increase their bone acquisition. Forty swimmers performed a six-month whole-body vibration (WBV) training. WBV had no effect on adolescent swimmers' bone mass or lean mass. PURPOSE: The aims of the present study were to evaluate the effects of a whole-body vibration (WBV) intervention on bone mineral density (BMD), bone mineral content (BMC) and lean mass (LM) in adolescent swimmers. METHODS: Forty male and female adolescent swimmers (VIB; mean age 14.2 ± 1.9 years) completed the WBV protocol that consisted of 15 min of training 3 days per week during a 6-month period (ranging from 3.6 to 11.6 g), while 23 swimmers (SWI; mean age 15.0 ± 2.2 years) continued with their regular swimming training alone. VIB were divided into tertiles according to training compliance in order to evaluate if any dose-effect relation existed. BMD, BMC and LM were measured longitudinally by dual energy X-ray at the whole body, lumbar-spine and hip. RESULTS: No group by time interactions and no differences in change percentage were found for BMD, BMC or LM in any of the measured variables. The mean change percentage of the subtotal body (whole body minus the head) for VIB and SWI, respectively, was 2.3 vs. 2.4% for BMD, 5.7 vs 5.7% for BMC and 7.3 vs. 8.0% for lean mass. Moreover, no indication for dose-response was observed. CONCLUSIONS: The proposed WBV protocol had no effect on BMD, BMC and LM in adolescent swimmers. Other types of training should be used in this population to improve both bone and lean mass.

Neumomediastino Espontáneo. Reporte de caso / Spontaneous Pneumomediastinum. Case report

El neumomediastino espontáneo, es una patología poco frecuente, benigna y autolimitada, se caracteriza por la presencia de aire en el mediastino, puede ser idiopática o secundaria a factores desencadenantes drogas, vómitos, accesos de tos. Se da a cualquier edad, aunque suele predominar en varones jóvenes, fumadores y con antecedentes de patología pulmonar previa. Su diagnóstico se establece ante una serie de síntomas y signos que lo caracterizan; e imágenes. Reportamos el caso de un paciente joven, que consulta a la urgencia por cuadro respiratorio, los estudios radiológicos, hicieron el diagnóstico, la evolución fue favorable, se discute los aspectos relevantes de esta entidad clínica.

Spontaneous pneumomediastinum, is a little common, benign and self-limited disease, characterized by the presence of air in the mediastinum, may be idiopathic or secondary to triggers drugs, vomiting, coughing. Occurs at any age, although it tends to predominate in young males, smokers with a history of prior pulmonary pathology. His diagnosis is established before a series of signs and symptoms that characterize it; e images. We report the case of a young patient, consulting to the urgency by respiratory picture, radiologic studies, made the diagnosis, evolution was favorable, discussed aspects of this clinical entity.

Swimming and bone: Is low bone mass due to hypogravity alone or does other physical activity influence it?

UNLABELLED: Swimming during adolescence has shown neutral or even negative effects on bone mass. Nevertheless, it is still unknown if these effects are due to swimming or to other factors, such as sedentary behaviors. INTRODUCTION: Three objectives were described (1) to measure objective physical activity (PA) additional to swimming performed by adolescent swimmers (SWI) and compare it to that performed by normo-active controls (CG), (2) to describe the relationship between objectively measured PA and bone mass, and (3) to compare bone mass of swimmers that meet the World Health Organization PA guidelines (active) WHO and those that do not (inactive). METHODS: A total of 71 SWI (33 females) and 41 CG (17 females) wore an accelerometer for at least 4 days. PA was expressed as the amount of time (minutes/day) in each intensity [sedentary/light/moderate or vigorous (VPA), and the sum of moderate and vigorous (MVPA)]. Using the cutoff points proposed by Vanhelst et al. SWI were classified as active or inactive according to whether they reached 60 min of weight-bearing MVPA per day or not. Bone mineral density (BMD) was measured by dual energy X-ray absorptiometry, and bone strength values were calculated with peripheral quantitative computed tomography. Differences in PA intensities were calculated between SWI and CG. The relation of VPA to bone mass was studied in the SWI. RESULTS: Male-SWI spend less time in VPA and MVPA than male-GC, which partly explains the lower BMD values in SWI than CG. CONCLUSION: Swimming may displace weight-bearing VPA with serious implications on bone health.

