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1.  A pilot study on the effects of pre‐event manipulation on jump height and running velocity 
British Journal of Sports Medicine  2006;40(11):947-949.
Purpose
To compare changes in jump height and running velocity with and without pre‐event high‐velocity, low‐amplitude manipulation (HVLA).
Methods
A crossover study design with elite healthy athletes was used. After a 15 min warm‐up, the subjects were tested for countermovement jump height (CMJ) and flying 40 m sprint time (SPRINT). A sport chiropractor then evaluated each subject. Subjects were randomised to either HVLA (applied to joints based on examination) or placebo (simulated performance‐enhancement stickers). They then rested for 60 min, performed another 15 min warm‐up, and were retested. The protocol was repeated 48 h later with the alternative intervention. The mean of two sprints and three jumps were analysed, as well as peak performances. The sample size was based on prior results from the effects of stretching.
Results
19 subjects involved in sprint sports were enrolled; two were too sore to participate on day 2, and one could only participate in the jump (all had HVLA on day 1). Of the 17 participants analysed, seven were female, age range was 19–35, and 17 were national or world‐class athletes. The ranges for baseline measures were: SPRINT 4.1–5.5 s; CMJ 47.4–92.7 cm. Overall, the greater than expected variability in this pilot study led to the study being underpowered. Subjects tended to perform better after HVLA for both CMJ and SPRINT (both mean and peak results), but none of the results were statistically significant (p  =  0.30–0.61).
Conclusion
Although the larger than expected variability in the pilot study means that the observed clinically relevant differences were not statistically significant, the direction and magnitude of the changes associated with HVLA suggest that it may be beneficial. That said, the increased soreness after HVLA suggests that it may be detrimental. HVLA warrants further study.
doi:10.1136/bjsm.2006.029439
PMCID: PMC2465028  PMID: 16954128
performance enhancement; elite athlete; crossover; manipulation
2.  The Effect of Immediate Post-Training Active and Passive Recovery Interventions on Anaerobic Performance and Lower Limb Flexibility in Professional Soccer Players 
Journal of Human Kinetics  2012;31:121-129.
The capacity to recover from intense training, competition and matches is considered an important determinant in soccer performance. At present, there is no consensus on the effect of post-training recovery interventions on subsequent training session. The aim of this study was to determine the effectiveness of active (12 min submaximal running and 8 min of static stretching) and passive recovery (20 min sitting on a bench) interventions performed immediately after a training session on anaerobic performances (CMJ, 20 m sprint and Balsom agility test) and lower limb flexibility 24 h after the training. During two experimental sessions, 31 professional soccer players participated in a randomized fully controlled trial design. The first session was designed to evaluate the player’s anaerobic performances and lower limb flexibility (pretest). After baseline measurements, participants performed a standardized soccer training during which heart rate and RPE were recorded to evaluate the training load. At the end of the training unit all players were randomly assigned to the active recovery group and the passive recovery group. A second experimental session was organized to obtain the posttest values. Players performed the same test, administered in the same order than in the first trial. No significant differences between groups were observed in heart rate and RPE. No significant effect due to recovery interventions was found on lower limb flexibility and anaerobic performances except CMJ that posttest value was significantly greater in the active recovery group than in the passive group (p < 0.05).
doi:10.2478/v10078-012-0013-9
PMCID: PMC3588659  PMID: 23486836
soccer; recovery; cool-down; fatigue
3.  Changes in Cardiac Tone Regulation with Fatigue after Supra-Maximal Running Exercise 
The Scientific World Journal  2011;2012:281265.
To investigate the effects of fatigue and metabolite accumulation on the postexercicse parasympathetic reactivation, 11 long-sprint runners performed on an outdoor track an exhaustive 400 m long sprint event and a 300 m with the same 400 m pacing strategy. Time constant of heart rate recovery (HRRτ), time (RMSSD), and frequency (HF, and LF) varying vagal-related heart rate variability indexes were assessed during the 7 min period immediately following exercise. Biochemical parameters (blood lactate, pH, PO2, PCO2, SaO2, and HCO3−) were measured at 1, 4 and 7 min after exercise. Time to perform 300 m was not significantly different between both running trials. HHRτ measured after the 400 m running exercise was longer compared to 300 m running bouts (183.7 ± 11.6 versus 132.1 ± 9.8 s, P < 0.01). Absolute power density in the LF and HF bands was also lower after 400 m compared to the 300 m trial (P < 0.05). No correlation was found between biochemical and cardiac recovery responses except for the PO2 values which were significantly correlated with HF levels measured 4 min after both bouts. Thus, it appears that fatigue rather than metabolic stresses occurring during a supramaximal exercise could explain the delayed postexercise parasympathetic reactivation in longer sprint runs.
