Sport; Body Composition; BMI; Fat Free Mass; Dual-energy X-ray Absorptiometry
Obesity; Performance; BMI; Body Composition
A 13-year-old boy presented to the ski clinic following a fall and a possible twisting of his right knee. He was not able to bear any weight on his right leg and was experiencing pain in the medial aspect of his right knee. His past medical and surgical histories were unremarkable and he was otherwise in good health. Physical examination revealed no ecchymosis or effusion. He had moderate tenderness over the medial femoral condyle. Stress valgus test did not reveal any laxity, but caused significant pain. Plain radiography was performed (Fig. 1).
How do you interpret his radiographs?
Enchondroma of the medial distal femur.
Nonossifying fibroma of the medial distal femur.
Osteoid osteoma of the medial distal femur.
Salter-Harris type II fracture of the distal femur.
Sport Injury; Ski; Knee Pain
Sudden Cardiac Death; Physical Examination; Athletes
Sudden Cardiac Death; Athletes; Asia
The respiratory movements are one of the factors influencing standing balance. Although well-trained athletes have better postural performance compared to untrained men, it's not quite clear, if the formers' upright posture would be more stable during different ventilation modes, maximal voluntary hyperventilation and inspiratory breath-holding. There are no studies on this subject in the available literature.
The aim of this study was to investigate an influence of maximal inspiratory breath-holding and maximal voluntary hyperventilation on the standing balance of athletes.
Patients and Methods:
We assessed the amplitude and the velocity of postural sway in the athletes (n = 38) and untrained subjects (n = 28) by the force platform. The frequency characteristics of the center of pressure (CP) oscillations' were also analyzed. The amplitude and the frequency of respiratory movements were estimated by the strain gauge.
It was found that during quiet breath velocity and frequency of CP oscillations were lower in the athletes. Breath holding led to an increase of velocity and frequency of CP displacement in both groups, increase of these indices was more pronounced in the athletes. Maximal voluntary hyperventilation caused a significant increase of all stabilographic indices in both groups. Increase of frequency and amplitude of respiratory movements were mainly observed during hyperventilation in athletes and it caused an increase of the velocity of CP displacement. Changes of sway amplitude were the same in both groups.
Breath holding led to activation of the postural control, which was more pronounced in the athletes. Hyperventilation caused an impairment of the postural stability. The athletes' postural system compensated the impact of hyperventilation more efficiently versus controls, but it was achieved at the expense of greater effort.
Hyperventilation; Breath Holding; Sport
To determine the 2D:4D ratio in elite Indian male kabaddi players and compare them with non-athletes.
Our study was undertaken to find out a possible relation between digit ratio and sporting ability of male kabaddi players. This study also gives an insight into the possible ethnic differences between Indian sports personnel and other populations.
Patients and Methods:
Both right and left hands of 33 male kabaddi players attending training camp at the Bangalore regional centre of Sports Authority of India were scanned. Lengths of second and fourth digits were measured and their ratio calculated. Age, weight, height and body mass index matched subjects (25 males) who did not participate in any sports formed the control group.
A highly significant difference was found in 2D:4D ratios of both the hands with Kabaddi players having a lower ratio compared to their controls. There was no statistically significant difference in 2D:4D (Δ r-l) between Kabaddi players and controls.
Kabaddi is an intermediate sport not requiring a high level of endurance but at the same time requires masculine traits because of combating nature of the game. 2D:4D ratios can be used as reliable additional criteria when screening for prospective players to be inducted into the team.
Digit Ratio; Athletic Performance; Kabaddi; Sport
Delayed onset muscle soreness (DOMS) occurs following unaccustomed or intense bouts of exercise. Previous research has demonstrated that that preconditioning with low load exercise or heat relieves muscle soreness. However, actively warming up the muscles with exercise may be an effective alternative.
This study compared preconditioning effect of light load eccentric exercise and heat using microwave diathermy on markers of muscle damage in collegiate males.
