Muscle dynamics analysis by clustered categories during jogging in patients with anterior cruciate ligament deficiency

BACKGROUND

Patients with anterior cruciate ligament (ACL) deficiency (ACLD) tend to have altered lower extremity dynamics. Little is known about the changes in dynamic function and activation during jogging in patients with ACLD.

METHODS

Twenty patients with an injured ACL before ACL reconstruction (ACLD group) and nine healthy male volunteers (control group) were recruited. Each volunteer repeated the jogging experiment five times. Based on the experimental data measured, a musculoskeletal multibody dynamics model was employed to simulate the tibiofemoral joint dynamics during jogging. Eighteen muscles were used for analysis. The obtained dynamics data were used for clustering and curve difference analysis.

RESULTS

The 18 muscles studied were divided into 3 categories. All the quadriceps, the soleus, the gastrocnemius, and the popliteus were classified as label 1. All the hamstrings were classified as label 2, and the sartorius muscles were classified as label 3. Among them, the classification of the short head of the biceps femoris was significantly different between the two groups (P < 0.001). The force curves of all 18 muscles and the between-group differences were studied according to clustered categories. Most muscle force in label 1 was approaching zero in the terminal stance phase, which was significantly lower than that in the control group (P < 0.05). The muscle force in label 2 had areas with significant differences in the stance phase. Muscle force in label 3 was significantly lower than that in the control group in the pre-swing phase.

CONCLUSIONS

This study showed that there are various changes of muscle function and activation in patients with ACLD. Through clustering and curve analysis, the joint reactions and changes of different muscle forces in the gait cycle between the ACLD and control groups could be further clarified.

Agreement of Two Physical Behaviour Monitors for Characterising Posture and Stepping in Children Aged 6-12 Years

All new physical behaviour measurement devices should be assessed for compatibility with previous devices. Agreement was assessed between the activPAL4TM and activPAL3TM physical behavior monitors within a laboratory and a multi-day free-living context. Healthy children aged 6-12 years performed standardised (sitting, standing, stepping) (12 min) and non-standardised (6 min) activities in a laboratory and a multi-day (median 3 days) free-living assessment whilst wearing both monitors. Agreement was assessed using Bland-Altman plots, sensitivity, and the positive predictive value (PPV). There were 15 children (7M/8F, 8.4 ± 1.8 years old) recruited. For the laboratory-based standardised activities, sitting time, stepping time, and fast walking/jogging step count were all within ±5% agreement. However, the activPAL4TM standing time was lower (-6.4%) and normal speed walking step count higher (+7.8%) than those of the activPAL3TM. For non-standardised activities, a higher step count was recorded by the activPAL4TM (+4.9%). The standardised activity sensitivity and PPV were all >90%, but the non-standardised activity values were lower. For free-living agreement, the standing time was lower (-7.6%) and step count higher (all steps + 2.2%, steps with cadence >100 step/min + 6.6%) for the activPAL4TM than the activPAL3TM. This study highlights differences in outcomes as determined by the activPAL4TM and activPAL3TM, which should be considered when comparing outcomes between studies.

Repeatability of Ad Libitum Water Intake during Repeated 1 h Walking/Jogging Exercise Sessions Conducted under Hot Ambient Conditions

A drinking strategy aiming to replace a given percentage of the sweat losses incurred during exercise should result in reproducible fluid intake volume and, hence, fluid balance from one exercise session to the other performed under similar scenarios. Whether this may also be the case with ad libitum drinking during exercise is unclear. We characterized the repeatability of ad libitum water intake during repeated 1 h exercise sessions and examined its effect over time on fluid balance and selected physiological functions and perceptual sensations. Twelve (3 women) healthy individuals participated in this study. At weekly intervals, they completed four 2 × 30 min walking/jogging exercise bouts (55% V˙O2max, 40 °C, 20-30% relative humidity) interspersed by a 3 min recovery period. During exercise, participants consumed water (20 °C) ad libitum. There were no significant differences among the four exercise sessions for absolute water intake volume (~1000 mL·h-1), percent body mass loss (~0.4%), sweat rate (~1300 mL·h-1) and percent of sweat loss replaced by water intake (~80%). Heart rate, rectal temperature, and perceived thirst and heat stress did not differ significantly between the first and fourth exercise sessions. Perceived exertion was significantly lower during the fourth vs. the first exercise session, but the difference was trivial (<1 arbitrary unit). In conclusion, ad libitum water intake during four successive identical 1 h walking/jogging sessions conducted in the heat will result in similar water intake volumes and perturbations in fluid balance, heart rate, rectal temperature, and perceived thirst, heat stress and exertion.

Adults: An NHANES Investigation

Telomere length is a good index of cellular aging. Longer telomeres are predictive of longer life, and healthy lifestyles are associated with longer telomeres. This study explored the relationship between time spent jogging or running each week and leukocyte telomere length (LTL) in 4458 randomly selected U.S. adults. The association was studied using data collected by the National Health and Nutrition Examination Survey (NHANES), and a cross-sectional design. Total weekly jog/run time was calculated from survey responses. From the minute totals, three categories were formed: <10 min/week, 10-74 min/week, and ≥75 min/week. Adults in the third category met the U.S. guidelines. Data were analyzed using one-way ANOVA. Partial correlation was used to adjust for differences in potential mediating factors, including demographic and lifestyle/medical factors. In the total sample, after adjusting for all the potential covariates, mean LTL significantly differed across the three jog/run categories (F = 4.1, p = 0.0272). Specifically, adults who met the guidelines via jogging and/or running had significantly longer telomeres than adults who performed no jogging/running. Adults in the middle category did not differ from the other two categories. A minimum of 75 min of jogging/running weekly is predictive of longer telomeres when compared to adults who do not jog or run regularly.

