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1.  Comparison of Effect of Regular Unstructured Physical Training and Athletic Level Training on Body Composition and Cardio Respiratory Fitness in Adolescents 
Background: Childhood obesity and hypertension are global problems that are on the rise in India. Improving physical activity is an accepted main line of strategy for overcoming poor body composition, hypertension and reduced cardio respiratory fitness (CRF) all of which are considered as independent risk factors for the development of future cardiovascular complications.
Aim: Present study was conducted to evaluate the effect of regular unstructured physical training and athletic level training on anthropometric measures, body composition, blood pressure and cardio respiratory fitness in adolescents.
Settings and Design: This is a collaborative study between the Department of physiology, Jawaharlal Institute of Postgraduate Medical Education and Research and Residential school, Jawahar Navodhya Vidyalaya, Puducherry, India.
Method and Material: Student volunteers in the age group of 12–17 years were classified into athletes (group 1) and physically active non-athletes (group 2). Parameters measured and calculated were weight, height, body mass index, waist and hip circumference, body fat percentage (BF%), fat free mass (FFM), Systolic (SBP) & Diastolic blood pressure (DBP), Mean arterial pressure (MAP), Rate pressure product (RPP) and Predicted VO2 max.
Statistical Analysis used: Mean difference between the groups was analysed using unpaired Student’s t–test. All statistical analysis was carried out for two-tailed significance at the 5 % level using SPSS version 19 (SPSSInc, USA).
Results: Anthropometric measures, body composition measures and blood pressure values of both the group students were within the normal limits. There was no significant difference in anthropometric and body composition parameters between the group 1 and group 2 students. DBP, MAP and RPP were significantly lower in group 1 students when compared to group 2 students. VO2 max values were more in group 1 girls as compared to group 2 girls while the values of boys were comparable between the two groups.
Conclusion: Regular unstructured physical activity for 60 minutes daily for the duration of one year can help the students to maintain their anthropometric parameters, body composition measures and CRF at par with the athletes of the same age and gender. However, athletic level training further reduces the cardiovascular load of the adolescent students.
PMCID: PMC3809626  PMID: 24179887
Physical activity; Body composition; Fat free mass; Cardio respiratory fitness
2.  Body Mass Index and Percentage of Body Fat as Indicators for Obesity in an Adolescent Athletic Population 
Sports Health  2011;3(3):249-252.
Body mass index (BMI) is widely accepted in determining obesity. Skinfold thickness measurements have been commonly used to determine percentage of body fat.
The authors hypothesize that because BMI does not measure fat directly but relies on body weight alone, a large percentage of athletic adolescents will be misclassified as obese by BMI.
Cross-sectional study.
To compare BMI and skinfold measurements as indicators for obesity in the adolescent athletic population, anthropometric data (height, weight, percentage body fat, age, and sex) were recorded from 33 896 student athletes (average age, 15 years; range, 11-19 years) during preparticipation physical examinations from 1985 to 2003. BMI was calculated from height and weight. Percentage of body fat was determined by measuring skinfold thickness.
According to their BMI percentile, 13.31% of adolescent athletes were obese. Using the skinfold method, only 5.95% were obese. Of those classified as obese by the BMI, 62% were considered false positives by the skinfold method. In contrast, there was a 99% probability that the nonobese by BMI would not be obese by the skinfold method (negative predictive value = 0.99).
BMI is a measurement of relative body weight, not body composition. Because lean mass weighs far more than fat, many adolescent athletes are incorrectly classified as obese based on BMI. Skinfold testing provides a more accurate body assessment than BMI in adolescent athletes.
Clinical Relevance:
Correct body composition data can help to provide better diet and activity guidelines and prevent the psychological problems associated with being labeled as obese.
PMCID: PMC3445161  PMID: 23016014
body mass index; skinfold; adolescent; obesity
3.  Pre, during, and post exercise anterior tibial compartment pressures in long distance runners 
The aim of the study was to assess pre, during, and postexercise compartment pressures in the anterior tibial compartment in asymptomatic long distance runners (5000 m) and recreational athletes. Forty-eight participants (n = 48, 24 females and 24 males) underwent the experimental procedures. The participants were assigned into 4 groups of 12 volunteers. Intracompartmental pressures measurements were recorded 1 minute before, at the 1st minute after the onset of exercise, and finally 5 minutes after the completion of the exercise on treadmill. The wick catheter technique was the method of choice for measuring intracompartmental pressure values. Post hoc analysis of the groups by measures interaction indicated that all pairwise comparisons among pre-test (1 minute before exercise), during-test (1st minute during exercise), and post-test measures (5 minutes after exercise) were statistically significant for male controls (p < .001), male athletes (p < .001), female controls (p < .001) and female athletes (p < .001). The results confirm the correlation between long distance runners and the increased risk of chronic exertional compartment syndrome (CECS) development.
