Validity and reliability study of the Turkish version of the 'A Sport Fitness Index'.

BACKGROUND: The aim of this study was to adapt the 'Sport Fitness Index' into Turkish and to ensure its validity and reliability. METHODS: After obtaining the necessary permissions, the Sports Fitness Index was independently translated from its English original to Turkish by four different physicians specialising in sports medicine. The content validity of index v.1 was calculated using the Davis technique in sample 1 of 20 people regularly participating in sports. In sample 2 consisting of 104 athletes who had a sports-related ligament/muscle injury or applied to the sports medicine clinic for general medical examination; the validity and reliability of index v.2 were examined. ROC analysis was applied to determine the cut-off point value of the score obtained from the Turkish version of the index. RESULTS: The calculated I-CVI (lowest: 0.80, highest: 0.95) and S-CVI/Ave values (0.87) showed that the index provided content validity. Item 1 and item 10 were removed from the Turkish version of the index, as it caused a decrease in the Cronbach's alpha coefficient of the index v.2. Thus, the Cronbach's alpha coefficient of the index was calculated as 0.925. In the Turkish version of index v.2, the single-factor structure (explained variance rate 66.22%; eigenvalue 5.29) was preserved. The index provided confirmatory factor analysis model fit indices. The index provided a high level of negative correlation (r Ëƒ -.60; P = .0001) with the total score of the Physical Activity Inadequacy Scale Short Form-10 and the sub-scores of all summary components (r Ëƒ -.60; P = .0001). According to the ROC curve, the best cut-off point was 70 points with 96.6% sensitivity and 75% specificity in the Turkish version of the index. CONCLUSION: The Sports Fitness Index-TR provided its Turkish validity and reliability with its 8-item and single-factor structure. The cut-off point is accepted as 70 points.

Balance disorder, falling risks and fear of falling in obese individuals: cross-sectional clinical research in Isparta.

OBJECTIVE: To examine the effect of obesity according to gender on balance, posture, the risk of falling and the fear of falling. METHODS: The cross-sectional study was conducted at the Department of Sports Medicine, Suleyman Demirel University, Isparta, Turkey, from December 2016 to June 2017, and comprised individuals aged 40-60 years who were divided into obese and non-obese groups based on their body mass index values. Demographic data was recorded before collecting target data using Tinetti Falls Efficacy Scale, Activities-Specific Balance Confidence Scale, History of Falls Scale, Single Leg Stance Test, Functional Reach Test and the New York Posture Rating Test. SPSS 20 was used for data analysis. RESULTS: Of the 251 subjects, 129(51.4%) were females and 122(48.6%) were males. The obese group had 125(49.8%) subjects. There was a significant difference between the history of stumbling in obese males and the history of stumbling and falls in obese females (p<0.05). A high restriction in activity was determined in obese females because of fear of falling (p<0.05). There was impaired posture in all 125(100%) obese individuals and they had all experienced loss of balance. Despite loss of balance and impaired posture in obese males, they did not experience fear of falling and no difference was determined in confidence (p>0.05). Fear of falling was high in obese females and confidence in daily activities was low (p<0.05). Significant negative relationship was found among body mass index, loss of balance and poor posture (p<0.05). No significant relationship was determined in males between obesity and Tinetti Falls Efficacy Scale and Activities-Specific Balance Confidence Scale scores (p>0.05). CONCLUSIONS: Obesity causes loss of balance and posture. However, despite functional losses in obese males, as there was no fear of falling and a deceptive sense of confidence, this prevented prediction of the risk of falling.

Evaluation of the Isokinetic Calf Muscle Strength and the Range of Motion of Joint in C3 Chronic Venous Insufficiency.