Bone structure of adolescent swimmers; a peripheral quantitative computed tomography (pQCT) study.

OBJECTIVES: The aims of the present study were: (1) to characterize vBMD, bone structure and strength with peripheral quantitative computerized tomography (pQCT) in adolescent swimmers and compare it to normo-active controls (CG); and (2) to evaluate the possible interaction that weight-bearing sports might have on swimmers bone. DESIGN: Cross-sectional. METHODS: The non-dominant radius and tibia of 79 (32 females) swimmers and 49 (22 females) CG (both 11-18 years old) were evaluated at proximal and distal sites with a pQCT scanner. Values of total, trabecular and cortical volumetric bone mineral density (vBMD) were obtained from each scan. Cortical thickness, endosteal and periosteal circumferences were also measured and bone strength indexes were calculated. Analyses of covariance were used to compare variables between groups adjusting for age, tanner stage and bone length. Three different analyses were performed according to present and past sport participation in addition to swimming in order to determine differences among swimmers who had performed or were performing other sports (OTHER-SP) (10 females/17 males) and swimmers who had not performed other sports (NO-OTHER-SP) (22 females/22 males). Both of these groups were compared to each other and to a CG (22 females/27 males). RESULTS: No differences were found between swimmers and CG for bone strength indexes, structure or vBMD (independently of the compared sample). CONCLUSIONS: These results indicate that swimmers present similar bone strength and structure than CG who did not present high physical activity levels.

Effect of whole-body vibration training on bone mass in adolescents with and without Down syndrome: a randomized controlled trial.

UNLABELLED: Whole-body vibration training (WBV) attracts great interest as osteoporosis prevention strategy. Twenty-six adolescents with and without Down syndrome (DS) (13 DS; 12-18 years) performed 20 weeks of WBV. The results indicate that WBV seems to provoke a lesser response in adolescents with DS than in those without DS. INTRODUCTION: This study aims to observe the differences between adolescents with and without DS in the effects of 20 weeks of WBV training, on bone mineral content (BMC) and density (BMD). METHODS: Twenty-six adolescents (13 DS; 12-18 years) were measured with dual-energy X-ray absorptiometry before and after the intervention (3/week, 10 repetitions (30-60 s) and 1-min rest, frequency 25-30 Hz and peak-to-peak displacement of 2 mm (peak acceleration 2.5-3.6 g)). Both, an intention-to-treat (ITT) analysis designed to assess the effects on bone mass and a per-protocol analysis, designed to compare poor and high compliers, were performed. RESULTS: The ITT analysis revealed significant increases in all BMC and BMD parameters (dz = 0.66 to 1.64; all p < 0.05) in the non-DS group, whilst DS group improved whole-body, subtotal (whole-body less head), upper limbs (ULIMBS), pelvis, lower limbs (LLIMBS) and spine BMC (dz = 0.75 to 1.76; all p < 0.05) and subtotal, pelvis, LLIMBS and spine BMD (dz = 0.73 to 1.28; all p < 0.05). Significantly greater increases were evident in the absolute and percent changes of the non-DS group over DS group (d = 0.88 to 3.85; all p < 0.05). ULIMBS BMD showed a tendency towards an interaction (f = 0.41 and p = 0.086) with higher increase for non-DS group. When a per-protocol analysis was considered, high-complier adolescents had 8.1 versus 5.3 % of gains in the spine BMC over poor-complier adolescents (d = 0.93; p < 0.05). CONCLUSIONS: Twenty weeks of WBV training may improve BMC and BMD in clinically relevant skeletal sites in both groups. Nevertheless, this type of training seems to provoke a lesser response in adolescents with DS than in those without DS.

Combined effects of interaction between physical activity and nutrition on bone health in children and adolescents: a systematic review.