Key pointsCompartment syndrome is a condition characterised by increased intracompartmental pressures within inelastic fascia which surrounds muscular compartmentsInitial CECS symptomatology is not clear and increases graduallyAll the study participants presented the lowest intra-compartment pressure values one minute before the beginning of exercise (at rest) with the highest value being recorded at the first minute of exercise.Control population had lower intra-compartment pressure than professional runners.One minute after the beginning of exercise control and athlete men group showed higher intra-compartment pressure than control and athlete women group, indicating a probable sex difference both for athletes and controls.Further studies on predisposing factors of CECS, such as increased intracompartmental pressure values in asymptomatic population is needed to establish the diagnosis in a proper time.
PMCID: PMC3763359  PMID: 24150140
Compartment syndrome; athletes; wick catheter; intracompartmental pressures; runners
4.  The effectiveness of two energy drinks on selected indices of maximal cardiorespiratory fitness and blood lactate levels in male athletes 
Consumption of energy drinks has become widespread among athletes. The effectiveness of Red Bull and Hype energy drinks on selected indices of maximal cardiorespiratory fitness and blood lactate levels in male athletes was examined in this study.
Ten male student athletes (age: 22.4 ± 2.1 years, height: 180.8 ± 7.7 cm, weight: 74.2 ± 8.5 kg) performed three randomized maximal oxygen consumption tests on a treadmill. Each test was separated by four days and participants were asked to ingest Red Bull, Hype or placebo drinks 40 minutes before the exercise bout. The VO 2max, time to exhaustion, heart rate and lactate were measured to determine if the caffeine-based beverages influence performance. ANOVA test was used for analyzing data.
A greater value was observed in VO 2maxand time to exhaustion for the Red Bull and Hype trial compared to the placebo trial (p < 0.05). No significant difference was found in pre-and post-test heart rate for two drinks (p > 0.05). For blood lactate levels no significant changes were observed before and two minute after the test (p > 0.05).
Ingestion of Red Bull and Hype prior to exercise testing is effective on some indices of cardiorespiratory fitness but not on the blood lactate levels.
PMCID: PMC3082800  PMID: 21526071
Energy Drink; Caffeine; Taurine; VO2max; Blood Lactate; Male Athletes
5.  Meal patterns and food choices of young African American men: understanding eating within the context of daily life 
Although young African-American males are at particularly high risk of developing hypertension at an early age, dietary interventions that have successfully reduced blood pressure among African-American adults have not been translated into programs for this group. Life contexts such as school enrollment, competitive athletics, and employment influence the daily activities and meal patterns of African-American males. This study explored the activities of young African-American males to identify opportunities to increase healthful food choices. A purposive sample was recruited which included five groups of African-American males (15–22 years of age, n=106): high school athletes and non-athletes, college athletes and non-athletes, and non-students. A structured interview guided participants through a description of their activities, meal patterns, and food choices over the course of a typical weekday. Common elements emerged that provided a contextual view of the participant meal patterns and food choices. These elements were sports team participation, college employment, school as a food source, non-student status, and eating dinner at home. These findings suggest opportunities for the design of dietary interventions for young African-American males which take into consideration how school, athletics and employment may influence opportunities to eat regular meals that include healthful foods.
PMCID: PMC3189498  PMID: 21872697
minority health; hypertension prevention; meal patterns; food choice; African-American men’s health; qualitative research
6.  Cortical Microstructure and Estimated Bone Strength in Young Amenorrheic Athletes, Eumenorrheic Athletes and Non-Athletes 
Bone  2012;51(4):680-687.
Lower bone density in young amenorrheic athletes (AA) compared to eumenorrheic athletes (EA) and non-athletes may increase fracture risk during a critical time of bone accrual. Finite element analysis (FEA) is a unique tool to estimate bone strength in vivo, and the contribution of cortical microstructure to bone strength in young athletes is not well understood.
We hypothesized that FEA-estimated stiffness and failure load are impaired in AA at the distal radius and tibia compared to EA and non-athletes despite weight-bearing exercise.
Cross-sectional study; Clinical Research Center
34 female endurance athletes involved in weight-bearing sports (17 AA, 17 EA) and 16 non-athletes (14-21y) of comparable age, maturity and BMI
We used HR-pQCT images to assess cortical microarchitecture and FEA to estimate bone stiffness and failure load.
Cortical perimeter, porosity and trabecular area at the weight-bearing tibia were greater in both groups of athletes than non-athletes, whereas the ratio (%) of cortical to total area was lowest in AA. Despite greater cortical porosity in EA, estimated tibial stiffness and failure load was higher than in non-athletes. However, this advantage was lost in AA. At the non-weight-bearing radius, failure load and stiffness were lower in AA than non-athletes. After controlling for lean mass and menarchal age, athletic status accounted for 5-9% of the variability in stiffness and failure load, menarchal age for 8-23%, and lean mass for 12-37%.
AA have lower FEA-estimated bone strength at the distal radius than non-athletes, and lose the advantage of weight-bearing exercise seen in EA at the distal tibia.
PMCID: PMC3482939  PMID: 22878154
athletes; adolescents; bone strength; stiffness; failure load
7.  A Study on Body Mass Index, Blood Pressure, and Red Blood Cell Indices in New Entering Students of the University of Isfahan 
Obesity and increased blood pressure are identified as risk factors for cardiac and pulmonary disorders. On the other hand, iron deficiency (another preventable disease) is common in adolescence and considered as associated with health impairment. The present study evaluates body mass index (BMI) and its association with blood pressure and hematological indices in freshman students entering the University of Isfahan in 2009.