Common High-Speed Running Thresholds Likely Do Not Correspond to High-Speed Running in Field Sports

ABSTRACT

Freeman, BW, Talpey, SW, James, LP, Opar, DA, and Young, WB. Common high-speed running thresholds likely do not correspond to high-speed running in field sports. J Strength Cond Res 37(7): 1411-1418, 2023-The purpose of this study was to clarify what percentage of maximum speed is associated with various running gaits. Fifteen amateur field sport athletes (age = 23 ± 3.6 years) participated in a series of 55-meter running trials. The speed of each trial was determined by instructions relating to 5 previously identified gait patterns (jog, run, stride, near maximum sprint, and sprint). Each trial was filmed in slow motion (240 fps), whereas running speed was obtained using Global Positioning Systems. Contact time, stride angle, and midstance free-leg knee angle were determined from video footage. Running gaits corresponded with the following running speeds, jogging = 4.51 m·s -1 , 56%Vmax, running = 5.41 m·s -1 , 66%Vmax , striding = 6.37 m·s -1 , 78%Vmax, near maximum sprinting = 7.08 m·s -1 , 87%Vmax, and sprinting = 8.15 m·s -1 , 100%Vmax. Significant ( p < 0.05) increases in stride angle were observed as running speed increased. Significant ( p < 0.05) decreases were observed in contact time and midstance free-leg knee angle as running speed increased. These findings suggest currently used thresholds for high-speed running (HSR) and sprinting most likely correspond with jogging and striding, which likely underestimates the true HSR demands. Therefore, a higher relative speed could be used to describe HSR and sprinting more accurately in field sports.

How Do Different Urban Footpath Environments Affect the Jogging Preferences of Residents of Different Genders? Empirical Research Based on Trajectory Data

In recent years, the impact of the urban environment on residents' physical activity (PA) has received extensive attention, but whether this impact has differences in the jogging preferences of residents in different footpath environments and different genders requires further research. Therefore, based on jogging trajectory data, this paper uses the grouping multiple linear regression model to study the different influencing factors of different footpath environments on the jogging of residents of different genders. The results show that (1) jogging activities (JA) were mainly concentrated in the community footpath environment, and its peak was reached at night; (2) the rise and fall of elements in built environments, social environments, and natural environments significantly affected the relative jogging distance of residents; (3) Residential land density (RLD) has a positive impact on the JA of community and green land footpaths and has a negative impact on the JA of urban footpaths. However, arterial road density (ARD) and bus distance density (BDD) have opposite significant effects on the JA of communities and green land footpaths; (4) ARD has the significant opposite effect on the JA for residents of different genders on urban footpaths and community footpaths. Facilities diversity (FD), population density (PD), and bus stop density (BSD) also had significant opposite effects on the JA of residents of different genders on green land footpaths. In general, we put forward a method theory to identify the footpath environment and provide references for improving the layout and construction of different gender residents for different footpath environment elements.

The effects of a motorized passive simulated jogging device on descent of the arterial pulse waveform dicrotic notch: A single arm placebo-controlled cross-over trial

Whole Body Periodic Acceleration (WBPA, pGz), is a bed that moves the body headward to forward, adds pulses to the circulation inducing descent of the dicrotic notch (DN) on the pulse waveform with an increase in a/b ratio (a = the height of the pulse waveform and b = the height of the secondary wave). Since the WBPA is large, heavy, and non-portable, we engineered a portable device (Jogging Device, JD). JD simulates passive jogging and introduces pulsations to the circulation. We hypothesized that JD would increase the a/b ratio during and after its use. In Study A, a single-arm placebo-controlled cross-over trial was conducted in24 adults (53.8 ± 14.4 years) using JD or control (CONT) for 30 min. Blood pressure (BPs and BPd) and photoplethysmograph pulse (a/b) were measured at baseline (BL), during 30 min of JD or CONT, and 5 and 60 min after. In Study B (n = 20, 52.2 ± 7 years), a single-arm observational trial of 7 consecutive days of JD on BP and a/b, measured at BL, and after 7 days of JD and 48 and 72 hr after its discontinuation. In Study A, BPs, and BPd decreased during JD by 13% and 16%, respectively, while in CONT both increased by 2% and 2.5%, respectively. The a/b increased by 2-fold and remained greater than 2-fold at all-time points, with no change in a/b during CONT. In Study B, BPs and BPd decreased by 9% and remained below BL, at 72 hr after discontinuation of JD. DN descent also occurred after 7 days of JD with a/b increase of 80% and remained elevated by 60% for at least 72 h. JD improves acute and longer-term vascular hemodynamics with an increase in a/b, consistent with increased effects of nitric oxide (NO). JD may have significant clinical and public health implications.

Step Length Estimation Using the RSSI Method in Walking and Jogging Scenarios

In this paper, human step length was estimated based on wireless channel properties and the received signal strength indicator (RSSI) method. Path loss between two ankles of the person under test was converted from the RSSI, which was measured using our developed wearable transceivers with embedded micro-controllers in four scenarios, namely indoor walking, outdoor walking, indoor jogging, and outdoor jogging. For brevity, we call it on-ankle path loss. The histogram of the on-ankle path loss showed clearly that there were two humps, where the second hump was closely related to the maximum path loss, which, in turn, corresponded to the step length. This histogram can be well approximated by a two-term Gaussian fitting curve model. Based on the histogram of the experimental data and the two-term Gaussian fitting curve, we propose a novel filtering technique to filter out the path loss outliers, which helps set up the upper and lower thresholds of the path loss values used for the step length estimation. In particular, the upper threshold was found to be on the right side of the second Gaussian hump, and its value was a function of the mean value and the standard deviation of the second Gaussian hump. Meanwhile, the lower threshold lied on the left side of the second hump and was determined at the point where the survival rate of the measured data fell to 0.68, i.e., the cumulative distribution function (CDF) approached 0.32. The experimental data showed that the proposed filtering technique resulted in high accuracy in step length estimation with errors of only 10.15 mm for the indoor walking, 4.40 mm for the indoor jogging, 4.81 mm for the outdoor walking, and 10.84 mm for the outdoor jogging scenarios, respectively.