Patients and Methods:
Thirty six sedentary collegiate males were randomly assigned into two experimental groups: 10% Eccentric exercise group (10% ECC group) and Microwave diathermy group (MWD group). Both the groups performed 30 repetitions of maximal eccentric exercise (Max-ECC) of the elbow flexors. The 10% ECC group performed light load eccentric exercise (10% ECC), five sets, six repetitions using a dumbbell set at 10% of maximal voluntary isometric contraction strength (MVC), 2 days prior to Max-ECC. The MWD group received heat using microwave diathermy (150 watts, 20 minutes) one day prior to Max-ECC. Changes in MVC, range of motion (ROM), upper arm circumference, soreness, were assessed before and 24-72 hours after whereas serum creatine kinase activity and lactate dehydrogenase (LDH) activity up to 48 hours following the Max-ECC were compared between groups by a mixed model ANOVA.
No significant difference (P > 0.05) were found between the groups for changes in all variables post Max-ECC, except for LDH activity showing significant interaction effect (P = 0.04).
Preconditioning with light load eccentric exercise and heat using microwave diathermy treatment did not differ in their effects on muscle damage markers after Max-ECC. However, with time their effects on LDH activity were found to be different.
Light; Exercise; Heat; Muscle
Polymorphisms at the angiotensin-converting enzyme gene (ACE), such as the indel [rs1799752] variant in intron 16, have been shown to be associated with aerobic performance of athletes and non-athletes. However, the relationship between ACE indel polymorphism and cardiorespiratory fitness has not been always demonstrated.
The relationship between ACE indel polymorphism and cardiorespiratory fitness was investigated in a sample of young Caucasian Brazilian women.
Patients and Methods:
This study investigated 117 healthy women (aged 18 to 30 years) who were grouped as physically active (n = 59) or sedentary (n = 58). All subjects performed an incremental exercise test (ramp protocol) on a cycle-ergometer with 20-25 W/min increments. Blood samples were obtained for DNA extraction and to analyze metabolic and hormonal profiles. ACE indel polymorphism was determined by polymerase chain reaction (PCR) and fragment size analysis.
The physically active group had higher values of peak oxygen uptake (VO2 peak), carbon dioxide output (VCO2), ventilation (VE) and power output than the sedentary group (P < 0.05) at the peak of the exercise test. However, heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) did not differ between groups. There was no relationship between ACE indel polymorphism and cardiorespiratory variables during the test in both the physically active and sedentary groups, even when the dominant (DD vs. D1 + 2) and recessive (2 vs. DI + DD) models of inheritance were tested.
These results do not support the concept that the genetic variation at the ACE locus contributes to the cardiorespiratory responses at the peak of exercise test in physically active or sedentary healthy women. This indicates that other factors might mediate these responses, including the physical training level of the women.
Exercise Test; Angiotensin-Converting Enzyme; Polymorphism, Genetic; Motor Activity
Injuries are common in contact sports like Australian football. The Australian Football League (AFL) has developed an extensive injury surveillance database that can be used for epidemiological studies.
The purpose of this study is to identify any association between the three most prevalent injuries in the AFL.
Patients and Methods:
From the AFL injury surveillance data 1997-2012 the injury incidence (new injuries per club per season) and the injury prevalence data (missed games per club per season) were analysed to detect the three most common injuries that would cause a player to miss a match in the AFL. The three most prevalent injuries in the AFL are hamstring strains, groin/hip/osteitis pubis injuries and Anterior Cruciate Ligament (ACL) knee injuries. Following this, further study was undertaken to detect the presence of any statistical relationship between injury incidences of the three most prevalent injuries over this sixteen year study period.
Statistical analysis demonstrates for any given year that there was an association between having a groin/hip/osteitis pubis injuriy and having a knee ACL injury (P < 0.05) over the entire sixteen years. In other words if the number of groin/hip/osteitis pubis injuries in any given season were higher than average (alternatively lower) then the number of knee ACL injuries were also higher than average (alternatively lower) for that same season. Hamstring injuries had the highest variance of incidence of the three most prevalent injuries.
Analysis of the AFL injury data demonstrates an association between incidence of groin/hip/osteitis pubis injuries and incidence of knee ACL injuries for any given playing season. This finding is difficult to explain with further research being required.