All the 1675 students who entered the University of Isfahan in September 2009 were examined. Height, weight, BMI, blood pressure, hemoglobin (Hb) and red blood cell (RBC) indices of these students were measured. The prevalence of high blood pressure, its association with BMI and the relation between BMI and anemia, iron deficiency and educational achievement were assessed.
All participants, including 514 males and 1161 females, went under clinical observations. The average age was 20.7 ± 3.8. year Among the students, 18.2% of males and 20% of females were underweight. High systolic blood pressure was more common in the students with BMI > 25 kg/m2 (p < 0.001). Anemia was seen in 8.7% of females. In males, however, a relation between anemia frequency and BMI < 18.5 kg/m2 was more distinct (p = 0.002). There was no association between anemia and students’ average test scores.
High incidence of abnormal BMI in the study population, and its association with systolic blood pressure indicate the importance of nutritional guidelines and counseling programs for freshman students. On the other hand, high incidence of anemia in this population ascertains the necessity of anemia screening programs before academic studies.
PMCID: PMC3237273  PMID: 22174970
Body mass index; Systolic blood pressure; Iron deficiency anemia
8.  The Effect of Goal Setting Difficulty on Serving Success in Table Tennis and the Mediating Mechanism of Self-regulation 
Journal of Human Kinetics  2012;33:173-185.
Goal setting difficulty has been shown to contribute to athletic performance (Burton et al., 2000). However, the potential mediating mechanism of goal difficulty on performance is unclear. Therefore, the purpose of this study was to verify the effect of goal setting difficulty on serving success in table tennis, and determine if self-regulation is the mediating variable. The current study used serving success within a one minute period as the task, and the “Athlete’s Self-regulation in Motor Learning” as the measurement tool. The experiment was designed as a 3 (serving frequency: 20/min, 23/min, and 26/min) × 2 (serving placement: left “small triangle”, and right “small triangle”) model. Participants (N = 60) in the current study were students from a physical education school. These participants were randomly assigned into the experimental and control groups. After the intervention, differences in self-regulation (p < 0.001) and serving success (p < 0.05) between the experimental and control groups were significant. For the experimental groups, there was a significant difference in self-regulation (p < 0.001) and serving success (p < 0.05) before and after the experiment. Serving frequency had a main effect on self-regulation (F (5, 24) = 12.398, p < 0.01) and serving success (F (5, 24) = 37.601, p < 0.001). Moderately difficult goal setting contributed to athletic performance. Regression analysis using bootstrapping methods revealed that self-regulation partially mediated the relationship between the two.
PMCID: PMC3588684  PMID: 23487526
table tennis athletes; goal setting difficulty; self-regulation; serving success
9.  An Assessment of Learning Styles Among Undergraduate Athletic Training Students 
Journal of Athletic Training  1998;33(1):50-53.
Increased attention has been directed toward assessing and improving academic quality in athletic training education. The educational process has been assessed from a global level, but little is known about how athletic training students learn. The purpose of this investigation was to assess the learning styles of undergraduate athletic training students.
Design and Setting:
Undergraduate students enrolled in a Committee on Accreditation of Allied Health Education Programs (CAAHEP)-accredited athletic training education program completed a learning styles inventory during a regularly scheduled athletic training class at the start of the spring semester.
Twenty-seven student athletic trainers (age range, 19-30 yrs, mean age = 20.5 yrs) served as subjects. Sixteen subjects (7 male, 9 female) were in the first year of this 3-year program. Eleven subjects (7 male, 4 female) were second-year students.
Learning style was assessed using the Productivity Environmental Preference Survey.
Parametric and nonparametric one-way analyses of variance for each learning subscale by sex and by year in program revealed significant differences (P < .05) in light preferences for male and female students. There were also significant differences (P < .05) between first-and second-year students in preferences for afternoon learning activities.
These findings suggest that undergraduate athletic training students function best as leamers in a well-lit leaming environment. The significance of aftemoon as the preferred time for learning reinforces the importance of the clinical setting in the introduction and mastery of skills. Athletic training educators and clinical instructors can use these results as they examine their teaching strategies and educational environments.
PMCID: PMC1320376  PMID: 16558485
learning preferences; Productivity Environmental Preference Survey
10.  Mid‐expiratory flow versus FEV1 measurements in the diagnosis of exercise induced asthma in elite athletes 
Thorax  2005;61(2):111-114.
A fall in FEV1 of ⩾10% following bronchoprovocation (eucapnic voluntary hyperventilation (EVH) or exercise) is regarded as the gold standard criterion for diagnosing exercise induced asthma (EIA) in athletes. Previous studies have suggested that mid‐expiratory flow (FEF50) might be used to supplement FEV1 to improve the sensitivity and specificity of the diagnosis. A study was undertaken to investigate the response of FEF50 following EVH or exercise challenges in elite athletes as an adjunct to FEV1.