Bone Mineral Density Changes during Weight Regain following Weight Loss with and without Exercise

The purpose of this study was to compare changes in bone mineral density (BMD) over a 6 month follow up (period of weight regain) in overweight, postmenopausal women having previously completed a 6 month weight loss (WL) intervention with and without aerobic exercise (AEX). Women (BMI > 25 kg/m²) underwent VO₂max and DEXA scans at baseline, after 6 months of WL or AEX + WL, and at 12 months ad libitum follow up. Both groups lost ~9% body weight from 0 to 6 months and regained ~2% from 6 to 12 months, while losing ~4% of appendicular lean mass (ALM) across the 12-month study duration. VO₂max increased 10% from 0 to 6 months and declined 12% from 6 to 12 months for AEX + WL, with no changes for WL. Total body (p < 0.01) and total femur (p = 0.03) BMD decreased similar between groups across time (combined groups: 0-6 months: total body: -1.2% and total femur: -1.2%; 6-12 months: total body: -0.26% and total femur: -0.09%). Less ALM loss and greater VO₂max increases during the WL phase were associated with attenuated BMD loss at various anatomical sites during periods of weight regain (6-12 months) p's < 0.05). Results suggest that BMD loss may continue following WL, despite weight regain. Further, this study adds to the literature by suggesting that preventing declines in muscle quality and function during WL may attenuate the loss of BMD during weight regain. Future studies are needed to identify mechanisms underlying WL-induced bone loss so that effective practices can be designed to minimize the loss of BMD during WL and weight maintenance in older women.

A Scoping Review of the Relationship between Running and Mental Health

Poor mental health contributes significantly to global morbidity. The evidence regarding physical benefits of running are well-established. However, the mental health impacts of running remain unclear. An overview of the relationship between running and mental health has not been published in the last 30 years. The purpose of this study was to review the literature on the relationship between running and mental health. Our scoping review used combinations of running terms (e.g., Run* and Jog*) and mental health terms (general and condition specific). Databases used were Ovid(Medline), Ovid(Embase), ProQuest and SportDiscus. Quantitative study types reporting on the relationships between running and mental health were included. Database searches identified 16,401 studies; 273 full-texts were analysed with 116 studies included. Overall, studies suggest that running bouts of variable lengths and intensities, and running interventions can improve mood and mental health and that the type of running can lead to differential effects. However, lack of controls and diversity in participant demographics are limitations that need to be addressed. Cross-sectional evidence shows not only a range of associations with mental health but also some associations with adverse mental health (such as exercise addiction). This review identified extensive literature on the relationship between running and mental health.

Secondary Prevention of Depressive Prodrome in Adolescents: Before and After Attending a Jogging Program on Campus

The adolescent depressive prodrome has been conceptualized as an early integrated sign of depressive symptoms, which may develop to a first episode of depression or return to normal for the adolescents. In this study, depressive prodrome presented the early self-rated depressive symptoms for the sample participants. By referring to the Kutcher Adolescent Depression Scale and the psychometric characteristics of the Adolescent Depression Scale (ADR), we proposed a self-rated questionnaire to assess the severity of the depressive symptoms in adolescents before and after attending the jogging program on a high school campus in Taiwan. With the parental co-signature and self-signed informed consent form, 284 high school students under the average age of 15 years, participated in this study in March 2019. Through the software of IBMSPSS 25, we used a binary logistic model, principal component analysis (PCA), multiple-dimensional analysis, and receiver operating characteristic curve (ROC) to analyze the severity of the depressive prodrome via the threshold severity score (SC) and false positive rate (FPR). Findings revealed that attending the 15-week jogging program (3 times a week, 45 min each) on campus can change the severity status and reduce the prevalence of moderate-severe depressive prodrome by 26%. The two-dimensional approach identified three symptoms, which were the crying spell, loss of pleasure doing daily activities, and feeling the decline in memory. They kept being invariant symptoms during the course of depressive prodrome assessment for sample participants. In this study, the campus jogging program appeared to be able to affect the FPR of the measure of depressive prodrome. Compared with the subthreshold depression, the depressive prodrome emphasized the assessment from the view of the secondary prevention by representing the change from a person's premorbid functioning up until the first onset of depression or returning to normal. However, the subthreshold depression is a form of minor depression according to DSM-5 criteria varying on the number of symptoms and duration required, highly prevalent in the concern of primary care.

Neuropsychological and Functional Impact of COVID-19 on Mild Cognitive Impairment

We present a case report to showcase that behavioral, cognitive, and functional decline may be associated with COVID-19 stay-home guidance among older adults with pre-existent cognitive impairment. In a functionally independent and physically active older adult with Mild Cognitive Impairment, there was worsening in depression and anxiety symptoms associated with the restrictions of COVID-19. Functional decline was also noted as assessed by Instrumental Activities of Daily Living. We discuss solutions to mitigate the effects of COVID-19 restrictions in this vulnerable population.

Effects of hyperbaric oxygen therapy on recovery acceleration in Japanese professional or semi-professional rugby players with grade 2 medial collateral ligament injury of the knee: A comparative non-randomized study

INTRODUCTION

The effects of hyperbaric oxygen (HBO2) therapy on sprains, ligament injuries, and muscle strains have been reported in several animal studies. In a dog model of compartment syndrome and in a rat contused skeletal muscle injury model, the significant effects of HBO2 therapy on the reduction of edema and muscle necrosis have been reported. In basic research HBO2 therapy stimulated fibroblast activity to improve the healing process. Because of this it expected that HBO2 therapy might improve focal edema and pain in the acute phase and accelerate the healing of injured tissues in athletes with a medial collateral ligament (MCL) injury of the knee. This study aimed to examine the short-term effects of HBO2 application subjectively, and the long-term effects of HBO2 therapy in Japanese professional or semi-professional rugby players with grade 2 MCL injury of the knee.

METHODS

Thirty-two professional or semi-professional rugby players with grade 2 MCL injury of the knee were investigated. First, in the HBO2 group (n=16), HBO2 therapy was performed during the acute phase. Visual analog scales (VASs) immediately before and after HBO2 therapy on the same day were compared. Next, we retrospectively evaluated the time to return to play in the HBO2 (n=16) and non-HBO2 (n=16) groups.