doi:10.1100/2012/281265
PMCID: PMC3361189  PMID: 22666098
4.  A laboratory running test: metabolic responses of sprint and endurance trained athletes. 
A laboratory-based sprint running test has been devised to examine the performance characteristics and metabolic responses of an individual to 30 seconds of maximal exercise. A non-motorised treadmill was used so that the individual was able to sprint at his own chosen speed and also to vary his speed as fatigue occurred. The treadmill was instrumented so that the chosen speeds as well as the equivalent distance travelled could be monitored by micro-computer throughout the test. The test-retest reliability of the procedure was investigated with 14 recreational runners who performed the test on different days. A good correlation (r = 0.93) was found between the values obtained for peak running speeds on the two occasions. In an attempt to establish whether or not this test could be used to identify the differences in the performance characteristics of highly trained individuals, the responses to the test of eleven sprint trained and eleven endurance trained athletes were examined. The sprint trained athletes covered a greater distance (162.2 +/- 5.95 m vis 153.51 +/- 12.32 m; p less than 0.01) and had higher blood lactate concentrations (16.52 +/- 1.23 mM vis 12.98 +/- 1.77 mM; p less than 0.01) than the endurance trained athletes. Therefore this laboratory sprint running test offers an additional way of investigating human responses to brief periods of high intensity exercise.
Images
PMCID: PMC1478520  PMID: 4027498
5.  Physiological and psychological correlates of success in track and field athletes. 
Twenty-four collegiate distance runners and 20 power athletes (sprinters and jumpers) of various success levels were tested on a number of physiological and psychological parameters. Multiple regression analysis indicated that physiological factors could explain over 81% of the variance related to successful distance running while physiological and psychological factors could explain over 80% of the of the variance related to successful sprinting and jumping. Body weight, fibre type, low density lipoprotein-cholesterol, and hamstring strength were significant singular correlates to successful distance running. Year in school, percent body fat, quadriceps strength, and leg muscle balance were significant single correlates to successful sprinting and jumping performance.
Images
PMCID: PMC1859022  PMID: 6883017
6.  Muscular and Functional Performance Characteristics of Individuals Wearing Prophylactic Knee Braces 
Journal of Athletic Training  1993;28(4):336-344.
The efficacy of prophylactic knee bracing has been refuted with regard to reducing the incidence and/or severity of injuries to the knee joint. This is thought to be a result of the prophylactic knee brace's ineffectiveness in protecting the knee joint from valgus loads. Furthermore, discrepancies exist regarding the prophylactic knee brace's detrimental effect on functional performance. The purpose of this study was to measure the effect of the prophylactic knee brace on selected isokinetic muscular characteristics and forward sprint speed. Twenty physically active, healthy, male college students with no prior history of brace use participated in this study. The subjects were randomly tested both with and without the prophylactic knee brace worn on various performance parameters. The dependent measures assessed included peak torque (PT) and torque acceleration energy (TAE) at 60 and 240°/s. A 40-yard forward sprint was selected to assess sprint speed. A paired t-test analysis revealed mean values which were significantly less for PT at 60°/s (p < .05), 240°/s (p < .01), and TAE at 240°/s (p < .05) with the prophylactic knee brace applied during knee extension. Analysis also revealed slower times for sprint speed (p < .01), while the subjects were wearing the prophylactic knee brace. Muscular strength (PT) and power (TAE) scores were not correlated (p > .05) with sprint speed. This study suggests that wearing the prophylactic knee brace may consequently inhibit muscular and functional performance of the athlete, but that specific population has yet to be studied.
Images
PMCID: PMC1317738  PMID: 16558250
7.  A Comparison of the Immediate Effects of Eccentric Training vs Static Stretch on Hamstring Flexibility in High School and College Athletes 
Background
A pre-event static stretching program is often used to prepare an athlete for competition. Recent studies have suggested that static stretching may not be an effective method for stretching the muscle prior to competition.
Objective
The intent of this study was to compare the immediate effect of static stretching, eccentric training, and no stretching/training on hamstring flexibility in high school and college athletes.
Methods
Seventy-five athletes, with a mean age of 17.22 (+/- 1.30) were randomly assigned to one of three groups - thirty- second static stretch one time, an eccentric training protocol through a full range of motion, and a control group. All athletes had limited hamstring flexibility, defined as a 20° loss of knee extension measured with the femur held at 90° of hip flexion.
Results
A significant difference was indicated by follow up analysis between the control group (gain = -1.08°) and both the static stretch (gain = 5.05°) and the eccentric training group (gain = 9.48°). In addition, the gains in the eccentric training group were significantly greater than the static stretch group.
Discussion and Conclusion
The findings of this study reveal that one session of eccentrically training through a full range of motion improved hamstring flexibility better than the gains made by a static stretch group or a control group.
PMCID: PMC2953312  PMID: 21522215
8.  The Effects of Different Stretching Techniques of the Quadriceps Muscles on Agility Performance in Female Collegiate Soccer Athletes: A Pilot Study 
Background
Stretching has long been an integral component of pre-performance activities for a multitude of athletic endeavors. Previous research has demonstrated that stretching may have detrimental effects on performance. Specific knowledge of the precise effects of stretching may influence the decision to appropriately apply stretching techniques in the sport and therapeutic settings.