Sixty six male (36 asthmatic, 30 non‐asthmatic) and 50 female (24 asthmatic, 26 non‐asthmatic) elite athletes volunteered for the study. Maximal voluntary flow‐volume loops were measured before and 3, 5, 10, and 15 minutes after stopping EVH or exercise. A fall in FEV1 of ⩾10% and a fall in FEF50 of ⩾26% were used as the cut off criteria for identification of EIA.
There was a strong correlation between ΔFEV1 and ΔFEF50 following bronchoprovocation (r = 0.94, p = 0.000). Sixty athletes had a fall in FEV1 of ⩾10% leading to the diagnosis of EIA. Using the FEF50 criterion alone led to 21 (35%) of these asthmatic athletes receiving a false negative diagnosis. The lowest fall in FEF50 in an athlete with a ⩾10% fall in FEV1 was 14.3%. Reducing the FEF50 criteria to ⩾14% led to 13 athletes receiving a false positive diagnosis. Only one athlete had a fall in FEF50 of ⩾26% in the absence of a fall in FEV1 of ⩾10% (ΔFEV1 = 8.9%).
The inclusion of FEF50 in the diagnosis of EIA in elite athletes reduces the sensitivity and does not enhance the sensitivity or specificity of the diagnosis. The use of FEF50 alone is insufficiently sensitive to diagnose EIA reliably in elite athletes.
PMCID: PMC2104577  PMID: 16227323
asthma; sensitivity; diagnosis; eucapnic voluntary hyperventilation; elite athletes
11.  Comparison of Brachial Artery Vasoreactivity in Elite Power Athletes and Age-Matched Controls 
PLoS ONE  2013;8(1):e54718.
Elite endurance athletes typically have larger arteries contributing to greater skeletal muscle blood flow, oxygen and nutrient delivery and improved physical performance. Few studies have examined structural and functional properties of arteries in power athletes.
To compare the size and vasoreactivity of the brachial artery of elite power athletes to age-matched controls. It was hypothesized brachial artery diameters of athletes would be larger, have less vasodilation in response to cuff occlusion, but more constriction after a cold pressor test than age-matched controls.
Eight elite power athletes (age = 23±2 years) and ten controls (age = 22±1 yrs) were studied. High-resolution ultrasonography was used to assess brachial artery diameters at rest and following 5 minutes of forearm occlusion (Brachial Artery Flow Mediated Dilation = BAFMD) and a cold pressor test (CPT). Basic fitness measures included a handgrip test and 3-minute step test.
Brachial arteries of athletes were larger (Athletes 5.39±1.51 vs. Controls: 3.73±0.71 mm, p<0.05), had greater vasodilatory (BAFMD%: Athletes: 8.21±1.78 vs. Controls: 5.69±1.56%) and constrictor (CPT %: Athletes: -2.95±1.07 vs. Controls: −1.20±0.48%) responses, compared to controls. Vascular operating range (VOR = Peak dilation+Peak Constriction) was also greater in athletes (VOR: Athletes: 0.55±0.15 vs. Controls: 0.25±0.18 mm, p<0.05). Athletes had superior handgrip strength (Athletes: 55.92±17.06 vs. Controls: 36.77±17.06 kg, p<0.05) but similar heart rate responses at peak (Athletes: 123±16 vs. Controls: 130±25 bpm, p>0.05) and 1 minute recovery (Athletes: 88±21 vs. Controls: 98±26 bpm, p>0.05) following the step test.
Elite power athletes have larger brachial arteries, and greater vasoreactivity (greater vasodilatory and constrictor responses) than age-matched controls, contributing to a significantly greater VOR. These data extend the existence of an ‘athlete’s artery’ as previously shown for elite endurance athletes to elite power athletes, and presents a hypothetical explanation for the functional significance of the ‘power athlete’s artery’.
PMCID: PMC3554649  PMID: 23359214
12.  Effect of a Single Finnish Sauna Session on White Blood Cell Profile and Cortisol Levels in Athletes and Non-Athletes 
Journal of Human Kinetics  2013;39:127-135.
The aim of the present study was to investigate the effect of Finnish sauna bathing on a white blood cell profile, cortisol levels and selected physiological indices in athletes and non-athletes. The study evaluated 9 trained middle-distance runners and 9 male non-athletes. The subjects from both groups participated in 15-minute sauna sessions until their core temperature rose by 1.2°C (mean temperature in the sauna room was 96° ± 2°C; relative humidity was 15 ± 3%) with a 2 minute cool down with water at a temperature of 19–20°C. Body mass was measured before and after the session and blood samples were taken for tests. Rectal temperature was monitored at five-minute intervals during the whole session. Serum total protein, haematological indices and cortisol levels were determined. Sauna bathing caused higher body mass loss and plasma volume in the athletes compared to the group of non-athletes. After the sauna session, an increased number of white blood cells, lymphocyte, neutrophil and basophil counts was reported in the white blood cell profile. Higher increments in leukocyte and monocyte after the sauna bathing session were recorded in the group of athletes compared to untrained subjects. The obtained results indicated that sauna bathing stimulated the immune system to a higher degree in the group of athletes compared to the untrained subjects.