Groin; Hip; Anterior Cruciate Ligament; Football; Groin; Muscles; Hip
Motor impairments in individuals with autism spectrum disorder (ASD) have been frequently reported. In this review, we narrow our focus on postural control impairments to summarize current literature for patterns, underlying mechanisms, and determinants of posture in this population.
A literature search was conducted through Medline, ISI web of Knowledge, Scopus and Google Scholar to include studies between 1992 and February 2013.
Individuals with ASD have problems in maintaining postural control in infancy that well persists into later years. However, the patterns and underlying mechanisms are still unclear.
Examining postural control as an endophenotype or early diagnostic marker of autism is a conceptual premise which should be considered in future investigations. At the end of the review, methodological recommendations on the assessment of postural control have also been provided.
Posture; Autism; Motor Skills; Postural Balance
Futsal is a growing sport with lots of fans in many countries including Iran, but there are few papers in the literature which report injuries in top level futsal.
The aim of this study is to record and analyze the incidence and characteristics of injuries in Iran futsal national teams from March 2011 to September 2012.
Patients and Methods:
55 Iranian national futsal players participated in this prospective cohort study. Before entering the study, all players took part in Pre-Competition Medical Assessment (PCMA) in accordance with FIFA protocol. Team physicians recorded the injuries throughout the match and trainings in a special form which was designed for this purpose. Finally, data analysis was done with the SPSS software.
The total exposure time for all players was 24326 hours (21138 hours during training and 3188 hours during matches). During the study period, 32 of the 55 national players (58.2%) incurred 54 injuries (incidence rate = 2.22 injuries per 1000 players-hours). The incidence rate of injury in female players was significantly higher than male players (P = 0.001). The majority of injuries (85.2%) were located on the lower extremities. The ankle was the most frequent injury location (40.7%) and sprain was the most frequent type of injury.
Injuries are common among futsal players and female players are more prone to injuries than male players. The ankle is the most frequent site and sprain is the most frequent type of injury among futsal players.
Incidence; Injuries; Soccer
Oral and dental injuries contribute to a major part of sports related injuries in children. Trauma occurring in developing years disrupts normal social functioning and brings about a major impact on quality of life due to their cumulative effect.
To assess the prevalence and causes of various sports related traumatic orodental injuries among 8 to 16 year school students along with identifying the associated risk factors in North India.
Patients and Methods:
A cross sectional study consisting of high school students of different organized sports teams aged 8-16 years was carried out in geographical area of north India. The students were selected by multistage cluster sampling methodology. 1105 students from 19 school teams (sports teams) and sports academies participated in study through structured interview and clinical examination in different sports situations.
30.3% (n = 335) of students suffered from orodental injuries. A higher number of girls had injury (32%) than boys (29%), though the difference was not significant. Most of the students suffered from soft tissue injuries (48%) followed by tooth fractures (43%). Maximum numbers of injuries were reported in high velocity (44.1%) and medium intensity sports (46.6%) (P < 0.001) Maximum injuries occurred in basketball (50%) and lowest in the field of badminton (6.1%) (P < 0.05). Amateurs (52%) suffered the most from injuries as per level of coaching. Only 6% of boys and 2% of girls used mouthguards.
The result of the present study confirmed that students participating in different organized sports at high school level are at a very high risk of getting orodental injury. Hence knowledge and education regarding prevention of traumatic injuries is of paramount importance.
Athletic Injuries; Tooth Fractures; Sports
Non-traumatic knee joint effusion and fullness is a relatively common presenting complaint among athletes and non-athletes. Due to its broad differential diagnosis, a comprehensive evaluation beginning with history and physical examination are recommended. Imaging including plain radiography, magnetic resonance imaging (MRI), and in some cases ultrasound are preferred modalities. If inflammatory arthritis is suspected, joint aspiration and analysis may help diagnosis.
A 37-year-old male soccer player presented with a complaint of left anterior knee pain and fullness for a few months. Physical examination revealed a healthy appearing male with obvious fullness of his left suprapatellar pouch and posterolateral knee. Plain radiographs were unremarkable. MRI demonstrated an effusion infiltrated by multiple, low intensity projections from a fatty mass in the suprapatellar pouch consistent with lipoma arborescens.