Objective
The purpose of this pilot study was to examine the effects of static stretching, proprioceptive neuromuscular facilitation (contract-relax) stretching, and no stretching of the quadriceps muscle group on agility performance.
Methods
Twelve healthy, female, collegiate soccer players aged 18 – 25 performed one of the three stretching protocols (static, contract-relax, no stretch) and the agility test (T-test) on three non-consecutive days. Agility times were recorded and compared based on stretching technique and day that each test was performed.
Results
No significant difference was found among the means of the different stretching techniques. The t-test agility performance times were as follows: control, =9.7 seconds; static stretch, =9.73 seconds; and contract-relax, =9.62 seconds.
Conclusion
The results of this study suggest that agility performance may be independent of stretching technique of the quadriceps performed in female collegiate soccer athletes. It is recommended that female soccer athletes about to engage in agility activity may perform either no stretch, static stretch, or contract-relax stretching according to individual preference.
PMCID: PMC2953305  PMID: 21509139
agility performance; contract-relax stretching; static-stretching; female athletes
9.  Sprint and endurance power and ageing: an analysis of master athletic world records 
Human physical performance is notably reduced with ageing. Although the effects of ageing are often compounded by disuse, the study of master athletes provides an opportunity for investigating the effects of ageing per se. It is often held that sprinting is more affected than endurance performance. However, past analyses of master athletic world record data have yielded opposite observations. We argue here that our understanding of these data improves by considering how, biomechanically, metabolic power is related to athletic performance. In line with earlier studies, our analysis showed that running speed declines with age in a more pronounced way for endurance events than for sprinting events, confirming former studies. However, when assessing the metabolic power required to achieve the running world records, sprint and endurance events show a relatively uniform decline with age across the different events. This study has reconciled formerly conflicting scientific results and improves our understanding of the ageing process. However, it is unclear as to which are the governing mechanisms that cause the different systems in our body, responsible for sprinting and for endurance performance, to be affected by ageing in a remarkably uniform way.
doi:10.1098/rspb.2008.1319
PMCID: PMC2660943  PMID: 18957366
master athletes; veteran athletes; maximum performance; sport; exercise
10.  Changes in performance, skinfold thicknesses, and fat patterning after three years of intense athletic conditioning in high level runners 
British Journal of Sports Medicine  2005;39(11):851-856.
Objectives: To determine if the changes in specific skinfold sites induced by intense athletic conditioning over a three year period were associated with changes in running performance in high level athletes.
Methods: Thirty seven top class runners (eight male and five female sprint trained, 16 male and eight female endurance trained) volunteered to participate in the study. The athletes were divided into class A (n = 18) and class B (n = 17), with class A having the best performance. Biceps, triceps, subscapular, pectoral, iliac crest, abdominal, front thigh, and medial calf skinfold thickness and the best running performance were recorded at the beginning and after one, two, and three years of training. A one way analysis of variance and a linear regression analysis were conducted to determine changes and association between performance and skinfold thicknesses. Analyses were controlled for sex, sprint event or endurance event, and class.
Results: Training resulted in a significant increase in performance and decreases in sum of six skinfolds, abdominal, front thigh, and medial calf skinfolds, and the ratio of extremity to trunk skinfolds (E/T, ∑triceps, front thigh, medial calf/∑subscapular, iliac crest, abdominal). There were no significant differences in body weight. Except for the abdominal skinfold, there was no significant difference in trunk skinfolds. Significant differences in these changes were observed by sex for E/T, which decreased and increased in male and female runners respectively, and by class. Class B runners significantly improved performance, with decreased skinfold thicknesses in the lower limb. There were no significant changes in performance or skinfold thicknesses in class A runners. Improvements in performance were consistently associated with a decrease in the lower limb skinfolds.
Conclusions: On the basis of these findings, anthropometric assessment of top class athletes should include an evaluation of all skinfolds. The loss of body fat appears to be specific to the muscular groups used during training. The lower limb skinfolds may be particularly useful predictors of running performance.
doi:10.1136/bjsm.2005.018960
PMCID: PMC1725063  PMID: 16244197
11.  Accounting for elite indoor 200 m sprint results 
Biology Letters  2005;2(1):47-50.
Times for indoor 200 m sprint races are notably worse than those for outdoor races. In addition, there is a considerable bias against competitors drawn in inside lanes (with smaller bend radii). Centripetal acceleration requirements increase average forces during sprinting around bends. These increased forces can be modulated by changes in duty factor (the proportion of stride the limb is in contact with the ground). If duty factor is increased to keep limb forces constant, and protraction time and distance travelled during stance are unchanging, bend-running speeds are reduced. Here, we use results from the 2004 Olympics and World Indoor Championships to show quantitatively that the decreased performances in indoor competition, and the bias by lane number, are consistent with this ‘constant limb force’ hypothesis. Even elite athletes appear constrained by limb forces.
doi:10.1098/rsbl.2005.0399
PMCID: PMC1617210  PMID: 17148323
biomechanics; sprint; run; force
12.  Acute Lower Extremity Running Kinematics After a Hamstring Stretch 
Journal of Athletic Training  2012;47(1):5-14.