RESULTS

VAS scores for pain while walking immediately before and after HBO2 therapy on the same day were 37.4 ± 20.1 (mean ± standard deviation) and 32.4 ± 21.8, respectively (p⟨0.001). The VAS scores for pain while jogging were 50.7 ± 25.6 and 43.9 ± 25.0, respectively (p⟨0.001). The time to return to play was 31.4 ± 12.2 days in the HBO2 group and 42.1 ± 15.8 days in the non-HBO2 group, indicating a significant difference between the groups (p⟨0.05).

CONCLUSION

HBO2 therapy may reduce pain and accelerate the return to play in athletes with grade 2 MCL injury of the knee in this non-randomized study.

A comparison of a GPS device and a multi-camera video technology during official soccer matches: Agreement between systems

The aim of this study was to compare the agreement of the movement demands data during a soccer match (total distance, distance per minute, average speed, maximum speed and distance covered in different speed sectors) between an optical tracking system (Mediacoach System) and a GPS device (Wimu Pro). Participants were twenty-six male professional soccer players (age: 21.65 ± 2.03 years; height: 180.00 ± 7.47 cm; weight: 73.81 ± 5.65 kg) from FC Barcelona B, of whom were recorded a total of 759 measurements during 38 official matches in the Spanish second division. The Mediacoach System and the Wimu Pro were compared using the standardized mean bias, standard error of estimate, intraclass correlation coefficients (ICC), coefficient of variation (%), and the regression equation to estimate data for each variable. In terms of agreement between systems, the magnitude of the ICC was almost perfect (> 0.90-1.00) for all variables analyzed. The coefficient of the variations between devices was close to zero (< 5%) for total distance, distance per minute, average speed, maximum speed, and walking and jogging, and between 9% and 15% for running, intense running, and sprinting at low and at high intensities. It can be observed that, compared to Wimu Pro the Mediacoach System slightly overestimated all the variables analyzed except for average speed, maximum speed, and walking variables. In conclusion, both systems can be used, and the information they provide in the analyzed variables can be interchanged, with the benefits implied for practitioners and researchers.

The characteristics of EEG power spectra changes after ACL rupture

Background

Reestablishing knee stability is the core of the treatment of ACL (Anterior Cruciate Ligament) injury. Some patients still have a feeling of instability of the knee after ACL injury treatment. This unstable feeling may be caused by central nervous system changes after ACL rupture.

Methods

To identify the central changes after ACL rupture, EEG spectra were recorded to compare ACL patients and healthy controls when they were walking, jogging, and landing.

Results

There was a significant increase in delta, theta, alpha and beta band power during walking, jogging and landing in ACL patients. We also found an asymmetry phenomenon of EEG only in the ACL patients, mainly in the frontal area and central-parietal area. The asymmetry of beta band power extended to the frontal and the central area during jogging and landing task.

Conclusions

There were significant differences in EEG power spectra between the ACL patients and healthy people. ACL patients showed high EEG band power activities and an asymmetry phenomenon. EEG power changes were affected by movements, the asymmetry extended when performing more complicated movements.

Similarity of Center of Pressure Progression during Walking and Jogging of Anterior Cruciate Ligament Deficient Patients

OBJECTIVE

To evaluate the center of pressure (COP) progression similarity and its change during walking and jogging in Anterior Cruciate Ligament deficient (ACLD) patients.

METHODS

A study was performed in 64 unilateral ACLD subjects and 32 healthy volunteers who walked and jogged on footscan® system at a self-selected speed. COP trajectory during walking and jogging was calculated. The robustness and similarity scores of COP (SSCOP, similarity scores with respect to corresponding COP trajectories) were computed, and then the Analysis of Variance test was employed to compare among different conditions (left or right side, within a subject or between subjects, walking or jogging).

RESULTS

(1) During the same motion status (walking or jogging), SSCOP were higher than 0.885. However, SSCOP between walking and jogging were lower than 0.25 in both the healthy and ACLD group. SSCOP between the intrasubjects were statistically higher than those between the intersubjects (p<0.01). (2) SSCOP in the ACLD group were statistically significantly reduced to 0.885±0.074 compared to 0.912±0.057 in healthy volunteers during walking, and 0.903±0.066 in the ACLD group compared to 0.919±0.050 in the healthy group during jogging (p<0.01).

CONCLUSIONS

SSCOP can distinguish walking from jogging, and SSCOP of ACLD patients would be different from that of healthy controls. The study protocol was approved by the Institutional Research Board of Peking University Third Hospital (IRB00006761-2012010).

Stiffness Effects in Rocker-Soled Shoes: Biomechanical Implications

Rocker-soled shoes provide a way to reduce the possible concentration of stress, as well as change movement patterns, during gait. This study attempts to examine how plantar force and spatio-temporal variables are affected by two rocker designs, one with softer and one with denser sole materials, by comparing them with the barefoot condition and with flat-soled shoes. Eleven subjects' gait parameters during walking and jogging were recorded. Our results showed that compared with barefoot walking, plantar forces were higher for flat shoes while lower for both types of rocker shoes, the softer-material rocker being the lowest. The plantar force of flat shoes is greater than the vertical ground reaction force, while that of both rocker shoes is much less, 13.87-30.55% body weight. However, as locomotion speed increased to jogging, for all shoe types, except at the second peak plantar force of the denser sole material rocker shoes, plantar forces were greater than for bare feet. More interestingly, because the transmission of force was faster while jogging, greater plantar force was seen in the rocker-soled shoes with softer material than with denser material; results for higher-speed shock absorption in rocker-soled shoes with softer material were thus not as good. In general, the rolling phenomena along the bottom surface of the rocker shoes, as well as an increase in the duration of simultaneous curve rolling and ankle rotation, could contribute to the reduction of plantar force for both rocker designs. The possible mechanism is the conversion of vertical kinetic energy into rotational kinetic energy. To conclude, since plantar force is related to foot-ground interface and deceleration methods, rocker-design shoes could achieve desired plantar force reduction through certain rolling phenomena, shoe-sole stiffness levels, and locomotion speeds.