PURPOSE: The present study aimed to compare the isokinetic muscle strength and range of motion (ROM) values of the ankle between patients diagnosed with C3 chronic venous insufficiency (group 1, n=57) and healthy individuals (group 2, n=30). MATERIALS AND METHODS: After identifying the venous refilling time (VRT) of all participants, the active ROM of the ankle joint and plantar flexion (PF) and dorsi-flexion (DF) muscle strength in the concentric/concentric mode at angular velocities of 60°/sec and 120°/sec were measured. RESULTS: No statistically significant differences were found between the demographic data of groups 1 and 2 (P>0.05). In total, 102 lower extremities were included in group 1 and 60 lower extremities in group 2. The VRT of the patients in group 1 was 15.5±5.6 seconds, the PF ROM of the ankle joint was 39.3°±9.5°, and the DF ROM of the ankle joint was 27°±8°; in group 2, the VRT, PF ROM, and DF ROM were 36±8.1 seconds, 41°±6.2°, and 27.2°±7.5°, respectively. Statistically significant differences were found between the two groups in terms of VRT (P<0.05); however, no statistically significant difference was observed in terms of ankle ROM (P>0.05). Statistically significant difference was found in terms of all parameters of isokinetic muscle strength measurements, such as peak torque, peak torque/body weight, total work done, and ratio (DF/PF) in group 1 (P=0.001). CONCLUSION: The lower extremity muscle strength of patients with chronic venous insufficiency was low, and this weakness was prominent particularly in the direction of PF.

Effect of Self-perceived Fatigue on Balance and Functional Mobility in Middle-Aged Obese Women.

The aim of this study was to examine effect of fatigue levels on functional mobility and balance in middle-aged obese females. The study included 98 healthy females aged 40-60 years with BMI ≥ 30 kg/m2. Self-perceived fatigue was evaluated with a self-administered questionnaire, the Checklist of Individual Strength in Turkish (CIS-T), on which 62.3% of the study subjects identified themselves as fatigued. The body weight and BMI values of fatigued subjects were found to be higher than those of the non-fatigue group (p<0.05). The reported exercise habits of the fatigue group were found to be significantly lower than their non-fatigued peers (p<0.05). The level of functional mobility (Timed Up and Go Test), static balance (One-Legged Stance Test with Eyes Open) and dynamic balance (Functional Reach Test and the 3-meter Timed Tandem Walk Test) were measured, and statistically significant differences were found between fatigue and non-fatigue groups on all of them (p<0.05). In addition, correlations were found between the sub-parameters of the CIS-T scale and the functional tests at.

Arthroscopic chronic tennis elbow surgery preserves elbow proprioception.

STUDY DESIGN: Retrospective cohort study. INTRODUCTION: A new method of accurately assessing the compromised elbow's proprioception was developed for this postsurgical population using information from previous neurophysiologic proprioception studies of healthy elbows. HYPOTHESIS: This retrospective cohort study investigated the patterns and the degree of proprioceptive impairment and recovery following arthroscopic surgery for chronic lateral epicondylitis. MATERIAL AND METHODS: Participants had undergone arthroscopic elbow surgery two years prior to this study (n=15). Healthy, non-injured volunteers with similar demographics (n=15) served as controls. Both groups were evaluated using quantitative measures of joint position sense for proprioceptive functioning. In order to obtain the most accurate proprioceptive measurements, interindividual interaction and visual input biases were eliminated. Retrospective chart reviews were performed to compare qualitative self-reported measures of proprioceptive function in arthroscopic surgery patients before surgery and two years post-surgery. RESULTS: Active and passive joint repositioning outcome measurements were similar between groups (p>0.05). No significant differences were found among any angles except one: passive joint position sense at 120° of flexion (p<0.05). At this angle, the arthroscopy group showed greater deviation from target angles than the control group. The novel proprioceptive testing method we developed was found to be accurate and reliable. DISCUSSION: Outcomes of arthroscopic treatment of chronic lateral epicondylitis with no decortication yielded outcomes measure similar to those of healthy controls. The sole significant difference was at 120° flexion passive joint repositioning, with a higher negative angular deviation from the target point. We propose that our study results and specific proprioception method may have implications for improving accuracy of future elbow arthroscopy and proprioceptive recovery in this population. LEVEL OF EVIDENCE: II, low-powered prospective randomized trial.

Is ACL reconstruction a prerequisite for the patients having recreational sporting activities?