CONTEXT: Osteoporosis is a major public health concern worldwide. Understanding the roles of diet and physical activity in ensuring adequate bone mass accrual during childhood and adolescence may help identify strategies to reduce the risk of osteoporotic fractures later in life. OBJECTIVE: The present systematic review was conducted to provide an overview of the current knowledge of the combined effects of physical activity and diet on bone mass accrual in children and adolescents. DATA SOURCES: Data were obtained via searches of the PubMed, EMBASE, SPORTDiscus, and ISI Web of Science databases. STUDY SELECTION: Studies published in English and Spanish between 1887 and August 2013 were eligible for inclusion. Two investigators evaluated the studies against the inclusion and exclusion criteria. A total of 14 studies (7 cross-sectional and 7 experimental) were included in the review. DATA EXTRACTION: The Pedro score and the Black and Down's checklist were used to evaluate the methodological quality of the experimental and the cross-sectional studies, respectively. Study characteristics were summarized in accordance with the review's PICO criteria. DATA SYNTHESIS: Significant exercise-by-calcium interaction was detected at several different bone sites. CONCLUSIONS: Although the results of cross-sectional studies were inconsistent, the results of randomized controlled trials showed that exercise has the potential to improve bone health under conditions of adequate calcium intake.

Effect of whole body vibration training on bone mineral density and bone quality in adolescents with Down syndrome: a randomized controlled trial.

UNLABELLED: Adolescents with Down syndrome (DS) have poorer bone health than their peers without DS. Twenty-five adolescents with DS were randomly assigned to whole-body vibration training (WBV) or control groups. The results indicate that a 20-week WBV might be useful to improve subtotal bone mineral content and density in adolescents with DS. INTRODUCTION: This study aims to determine the effects of 20 weeks of whole body vibration training (WBV) on bone mineral content (BMC), density (BMD), and structure variables in adolescents with Down syndrome (DS). METHODS: This randomized controlled trial of 25 adolescents (12-18 years) with DS (8 females) generated 2 non-equal groups, WBV group (n = 11) and CON group (n = 14). Using an efficacy analysis, the primary outcomes were BMC and BMD by dual-energy X-ray absorptiometry and the secondary were bone structure variables by peripheral quantitative computed tomography. A synchronous vibration platform (PowerPlate®) was used (3/week, 10 repetitions (30-60 s) 1-min rest, frequency of 25-30 Hz, and peak-to-peak displacement of 2 mm (peak acceleration 2.5-3.6 g)). RESULTS: WBV group improved whole body BMC 2.8%, 95% CI [3.5, 2.1], subtotal area, BMC, and BMD by 2.8, 4.8, and 2%, respectively, 95% confidence intervals (CIs) [3.4, 2.1], [6.5, 3.1], and [2.8, 1.1], respectively (all, p < 0.05), showing group by time interactions in BMC and BMD (both p < 0.05). Lumbar spine BMC and BMD also increased in the WBV group by 6.6 and 3.3% both p < 0.05, 95 % CIs [8.6, 4.7], and [4.9, 1.7], respectively. Regarding bone structure, WBV group showed improvements in tibial BMC at 4 % (2.9 %, 95 % CI [3.0, 2.8]) and in volumetric BMD (vBMD), cortical vBMD, and cortical thickness at 66% of the radius (by 7.0, 2.4, and 10.9%; 95% CIs [7.4, 6.7], [2.6, 2.3], and [12.4, 9.3], respectively) (all, p < 0.05). CONCLUSIONS: A 20-week WBV, with this protocol, might be useful to improve subtotal BMC and BMD in adolescents with DS.

Body Composition Evolution in Elite Football Referees; an Eleven-years Retrospective Study.

Fitness, and specifically body composition of football referees requires attention in order to achieve the highest possible standards. The aim of the present study was to describe body composition of elite Spanish football referees over 11 years. Data from 2001 to 2012 pre-seasons were analyzed from a total of 470 referees of 1(st) and 2(nd) categories in Spanish male football (1C and 2C respectively). Body mass index (BMI), sum of 6 skinfolds (6SS) and percentage of body fat (%BF) were assessed. 2-independent samples Student's t-test between categories, and ANOVA tests with Bonferroni post-hoc analyses among seasons were applied. Overall, 1C referees were older than 2C in every season, and both 1C and 2C showed a decrease in 6SS, BMI and %BF throughout seasons (all p<0.05; from 82.5 to 62.9 mm, from 23.7 to 22.4 kg/m(2) and from 13.7 to 11.7%). No differences were observed between categories in any season. Since football referees at the highest levels need to have a low %BF for the intense matches nowadays, an improvement in their body composition profile has been observed in a highly competitive league as 'La Liga' in Spain over the last decade.