Is there a relationship between functional at foot and prevalence of non-insertional achilles tendinopathy in joggers? - a pilot study

INTRODUCTION

Non-insertional Achilles tendinopathy is one of the most common overuse injuries experienced by joggers. The pes planus evaluation is often based only on the visual method without a dynamic test. Functionally inefficiency of longitudinal or transverse arch of the foot may be a significant risk factor affecting the lower limb biomechanics and causing of pain in the Achilles tendon area. Assumptions and purpose of the study: This is study was undertaken to determine and investigate the relationship between the functionally inefficient longitudinal and transverse arch of the foot and the prevalence of non-insertional Achilles tendinopathy.

MATERIALS AND METHODS

The study group consisted of 11 regular joggers at different levels, who were diagnosed with non-insertional Achilles tendinopathy. The clinical evaluation involved pedobarographic analysis using the Footscan pressure plate. Information on loads applied to metatarsal area, the basis of the second and third metatarsal bones were subjected to statistical analysis.

RESULTS

All subjects who were diagnosed with overuse injuries in the Achilles tendon area showed a functionally inefficient transverse arch of the foot. Despite their pain, the individuals subjected to the study did not cease completely their physical activity.

CONCLUSIONS

Collapse of the natural arch of the foot can lead to biomechanical disorder in the lower limb joints. This is one of the risk factors for the occurrence of changes due to overuse injuries within the Achilles tendon.

Popliteal artery entrapment syndrome: an important differential diagnosis to consider in young military personnel presenting with calf claudication

Popliteal artery entrapment syndrome is a rare but important condition, which all military health practitioners should be aware of. It should be considered in all young military personnel presenting with symptoms of calf claudication. This article explains the condition, its classification and the key examination findings, allowing differentiation from other diagnoses, as well as advice on management, definitive treatment and prognosis.

Jogging-induced spontaneous peri-renal hemorrhage: a rare urologic emergency

Spontaneous peri-renal hemorrhage (SPH), also known as Wünderlich's syndrome, is an uncommon and rare urologic emergency, which could become life-threatening, requiring immediate diagnosis and management. The diagnosis can be challenging, even with new imaging modalities, and management can vary from conservative approach, to surgical intervention. We present a case of jogging-induced SPH diagnosed using CT scan that was managed conservatively, with follow-up for up to five years using CT imaging studies.

Standardized loads acting in knee implants

The loads acting in knee joints must be known for improving joint replacement, surgical procedures, physiotherapy, biomechanical computer simulations, and to advise patients with osteoarthritis or fractures about what activities to avoid. Such data would also allow verification of test standards for knee implants. This work analyzes data from 8 subjects with instrumented knee implants, which allowed measuring the contact forces and moments acting in the joint. The implants were powered inductively and the loads transmitted at radio frequency. The time courses of forces and moments during walking, stair climbing, and 6 more activities were averaged for subjects with I) average body weight and average load levels and II) high body weight and high load levels. During all investigated activities except jogging, the high force levels reached 3,372–4,218N. During slow jogging, they were up to 5,165N. The peak torque around the implant stem during walking was 10.5 Nm, which was higher than during all other activities including jogging. The transverse forces and the moments varied greatly between the subjects, especially during non-cyclic activities. The high load levels measured were mostly above those defined in the wear test ISO 14243. The loads defined in the ISO test standard should be adapted to the levels reported here. The new data will allow realistic investigations and improvements of joint replacement, surgical procedures for tendon repair, treatment of fractures, and others. Computer models of the load conditions in the lower extremities will become more realistic if the new data is used as a gold standard. However, due to the extreme individual variations of some load components, even the reported average load profiles can most likely not explain every failure of an implant or a surgical procedure.

[Effects of aquatic physical exercise on the kinematic gait pattern in patients with Parkinson's disease: a pilot study]

AIM. To determine the effects of an aquatic-based physical exercise program on gait parameters of patients with Parkinson's disease (PD). PATIENTS AND METHODS. A total of nine patients diagnosed with idiopathic PD (stages I-III according to the Hoehn and Yahr scale) carried out an aquatic physical exercise program which lasted for five months, with one session per week. A three-dimensional biomechanical analysis was used to determine the effects of the program on several kinematic variables (walking speed, cadence, stride length, step time, single and double support time, angles of the hip, knee and ankle joints) which were assessed by a treadmill-walking test. RESULTS. At the end of the program, significant improvement in walking speed, stride length and on the relationship between single and double support time (p < 0,05). Although improvements in all tested ranges of motion were obtained, these did not reach statistical significance. CONCLUSIONS. Aquatic-based physical exercise seems to have positive effects in some aspects of the gait kinematics parameters present in the typical gait pattern of patients with PD.

Different physical activity subtypes and risk of metabolic syndrome in middle-aged and older Chinese people

BACKGROUND

The prevalence of metabolic syndrome (MetS) is growing rapidly in China. Tai chi and dancing are common types of exercise among middle-aged and elderly Chinese. It remains unclear whether these activities are associated with a lower risk of MetS.

METHODOLOGY/PRINCIPAL FINDINGS

A total of 15,514 individuals (6,952 men, 8,562 women) aged 50 to 70 years from the Dongfeng-Tongji Cohort in Shiyan, China participated in a cross-sectional study. Physical activity and other lifestyle factors were assessed with semi-structured questionnaires during face-to-face interviews. MetS was defined by the current National Cholesterol Education Program/Adult treatment Panel III criteria for Asian Americans. The prevalence of MetS was 33.2% in the study population. In the multivariable-adjusted logistic regression analyses, total physical activity levels were monotonically associated with a lower odds of MetS [OR 0.75 comparing extreme quintiles, 95% confidence interval (CI) 0.66-0.86, P<0.001]. Compared with non-exercisers in a specific exercise type, jogging (OR 0.82, 95% CI 0.68-1.00, P = 0.046), tai chi (OR 0.72, 95% CI 0.60-0.88, P<0.001), and dancing (OR 0.56, 95% CI 0.47-0.67, P<0.001) were associated with significantly lower odds of MetS. Furthermore, each 1-h/week increment in tai chi and dancing was associated with a 5% (95% CI 2%-9%) and a 9% (95% CI 6%, 12%) lower risk of MetS.