OBJECTIVE: Whether surgical or conservative treatment is more effective in allowing patients to return to physical activity after anterior cruciate ligament (ACL) injury is controversial. We sought to compare mid-term outcome measures between isolated ACL tear patients who underwent reconstruction followed by closed kinetic chain exercises and those who underwent neuromuscular training only. METHODS: We retrospectively evaluated patients with ACL tears who underwent post-surgery CKC strength training after ACL reconstruction (Group A), and patients who only underwent neuromuscular training (Group B) with a minimum follow-up time of 5 years. Surgical techniques, rehabilitation, assessment of subjective knee function, one-leg hop test, assessment of joint position sense, muscle strength, and the health profile of the patient were evaluated. RESULTS: Overall, 43 patients were included in Group A (mean age, 32.56 ± 4.89; Tegner activity scale, 5) and 39 patients in Group B (31.67 ± 7.27; 5). Patients in both groups returned to their regular physical activity level after a similar time frame (Group A: average, 12 months; Group B, average, 13.4 months). The mean Lysholm knee score was 88.52 ± 7.65 in Group A and 86.21 ± 13.72 in Group B. Mean distances for the one-leg hop test for Group A were 135.21 ± 31.66 and 145.36 ± 42.10 mm in the reconstructed and uninjured knees, respectively. In Group B, the mean hop distances were 132.47 ± 28.13 and 147.89 ± 21.45 mm in the rehabilitated and uninjured knees, respectively. No statistical difference was observed between the groups for any of the parameters evaluated, including assessment of subjective knee function, one-leg hop test, assessment of joint position sense, muscle strength, and the health profile. CONCLUSION: Our data suggest that early surgical reconstruction may not be a prerequisite to returning to recreational physical activities after injury in patients with ACL tears. LEVEL OF EVIDENCE: Level IV, therapeutic study.

Effects of isokinetic calf muscle exercise program on muscle strength and venous function in patients with chronic venous insufficiency.

Objective The aim of this study was to observe the change of the ankle joint range of motion, the muscle strength values measured with an isokinetic dynamometer, pain scores, quality of life scale, and venous return time in chronic venous insufficiency diagnosed patients by prospective follow-up after 12-week exercise program including isokinetic exercises. Methods The patient group of this study comprised 27 patients (23 female, 4 male) who were diagnosed with chronic venous insufficiency. An exercise program including isokinetic exercise for the calf muscle was given to patients three days per week for 12 weeks. At the end of 12 weeks, five of the patients left the study due to inadequate compliance with the exercise program. As a result, control data of 22 patients were included. Ankle joint range of active motion, isokinetic muscle strength, pain, quality of life, and photoplethysmography measurements were assessed before starting and after the exercise program. Results Evaluating changes of the starting and control data depending on time showed that all isokinetic muscle strength measurement parameters, range of motion, and overall quality of life values of patients improved. Venous return time values have also increased significantly ( p < 0.05). Conclusion In conclusion, increase in muscle strength has been provided with exercise therapy in patients with chronic venous insufficiency. It has been determined that the increase in muscle strength affected the venous pump and this ensured improvement in venous function and range of motion of the ankle. In addition, it has been detected that pain reduced and quality of life improved after the exercise program.

Synchronous Endometrial and Ovarian Cancer in Young Women: Case Report and Review of the Literature.

BACKGROUND: Young women with endometrial cancer (EC) have an increased risk of synchronous ovarian cancer. The prognosis of women with synchronous endometrial and ovarian cancer (SEOC) is good. A high proportion of affected women have hereditary non-polyposis colon cancer syndrome (HNPCC). CASE PRESENTATION: We present the case of a 45-year-old woman with histologically proven endometrioid adenocarcinoma of the endometrium (pT1B, G2, R0 without lymphovascular space invasion). She underwent laparoscopic hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymphadenectomy. Final histology revealed a synchronous bilateral endometrioid ovarian cancer (pT1A, G2, R0). HNPCC analysis by immunohistochemistry showed no microsatellite instability in MSH2, MSH6, MLH1, and PMS2. No adjuvant therapy was administered, clinical follow-up with regular gynecological examinations was recommended. In a systematic literature review, 2,904 cases of women with SEOC were identified with 1,035 (36%) of them being premenopausal or <50 years of age. The proportion of women with SEOC among all reported EC cases was 842/23,498 (3%) and the proportion of young women with SEOC among all reported EC cases was 261/23,498 (1%). In summary, microsatellite instability and subsequent mutations in mismatch repair genes compatible with HNPCC were identified in 6/15 (40%) women analyzed. The mean recurrence-free and overall survival times of young women with SEOC were 1.9 (min 0.2, max 3) and 4.0 (min 0.2, max 22.1) years, respectively. CONCLUSION: Young women with EC have a high risk of synchronous ovarian cancer. Thus, in young women with EC, bilateral salpingo-oophorectomy or careful histological assessment of both ovaries are recommended in order to confirm or rule out SEOC. HNPCC testing should be offered to all women.