Context:
Limited passive hamstring flexibility might affect kinematics, performance, and injury risk during running. Pre-activity static straight-leg raise stretching often is used to gain passive hamstring flexibility.
Objective:
To investigate the acute effects of a single session of passive hamstring stretching on pelvic, hip, and knee kinematics during the swing phase of running.
Design:
Randomized controlled clinical trial.
Setting:
Biomechanics research laboratory.
Patients or Other Participants:
Thirty-four male (age = 21.2 ± 1.4 years) and female (age = 21.3±2.0 years) recreational athletes.
Intervention(s):
Participants performed treadmill running pretests and posttests at 70% of their age-predicted maximum heart rate. Pelvis, hip, and knee joint angles during the swing phase of 5 consecutive gait cycles were collected using a motion analysis system. Right and left hamstrings of the intervention group participants were passively stretched 3 times for 30 seconds in random order immediately after the pretest. Control group participants performed no stretching or movement between running sessions.
Main Outcome Measure(s):
Six 2-way analyses of variance to determine joint angle differences between groups at maximum hip flexion and maximum knee extension with an α level of .008.
Results:
Flexibility increased between pretest and post-test in all participants (F1,30 = 80.61, P<.001). Anterior pelvic tilt (F1,30 = 0.73, P=.40), hip flexion (F1,30 = 2.44, P=.13), and knee extension (F1,30 = 0.06, P=.80) at maximum hip flexion were similar between groups throughout testing. Anterior pelvic tilt (F1,30 = 0.69, P=.41), hip flexion (F1,30 = 0.23, P=.64), and knee extension (F1,30 = 3.38, P=.62) at maximum knee extension were similar between groups throughout testing. Men demonstrated greater anterior pelvic tilt than women at maximum knee extension (F1,30 = 13.62, P=.001).
Conclusions:
A single session of 3 straight-leg raise hamstring stretches did not change pelvis, hip, or knee running kinematics.
PMCID: PMC3418114  PMID: 22488225
straight-leg raises; flexibility
13.  Maximal shuttle running over 40 m as a measure of anaerobic performance. 
Over the last decade increasing interest has been shown in the measurement of anaerobic power and capacity in athletic men. These physiological characteristics have been determined predominantly using cycle ergometry and treadmill sprinting. The purpose of the present study was to examine the relationship between 40-m maximal shuttle run times and performance indices obtained during treadmill sprinting and cycle ergometry. Moderate correlations were found between 10-m split times (the time taken to cover the initial 10 m of the shuttle course) and treadmill peak power outputs (r = -0.67; P < 0.05). Similar relationships were also found between the fastest 40-m time and mean power outputs generated on both the treadmill and cycle ergometer (r = -0.67; P < 0.05) and (r = -0.75; P < 0.05) respectively. The correlations remained unchanged when the values were adjusted for body weight (W kg-1). The results of the present study suggest that maximal 40-m shuttle running ability may reflect anaerobic indices of power and capacity, determined using standard laboratory procedures.
PMCID: PMC1332009  PMID: 8130958
14.  Attentional and visual demands for sprint performance in non-fatigued and fatigued conditions: reliability of a repeated sprint test 
Background
Physical performance measures are widely used to assess physical function, providing information about physiological and biomechanical aspects of motor performance. However they do not provide insight into the attentional and visual demands for motor performance. A figure-of-eight sprint test was therefore developed to measure the attentional and visual demands for repeated-sprint performance. The aims of the study were: 1) to assess test-retest reliability of the figure-of-eight sprint test, and 2) to study the attentional and visual demands for sprint performance in a non-fatigued and fatigued condition.
Methods
Twenty-seven healthy athletes were included in the study. To determine test-retest reliability, a subgroup of 19 athletes performed the figure-of-eight sprint test twice. The figure-of-eight sprint test consisted of nine 30-second sprints. The sprint test consisted of three test parts: sprinting without any restriction, with an attention-demanding task, and with restricted vision. Increases in sprint times with the attention-demanding task or restricted vision are reflective of the attentional and visual demands for sprinting. Intraclass correlation coefficients (ICCs) and mean difference between test and retest with 95% confidence limits (CL) were used to assess test-retest reliability. Repeated-measures ANOVA were used for comparisons between the sprint times and fatigue measurements of the test parts in both a non-fatigued and fatigued condition.
Results
The figure-of-eight sprint test showed good test-retest reliability, with ICCs ranging from 0.75 to 0.94 (95% CL: 0.40-0.98). Zero lay within the 95% CL of the mean differences, indicating that no bias existed between sprint performance at test and retest. Sprint times during the test parts with attention-demanding task (P = 0.01) and restricted vision (P < 0.001) increased significantly compared to the base measurement. Furthermore the sprint times and fatigue measurements increased significantly in fatigued condition. There was a significant interaction effect between test part and level of fatigue (P = 0.03).