CONCLUSIONS/SIGNIFICANCE

Jogging, tai chi and dancing are associated with a significantly lower risk of having MetS in middle-aged and older Chinese. Future intervention studies should consider the role of jogging, tai chi and dancing in preventing MetS.

Influence of Carbohydrate Ingestion on Oxidative Stress and Plasma Antioxidant Potential Following a 3 h Run

Concentrations of reactive oxygen species (ROS) increase during exercise secondary to increased oxygen uptake, xanthine oxidase activity, and immune system activation. Carbohydrate compared to placebo beverage ingestion is associated with an attenuated cortisol and catecholamine response. Catecholamines can undergo autooxidation to form ROS. We hypothesized that during intense exercise, ingestion of carbohydrate compared to placebo would diminish oxidative stress. Sixteen experienced marathoners ran on treadmills for 3 h at approximately 70% VO2(max) on two occasions while receiving carbohydrate or placebo beverages (11/h, double-blinded) in a randomized, counterbalanced order. Blood samples were collected before and immediately after exercise, snap frozen in liquid nitrogen, and stored at -80 degrees C until analysis. Plasma samples were analyzed for F2-isoprostanes (FIP) and lipid hydroperoxides (ROOH) as measures for lipid peroxidation, ferric reducing ability of plasma (FRAP) as a measure of plasma antioxidant potential and for cortisol. The pattern of change in cortisol was significantly different between carbohydrate and placebo conditions (P = 0.024), with post-exercise levels higher in the placebo condition. Under both carbohydrate and placebo conditions, significant increases in FIP, ROOH, and FRAP were measured, but the pattern of increase was not different (FIP, interaction effect, P = 0.472; ROOH, P = 0.572; FRAP, P = 0.668). Despite an attenuation in the cortisol response, carbohydrate compared to placebo ingestion does not counter the increase in oxidative stress or modulate plasma antioxidant potential in athletes running 3 h at 70% VO2(max).

[Physical exercise and intraocular pressure]

In the 1960s, it had been observed that physical exercises could reduce the intraocular pressure (IOP) in patients with glaucoma. However, the effect of IOP reduction varied with exercise type and intensity, as well as the duration after exercise. Difference of lowering the IOP in glaucoma patients and healthy people were also observed. The mechanisms of reducing the IOP by exercise were very complicated and believed to be associated with the lower concentration of norepinephrine, the rising of colloid osmotic pressure, the co-action of nitric oxide and endothelin after exercise, and also related to the gene polymorphism of β2-adrenergic receptor. Physical exercise, such as jogging, walking and bicycle riding, could be suggested as a complimentary therapy in addition to the pharmaceutical and surgical therapies available for glaucoma patients, even though the mechanism for lowering IOP is not clear enough.

The effectiveness of healthy physical fitness programs on people with intellectual disabilities living in a disability institution: six-month short-term effect

Little information is available on the provision of physical fitness and intervention program among people with intellectual disabilities. The aim of this study is to provide information of examining the effectiveness of healthy physical fitness programs on people with intellectual disabilities living in a disability institution. There were 146 participants with intellectual disabilities (age 19-67 years) were recruited in the study. We collected information on disability condition (type and level), height, weight, BMI, and physical fitness status (includes V-shape sit and reach test, sit-up 30s, sit-up 60s, and shuttle run) at the beginning and 6 months later of the program intervention. The results show that there were statistical decreases in individual's weight, BMI score, BMI category, and positive improvement in V-shape sit and reach test, sit-up in 30s and 60s tests after 6-month interventions. However, the shuttle run test did not improve at the post-test among people with intellectual disabilities. The results also showed that the mild disability level group has the highest effectiveness on the healthy fitness program on decreasing body weight. Generally speaking, the preliminary study found the healthy exercise program has positive fitness effects on people with intellectual disabilities. To maximize the benefits of regular physical activity on people with ID, there is a need to evaluate the long-term effect of the intervention program and then to initiate the healthy exercise strategies in institution for this group of people.

Midpoint-based empirical decomposition for nonlinear trend estimation

This paper presents a new method for nonlinear trend estimation of non-stationary signals, by which the trend can be self-adaptively decomposed through calculating the midpoint-based local means. In this method, the so-called midpoints are proposed to construct the local mean of a signal instead of two envelopes in the classical empirical mode decomposition (EMD) algorithm, thus resulting in the midpoint-based empirical decomposition. Furthermore, a negentropy-based statistical method is presented to justify decomposition of the trend. Simulation results indicate that the new algorithm improves the performance of signal decomposition and trend estimation in comparison with the classical EMD algorithm. The proposed method also shows the value in self-adaptively estimating the nonlinear respiratory component from non-invasively measured ventilation signals.

[Exercise-induced anaphylaxis]

Exercise-induced anaphylaxis (EIA) was defined for the first time in 1980. EIA is associated with different kind of exercise, although jogging is the most frequently reported. The clinical manifestations progress from itching, erythema and urticaria to some combination of cutaneous angioedema, gastrointestinal and laryngeal symptoms and signs of angioedema and vascular collapse. Mast cell participation in the pathogenesis of this syndrome has been proved by the finding of an elevated serum histamine level during experimentally-induced attacks and by cutaneous degranulation of mast cells with elevated serum tryptase after attacks. As predisposing factors of EIA, a specific or even aspecific sensitivity to food has been reported and such cases are called "food-dependent EIA". Many foods are implicated but particularly wheat, vegetables, crustacean. Another precipitating factor includes drugs intake (non steroidal anti-inflammatory drugs), climate variations and menstrual cycle factors. Treatment of an attack should include all the manoeuvres efficacious in the management of conventional anaphylactic syndrome, including the administration of epinephrine and antihistamines. Prevention of the attacks may be achieved with the interruption of the exercise at the appearance of the first premonitory symptoms. To prevent the onset of EIA it is also suitable to delay the exercise practice after at least 4-6 hours from the swallowing of food.