A randomized comparison of video demonstration versus hands-on training of medical students for vacuum delivery using Objective Structured Assessment of Technical Skills (OSATS).

BACKGROUND: To compare medical students' skills for vaginal operative delivery by vacuum extraction (VE) after hands-on training versus video demonstration. METHODS: We randomized medical students to an expert demonstration (group 1) or a hands-on (group 2) training using a standardized VE algorithm on a pelvic training model. Students were tested with a 40-item Objective Structured Assessment of Technical Skills (OSATS) scoring system after training and 4 days later. OSATS scores were the primary outcome. Performance time, self-assessment, confidence, and global rating scale were secondary outcomes. We assessed the constructive validity of OSATS in this VE model comparing metric scores of experts and students. RESULTS: In all, 137 students were randomized. OSATS scores were higher in group 2 (n = 63) compared with group 1 (n = 74) (32.89 ±â€Š6.39 vs 27.51 ±â€Š10.27, respectively; P < 0.0001). Global rating scale (1.49 ±â€Š0.76 vs 2.33 ±â€Š0.94, respectively; P < 0.0001), confidence (2.22 ±â€Š0.75 vs 3.26 ±â€Š0.94, respectively; P = 0.04), self-assessment (2.03 ±â€Š0.62 vs 2.51 ±â€Š0.77, respectively; P < 0.0001), and performance time (38.81 ±â€Š11.58 seconds vs 47.23 ±â€Š17.35 seconds, respectively; P = 0.001) also favored group 2. After 4 days, this effect persisted with OSATS scores still being significantly higher in group 2 (30.00 ±â€Š6.50 vs 25.59 ±â€Š6.09, respectively; P = 0.001). The assessed OSATS scores showed constructive validity. In a multiple linear regression analysis, group assignment independently influenced OSATS scores, whereas sex, handedness, sports activities, and type of curriculum were not independently associated with OSATS scores. CONCLUSIONS: Hands-on training is superior to video demonstration for teaching VE on a pelvic model.

Paget's Disease of the Vulva Treated with Imiquimod: Case Report and Systematic Review of the Literature.

BACKGROUND: Extramammary Paget's disease of the vulva (EPDV) is a rare adenocarcinoma in situ of the vulvar skin and is often resected with involved margins due to its reticular growth pattern. Adjuvant treatment with the immunomodulator imiquimod may be suitable to avoid repeated and mutilating surgery. CASE PRESENTATION: We present the case of a 73-year-old woman with EPDV, initially treated with surgical resection and re-resection for involved margins. Final histology revealed Paget's disease of the left vulva with 8 cm in the largest diameter and again involved margins. Subsequently, topical therapy with imiquimod 5% cream twice weekly was applied for 3 months. Vulvoscopy and local biopsies confirmed complete remission (CR). Based on a literature search using PubMed and the Cochrane Central Register of Controlled Trials, 21 reports on the therapeutic efficacy of imiquimod in 70 women with EPDV have been published. Pooled rates of CR and partial remission were 71% (50/70) and 16% (11/70), respectively. There were 4 cases of disease progression under imiquimod and the therapy was generally well tolerated with mild to moderate local reactions in >50% of cases. CONCLUSION: EPDV is a rare genital neoplasia and may be successfully treated with the topical immunomodulator imiquimod. Specifically, adjuvant imiquimod is a feasible and efficacious treatment option for women with involved resection margins after surgery.

What Characterizes Long-term Survivors of Recurrent Ovarian Cancer? Case Report and Review of the Literature.