PMCID: PMC3916915  PMID: 24511348
sauna bath; white blood cell profile; cortisol; immunology
13.  Prevalence of Disordered-Eating Behaviors in Undergraduate Female Collegiate Athletes and Nonathletes 
Journal of Athletic Training  2005;40(1):47-51.
Context: As the number of female college students participating in athletics has grown dramatically in the last few decades, sports medicine health care providers have become more aware of the unique health concerns of athletic women. These concerns include disordered eating, amenorrhea, and osteoporosis: the female athlete triad. Disordered eating appears to be central in the triad, and the literature has conflicting data regarding the influence of athletic participation on disordered-eating behaviors.
Objective: To compare disordered-eating symptoms between collegiate athletes (in lean and non-lean sports) and nonathletes.
Design: A volunteer, cross-sectional cohort study of female students during the 2002–2003 academic year.
Setting: A National Collegiate Athletic Association Division I institution.
Patients or Other Participants: Undergraduate females, including 84 collegiate athletes and 62 nonathletes.
Main Outcome Measure(s): Symptoms associated with disordered eating were assessed using the Eating Disorders Inventory-2, a self-report measure of 91 items, and self-reported weight and menstrual function.
Results: The athletes had significantly lower scores in body dissatisfaction (P = .01) and ineffectiveness (P = .002). No difference in mean body weight was noted between the 2 groups, but the nonathlete group had a significantly lower desired body weight (P = .004). Lean-sport athletes had a higher score on body dissatisfaction (P = .008) and lower actual (P = .024) and desired body weight (P = .002) than non–lean-sport athletes. A total of 7.1% of the collegiate athletes and 12.9% of the nonathletes were classified as having a high risk for disordered eating. Within the athlete sample, the high-risk group included 2.9% of the non–lean-sport athletes and 25% of the lean-sport athletes.
Conclusions: In our study, female athletes did not exhibit more disordered-eating symptoms than women who did not participate in collegiate sports. However, our data suggest that lean-sport athletes are at greater risk for disordered eating than athletes in non-lean sports.
PMCID: PMC1088345  PMID: 15902324
female athlete triad; nutrition; psychology
14.  Age at menarche in Nigerian athletes. 
The subjects of the study were 418 highly successful female athletes and 512 female non-athletes drawn from all over Nigeria. Recall procedures were used to ascertain the age at menarche. The study gave the following results: In general, over-all mean menarcheal age of athletes (14.13 years) was significantly higher (p less than .05) than that of non-athletes (13.57 years). Menarche was significantly (p less than .05) delayed (14.41 years) in those athletes (n = 272) who started physical activities before the onset of menstruation. The mean menarcheal age of non-athletes i.e. general population was significantly lower (p less than .05) than that established thirty years ago in Nigerian women.
PMCID: PMC1858921  PMID: 7159817
15.  The effects of peppermint on exercise performance 
Enhancing athletic performance is a great desire among the athletes, coaches and researchers. Mint is one of the most famous natural herbs used for its analgesic, anti-inflammatory, antispasmodic, antioxidant, and vasoconstrictor effects. Even though inhaling mint aroma in athletes has been investigated, there were no significant effects on the exercise performance.
Twelve healthy male students every day consumed one 500 ml bottle of mineral water, containing 0.05 ml peppermint essential oil for ten days. Blood pressure, heart rate, and spirometry parameters including forced vital capacity (FVC), peak expiratory flow rate (PEF), and peak inspiratory flow (PIF) were determined one day before, and after the supplementation period. Participants underwent a treadmill-based exercise test with metabolic gas analysis and ventilation measurement using the Bruce protocol.
The FVC (4.57 ± 0.90 vs. 4.79 ± 0.84; p < 0.001), PEF (8.50 ± 0.94 vs. 8.87 ± 0.92; p < 0.01), and PIF (5.71 ± 1.16 vs. 6.58 ±1.08; p < 0.005) significantly changed after ten days of supplementation. Exercise performance evaluated by time to exhaustion (664.5 ± 114.2 vs. 830.2 ± 129.8 s), work (78.34 ±32.84 vs. 118.7 ± 47.38 KJ), and power (114.3 ± 24.24 vs. 139.4 ± 27.80 KW) significantly increased (p < 0.001). In addition, the results of respiratory gas analysis exhibited significant differences in VO2 (2.74 ± 0.40 vs. 3.03 ± 0.351 L/min; p < 0.001), and VCO2 (3.08 ± 0.47 vs. 3.73 ± 0.518 L/min; p < 0.001).
The results of the experiment support the effectiveness of peppermint essential oil on the exercise performance, gas analysis, spirometry parameters, blood pressure, and respiratory rate in the young male students. Relaxation of bronchial smooth muscles, increase in the ventilation and brain oxygen concentration, and decrease in the blood lactate level are the most plausible explanations.
PMCID: PMC3607906  PMID: 23517650
Peppermint essential oil; Exercise performance; Respiratory gas analysis; Spirometry
16.  Weight changes, medical complications, and performance during an Ironman triathlon 
Background: Subjects exercising without fluid ingestion in desert heat terminated exercise when the total loss in body weight exceeded 7%. It is not known if athletes competing in cooler conditions with free access to fluid terminate exercise at similar levels of weight loss.