Characteristics of urban sidewalks/streets and objectively measured physical activity

Several studies have found significant relationships between environmental characteristics (e.g., number of destinations, aesthetics) and physical activity. While a few of these studies verified that the physical activities assessed were performed in the environments examined, none have done this in an urban, neighborhood setting. This information will help efforts to inform policy decisions regarding the design of more "physically active" communities. Fourteen environmental characteristics of 60, 305-m-long segments, located in an urban, residential setting, were directly measured using standardized procedures. The number of individuals walking, jogging, and biking in the segments was assessed using an observation technique. The segments were heterogeneous with regards to several of the environmental characteristics. A total of 473 individuals were seen walking, bicycling, or jogging in the segments during 3,600 min of observation (60 min/segment). Of the 473 seen, 315 were walking, 116 bicycling, and 42 jogging. A greater number of individuals were seen walking in segments with more traffic, sidewalk defects, graffiti, and litter and less desirable property aesthetics. Only one environmental characteristic was associated with bicycling and none were significantly related with jogging. This study provides further evidence that environmental characteristics and walking are related. It also adds new information regarding the importance of scale (e.g., micro, macro) and how some environmental characteristics of urban, residential sidewalks and streets relate to physical activity.

[Blood pressure lowering through physical training--what can be achieved?]

In the meantime, the positive effect of physical training, both in primary and secondary prevention of hypertension, has been confirmed in numerous studies. In recent years, it has been shown that regular sports activity of moderate intensity suffices to bring about a lowering of blood pressure. Highly recommended forms of training include walking, jogging, cycling and dynamic power training. Over a period of three to four months,a gradual increase in activity--for example, a daily training period of 15 to 20 minutes--should be the aim. However, an intensification of general physical activities may also lower blood pressure, irrespective of other risk factors.

Effect of regular Tai Chi and jogging exercise on neuromuscular reaction in older people

OBJECTIVES

to investigate the effects of regular Tai Chi (TC) or jogging exercise on neuromuscular reaction in older people.

DESIGN

cross-sectional study.

SETTING

university biomechanics laboratory.

SUBJECTS

21 long-term elderly TC practitioners were compared with 18 regular elderly joggers and 22 sedentary counterparts.

MEASUREMENTS

electromyography (EMG) was used to detect the neuromuscular reaction of the leg muscles to an unexpected ankle inversion perturbation. The latency of the muscles, which was defined as the time that the moment of perturbation began to the onset of the EMG response, was evaluated.

RESULTS

a one-way ANOVA revealed that there were significant differences in the latency of the rectus femoris (R) and anterior tibialis (T) muscles between the three groups, but that there were no differences in the latency of the semitendinosus (S) and gastrocnemius (G) muscles. Further tests indicated that the R and T muscles in the TC and jogging groups were activated significantly faster than those in the control group. No significant difference was found for the muscle onset latencies between the TC and jogging groups.

CONCLUSION

maintaining information processing speed during ageing is important, because of the role that it plays in many everyday events. The R and T muscles in the regular TC and jogging groups showed faster responses to unexpected ankle inversion perturbations, which is helpful for the timely correction of postural disturbances, than those in the sedentary control group.

Endurance Exercise Training in Orthostatic Intolerance

Orthostatic intolerance is a syndrome characterized by chronic orthostatic symptoms of light-headedness, fatigue, nausea, orthostatic tachycardia, and aggravated norepinephrine levels while standing. The aim of this study was to assess the protective effect of exercise endurance training on orthostatic symptoms and to examine its usefulness in the treatment of orthostatic intolerance. 2768 military recruits were screened for orthostatic intolerance by questionnaire. Tilt-table testing identified 36 cases of orthostatic intolerance out of the 2768 soldiers. Subsequently, 31 of these subjects with orthostatic intolerance entered a randomized, controlled trial. The patients were allocated randomly to either a “training” (3 months jogging) or a “control” group. The influence of exercise training on orthostatic intolerance was assessed by determination of questionnaire scores and tilt-table testing before and after intervention. After training, only 6 individuals of 16 still had orthostatic intolerance compared with 10 of 11 in the control group. The Fisher exact test showed a highly significant difference in diagnosis between the 2 groups ( P =0.008) at the end of the study. Analysis of the questionnaire-score showed significant interaction between time and group ( P =0.001). The trained subjects showed an improvement in the average symptom score from 1.79±0.4 to 1.04±0.4, whereas the control subjects showed no significant change in average symptom score (2.09±0.6 and 2.14±0.5, respectively). Our data demonstrate that endurance exercise training leads to an improvement of symptoms in the majority of patients with orthostatic intolerance. Therefore, we suggest that endurance training should be considered in the treatment of orthostatic intolerance patients.

Lower airway inflammatory responses to high-intensity training in athletes

PURPOSE

There is an increased prevalence of asthma and airway hyperresponsiveness in elite athletes, particularly in swimmers. High intensity exercise may induce airway inflammation and subsequent remodelling in these subjects. Our aim was to evaluate the effects of high-intensity training on induced-sputum cell populations in elite athletes.

METHODS

Swimmers and runners with hyperresponsive airways (SH and RH), defined by a provocative concentration of methacholine inducing a 20% decrease in FEV1 (PC20) <16 mg/ml or with normoresponsive airways (PC20 > 16 mg/ml; SN, RN) to methacholine were enrolled. The mean PC20 was 2.27 mg/ml in SH (n=12), 32.2 in SN (n=10), 3.25 in RH (n=10) and 41.5 in RN (n=13). All athletes had two induced sputum analyses at one- to two-week intervals in random order: after a period of 72 hours without training, 24 hours after a training session.

RESULTS

PC20 was unchanged after training. The median % neutrophils and eosinophils in groups SH, SN, RH, and RN, respectively, were 26.5-1.6, 8.6-0.3, 28.0-0.03 and 25.5-0.1 before and 45.0-0.5, 31.1-0.4, 54.0-0.6 and 48.3-0.3 after training. While the magnitude of the increase in neutrophils was similar for all groups, it reached statistical significance (pre-post-training) only in the SH group (P = 0.039).