The effects of swimming training on bone tissue in adolescence.

The aim was to analyze bone mineral content (BMC) and density (BMD) in regular swimming trained adolescents and the interaction that weigh-bearing sports may have on these values. Bone mass was evaluated by dual energy x-ray absorptiometry (DXA) and quantitative ultrasound (QUS) in 77 swimmers (34 females/43 males) and 52 normoactive controls (CG; 23 females/29 males) from 11 to 18 years. Swimmers who had performed or were performing other sports (OSP; 11 females/20 males) were compared with pure swimmers (PSW; 23 females/23 males). Both groups were compared with CG. Bone values were compared using analyses of covariance adjusting for height, calcium intake, subtotal lean (whole body lean minus head), and pubertal status. Male PSW showed lower BMD and BMC at several sites than male CG. However, for male OSP, only lumbar spine BMC was lower in OSP than male CG. Male PSW showed lower BMD and BMC when compared with male OSP. Female PSW showed higher arm BMD and lower leg BMC than female CG, while female OSP only presented lower leg BMC than female CG. Contrary to males, female-PSW presented higher BMD and BMC than female OSP. No differences in QUS values were found between swimmers and CG. To summarize, although more information is needed for females, it seems that for males, swimming is associated with lower BMC and BMD.

Efectos del entrenamiento pliométrico sobre la resistencia cardiorrespiratoria de niños y adolescentes con síndrome de Down / Effects of a circuit training including plyometric jumps on cardiorespiratory fitness of children and adolescents with Down syndrome

Objetivo: Determinar los efectos de 21 semanas de entrenamiento en circuito, incluyendo saltos pliométricos sobre la resistencia cardiorrespiratoria de jóvenes con síndrome de Down (SD). Método: Veintisiete jóvenes con SD de entre 10 y 19 años participaron en este estudio. Los participantes se dividieron en dos grupos: ejercicio (EJE; n= 14) y control (CON; n=13). Antes y después de la realización del programa de entrenamiento se midieron los siguientes parámetros: tiempo de trabajo, valores máximos de consumo de oxígeno, cociente respiratorio, frecuencia cardíaca y ventilación minuto de los participantes mediante una prueba de esfuerzo progresiva en tapiz rodante. Resultados: Los participantes del grupo EJE aumentaron todos los parámetros cardiovasculares en comparación con su valor basal, después del entrenamiento (todos p< 0,05). Además, a pesar de tener unos valores similares antes del entrenamiento, el grupo EJE mostró valores más elevados que el grupo CON después del entrenamiento (todos p<0,05). Conclusión: Se puede concluir que los jóvenes con síndrome de Down pueden conseguir mejoras en diversos parámetros cardiorrespiratorios tras la ejecución de 21 semanas de entrenamiento con ejercicios pliométricos (AU)

Aim: To ascertain the effects of 21 weeks of circuit training, including plyometric jumps, on cardiorespiratory fitness of youths with Down’s syndrome (DS). Methods: Twenty-seven children and adolescent aged 10 to 19 years with DS participated in this study and were divided in two groups: exercise (EXE, n=14) and control (CON, n=13). Work time, peak values of oxygen consumption, respiratory exchange ratio, heart rate and minute ventilation of the participants were measured pre- and post-training with a graded exercise treadmill test. Results: EXE group increased all their cardiorespiratory parameters compared to baseline after 21 weeks of training (all P<.05). Additionally, and despite having similar pre-training values, the EXE group showed higher values than the CON group in all cardiorespiratory parameters after training (all P<.05). Conclusion: It may be concluded that youths with Down syndrome can achieve improvements in several cardiorespiratory parameters when performing 21 weeks of training including plyometric exercises (AU)

Swimming training repercussion on metabolic and structural bone development; benefits of the incorporation of whole body vibration or pilometric training; the RENACIMIENTO project.