Conclusions
High ICCs and the absence of systematic variation indicate good test-retest reliability of the figure-of-eight sprint test. The attentional and visual demands for sprint performance, in both a non-fatigued and fatigued condition, can be measured in healthy team-sport athletes with the figure-of-eight sprint test.
doi:10.1186/1471-2474-11-84
PMCID: PMC3003243  PMID: 20438646
15.  Implementation and evaluation of the SPRINT protocol for tight glycaemic control in critically ill patients: a clinical practice change 
Critical Care  2008;12(2):R49.
Introduction
Stress-induced hyperglycaemia is prevalent in critical care. Control of blood glucose levels to within a 4.4 to 6.1 mmol/L range or below 7.75 mmol/L can reduce mortality and improve clinical outcomes. The Specialised Relative Insulin Nutrition Tables (SPRINT) protocol is a simple wheel-based system that modulates insulin and nutritional inputs for tight glycaemic control.
Methods
SPRINT was implemented as a clinical practice change in a general intensive care unit (ICU). The objective of this study was to measure the effect of the SPRINT protocol on glycaemic control and mortality compared with previous ICU control methods. Glycaemic control and mortality outcomes for 371 SPRINT patients with a median Acute Physiology And Chronic Health Evaluation (APACHE) II score of 18 (interquartile range [IQR] 15 to 24) are compared with a 413-patient retrospective cohort with a median APACHE II score of 18 (IQR 15 to 23).
Results
Overall, 53.9% of all measurements were in the 4.4 to 6.1 mmol/L band. Blood glucose concentrations were found to be log-normal and thus log-normal statistics are used throughout to describe the data. The average log-normal glycaemia was 6.0 mmol/L (standard deviation 1.5 mmol/L). Only 9.0% of all measurements were below 4.4 mmol/L, with 3.8% below 4 mmol/L and 0.1% of measurements below 2.2 mmol/L. On SPRINT, 80% more measurements were in the 4.4 to 6.1 mmol/L band and standard deviation of blood glucose was 38% lower compared with the retrospective control. The range and peak of blood glucose were not correlated with mortality for SPRINT patients (P >0.30). For ICU length of stay (LoS) of greater than or equal to 3 days, hospital mortality was reduced from 34.1% to 25.4% (-26%) (P = 0.05). For ICU LoS of greater than or equal to 4 days, hospital mortality was reduced from 34.3% to 23.5% (-32%) (P = 0.02). For ICU LoS of greater than or equal to 5 days, hospital mortality was reduced from 31.9% to 20.6% (-35%) (P = 0.02). ICU mortality was also reduced but the P value was less than 0.13 for ICU LoS of greater than or equal to 4 and 5 days.
Conclusion
SPRINT achieved a high level of glycaemic control on a severely ill critical cohort population. Reductions in mortality were observed compared with a retrospective hyperglycaemic cohort. Range and peak blood glucose metrics were no longer correlated with mortality outcome under SPRINT.
doi:10.1186/cc6868
PMCID: PMC2447603  PMID: 18412978
16.  Relationships Between Vertical Jump Strength Metrics and 5 Meters Sprint Time 
Journal of Human Kinetics  2011;29:115-122.
The aim of this study was to examine the relationship between short sprint time (5 m) and strength metrics of the countermovement jump (CMJ) using a linear transducer in a group of trained athletes. Twenty-five male, trained subjects volunteered to participate in the study. Each volunteer performed 3 maximal CMJ trials on a Smith machine. Peak instantaneous power was calculated by the product of velocity taken with the linear transducer. For sprint testing, each subject performed three maximum 5 m sprints. Only the best attempt was considered in both tests. Pearson product–moment correlation coefficients between 5 m sprint performance and strength metrics of the CMJ were generally positive and of clear moderate to strong magnitude (r = −0.664 to −0.801). More noticeable was the significant predictive value of bar displacement time (r= ∼0.70) to sprint performance. Nevertheless, a non-significant predictive value of peak bar velocity and rate of force development measurements was found. These results underline the important relationship between 5 m sprint and maximal lower body strength, as assessed by the force, power and bar velocity displacement. It is suggested that sprinting time performance would benefit from training regimens aimed to improve these performance qualities.
doi:10.2478/v10078-011-0045-6
PMCID: PMC3588612  PMID: 23486705
lower extremity; force; power; sprinting
17.  Significant Molecular and Systemic Adaptations after Repeated Sprint Training in Hypoxia 
PLoS ONE  2013;8(2):e56522.
