Psychophysical effects of an exercise therapy during pediatric stem cell transplantation: a randomized controlled trial.

This study evaluates the physical and psychosocial effects of an inpatient exercise program for children and adolescents undergoing hematopoietic stem cell transplantation (HSCT). Participants (n = 70) were randomized to an exercise intervention (IG: resistance, endurance, and flexibility training) or a non-exercise control group (CG: mental and relaxation training). Pre- (prior hospital admission; T0) and post- (day of discharge; T1) measurements included maximal isometric knee extension strength (KES; strain gauge force transducer), hand grip strength (HGS; JAMAR dynamometer), distance walked in 6 min (6MWD; 6-minute walk test), quality of life (QoL; KINDL-R) and medical parameters. Fifty-seven patients (IG: n = 28; 11.0 (5-17) years; CG: n = 29; 12.0 (6-18) years) completed the study. During hospitalization the IG and CG attended on average 3.1 (2-4) or 2.9 (0.3-4) training sessions weekly. KES, 6MWD, and HGS significantly decreased (p < 0.05) in the CG, while there were no changes in the IG. Pre- to post-changes in 6MWD and HGS differed significantly between groups (p < 0.05). QoL declined in both groups (p < 0.05). Our results indicate that a moderate exercise program is feasible and might counteract a treatment-associated decline of physical performance.

Knee misalignment and exercise amount: Predictive value for chronic low back pain in young competitive athletes.

Sports medical examinations of juvenile athletes provide an opportunity for preventive measures against sports-related diseases. Determining the leg axis deviation as a risk factor for future constraints may offer approaches for such measures. Data were obtained from 789 youth athletes: 166 with coronal plane knee misalignment and 623 without. After a seven-year period, 64 participants (m: 33, f: 31) from both groups were reassessed for the incidence of nonspecific chronic low back pain (CLBP). To distinguish participants with increased risk for CLBP, contingency tables for comparison of expected and joint frequency distribution testing and receivers operating characteristic (ROC) analyses for the weekly training time were conducted. Subjects with an initial diagnosed knee misalignment showed increased risk for the development of CLBP (CHI2 = 4.2, p < .05, OR = 3.4) compared to participants without knee misalignment. In athletes with knee misalignment, ROC analysis revealed an optimal cut-off of 6.75 h/w (AUC = 0.8; Chi2 = 4.2, p < .05, OR = 8.0). In athletes without leg axis deviation, no association to training volume was detected. Our results suggest a predictive value of knee misalignment on the later occurrence of CLBP in young competitive athletes and underline the importance of an examination of the motor system during sports medical assessments in youth athletes. Training volume of almost more than 7 h a week enhances this risk.

Functional overreaching during preparation training of elite tennis professionals.

This case study evaluated the response of objective and subjective markers of overreaching to a highly demanding conditioning training mesocycle in elite tennis players to determine 1) whether players would become functionally or non-functionally overreached, and 2) to explore how coherently overreaching markers would respond. Performance, laboratory and cardiac autonomous activity markers were evaluated in three experienced male tennis professionals competing at top 30, top 100 and top 1000 level before and after their strength and conditioning training was increased by 120, 160 and 180%, respectively, for 30 days. Every week, subjective ratings of stress and recovery were evaluated by means of a questionnaire. After 74, 76 and 55 h of training, increases in V̇O2max (+8, +5 and +18%) and speed strength indices (+9, +23 and +5%) were observed in all players. Changes of maximal heart rate (-5, -6, +4 beats per minute), laboratory markers (e.g. insulin-like growth factor -26, -17, -9%; free testosterone to cortisol ratio -63, +2, -12%) and cardiac autonomous activity markers (heart rate variability -49, -64, -13%) were variable among the players. Improved performance provides evidence that overreaching was functional in all players. However, several overreaching markers were altered and these alterations were more pronounced in the two top 100 players. The response of overreaching indicators was not coherent.

Tennis ranking related to exercise capacity.

This is the first 7-year prospective case report on the relationship between VO(2)max during preparation and the following year's entry ranking for a top athlete. The strong relationship between VO(2)max and the following year's ATP entry ranking over time underlines the importance of the preseason training period to optimise cardiorespiratory capacity. The current findings emphasise the relevance and predictive value of continuous performance tests and the need for more elaborate and longitudinal tracking study designs, as well as regression models that include playing style as a covariate.

Performance-related workload in alpine skiing with congenital heart disease.

The present case report assesses the individual performance-related workload in three male children with left ventricular outflow tract (LVOT) obstruction during alpine skiing. Spirometric data (VO(2)) and heart rate (HR) were monitored during alpine skiing in various terrains according to the subject's performance level. A portable spirometric device was used for on-slope data sampling. Relative workload was calculated in relation to peak cardiorespiratory values, obtained during an incremental laboratory cycle test. On the slope the subjects reached 78% to 103% of their peak ergometric HR and a VO(2peak) of 65% to 100%. Young beginners and intermediates with LVOT obstruction seem to face a high cardiorespiratory stress during alpine skiing. For the beginner, an additional load is seen during uphill sidestepping with skis. In children suffering from congenital heart disease, physiological aspects of sports activities such as skiing should not be viewed separately from the possibilities of sports participation and social interactions.

Effects of acupuncture on symptoms and muscle function in delayed-onset muscle soreness.

OBJECTIVE: This study was done to investigate the effects of a standardized acupuncture treatment on symptoms and muscle function in exercise-induced delayed-onset muscle soreness (DOMS). METHODS: A prospective, randomized, controlled, observer and subject-blinded trial was undertaken. Twenty-two (22) healthy subjects (22-30 years; 10 males and 12 females) were randomly assigned to three treatment groups: real acupuncture (deep needling at classic acupuncture points and tender points; n = 7), sham-acupuncture (superficial needling at nonacupuncture points; n = 8), and control (no needling; n = 7). DOMS of the nondominant elbow-flexors was experimentally induced through eccentric contractions until exhaustion. The outcome measures were pain perception (visual analogue scale; VAS; range: 0-10 cm), mechanical pain threshold (MPT; pressure algometer), and maximum isometric voluntary force (MIVF; force transducer). Treatment was applied immediately, 24 and 48 hours after DOMS induction. Measurements of MPT and MIVF were made prior to DOMS induction as well as before and after every treatment session. VAS data were acquired after DOMS induction as well as pre- and post-treatment. Final pain, MPT, and MIVF measurements were performed 72 hours after DOMS induction. RESULTS: Following nonparametric testing, there were no significant differences between groups in outcome measures at baseline. After 72 hours, pain perception (VAS) was significantly lower in the acupuncture group compared to the sham acupuncture and control subjects. However, the mean MPT and MIVF scores were not significantly different between groups. CONCLUSIONS: Although acupuncture seemed to have no effects on mechanical pain threshold and muscle function, it proved to reduce perceived pain arising from exercise-induced muscle soreness.