INTRODUCTION: Enviromental factors such as exercise participation and nutrition have often been linked to bone improvements. However, not all sports have the same effects, being non-osteogenic sports such as swimming defined as negative or neutral sports to practice regarding bone mass by some authors, similarly exercise-diet interaction in especific groups is still not clear. OBJECTIVE: To present the methodology of the RENACIMENTO project that aims to evaluate body composition and more specifically bone mass by several techniques in adolescent swimmers and to observe the effects and perdurability of whole body vibration (WBV) and jumping intervention (JIN) on body composition and fitness on this population and explore posible diet interactions. DESIGN: Randomized controlled trial. METHODS: 78 swimmers (12-17 y) and 26 sex- and age-matched controls will participate in this study. Dual energy X-ray, peripheral Quantitative Computed Tomography, Quantitative Ultrasound, Bioelectrical Impedance Analysis, and anthropometry measurements will be performed in order to evaluate body composition. Physical activity, nutrition, pubertal development and socio-economical status may act as confounders of body composition and therefore will also be registered. Several fitness factors regarding strength, endurance, performance and others will also be registered to evaluate differences with controls and act as confounders. A 7-month WBV therapy will be performed by 26 swimmers consisting of a training of 15 minutes 3 times per week. An 8 month JIM will also be performed by 26 swimmers 3 times per week. The remaining 26 swimmers will continue their normal swimming training. Four evaluations will be performed, the first one in order to describe differences between swimmers and controls. The second one to describe the effects of the interventions and the third and fourth evaluations to describe the perdurability of the effects of the WBV and JIN. CONCLUSION: The RENACIMIENTO project will allow to answer several questions regarding body composition, fitness, bone mass and interaction with diet of adolescent swimmers, describe swimming as a positive, negative or neutral sport to practice regarding these parameters and elucidate the effects and perdurability of WBV and JIM on body composition.

Introducción: En la actualidad se ha demostrado que el ejercicio físico y la nutrición mejoran la masa ósea. Sin embargo, existen deportes de bajo impacto como la natación que no presentan efectos positivos en su desarrollo. Además, la interacción ejercicio-dieta y su efecto osteogénico sigue sin estar clara. Objetivo: Presentar la metodología del proyecto RENACIMIENTO que tiene por objetivo evaluar la composición corporal del nadador adolescente y más concretamente la masa ósea a través de diversas técnicas. Además se pretenden determinar los efectos y la perdurabilidad que pueden tener el entrenamiento vibratorio (WBV) y una intervención con saltos (JIN) sobre la composición corporal y condición física de estos adolescentes, explorando la posible interacción con la dieta. Diseño: Ensayo clínico aleatorizado. Metodología: 78 nadadores (12-17 años) y 26 controles del mismo sexo y edad participarán en el estudio. Se utilizarán absorciometría dual de rayos-x, tomografía axial computerizada, ultrasonidos cuantitativo, bioimpedancia eléctrica, y medidas antropométricas para evaluar la composición corporal. La actividad física, nutrición, desarrollo puberal y status socio-económico podrían actuar como covariables de la composición corporal y por lo tanto también serán registradas. Se evaluarán diversos factores de la condición física relacionados con la fuerza, resistencia, rendimiento y otros para definir las diferencias con los controles y para que sirvan como covariables. 26 nadadores realizarán una intervención de WBV 7 meses 15 minutos 3 veces por semana. Además otros 26 nadadores realizarán una JIN 3 veces por semana durante 8 meses. Los 26 nadadores restantes continuarán con su entrenamiento habitual de natación. Se realizaran 4 evaluaciones, la primera de ellas para describir las diferencias existentes entre nadadores y controles, la segunda para describir los efectos de las intervenciones realizadas y la tercera y cuarta para evaluar la perdurabilidad de estas intervenciones. Conclusión: El proyecto RENACIMIENTO permitirá contestar a diversas preguntas relacionadas con la composición corporal, condición física y masa ósea de los nadadores adolescentes y el posible efecto combinado dieta-ejercicio en esta población. Definirá la natación como un deporte positivo, neutral o negativo en relación con estos parámetros y esclarecerá los efectos y perdurabilidad de la WBV y JIN sobre la composición corporal.