While intermittent hypoxic training (IHT) has been reported to evoke cellular responses via hypoxia inducible factors (HIFs) but without substantial performance benefits in endurance athletes, we hypothesized that repeated sprint training in hypoxia could enhance repeated sprint ability (RSA) performed in normoxia via improved glycolysis and O2 utilization. 40 trained subjects completed 8 cycling repeated sprint sessions in hypoxia (RSH, 3000 m) or normoxia (RSN, 485 m). Before (Pre-) and after (Post-) training, muscular levels of selected mRNAs were analyzed from resting muscle biopsies and RSA tested until exhaustion (10-s sprint, work-to-rest ratio 1∶2) with muscle perfusion assessed by near-infrared spectroscopy. From Pre- to Post-, the average power output of all sprints in RSA was increased (p<0.01) to the same extent (6% vs 7%, NS) in RSH and in RSN but the number of sprints to exhaustion was increased in RSH (9.4±4.8 vs. 13.0±6.2 sprints, p<0.01) but not in RSN (9.3±4.2 vs. 8.9±3.5). mRNA concentrations of HIF-1α (+55%), carbonic anhydrase III (+35%) and monocarboxylate transporter-4 (+20%) were augmented (p<0.05) whereas mitochondrial transcription factor A (−40%), peroxisome proliferator-activated receptor gamma coactivator 1α (−23%) and monocarboxylate transporter-1 (−36%) were decreased (p<0.01) in RSH only. Besides, the changes in total hemoglobin variations (Δ[tHb]) during sprints throughout RSA test increased to a greater extent (p<0.01) in RSH. Our findings show larger improvement in repeated sprint performance in RSH than in RSN with significant molecular adaptations and larger blood perfusion variations in active muscles.
doi:10.1371/journal.pone.0056522
PMCID: PMC3577885  PMID: 23437154
18.  Type of acute hamstring strain affects flexibility, strength, and time to return to pre‐injury level 
Objectives
To investigate possible links between aetiology of acute, first time hamstring strains in sprinters and dancers and recovery of flexibility, strength, and function as well as time to return to pre‐injury level.
Methods
Eighteen elite sprinters and 15 professional dancers with a clinically diagnosed hamstring strain were included. They were clinically examined and tested two, 10, 21, and 42 days after the acute injury. Range of motion in hip flexion and isometric strength in knee flexion were measured. Self estimated and actual time to return to pre‐injury level were recorded. Hamstring reinjuries were recorded during a two year follow up period.
Results
All the sprinters sustained their injuries during high speed sprinting, whereas all the dancers were injured while performing slow stretching type exercises. The initial loss of flexibility and strength was greater in sprinters than in dancers (p<0.05). At 42 days after injury, both groups could perform more than 90% of the test values of the uninjured leg. However, the actual times to return to pre‐injury level of performance were significantly longer (median 16 weeks (range 6–50) for the sprinters and 50 weeks (range 30–76) for the dancers). Three reinjuries were noted, all in sprinters.
Conclusion
There appears to be a link between the aetiologies of the two types of acute hamstring strain in sprinters and dancers and the time to return to pre‐injury level. Initially, sprinters have more severe functional deficits but recover more quickly.
doi:10.1136/bjsm.2005.018879
PMCID: PMC2491922  PMID: 16371489
hamstrings; injury; sprinters; dancers; recovery
19.  Intravascular haemolysis in the recreational runner. 
Intravascular haemolysis has been found to result from prolonged endurance competition, rigorous military training and participation in impact sports. Haematological research involving the recreational runner is sparse. Recreational runners frequently vary their training to avoid monotony and improve endurance capacity. This study investigated the haematological effects of a typical day of increased distance training in 15 male recreational runners (62.4(3.1) ml kg-1 min-1 treadmill VO2max; 44.6(8.4) km per week training (means(s.d.)). Venous blood samples were collected before, immediately after, 1 day, 4 days, and 10 days after a 13-km training run (about twice the subjects' typical running distance) and analysed for changes in bilirubin, serum potassium, haematocrit, haemoglobin, red blood cell count, haptoglobin, poikilocytosis and reticulocytosis. Urine samples were collected at the same times as the blood samples and analysed for urobilinogen. Significant (P less than 0.05) 1-day and 4-day decreases in mean haemoglobin, red blood cell count, and haptoglobin values, compared to before training venous blood values and significant (P less than 0.05) post-training increases in bilirubin, serum potassium, urobilinogen and poikilocytosis provided evidence for increased intravascular haemolysis. After 10 days the values for haematocrit, bilirubin, serum potassium, red blood cell count, urobilinogen and poikilocytosis were not significantly (P less than 0.05) different from pre-training values while haemoglobin remained significantly (P less than 0.05) lower, exhibiting a constant but not significant increase over the period from 1 to 10 days. The results indicate that mild intravascular 'footstrike' haemolysis can occur in the recreational runner when typical training distance is increased. This condition appears to be transient and benign.
PMCID: PMC1479038  PMID: 1810610
20.  Effects of Prior Hamstring Strain Injury on Strength, Flexibility, and Running Mechanics 
Background
Previous studies have shown evidence of residual scar tissue at the musculotendon junction following an acute hamstring strain injury, which could influence re-injury risk. The purpose of this study was to investigate whether bilateral differences in strength, neuromuscular patterns, and musculotendon kinematics during sprinting are present in individuals with a history of unilateral hamstring injury, and whether such differences are linked to the presence of scar tissue.