CONCLUSION

A one-hour session of high-intensity training was associated with an increase in airway neutrophils among hyperresponsive swimmer athletes, while airway responsiveness remained unchanged in all groups.

Combined endurance/resistance training reduces NT-proBNP levels in patients with chronic heart failure

AIMS

This study was designed to evaluate the effects of combined endurance/resistance training on NT-proBNP levels in patients with chronic heart failure (CHF). The safety of resistive weight training for patients with CHF is questioned. Possible detrimental effects include an increase in ventricular diastolic pressure and secondary unfavourable remodelling. Circulating levels of the N-terminal fragment of brain natriuretic peptide (NT-proBNP) reflect left ventricular diastolic wall stress and are strongly related to mortality and treatment success in CHF.

METHODS AND RESULTS

In this study, 27 consecutive patients with stable CHF and left ventricular ejection fraction (LVEF) <35% were enrolled in a 4 months non-randomized combined endurance/resistance training programme. Blood sampling for measurement of NT-proBNP, functional assessment, cardiopulmonary exercise testing, echocardiography and radionuclide angiography were performed at entry and after 4 months. After 4 months, exercise training caused a significant reduction in circulating concentrations of NT-proBNP (2124+/-397 pg/ml before, 1635+/-304 pg/ml after training, p=0.046, interaction), whereas no changes were observed in an untrained heart failure control group. NYHA functional class (p=0.02, interaction), maximal (peak VO2: p=0.035, interaction; maximal workload: p<0.00001, interaction) and submaximal (workload at anaerobic threshold: p=0.001, interaction; rate-pressure product at anaerobic threshold: p=0.001, interaction) exercise parameters as well as work efficiency (Wattmax/VO2peak: p=0.0001, interaction) were significantly improved. In addition, a decrease in left ventricular end-systolic diameter was observed in the trained heart failure group (p=0.016).

CONCLUSION

Four months of combined endurance/resistance training significantly reduced circulating levels of NT-proBNP in patients with CHF, without evidence of adverse remodelling. Exercise training might offer additional non-pharmacological modulation of the activated neurohormonal pathways in the setting of CHF.

Construct validity of self-reported historical physical activity

The purpose of this study was to determine the construct-related validity of self-reported historical walking, running, and jogging (WRJ) activity on the basis of data from the Aerobics Center Longitudinal Study (Dallas, Texas). A total of 4,100 men and 963 women underwent at least one medical examination between 1976 and 1985 and completed a follow-up questionnaire in 1986. Levels of glucose, cholesterol, and triglycerides, resting systolic blood pressure, body mass index (weight (kg)/height (m)(2)), and cardiorespiratory fitness were measured at the time of the medical examination. The follow-up questionnaire assessed WRJ and other strenuous activities for each year from 1976 through 1985. Data analysis included Spearman and partial correlations, analysis of variance, analysis of covariance, and t tests. Results indicated significant correlations between recalled WRJ and treadmill times for each year throughout the 10-year period (r = 0.40-0.61). Participants were classified as historically either sufficiently physically active to receive a health benefit or insufficiently active for a health benefit. Engaging in sufficient levels of historical WRJ was associated with higher treadmill times and lower body mass indices for men and women and lower triglyceride levels for men. Self-reported historical WRJ can be assessed with reasonable validity in comparison with measured treadmill performance, with no decay in accuracy of reporting for up to 10 years in the past.

[The role of jogging in the prevention and treatment of cardiovascular disease]

Lack of exercise and poor eating habits are considered to be major causes of most diseases of civilization. In consequence, endurance sports, but also an integration of physical activity in everyday life, are gaining in importance. Positive effects of regular physical exercise have been described for CAD, arterial hypertension, lipid metabolic disorders, type 2 diabetes mellitus and the metabolic syndrome. In order to achieve an optimal training effect, exercise intensity should be oriented to the individual anaerobic threshold. As a rule of thumb, 30 minutes of endurance training--ideallyevery day--is considered necessary. Prior testing of a person's ability to undertake such activities should include ECG and blood pressure measurements, spirometry and lactate determination, and contraindications must be taken into account.

Health benefits associated with exercise habituation in older Japanese men

BACKGROUND AND AIMS

The purpose of this study was to compare the effects of exercise habituation (3-32 years, mean 13.2 years) on physical vitality among five different groups.

METHODS

One hundred and two independent, community-dwelling elderly Japanese men, aged 64.6 +/- 6.6 years, were recruited as subjects. The vital age test battery consisted of various coronary heart disease risk factors and physical fitness elements.

RESULTS

The results of analysis of variance revealed that vital age as an index of physical vitality was youngest in joggers (47.9 yr, N=18), intermediate in trekkers (55.8 yr, N=20) and walkers (59.1 yr, N=18), and oldest (69.6 yr, N=20) in patients with ischemic heart disease (IHD). The difference between chronological age and vital age was approximately 15 years (p<0.05) in joggers, and 8 years (p<0.05) in trekkers and walkers. The vital age of sedentary persons (N=26) was only 1.9 years (NS) younger than their chronological age, which was similar to the difference (vital age of 64.1 +/- 8.5 yr vs chronological age of 65.7 +/- 5.4 yr) previously observed in similarly aged exercising IHD patients.

CONCLUSIONS

These results indicate that exercise habituation significantly affects the overall health status of most individuals, irrespective of mode of exercise. Among the three modes of exercise, jogging may be most beneficial. Furthermore, regularly exercising coronary patients may have physical vitality similar to that of sedentary men.

Jogging support system with portable monitoring device and health manage software

At MEDINFO 2001 we reported about an ambulatory biosignal memory device. As an application of this system, we have developed a portable jogging monitoring device and studied its application for health management here. This device is a micro processor based system with some sensors necessary to monitor condition of the user during jogging, that is, a heart rate sensor, a GPS sensor and a physical activity sensor. We also have developed PC based health management software that receives jogging data after jogging and stores it as a long term jogging trend data. From these long term data it feeds back the distance completion of jogging on the virtual course. Moreover it can show the trend of jogging time, distance, average heart rate and the user can know his/her own health condition.