BACKGROUND: Women with recurrent ovarian cancer have a poor prognosis and short survival. However, some women are long-term survivors and it is unclear whether they share specific common characteristics. CASE REPORT: We present the case of a 63-year-old woman with histologically-proven recurrent ovarian cancer and a survival time of 16 years after the diagnosis of recurrence. She underwent initial debulking surgery in 1994, followed by 6 cycles of adjuvant chemotherapy with cisplatin and paclitaxel. After recurrent disease was diagnosed by re-laparotomy in 2000, she underwent four lines of systemic chemotherapy from 2000 to 2009 (carboplatin/paclitaxel, topotecan, etoposide/treosulfan and liposomal doxorubicin) and four lines of endocrine therapy between 2002 and 2014 (tamoxifen, goserelin, tamoxifen and exemestane). In 2014, she underwent secondary debulking surgery and was tumor-free until 2015. Upon progression, she was then started on the fifth-line of endocrine therapy, fulvestrant, which was changed to the mTOR inhibitor everolimus in June 2016. In a PUBMED literature search, 360 cases of long-term survivors of recurrent ovarian cancer (LTSROC), defined as women with survival >5 years after the diagnosis of recurrence, were identified with a mean post-recurrence survival time of 7.5 years. Comparing the patient and therapy details of these women, we identified common characteristics of LTSROC, i.e. young age and optimal debulking at initial surgery, a long time span between first-line therapy and first recurrence and the combined use of optimal cytoreductive surgery and systemic chemotherapy. CONCLUSION: LTSROC are rare, with 360 cases described in the literature. LTSROC are characterized by young age, low tumor stage, long recurrence-free interval and combined modality treatment with optimal cytoreductive surgery and systemic chemotherapy.

Lymphoma of the Cervix: Case Report and Review of the Literature.

BACKGROUND: Lymphoma of the uterine cervix (LUCX) is rare and may occur as a primary or secondary manifestation of this disease. Clinical and cytological presentations of LUCX vary and establishing diagnosis is often difficult. Surgery followed by radiation or chemotherapy is the mainstay of treatment. CASE REPORT: We present the case of a 73-year-old woman with recurrent pathological PAP smears of the cervix and a history of chronic lymphatic leukemia 15 years ago. Colposcopy of the cervix showed no acetowhite lesion and a conization was performed. Histology revealed endocervical lymphoid cells, specified as low-malignant B-Non-Hodgkin lymphoma of the cervix based on the expression of CD5, CD20, and CD23, whilst CD10 and cyclin D1 were negative. The diagnosis was confirmed by flow cytometry of peripheral blood. Staging revealed enlarged iliacal, para-aortic, mediastinal, cervical, subclavicular, and inguinal lymph nodes and hepatosplenomegaly. Bone marrow analysis confirmed lymphoid infiltration consistent with B-cell lymphoma. The patient was scheduled for a combined immuno-chemotherapy with obinutuzumab and chlorambucil. In a MEDLINE literature search, 246 cases of LUCX were identified. One hundred and eighty-five cases were primary and 61 cases were secondary manifestations of LUCX. With a mean follow-up time of 38 months, overall survival was 81%. Data in the literature including clinical and histological characteristics of LUCX as well as the clinical management and prognosis are discussed herein. CONCLUSION: LUCX is rare and has distinct clinical and histological features. LUCX is usually treated with local surgical excision followed by radiotherapy or chemotherapy.

An evaluation of the lower extremity muscle strength of patients with chronic venous insufficiency.

OBJECTIVE: In this study, the aim was to evaluate the lower extremity muscle strength in patients with chronic venous insufficiency using an isokinetic dynamometer. METHODS: The study comprised a group of 36 lower extremities of 23 patients diagnosed with chronic venous insufficiency and a control group of 40 lower extremities of 20 patients who did not have chronic venous insufficiency. In the diagnosis and evaluation of chronic venous insufficiency, photoplethysmography was used to evaluate the venous return circulation time. Visual Analog Scale scoring was applied to define the level of pain of the patients. Muscle strength measurements were made in all the lower extremities by using an isokinetic dynamometer. RESULTS: A statistically significant difference was detected between the groups in terms of the muscle strength parameters in the ankle plantar flexion, and knee flexor and extensor muscles. However, no statistically significant difference was found between the groups in the ankle dorsiflexion muscle strength parameters. A significant difference was determined in the ratio of ankle dorsiflexion/plantar flexion muscle strength between the mild, moderate and severe venous insufficiency groups. A statistically considerable negative correlation was found between the Visual Analog Scale scores and the photoplethysmography results. According to the Visual Analog Scale results, as the degree of venous insufficiency increased, so did the level of pain. CONCLUSION: Impaired lower extremity muscle strength was observed in chronic venous insufficiency patients. Although the current study was consistent with literature in respect of impaired calf muscle strength, this finding was also seen in the thigh muscles. Furthermore, we concluded that if venous insufficiency becomes more severe, impaired calf muscle strength becomes more evident.

