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1.  [No title available] 
PMCID: PMC2658969
2.  Breaking butterflies on a wheel 
PMCID: PMC2658970  PMID: 18037631
3.  [No title available] 
PMCID: PMC2658971
4.  [No title available] 
doi:10.1136/bjsm.2007.039347
PMCID: PMC2658972
5.  [No title available] 
doi:10.1136/bjsm.2007.039354
PMCID: PMC2658973
6.  Contact events in rugby union and their propensity to cause injury 
British Journal of Sports Medicine  2007;41(12):862-867.
Objective
The objective of this study was to determine the incidence of contact events in professional rugby union matches and to assess their propensity to cause injury.
Design
The study was a two‐season (2003/2004 and 2005/2006) prospective cohort design. It included 645 professional rugby union players from 13 English Premiership rugby union clubs. The main outcome measures were: incidence of match contact events (events per game); incidence (injuries per 1000 player‐hours and per 1000 contact events), risk (days lost per 1000 player‐hours and per 1000 contact events) and diagnosis of injury; referee's decision. Risk factors were player–player contact, position on pitch and period of play.
Results
Tackles (221.0 events/game) and rucks (142.5 events/game) were the most common events and mauls (13.6%) and scrums (12.6%) the most penalised. Tackles (701.6 days/1000 player‐hours) were responsible for the greatest loss of time but scrums (213.2 days lost/1000 events) and collisions (199.8 days lost/1000 events) presented the highest risk per event.
Conclusions
Tackles were the game event responsible for the highest number of injuries and the greatest loss of time in rugby union because they were by far the most common contact event. Collisions were 70% more likely to result in an injury than a tackle and scrums carried a 60% greater risk of injury than a tackle. The relative propensities for contact events to cause injury were rated as: lineout – very low; ruck – low; maul and tackle – average; collision and scrum – high.
doi:10.1136/bjsm.2007.037499
PMCID: PMC2658974  PMID: 17513332
7.  [No title available] 
doi:10.1136/bjsm.2007.039313
PMCID: PMC2658975
8.  Recovery of cognitive and dynamic motor function following concussion 
British Journal of Sports Medicine  2007;41(12):868-873.
Objective
Neuropsychological testing has been advocated as an important tool of proper post‐concussion management. Although these measures provide information that can be used in the decision of when to return an individual to previous levels of physical activity, they provide little data on motor performance following injury. The purpose of this investigation was to examine the relationship between measures of dynamic motor performance and neuropsychological function following concussion over the course of 28 days.
Methods
Participants completed two experimental protocols: gait stability and neuropsychological testing. The gait stability protocol measured whole‐body centre of mass motion as subjects walked under conditions of divided and undivided attention. Neuropsychological testing consisted of a computerised battery of tests designed to assess memory, reaction time, processing speed and concussion symptoms. Correlation coefficients were computed between all neuropsychological and gait variables and comparisons of neuropsychological and gait stability post‐concussion recovery curves were assessed.
Results
Dynamic motor tasks, such as walking under varying conditions of attention, are complex and demanding undertakings, which require a longer recovery time following a concussion than cognitive measures. Little statistical relationship was found between the neuropsychological and gait variables, and the recovery curves of neuropsychological and gait domains were observed to be independent.
Conclusions
In order to fully examine the effects of concussion and determine the optimal time for a safe return to activity, a multi‐factorial approach, including both cognitive and motor tasks, should be employed.
doi:10.1136/bjsm.2006.033761
PMCID: PMC2658976  PMID: 17517857
9.  [No title available] 
doi:10.1136/bjsm.2007.039370
PMCID: PMC2658977
10.  [No title available] 
doi:10.1136/bjsm.2007.039388
PMCID: PMC2658978
11.  Salbutamol exhibits androgenic activity in vitro 
British Journal of Sports Medicine  2007;41(12):874-878.
Background
Salbutamol has been shown to mediate anabolic effects after intravenous administration. However, the mechanism responsible for the anabolic actions of salbutamol remains unknown.
Aim
To investigate the potential mechanism by which salbutamol mediates anabolic effects in vitro.
Methods
The potential androgenic activity of salbutamol was investigated in vitro by the A‐Screen assay that measures androgen‐dependent inhibition of proliferation of the androgen receptor (AR)‐positive human mammary carcinoma cell line, MCF7‐AR1.
Results
The assay was validated with three known androgens; methyltrienolone (R1881), 5α‐dihydrotestosterone (DHT) and danazol. IC50 values of R1881, DHT and danazol, 4.41×10–11, 4.44×10−11 and 1.08×10−8 M, respectively, were in the ranges known from earlier studies. Our results demonstrate that salbutamol exhibits androgenic activity, with an IC50 value of 8.93×10−6 M. Anti‐estrogenic or cytotoxic effects, which might have interfered with the assay, were excluded by additional experiments on wild‐type MCF7 and MCF7‐AR1 cells, respectively.