Objectives: To determine any associations between percentage weight losses during a 224 km Ironman triathlon, serum sodium concentrations and rectal temperatures after the race, and prevalence of medical diagnoses.
Methods: Athletes competing in the 2000 and 2001 South African Ironman triathlon were weighed on the day of registration and again immediately before and immediately after the race. Blood pressure and serum sodium concentrations were measured at registration and immediately after the race. Rectal temperatures were also measured after the race, at which time all athletes were medically examined. Athletes were assigned to one of three groups according to percentage weight loss during the race.
Results: Body weight was significantly (p<0.0001) reduced after the race in all three groups. Serum sodium concentrations were significantly (p<0.001) higher in athletes with the greatest percentage weight loss. Rectal temperatures were the same in all groups, with only a weak inverse association between temperature and percentage weight loss. There were no significant differences in diagnostic indices of high weight loss or incidence of medical diagnoses between groups.
Conclusions: Large changes in body weight during a triathlon were not associated with a greater prevalence of medical complications or higher rectal temperatures but were associated with higher serum sodium concentrations.
PMCID: PMC1724978  PMID: 15562165
17.  Optic Nerve Head Blood Flow Autoregulation during Changes in Arterial Blood Pressure in Healthy Young Subjects 
PLoS ONE  2013;8(12):e82351.
In the present study the response of optic nerve head blood flow to an increase in ocular perfusion pressure during isometric exercise was studied. Based on our previous studies we hypothesized that subjects with an abnormal blood flow response, defined as a decrease in blood flow of more than 10% during or after isometric exercise, could be identified.
A total of 40 healthy subjects were included in this study. Three periods of isometric exercise were scheduled, each consisting of 2 minutes of handgripping. Optic nerve head blood flow was measured continuously before, during and after handgripping using laser Doppler flowmetry. Blood pressure was measured non-invasively in one-minute intervals. Intraocular pressure was measured at the beginning and the end of the measurements and ocular perfusion pressure was calculated as 2/3*mean arterial pressure –intraocular pressure.
Isometric exercise was associated with an increase in ocular perfusion pressure during all handgripping periods (p < 0.001). By contrast no change in optic nerve head blood flow was seen. However, in a subgroup of three subjects blood flow showed a consistent decrease of more than 10% during isometric exercise although their blood pressure values increased. In addition, three other subjects showed a consistent decline of blood flow of more than 10% during the recovery periods.
Our data confirm previous results indicating that optic nerve head blood flow is autoregulated during an increase in perfusion pressure. In addition, we observed a subgroup of 6 subjects (15%) that showed an abnormal response, which is in keeping with our previous data. The mechanisms underlying this abnormal response remain to be shown.
PMCID: PMC3855769  PMID: 24324774
18.  Athletic Training Students in the College/ University Setting and the Scope of Clinical Education 
Journal of Athletic Training  2006;41(4):422-426.
Context: Athletic training education programs must provide the proper type and amount of clinical supervision in order for athletic training students to obtain appropriate clinical education and to meet Board of Certification examination requirements.
Objective: To assess athletic training students' perceptions of the type and amount of clinical supervision received during clinical education.
Design: Cross-sectional design.
Setting: 124 CAAHEP-accredited NCAA institutions.
Patients or Other Participants: We obtained a national stratified random sample (by National Athletic Trainers' Association district) of undergraduate athletic training students from 61 Commission on Accreditation of Allied Health Education Programs–accredited athletic training education programs. A total of 851 athletic training students participated in the study.
Main Outcome Measure(s): Differences among athletic training students with first-aider/provider qualifications, student supervision during moderate-risk and increased-risk sports, program/institutional characteristics, type and amount of clinical supervision, and students' academic level and mean percentage of time spent in different types of clinical supervision.
Results: A total of 276 (32.4%) of the students reported that they supplied medical care and athletic training–related coverage beyond that of a first aider/provider. Athletic training students stating that they traveled with teams without supervision numbered 342 (40.2%). A significant difference was noted between the amount of supervision reported by sophomore and senior students ( P < .01).
Conclusions: Athletic training students do not seem to be receiving appropriate clinical supervision and are often acting outside the scope of clinical education.
PMCID: PMC1748417  PMID: 17273468
clinical experience; field experience; clinical instruction; athletic training education
19.  Detecting altered postural control after cerebral concussion in athletes with normal postural stability 
British Journal of Sports Medicine  2005;39(11):805-811.
Objective: To determine if approximate entropy (ApEn), a regularity statistic from non-linear dynamics, could detect changes in postural control during quiet standing in athletes with normal postural stability after cerebral concussion.
Methods: The study was a retrospective, case series analysis of centre of pressure (COP) data collected during the Sensory Organization Test (SOT) from NCAA Division I (USA) athletes prior to and within 48 h after injury. Subjects were 21 male and six female athletes from a variety of sports who sustained a cerebral concussion between 1997 and 2003. After injury, athletes displayed normal postural stability equivalent to preseason levels. For comparison, COP data also were collected from 15 male and 15 female healthy non-athletes on two occasions. ApEn values were calculated for COP anterior-posterior (AP) and medial-lateral (ML) time series.