Swimming training repercussion on metabolic and structural bone development; benefits of the incorporation of whole body vibration or pilometric training; the RENACIMIENTO Project / Repercusión del entrenamiento y la práctica de la natación sobre el desarrollo metabólico y estructural del hueso en crecimiento; beneficios de la incorporación de entrenamiento pilométrico o vibratorio; el estudio RENACIMIENTO

Introduction: Enviromental factors such as exercise participation and nutrition have often been linked to bone improvements. However, not all sports have the same effects, being non-osteogenic sports such as swimming defined as negative or neutral sports to practice regarding bone mass by some authors, similarly exercise diet interaction in especific groups is still not clear. Objective: To present the methodology of the RENACIMENTO project that aims to evaluate body composition and more specifically bone mass by several techniques in adolescent swimmers and to observe the effects and perdurability of whole body vibration (WBV) and jumping intervention (JIN) on body composition and fitness on this population and explore possible diet interactions. Design: Randomized controlled trial. Methods: 78 swimmers (12-17 y) and 26 sex- and agematched controls will participate in this study. Dual energy X-ray, peripheral Quantitative Computed Tomography, Quantitative Ultrasound, Bioelectrical Impedance Analysis, and anthropometry measurements will be performed in order to evaluate body composition. Physical activity, nutrition, pubertal development and socio-economical status may act as confounders of body composition and therefore will also be registered. Several fitness factors regarding strength, endurance, performance and others will also be registered to evaluate differences with controls and act as confounders. A 7- month WBV therapy will be performed by 26 swimmers consisting of a training of 15 minutes 3 times per week. An 8 month JIM will also be performed by 26 swimmers 3 times per week. The remaining 26 swimmers will continue their normal swimming training. Four evaluations will be performed, the first one in order to describe differences between swimmers and controls. The second one to describe the effects of the interventions and the third and fourth evaluations to describe the perdurability of the effects of the WBV and JIN. Conclusion: The RENACIMIENTO project will allow to answer several questions regarding body composition, fitness, bone mass and interaction with diet of adolescent swimmers, describe swimming as a positive, negative or neutral sport to practice regarding these parameters and elucidate the effects and perdurability of WBV and JIM on body composition (AU)

Introducción: En la actualidad se ha demostrado que el ejercicio físico y la nutrición mejoran la masa ósea. Sin embargo, existen deportes de bajo impacto como la natación que no presentan efectos positivos en su desarrollo. Además, la interacción ejercicio-dieta y su efecto osteogénico sigue sin estar clara. Objetivo: Presentar la metodología del proyecto RENACIMIENTO que tiene por objetivo evaluar la composición corporal del nadador adolescente y más concretamente la masa ósea a través de diversas técnicas. Además se pretenden determinar los efectos y la perdurabilidad que pueden tener el entrenamiento vibratorio (WBV) y una intervención con saltos (JIN) sobre la composición corporal y condición física de estos adolescentes, explorando la posible interacción con la dieta. Diseño: Ensayo clínico aleatorizado. Metodología: 78 nadadores (12-17 años) y 26 controles del mismo sexo y edad participarán en el estudio. Se utilizarán absorciometría dual de rayos-x, tomografía axial computerizada, ultrasonidos cuantitativo, bioimpedancia eléctrica, y medidas antropométricas para evaluar la composición corporal. La actividad física, nutrición, desarrollo puberal y status socio-económico podrían actuar como covariables de la composición corporal y por lo tanto también serán registradas. Se evaluarán diversos factores de la condición física relacionados con la fuerza, resistencia, rendimiento y otros para definir las diferencias con los controles y para que sirvan como covariables. 26 nadadores realizarán una intervención de WBV 7 meses 15 minutos 3 veces por semana. Además otros 26 nadadores realizarán una JIN 3 veces por semana durante 8 meses. Los 26 nadadores restantes continuarán con su entrenamiento habitual de natación. Se realizaran 4 evaluaciones, la primera de ellas para describir las diferencias existentes entre nadadores y controles, la segunda para describir los efectos de las intervenciones realizadas y la tercera y cuarta para evaluar la perdurabilidad de estas intervenciones. Conclusión: El proyecto RENACIMIENTO permitirá contestar a diversas preguntas relacionadas con la composición corporal, condición física y masa ósea de los nadadores adolescentes y el posible efecto combinado dieta-ejercicio en esta población. Definirá la natación como un deporte positivo, neutral o negativo en relación con estos parámetros y esclarecerá los efectos y perdurabilidad de la WBV y JIN sobre la composición corporal (AU)

Do calcium and vitamin D intake influence the effect of cycling on bone mass through adolescence? / ¿Influye la ingesta de calcio y vitamina D en el efecto del ciclismo sobre la masa ósea durante la adolescencia?