Accuracy of the Polar S810i(TM) Heart Rate Monitor and the Sensewear Pro Armband(TM) to Estimate Energy Expenditure of Indoor Rowing Exercise in Overweight and Obese Individuals.

Accurately assessing the energy expenditure (EE) of different types of physical activity is important for exercise prescription in obese individuals. The aim of this study was to examine the accuracy of the Polar S810i Heart Rate Monitor and SenseWear Pro Armband (SWA) for estimating energy expenditure (EE) during indoor rowing versus indirect calorimetry (IC). 43 overweight and obese adults (16 men, 27 women, BMI = 31.2 ± 3.7) participated in the study. Within a week after a maximal incremental test on a rowing ergometer, EE was assessed with Polar S810i, SWA and IC during two different intensities of rowing exercises (at 50% VO2max and 70% VO2max) on a Concept II ergometer. Data were analyzed with Pearson's product moment correlations and repeated measures ANOVA. Post hoc multiple comparisons were performed using the Bonferroni test. Bland-Altman plots were created to assess the agreement between the EE estimates and IC measurements. At 50% VO2max, Polar S810i and SWA significantly overestimated EE by 0.5 ± 0.50 kcal·min(-1) (p < 0.001) and by 0.9 ± 0.92 kcal·min(-1) (p < 0.001), respectively. At 70% VO2max, no significant differences were found between the SWA and IC, and between Polar S810i and IC measurements. Bland-Altman plots showed good agreements between the measured EE and estimates by Polar S810i and SWA at 70% VO2max. At 50% VO2max, there was a poor agreement between SWA and IC measurements. There were high correlations among three methods at both intensities (r = 0.82 to r = 0.95). In conclusion, Polar S810i and SWA showed reasonable concordance with IC for measuring EE of the moderate intensity exercise but not the lower intensity exercise on indoor rowing in the participants of this study. Polar S810i and SWA might be useful to assess EE during indoor rowing for overweight and obese individuals who try to manage their body weight, but it is necessary to develop exercise and population specific algorithms to enhance the accuracy of SWA to estimate energy expenditure during various intensities of physical exercises. Key pointsPolar S810i and SWA when compared to the indirect calorimetry, provide reasonable estimates of energy expenditure on rowing ergometer at the moderate exercise intensity, but not at the low exercise intensity.The monitor of the Concept II Model D rowing ergometer significantly overestimated the energy expenditure during low and moderate intensity exercises. However there was a moderate correlation between EE estimates of this device and indirect calorimetry measurements.

Influence of custom-made mouth guards on strength, speed and anaerobic performance of taekwondo athletes.

The purpose of this study was to test the influence of custom-made mouth guards on strength and anaerobic performance of taekwondo athletes. The study included 21 (11 male and 10 female) trained subjects participating in taekwondo. Anaerobic power and anaerobic capacity, isokinetic quadriceps and hamstring strength, handgrip strength, isometric lower extremity and back strength, 20 m sprint time, squat and counter movement jumping height were measured in two randomized conditions: with or without custom-made (CM) mouth guards. No significant differences were observed between the two conditions (with or without CM mouth guards) in 20 m sprint time, jumping tests, handgrip strength, isometric leg or back strength. On the other hand, peak power and average power in Wingate Anaerobic Test and Hamstring Isokinetic Peak Torque significantly increased as a result of wearing mouth guard (P < 0.05). In conclusion, we can suggest that taekwondo athletes can use CM mouth guards without any negative effects on their strength and anaerobic performance.

Effects of swimming training and free mobilization on bone mineral densities of rats with the immobilization-induced osteopenia.