Methods
Eighteen subjects with a previous hamstring injury (>5 months prior) participated in a magnetic resonance (MR) imaging exam, isokinetic strength testing, and a biomechanical assessment of treadmill sprinting. Bilateral comparisons were made for peak knee flexion torque, angle of peak torque, and hamstrings:quadriceps strength ratio during strength testing, and muscle activations and peak hamstring stretch during sprinting. MR images were used to measure the volumes of the proximal tendon/aponeurois of the biceps femoris, with asymmetries considered indicative of residual scar tissue.
Findings
A significantly enlarged proximal biceps femoris tendon volume was measured on the side of prior injury. However, no significant differences between the previously injured and uninjured limbs were found in strength measures, peak hamstring stretch, or muscle activation patterns. Further, the degree of asymmetry in tendon volume was not correlated to any of the functional measures.
Interpretation
The results of this study indicate that injury-induced changes in morphology do not seem discernable from strength measures, running kinematics, or muscle activity patterns. Further research is warranted to ascertain whether residual scarring alters localized musculotendon tissue mechanics in a way that may contribute to the high rates of muscle re-injury that are observed clinically.
doi:10.1016/j.clinbiomech.2010.04.015
PMCID: PMC2923440  PMID: 20621753
muscle injury; running; electromyography; magnetic resonance imaging; isokinetic strength
21.  Exercise-induced knee joint laxity in distance runners. 
The objectives of this study were to evaluate the effect of exercise on knee joint laxity. If exercise induced laxity is physiological, incorporation of this quality into a ligament replacement material would be indicated. Twenty recreational long distance runners average age 41 (range 24 to 50 yr) were tested before and immediately after 30 minutes of running. Using a computerized goniometer type instrument (Acufex KSS), knee flexion, axial tibial rotation and anterior-posterior tibial displacement were simultaneously recorded, while the runners underwent tests of static as well as dynamic knee joint laxity. At 30 degrees of knee flexion, a maximum increase of 16 per cent in mean total anterior-posterior laxity post-exercise was found. At the examination 30 minutes post-exercise, laxity at 30 degrees of knee flexion was still increased. However, laxity at 90 degrees of knee flexion had decreased to pre-exercise levels or below. Anterior tibial displacement, recorded during eccentric quadriceps activity (0 to 90 degrees of knee flexion) with weights attached to the foot, showed a maximum of 18 per cent increase in total anterior-posterior laxity post-exercise. It is suggested that the laxity increase is caused in part by a true ligamentous laxity increase, and in part by a decreased resting tone of the fatigued muscles.
PMCID: PMC1478675  PMID: 2620230
22.  Strong correlation of maximal squat strength with sprint performance and vertical jump height in elite soccer players 
Background: A high level of strength is inherent in elite soccer play, but the relation between maximal strength and sprint and jumping performance has not been studied thoroughly.
Objective: To determine whether maximal strength correlates with sprint and vertical jump height in elite male soccer players.
Methods: Seventeen international male soccer players (mean (SD) age 25.8 (2.9) years, height 177.3 (4.1) cm, weight 76.5 (7.6) kg, and maximal oxygen uptake 65.7 (4.3) ml/kg/min) were tested for maximal strength in half squats and sprinting ability (0–30 m and 10 m shuttle run sprint) and vertical jumping height.
Result: There was a strong correlation between maximal strength in half squats and sprint performance and jumping height.
Conclusions: Maximal strength in half squats determines sprint performance and jumping height in high level soccer players. High squat strength did not imply reduced maximal oxygen consumption. Elite soccer players should focus on maximal strength training, with emphasis on maximal mobilisation of concentric movements, which may improve their sprinting and jumping performance.
doi:10.1136/bjsm.2002.002071
PMCID: PMC1724821  PMID: 15155427
23.  Organ failure and tight glycemic control in the SPRINT study 
Critical Care  2010;14(4):R154.
Introduction
Intensive care unit mortality is strongly associated with organ failure rate and severity. The sequential organ failure assessment (SOFA) score is used to evaluate the impact of a successful tight glycemic control (TGC) intervention (SPRINT) on organ failure, morbidity, and thus mortality.
Methods
A retrospective analysis of 371 patients (3,356 days) on SPRINT (August 2005 - April 2007) and 413 retrospective patients (3,211 days) from two years prior, matched by Acute Physiology and Chronic Health Evaluation (APACHE) III. SOFA is calculated daily for each patient. The effect of the SPRINT TGC intervention is assessed by comparing the percentage of patients with SOFA ≤5 each day and its trends over time and cohort/group. Organ-failure free days (all SOFA components ≤2) and number of organ failures (SOFA components >2) are also compared. Cumulative time in 4.0 to 7.0 mmol/L band (cTIB) was evaluated daily to link tightness and consistency of TGC (cTIB ≥0.5) to SOFA ≤5 using conditional and joint probabilities.
