The 2004 Olympic Games: physiotherapy services in the Olympic Village polyclinic.

OBJECTIVE: First, to document the injuries sustained during the 2004 Olympic Games in a sample of patients visiting the physiotherapy department of the Olympic Village polyclinic. Second, to provide information and data about the physiotherapy services for planning future Olympics and other mass gatherings. DESIGN: Observational study. SETTING: Olympic Village polyclinic. PARTICIPANTS: 457 patients aged 15-72 years visited the physiotherapy department from 30 July through 30 August. RESULTS: The department's workload was at a peak during the last 15 days of the Olympic Games (periods B and C). The most common injuries were overuse injuries (47.3%). The most common pathology for physiotherapy attendance was myofascial pain/muscle spasm (32.5%), followed by tendinopathy (19.2%) and ligament sprain (18.7%). The most prevalent site of injury was the thigh (21%), followed by the knee (14.1%) and the lumbar spine (13.5%). Most injuries had symptoms of <7 days' duration. The geographical region with the greatest demand for physiotherapy services was Africa (40.6%). Most patients were athletes (74.8%), although team officials accounted for a considerable number (14%). CONCLUSIONS: The smallest national teams--especially those from developing countries--were more likely to take advantage of services, probably because the larger teams had their own medical and physiotherapy staff. The characteristics of patients, their sustained injuries and the subsequent treatment varied by the accreditation status of the patients. The physiotherapy department's workload was dependent on the Olympic Games schedule.

The anterior cruciate ligament deficiency as a model of brain plasticity.

This paper describes a plausible mechanism for the development of brain plastic changes due to a peripheral joint injury, such as anterior cruciate ligament (ACL) rupture. Evidence for the hypothesis is based on mainly three indications derived from the literature review: (a) the existence of two different categories of ACL patients, the copers and non-copers, presenting different features of functional deficiencies, (b) the demand of a sufficient post-traumatic time (more than 6 months) for the dysfunction development and (c) the fact that the dysfunction is not limited to the injured limb but also concerns the non-injured one. Considering the fact that ACL contains mechanoreceptors, which inform the central nervous system (CNS) about joint sense position and kinaesthesia, it can be suggested that this kind of injury might be regarded as a neurophysiological dysfunction, not being a simple musculoskeletal injury. The rupture of the ACL could lead to the cessation/depletion or differentiation of the ascending afferent pathway from the injured joint towards CNS, inducing to the joint de-afferentation and consequently CNS reorganization and joint de-efferentation. In case of presumable evidence of the proposed hypothesis, its clinical application could concern several aspects of the intervention procedures. For example, a number of clinical findings, such as the functional differences presented between two separate clinical groups of patients (copers and non-copers) could be justified or the rehabilitation strategies might have to be revised, provided that certain therapeutic components have influence on facilitating brain plastic changes that induce to beneficial functional outcomes.

Effects of eccentric exercise-induced muscle injury on blood levels of platelet activating factor (PAF) and other inflammatory markers.

It has been reported that exercise with eccentric contractions can induce damage and inflammation in human muscle tissue, the severity of which depends on the duration and the intensity of exercise. Platelet activating factor (PAF) is a potent inflammatory mediator implicated in a series of pathophysiological conditions. We sought to investigate the relationship between PAF and eccentric exercise induced muscle damage. Thirteen healthy, recreationally active male subjects (27.5+/-3.78 year) performed 36 maximum voluntary eccentric contractions on a motorized muscle dynamometer using the elbow flexor muscles of the non-dominant arm. Venous blood samples were collected immediately before and after exercise at 2, 24, 48, 72 and 96 h. PAF was isolated, purified and determined by a platelet aggregation assay. Serum levels of creatine kinase (CK), lactate dehydrogenase (LDH), C-reactive protein (CRP) and complement C3 (C3), plasma level of fibrinogen and whole blood level of leukocytes (and their subsets) were determined. Established indicators of muscle damage as maximum isometric torque (MIT), range of motion (ROM), relaxed arm angle (RANG), flexed arm angle (FANG), arm circumference (CIRC) and muscle soreness were also measured at the same time points. PAF, leukocytes, CK and LDH were elevated after exercise, while other biochemical parameters such as CRP, C3 and fibrinogen were unchanged. We also observed an inverse association between PAF and MIT and ROM, as well as a positive association with other markers of muscle injury, i.e. CK, LDH, FANG and CIRC (all P's<0.05). Our findings may imply a role for PAF in the mechanism of eccentric exercise induced muscle damage.