OBJECTIVE: To investigate the possible effects of regular swimming exercise on bone mineral density (BMD) compared with free activity after cast immobilization of rats. METHODS: We carried out the study from April 2005 to June 2005 at the Department of Sports Medicine, Medical School of Suleyman Demirel University, Isparta, Turkey. The study included a total of 24 female Wistar rats. The rats were randomized to control (n = 6), swimming training (ST) n = 9, and free mobilization (FM) n = 9 groups. We measured Bone mineral densities of femur and vertebra of all rats with a total body scanner using software specifically designed for small animals, before study started and at weeks 3 and 7. Timepoints corresponded to basal, after cast removal (ACIM), and after 3 weeks of free mobilization (AFM) or swimming training (AST). We immobilized the right hindlimb of each ST and FM animal with a cast while the left hindlimbs were kept free. After 3 weeks, the casts were removed. Then we allowed the rats to move freely in their cage for one week, after which the animals in ST group started to swim for 5 days a week for 3 weeks for 30 minutes per day. The group FM rats moved freely in the cage. RESULTS: Bone mineral density of the femur and vertebra after cast immobilization was significantly decreased compared with both their basal and age-matched control group. After mobilization, significant increases occurred in both groups according to ACIM. Similar but milder changes were observed in free limbs femur BMD of rats. Interestingly, vertebra BMD of swimming group was also higher than its age-matched control group (p<0.05). CONCLUSION: Our study showed that swimming exercise had a significant rehabilitative effect on BMD loss associated with immobilization. Further studies are needed to investigate the effects of swimming on other bone properties.

Effects of anterior tibial displacement on the proprioceptive functions of soccer players` knee joints.

OBJECTIVE: To investigate the effects of joint laxity on proprioceptive functions of the knee joints of soccer players. METHODS: In this study, we measured anterior tibial displacements and thresholds to detect the knee joint passive motion of 20 healthy soccer players (18.1+/-1.6 years of age). We performed all the measurements in Autumn 2000 in Ankara, Turkey. We applied the Mann-Whitney U test to analyze the relationship between the anterior tibial displacement and threshold to detect the passive motion (TDPM). RESULTS: There were no statistically significant differences between the TDPM values of the knee joints with insignificant laxity differences at different angles, and direction of motion (p>0.05). At 45 degrees of knee flexion and externally directed motion, we found the TDPM of looser knees to be significantly greater (p<0.05). CONCLUSION: Increased knee laxities without any clinical pathologic findings, have negative effects on knee joint proprioception. This is possibly due to the overuse degeneration of the anterior cruciate ligaments, which are the main stabilizers of knee joints.

Do custom-made mouth guards have negative effects on aerobic performance capacity of athletes?

Mouth guards are considered an essential part of equipment for athletes participating in contact sports. The purpose of this study was to evaluate the effect of custom-made mouth guards on the ventilatory gas exchange effects of taekwondo athletes. The subjects were 22 elite athletes aged between 14 and 17 years. To determine the effect of mouth guard use during exercise, oxygen consumption (VO(2)) was measured with a portable gas analysis system while an exercise tolerance test with a shuttle run test protocol was performed. Values with and without mouth guard were compared. Wilcoxon ranks test was used for the statistical analysis. The results show that wearing mouth guards has no significant effect on maximal oxygen uptake (VO(2max)), minute ventilation (VE), tidal volume (VT) and respiratory exchange ratio (RER) while performing maximal exercise (P > 0.05). In conclusion, taekwondo athletes can use custom-made mouth guards without negative effects on their aerobic performance capacity.

A regression equation to predict true maximal oxygen consumption of taekwondo athletes using a field test.

OBJECTIVE: The purpose of the present study was to examine the validity of using a 20 meter multistage shuttle run test to estimate maximal oxygen uptake. METHODS: Twenty-two elite taekwondo athletes (11 male, 11 female, members of the Turkish young national team), participated in the study. The respiratory gas exchange parameters were measured using portable gas analysis system while shuttle run test was carried out. All tests were performed last August 2004, in the gymnasium of Suleyman Demirel University, Isparta, Turkey. RESULTS: Analysis of the test scores showed a mean score on gas analysis of 51.79 ml/kg/min and a mean score of 43.59 ml/kg/min on the shuttle run test. On average, the scores predicted by the shuttle run test were 16% lower than those for the gas analysis score. The correlation between the tests was significant at a level of r = 0.810. CONCLUSION: Maximal oxygen consumption (VO2 max) can be predicted from shuttle run test scores, but not as indicated with the test package. In order to obtain the true score one must apply a regression equation.