Results: Compared to healthy subjects, COP oscillations among athletes generally became more regular (lower ApEn value) after injury despite the absence of postural instability. For AP time series, declines in ApEn values were much larger in SOT conditions 1 and 2 (approximately three times as large as the standard error of the mean) than for all other conditions. For ML time series, ApEn values declined after injury in all sensory conditions (F1,55 = 6.36, p = 0.02).
Conclusions: Athletes who demonstrated normal postural stability after concussion nonetheless displayed subtle changes in postural control. Changes in ApEn may have represented a clinically abnormal finding. ApEn analysis of COP oscillations may be a valuable supplement to existing concussion assessment protocols for athletes.
PMCID: PMC1725054  PMID: 16244188
20.  The Isometric Handgrip Exercise As a Test for Unmasking Hypertension in the Offsprings of Hypertensive Parents 
Background: A familial history of hypertension increases the risk of hypertension in the offsprings.
Aims and objectives: The present study was undertaken to assess the underlying hypertension by using the Isometric Handgrip (IHG) exercise test in the offsprings of hypertensive parents and to compare it with age-matched controls of normotensive parents.
Material and Methods: The isometric handgrip test was performed in the study and control groups. The resting blood pressure was recorded before exercise and afterwards the subjects were asked to perform the isometric handgrip exercise with the dominant hand for 2 minutes. Then the blood pressure was recorded in the sitting position during and 5 minutes after the completion of the exercise.
Statistical Analysis: The analysis of the results was done by ANOVA with SPSS, version 17.0, by using the unpaired ‘t’ test.
Results: The results showed that the Resting Systolic (SBP), Diastolic (DBP) and the Mean (MBP) Blood Pressures were higher (p <0.001) in the offsprings of the hypertensive parents as compared to those in the control subjects of normotensive parents. During the isometric handgrip exercise test, the rise in the systolic, diastolic and the mean blood pressures was significantly higher (p<0.001) in the offsprings of the hypertensive parents. After 5 minutes of exercise, the SBP, DBP and the MBP were found to be significantly higher (p<0.001) in the study group as compared to those in the control group.
Conclusions: An early and a regular screening of the children of hypertensive parents is necessary to prevent any future cardiovascular complications.
PMCID: PMC3708258  PMID: 23905088
Hypertension; Isometric handgrip; Resting blood pressure
21.  Life-Stress Sources and Symptoms of Collegiate Student Athletic Trainers Over the Course of an Academic Year 
Journal of Athletic Training  2001;36(4):401-407.
To examine the impact of life-stress sources that student athletic trainers encountered over the course of an academic year, to investigate the existence of sex differences in stress source symptoms, and to provide athletic training staffs with suggestions on ways to assist student athletic trainers.
Design and Setting:
In a classroom setting, the 25-item Quick Stress Questionnaire (QSQ) was administered to all subjects at the beginning of each month during an academic year. The QSQ, which can be completed in approximately 5 minutes, uses a 9-point Likert scale ranging from 1 (little stress) to 9 (extreme stress) to measure sources of stress and stress-related symptoms.
The sample consisted of 11 male and 9 female student athletic trainers enrolled in a Commission on Accreditation of Allied Health Education Programs (CAAHEP)-accredited undergraduate program at a mid-Atlantic university.
We computed descriptive statistics for the stress items and symptoms (ie, cognitive, somatic, and behavioral) and graphed them according to sex. Separate sex × time analyses of variance were performed to investigate changes in cognitive, somatic, and behavioral stress over the course of the study and to determine if these changes were different for male and female student athletic trainers.
Academic and financial concerns represented the greatest sources of stress for student athletic trainers. Repeated-measures analyses of variance indicated that stress levels fluctuated significantly during the academic year, with peak stress levels experienced during midterm and at the end of the spring semester. Although female student athletic trainers consistently reported higher levels of stress than their male counterparts, these differences were not statistically significant.
Student athletic trainers exhibited fluctuations in their stress levels throughout an academic calendar. Academic and financial concerns were the most common stressors. Certified athletic trainers should take an interest in their student athletic trainers and be willing to provide assistance in times of need. Additional research is needed regarding student athletic trainers and stress.
PMCID: PMC155436  PMID: 12937483
burnout; college students; coping; stress
22.  The effects of 8 weeks of regular aerobic exercise on the symptoms of premenstrual syndrome in non-athlete girls 
Premenstrual syndrome (PMS) is a combination of physical, psychological, or behavioral changes in the late secretary phase of menstrual cycle and interferes with interpersonal relationships or activities. The purpose was to assess the effects of 8 weeks of regular aerobic exercise on PMS in non-athlete girls.