INTRODUCTION: Cycling has been associated with decreased bone mass during adolescence. Calcium (Ca) and vitamin D (VitD) intake are associated to bone mass and may be important confounders when studying bone mass.AIM: To clarify the effect that Ca and VitD may have on bone mass in adolescent cyclists. METHODS: Bone mineral content (BMC) and density (BMD) of 39 male adolescents (20 cyclists) were measured. Ca and VitD intake were also registered. Different ANCOVA analyses were performed in order to evaluate the influence of Ca and VitD on BMC and BMD. RESULTS: Cyclists showed lower values of BMC and BMD than controls at several sites and when adjusting by Ca, Wards triangle BMD appeared also to be lower in cyclists than controls. CONCLUSION: Nutritional aspects might partially explain differences regarding bone mass in adolescent cyclists and should be taken into account inbone mass analysis as important confounders (AU)

Introducción: El ciclismo se ha asociado con un descenso de la masa ósea durante la adolescencia. La ingesta de calcio (Ca) y vitamina D (VitD) repercute sobre la masa ósea llegando a ser factores de confusión importantes al estudiarla. Objetivo: Clarificar el efecto que el Ca y la VitD pueden tener sobre la masa ósea de ciclistas adolescentes. Métodos: se midió el contenido mineral óseo (CMO) y la densidad mineral ósea (DMO) de 39 varones adolescentes (20 ciclistas). También se registró la ingesta de Ca y VitD. Se realizaron distintos análisis ANCOVA para evaluar la influencia del Ca y la VitD sobre el CMO y la DMO. Resultados: Los ciclistas mostraron menores valores de CMO y DMO que los controles en diversas zonas y, cuando se ajustó por Ca, la DMO del triángulo de Wards también pasó a ser menor en los ciclistas que en los controles. Conclusión: Los aspectos nutricionales podrían explicar en parte las diferencias de masa ósea en ciclistas adolescentes y deberían tenerse en cuenta en el análisis de masa ósea como factores de confusión importantes (AU)

Physical activity and cardiorespiratory fitness in adolescents with Down syndrome / Actividad física y estado de forma cardiovascular en adolescentes con síndrome de down

AIMS: To determine if adolescents with and without Down syndrome (DS) accomplish the physical activity (PA) guidelines and to evaluate relationships between PA and cardiorespiratory variables.METHODS:42 adolescents (27 with DS) participated in this study. PA was measured using accelerometers. Walking-graded treadmill protocol with a breath-by-breath gas analyzer was employed to assess cardiorespiratory fitness. RESULTS: Adolescents with DS spent less time in sedentary PA, moderate PA (MPA), vigorous PA (VPA) and moderate to vigorous PA (MVPA) than those without DS. VO2peak was correlated with total minutes spent in light PA, MPA, VPA and MVPA in the control group (from r = 0.55 to r = 0.61, p < 0.05) and with MPA and MVPA in the DS group (from r = 0.38 to r = 0.41, p < 0.05). CONCLUSION: Nor DS neither control groups achieved at least 60 minutes of MPA daily. Engaging more time in MPA was associated with greatercardiorespiratory fitness in adolescents with DS (AU)

Objetivos: Comprobar si los adolescentes con síndrome de Down (SD) cumplen las guías de actividad física (AF) y evaluar la relación entre AF y la condición cardiorrespiratoria. Métodos: 42 adolescentes (27 con SD) participaron en este estudio. La AF se midió usando acelerometría. La condición cardiorrespiratoria se evaluó mediante ergoespirometría en tapiz rodante con un protocolo progresivo continuo. Resultados: Los adolescentes con SD pasaron menos tiempo en AF sedentaria, moderada (MAF), vigorosa (VAF) y moderada-vigorosa (MVAF) que los adolescentes sin SD. El VO2peak mostró correlación con minutos totales en AF ligera, MAF, VAF y MVAF en el grupo control (desde r = 0,55 hasta r = 0,61, p < 0,05) y con MAF y VAF en el grupo de adolescentes con SD (desde r = 0,38 hasta r = 0,41, p < 0,05). Conclusión: Ningún grupo alcanzó 60 minutos de MAF diaria. La capacidad cardiorrespiratoria en adolescentes con SD se asoció con una mayor participación en MAF (AU)