Conclusion
These data indicate that salbutamol exerts anabolic effects through androgen receptor agonistic activity in vitro.
doi:10.1136/bjsm.2007.035162
PMCID: PMC2658979  PMID: 17510230
12.  [No title available] 
PMCID: PMC2658980
13.  [No title available] 
PMCID: PMC2658981
14.  Does deep water running reduce exercise‐induced breast discomfort? 
British Journal of Sports Medicine  2007;41(12):879-883.
Aim
To establish whether exercise‐induced vertical breast displacement and discomfort in women with large breasts were reduced during deep water running compared to treadmill running.
Methods
Sixteen women (mean age  = 32 years, range 19–43 years; mean mass  = 74.1 kg, range 61–114 kg; mean height  = 1.7 m, range 1.61–1.74 m), who were professionally sized to wear a C+ bra cup, were recruited as representative of women with large breasts. After extensive familiarisation, vertical breast motion of the participants was quantified as they ran at a self‐selected stride rate on a treadmill and in 2.4 m deep water. Immediately after running, the subjects rated their breast discomfort and breast pain (visual analogue scale) and their perceived exertion (Borg scale). Breast discomfort, breast pain, perceived exertion, vertical breast displacement and vertical breast velocity were compared between the two experimental conditions.
Results
Exercise‐induced breast discomfort was significantly less and perceived exertion was significantly greater during deep water running relative to treadmill running. Although there was no significant between‐condition difference in vertical breast displacement, mean peak vertical breast velocity was significantly (p<0.05) less during deep water (upward mean (SD): 29.7 (14.0) cm.s‐1; downward: 31.1 (17.0) cm.s‐1) compared to treadmill running (upward mean (SD): 81.4 (21.7) cm.s‐1; downward: 100.0 (25.0) cm.s‐1).
Conclusion
Deep water running was perceived as a more strenuous but comfortable exercise mode for women with large breasts. Increased comfort was attributed to reduced vertical breast velocity rather than reduced vertical breast displacement.
doi:10.1136/bjsm.2007.036251
PMCID: PMC2658982  PMID: 17535854
16.  [No title available] 
PMCID: PMC2658984
17.  Shoulder joint loading in the high performance flat and kick tennis serves 
British Journal of Sports Medicine  2007;41(12):884-889.
Objective
To quantify and compare the full body kinematics and shoulder joint kinetics during the high‐performance tennis flat (FS) and kick serves (KS).
Methods
A 12‐camera 250 Hz, Vicon motion analysis system recorded the three‐dimensional FS and KS of 12 high‐performance male players. A total of 22 paired Student's t tests, with an accompanying partial Bonferroni correction (p<0.01), determined statistically significant differences between the variables of interest in both serves.
Results
Higher peak horizontal, vertical and absolute racquet velocities were developed during the FS, while higher lateral velocities characterised the KS. Similar shoulder joint kinematics and kinetics punctuated both serves, but with some variation in trunk and lower limb mechanics.
Conclusions
Similar shoulder joint kinetics assisted the development of varying three‐dimensional racquet velocities in the FS and KS. The comparable shoulder joint loading conditions point to the repetitive, long‐term performance of either serve as relevant in shoulder joint injury pathologies.
doi:10.1136/bjsm.2007.036657
PMCID: PMC2658985  PMID: 17513331
18.  [No title available] 
PMCID: PMC2658986
19.  Physiological responses to rock climbing in young climbers 
British Journal of Sports Medicine  2007;41(12):852-861.
Key questions regarding the training and physiological qualities required to produce an elite rock climber remain inadequately defined. Little research has been done on young climbers. The aim of this paper was to review literature on climbing alongside relevant literature characterising physiological adaptations in young athletes. Evidence‐based recommendations were sought to inform the training of young climbers. Of 200 studies on climbing, 50 were selected as being appropriate to this review, and were interpreted alongside physiological studies highlighting specific common development growth variables in young climbers. Based on injury data, climbers younger than 16 years should not participate in international bouldering competitions and intensive finger strength training is not recommended. The majority of climbing foot injuries result from wearing too small or unnaturally shaped climbing shoes. Isometric and explosive strength improvements are strongly associated with the latter stages of sexual maturation and specific ontogenetic development, while improvement in motor abilities declines. Somatotyping that might identify common physical attributes in elite climbers of any age is incomplete. Accomplished adolescent climbers can now climb identical grades and compete against elite adult climbers aged up to and >40 years. High‐intensity sports training requiring leanness in a youngster can result in altered and delayed pubertal and skeletal development, metabolic and neuroendocrine aberrations and trigger eating disorders. This should be sensitively and regularly monitored. Training should reflect efficacious exercises for a given sex and biological age.
doi:10.1136/bjsm.2007.034827
PMCID: PMC2658987  PMID: 18037632
20.  [No title available] 
PMCID: PMC2658988
21.  Preparticipation medical evaluation in professional sport in the UK: theory or practice? 
British Journal of Sports Medicine  2007;41(12):890-896.
Objective
To determine the level of pre‐employment, pre‐season, and post‐injury medical evaluation of players undertaken within UK professional team sports.
Design
A postal, whole population survey.
Setting
Elite professional sports teams in England.