Materials and Methods:
This quasi-experimental study was conducted on 40 non-athlete girl students aged 18-25 years at Khorasgan Azad University, with a diagnosis of PMS. The instruments included personal information and a medical questionnaire, a form of premenstrual symptoms DSM-IV, the GHQ 28 questionnaire, and the Beck Depression and Anxiety questionnaire, and also, daily symptoms were recorded for 4 months (two courses before the training period and two during training). Individuals in the experimental group practiced aerobic exercise for 8 weeks, three sessions per week for 60 min. The subjects were evaluated during the first (the pre-test), second (the mid-test), and third menstrual period (the post-test). Statistical analysis used in this study is t-test and repeated measurement analysis of variance (ANOVA).
Results showed that the mean scores of PMS and symptoms declined after 8 weeks of training in the experimental group. The comparison of the two groups showed that the mean scores of PMS, for symptoms during and after exercise, were significantly different (P ≤ 0.001) and the percentages of scores PMS changes, physical, and psychological symptoms of experimental and control groups had a significant difference (P ≤ 0.001) after 8 weeks of training.
Overall, the findings showed that 8 weeks of aerobic exercise is effective in reducing the symptoms of PMS and can be used as a treatment.
PMCID: PMC3748549  PMID: 23983722
Aerobic exercise; Iran; non-athlete girls; premenstrual syndrome
23.  Peripheral and central vascular conductance influence on post-exercise hypotension 
Post-exercise hypotension (PEH) following prolonged dynamic exercise arises from increased total vascular conductance (TVC) via skeletal muscle vasodilation. However, arterial vasodilation of skeletal musculatures does not entirely account for the rise in TVC. The aim of the present study was to determine the contribution of vascular conductance (VC) of the legs, arms, kidneys and viscera to TVC during PEH.
Eight subjects performed a single period of cycling at 60% of heart rate (HR) reserve for 60 minutes. Blood flow in the right renal, superior mesenteric, right brachial and right femoral arteries was measured by Doppler ultrasonography in a supine position before exercise and during recovery. HR and mean arterial pressure (MAP) were measured continuously. MAP decreased significantly from approximately 25 minutes after exercise cessation compared with pre-exercise baseline. TVC significantly increased (approximately 23%; P <0.05) after exercise compared with baseline, which resulted from increased VC in the leg (approximately 33%) and arm (approximately 20%), but not in the abdomen.
PEH was not induced by decreased cardiac output, but by increased TVC, two-thirds of the rise in which can be attributed to increased VC in active and inactive limbs.
PMCID: PMC3545848  PMID: 23249623
Regional hemodynamics; Central hemodynamics; Post-exercise hypotension; Doppler ultrasonography
24.  Habituation to the Perception of the Qualities of Cold-Induced Pain 
Journal of Athletic Training  1992;27(3):218-222.
This study was conducted in order to measure the reported pain caused by cold immersions over a 5-day period to determine if habituation to the perception of cold pain occurs. Numerous authors have described a habituation phenomenon to therapeutic ice bath immersions. Athletic trainers often explain to athletes that their perceptions of the pain induced by a therapeutic ice bath will decrease each day as they proceed through therapy. Essentially, it is assumed that there is a habituation to the perception of cold-induced pain shortly after initiation of the treatment regime. The subjects were 22 male and female college students who had limited experience with cold immersion. The subjects' right feet and ankles were immersed in an ice bath for 21 minutes on 5 consecutive days followed by a 21-minute recovery period. The McGill Pain Questionnaire (MPQ) was used to measure pain during the immersions. Sensory, affective, evaluative, and miscellaneous qualities of pain were determined from the MPQ. During the testing session, each subject completed the MPQ 30 seconds following immersion and then every 3 minutes until completion of the test. Repeated measures analyses of variance (ANOVAs) adjusted according to the Bonferroni correction revealed no significant differences for any of the qualities of pain over a 5-day period. The subjects' perception of cold-induced pain did appear to decrease during the immersion and there was a trend towards decreasing pain during day five, but a habituation effect was not documented in this study.
PMCID: PMC1317249  PMID: 16558164
25.  Physical exercise speeds up motor timing 
This study aimed to examine effect of physical exercise on motor timing: personal, maximum and “once per second” tapping. The acute effect was examined by comparing the baseline tapping with that after acute exercise in 9 amateur athletes, 8 elite synchronous swimmers and 9 elite biathletes. Then the baseline tapping was compared among athletes of different sports and professional levels (15 elite biathletes, 27 elite cross-country skiers, 15 elite synchronous swimmers and 9 amateur wrestlers) with a control group (44 non-athletes) not involved in regular exercise to examine the sport-specific or long-term effects. Maximum and “once per second” tapping speed increased after acute physical exercise and were also faster in elite athletes compared to controls during the baseline condition. However, personal tapping tempo was not affected by exercise. In addition, physical exercise had no effects on the variability of the intertap interval. The accuracy of “once per second” tapping differentiates controls and amateur wrestlers from elite synchronous swimmers and skiers suggesting sport-specific adaptations to play a role. It is concluded that acute physical exercise selectively speeds up motor timing but does not affect its variability and accuracy, and this speeding-up is suggested to transfer into a long-term effect in elite athletes.
PMCID: PMC3769678  PMID: 24062707
physical exercise; motor timing; elite athletes; sport; cognition

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