Results
Admission and maximum SOFA scores were similar (P = 0.20; P = 0.76), with similar time to maximum (median: one day; IQR: [1,3] days; P = 0.99). Median length of stay was similar (4.1 days SPRINT and 3.8 days Pre-SPRINT; P = 0.94). The percentage of patients with SOFA ≤5 is different over the first 14 days (P = 0.016), rising to approximately 75% for Pre-SPRINT and approximately 85% for SPRINT, with clear separation after two days. Organ-failure-free days were different (SPRINT = 41.6%; Pre-SPRINT = 36.5%; P < 0.0001) as were the percent of total possible organ failures (SPRINT = 16.0%; Pre-SPRINT = 19.0%; P < 0.0001). By Day 3 over 90% of SPRINT patients had cTIB ≥0.5 (37% Pre-SPRINT) reaching 100% by Day 7 (50% Pre-SPRINT). Conditional and joint probabilities indicate tighter, more consistent TGC under SPRINT (cTIB ≥0.5) increased the likelihood SOFA ≤5.
Conclusions
SPRINT TGC resolved organ failure faster, and for more patients, from similar admission and maximum SOFA scores, than conventional control. These reductions mirror the reduced mortality with SPRINT. The cTIB ≥0.5 metric provides a first benchmark linking TGC quality to organ failure. These results support other physiological and clinical results indicating the role tight, consistent TGC can play in reducing organ failure, morbidity and mortality, and should be validated on data from randomised trials.
doi:10.1186/cc9224
PMCID: PMC2945138  PMID: 20704712
24.  Effect of Various Warm-Up Protocols on Jump Performance in College Football Players 
Journal of Human Kinetics  2012;35:127-132.
The purpose of this study was to identify the effects of warm-up strategies on countermovement jump performance. Twenty-nine male college football players (age: 19.4 ± 1.1 years; body height: 179.0 ± 5.1 cm; body mass: 73.1 ± 8.0 kg; % body fat: 11.1 ± 2.7) from the Tuzla University underwent a control (no warm-up) and different warm-up conditions: 1. general warm-up; 2. general warm-up with dynamic stretching; 3. general warm-up, dynamic stretching and passive stretching; 4. passive static stretching; 5. passive static stretching and general warm-up; and, 6. passive static stretching, general warm-up and dynamic stretching. Countermovement jump performance was measured after each intervention or control. Results from one way repeated measures ANOVA revealed a significant difference on warm-up strategies at F (4.07, 113.86) = 69.56, p < 0.001, eta squared = 0.72. Bonferonni post hoc revealed that a general warm-up and a general warm-up with dynamic stretching posted the greatest gains among all interventions. On the other hand, no warm-up and passive static stretching displayed the least results in countermovement jump performance. In conclusion, countermovement jump performance preceded by a general warm-up or a general warm-up with dynamic stretching posted superior gains in countermovement jump performance.
doi:10.2478/v10078-012-0086-5
PMCID: PMC3588691  PMID: 23486654
warm-up; static stretching; dynamic stretching; athletes; vertical jump
25.  Duration of Maintained Hamstring Flexibility After a One-Time, Modified Hold-Relax Stretching Protocol 
Journal of Athletic Training  2001;36(1):44-48.
Objective:
Previous research suggests proprioceptive neuromuscular facilitation (PNF) stretching techniques produce greater increases in range of motion than passive, ballistic, or static stretching methods. The purpose of our study was to measure the duration of maintained hamstring flexibility after a 1-time, modified hold-relax stretching protocol.
Design and Setting:
The study had a 1 × 1 mixed-model, repeated-measures design. The independent variables were group (control and experimental) and time (0, 2, 4, 6, 8, 16, and 32 minutes). The dependent variable was hamstring flexibility as measured in degrees of active knee extension with the hip flexed to 90°. Measurements were taken in a preparatory military academy athletic training room.
Subjects:
Thirty male subjects (age, 18.8 ± 0.63 years; height, 185.2 ± 14.2 cm; weight, 106.8 ± 15.7 kg) with limited hamstring flexibility in the right lower extremity were randomly assigned to a control (no-stretch) group or an experimental (stretch) group.
Measurements:
All subjects performed 6 warm-up active knee extensions, with the last repetition serving as the prestretch measurement. The experimental group received 5 modified (no-rotation) hold-relax stretches, whereas the control group rested quietly supine on a table for 5 minutes. Posttest measurements were recorded for both groups at 0, 2, 4, 6, 8, 16, and 32 minutes.
Results:
The repeated-measures analysis of variance revealed a significant group-by-time interaction, a significant main effect for group, and a significant main effect for time. Dunnett post hoc analysis revealed a significant improvement in knee-extension range of motion in the experimental group that lasted 6 minutes after the stretching protocol ended.
Conclusions:
Our findings suggest that a sequence of 5 modified hold-relax stretches produced significantly increased hamstring flexibility that lasted 6 minutes after the stretching protocol ended.
PMCID: PMC155401  PMID: 12937514
active knee-extension test; knee joint range of motion

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