Population
Six groups comprising the following clubs: professional football (Premiership, 15 of 20; Championship, 22 of 24), rugby union (Premiership, 9 of 12; Division 1, 11 of 14), rugby league (Super League, 6 of 11) and cricket (County, 12 of 18).
Main outcome measures
Number (percentage) of clubs recording players' medical history and undertaking medical examinations of players' cardiovascular, respiratory, neurological, and musculoskeletal systems at pre‐employment, pre‐season and post‐injury.
Results
The overall response to the survey was 74%, with a range from 55% to 92% among groups. Almost 90% of football (Premiership and Championship) and rugby union (Premiership) clubs took a pre‐employment history of players' general health, cardiovascular, respiratory, neurological, and musculoskeletal systems, but fewer than 50% of cricket and rugby union (Division 1) clubs recorded a history. The majority of football (Premiership and Championship) and rugby union (Premiership) clubs implemented both cardiovascular and musculoskeletal examinations of players before employment. Fewer than 25% of clubs in any of the groups implemented neurological examinations of players at pre‐employment, although 100% of rugby union (Premiership) and rugby league clubs implemented neurological testing during pre‐season.
Conclusions
None of the sports implemented best practice guidelines for the preparticipation evaluation of players at all stages of their employment. Departures from best practice guidelines and differences in practices between clubs within the same sport leave club physicians vulnerable if their players sustain injuries or ill health conditions that could have been identified and avoided through the implementation of a preparticipation examination.
doi:10.1136/bjsm.2007.038935
PMCID: PMC2658989  PMID: 17609223
preparticipation evaluation; professional sport; risk factors for injury; medical risk factors
22.  Computer‐based quantification of the mean Achilles tendon thickness in ultrasound images: effect of tendinosis 
British Journal of Sports Medicine  2007;41(12):897-902.
Background
B‐mode measurement of the sagital diameter of the Achilles tendon based on a manual tracing (MT) procedure is partly dependent on the subjectivity of the reader. The aim of this study is to establish a standardised automatic procedure to differentiate between normal and chronically degenerated tendons. For this comparison, the tracing results of the tendon boundaries of an automatic identification (AI) process, already established with the detection of intima–media thickness, are compared with computer‐assisted MT.
Methods
The detection of the tendon boundaries was performed in 115 ultrasound images including the cranial border of the calcaneal tuberosity. The measured section (starting point 4 cm away from the anterior boundary of the calcaneal tuberosity) amounted to 3 cm, and was divided into three sub‐segments (1 cm each). Intra‐ and inter‐reader/observer variability for mean and maximum Achilles tendon thickness (ATT) with AI and MT were evaluated. A normal group and a group with clinically diagnosed chronic tendon degeneration had mean and maximum ATT readings compared.
Results
Using MT, the intra‐ and inter‐reader variability was 3.0% and 6.8%, respectively, using AI the variability was 1.6% and 3.9%, respectively. Mean and maximum ATT were measured systematically lower by AI compared to MT in all regions by 0.4 mm. The AI procedure was most accurate in the second segment. The mean ATT and maximum ATT were correctly detected in 93.9% and 96.6% of the images.
Conclusion
The AI procedure detected the ATT with a high level of precision in all three segments. The most robust measurement was reached in the second segment. It eliminates most of the inter‐/intra‐reader variability in ATT measurement using MT. We suggest this new method could be a new gold standard for quantification of chronic disorder in Achilles tendons.
doi:10.1136/bjsm.2007.037812
PMCID: PMC2658990  PMID: 17550920
23.  [No title available] 
PMCID: PMC2658991
25.  An office‐place stepping device to promote workplace physical activity 
British Journal of Sports Medicine  2007;41(12):903-907.
Objective
It was proposed that an office‐place stepping device is associated with significant and substantial increases in energy expenditure compared to sitting energy expenditure. The objective was to assess the effect of using an office‐place stepping device on the energy expenditure of lean and obese office workers.
Methods
The office‐place stepping device is an inexpensive, near‐silent, low‐impact device that can be housed under a standard desk and plugged into an office PC for self‐monitoring. Energy expenditure was measured in lean and obese subjects using the stepping device and during rest, sitting and walking. 19 subjects (27±9 years, 85±23 kg): 9 lean (BMI<25 kg/m2) and 10 obese (BMI>29 kg/m2) attended the experimental office facility. Energy expenditure was measured at rest, while seated in an office chair, standing, walking on a treadmill and while using the office‐place stepping device.
Results
The office‐place stepping device was associated with an increase in energy expenditure above sitting in an office chair by 289±102 kcal/hour (p<0.001). The increase in energy expenditure was greater for obese (335±99 kcal/hour) than for lean subjects (235±80 kcal/hour; p = 0.03). The increments in energy expenditure were similar to exercise‐style walking.
Conclusion
The office‐place stepping device could be an approach for office workers to increase their energy expenditure. If the stepping device was used to replace sitting by 2 hours per day and if other components of energy balance were constant, weight loss of 20 kg/year could occur.
doi:10.1136/bjsm.2006.034900
PMCID: PMC2658993  PMID: 17513333

Results 1-25 (4569)