Lipoma arborescens is a rare synovial disorder characterized by replacement of subsynovial tissue with mature fat cells, most commonly in the knee joint. MRI is the best diagnostic modality to evaluate and confirm the diagnosis as well as rule out other pathologies. More recent single case-reports and clinical series endorse arthroscopic synovectomy as the treatment of choice.
Knee; Lipoma; Arthroscopy
Cryotherapy, in the form of ice massge is used to reduce inflammation after acute musculoskeletal injury or trauma. The potential negative effects of ice massage on proprioception are unknown, despite equivocal evidence supporting its effectiveness
The purpose of the study was to test the influence of cooling on weight discrimination ability and hence the performance in footballers.
Patients and Methods:
The study was of same subject experimental design (pretest-posttest design). Thirty male collegiate football players, whose mean age was 21.07 years, participated in the study. The participants were assessed for two functional performance tests, single leg hop test and crossed over hop test and weight discrimination ability before and after ice massage for 5 minutes on hamstrings muscle tendon.
Pre cooling scores of Single Leg Hop Test of the dominant leg in the subjects was 166.65 (± 10.16) cm and post cooling scores of the dominant leg was 167.25 (± 11.77) cm. Pre cooling scores of Crossed Over Hop Test of the dominant leg in the subjects was 174.14 (± 8.60) cm and post cooling scores of the dominant leg was 174.45 (± 9.28) cm. Pre cooling scores of Weight Discrimination Differential Threshold of the dominant leg in the subjects was 1.625 ± 1.179 kg compared with post cooling scores of the dominant leg 1.85 (± 1.91) kg. Pre cooling scores of single leg hop and crossed over hop test of the dominant leg in the subjects compared with post cooling scores of the dominant leg showed no significant differences and it was also noted that the weight discrimination ability (weight discrimination differential threshold) didn’t show any significant difference. All the values are reported as mean ± SD.
This study provides additional evidence that proprioceptive acuity in the hamstring muscles (biceps femoris) remains largely unaffected after ice application to the hamstrings tendon (biceps femoris).
Sports Injury; Proprioception; Functional Performance; Cryotherapy
There is a relationship between exercise and changes in immunity. So athletes are prone to different medical problems such as injuries and infections. Infection is an important medical problem which could be a reason for athletes’ absence from training. The relationship between physical activity and immune system, characteristics of different types of infections in athletes with emphasis on special clinical presentations or complications, time to return to physical activity and training and strategies to prevent development and transmission of infections in athletes or physically active people are the main topics of this review.
Sports Medicine; Infectious Diseases; Respiratory Tract Infections; Blood Borne Pathogens; Viral Hepatitis; Skin Infections; Immunity
Lower limb skin-fold thicknesses have been differentially associated with sex in elite runners. Front thigh and medial calf skin-fold appear to be related to 1,500m and 10,000m time in men but 400m time in women. The aim of the present study was to compare anthropometric and training characteristics in recreational female and male half-marathoners.
The association between both anthropometry and training characteristics and race time was investigated in 83 female and 147 male recreational half marathoners using bi- and multi-variate analyses.
In men, body fat percentage (β=0.6), running speed during training (β=-3.7), and body mass index (β=1.9) were related to half-marathon race time after multi-variate analysis. After exclusion of body mass index, r2 decreased from 0.51 to 0.49, but body fat percentage (β=0.8) and running speed during training (β=-4.1) remained predictive. In women, body fat percentage (β=0.75) and speed during training (β=-6.5) were related to race time (r2=0.73). For women, the exclusion of body mass index had no consequence on the predictive variables for half-marathon race time.
To summarize, in both female and male recreational half-marathoners, both body fat percentage and running speed during training sessions were related to half-marathon race times when corrected with co-variates after multi-variate regression analyses.
Body Fat; Running Speed; Body Mass Index
This study aimed to compare physiological responses and time-motion analysis between official and simulated karate combat.
Ten high-level karatekas participated in this study, which included official and simulated karate combat.
Karatekas used more upper-limb attack techniques during official combat compared to simulated ones (6±3 vs 3±1; P=0.05, respectively). For official and simulated karate matches, the numbers of high-intensity actions (i.e. offensive and defensive fighting activity) were 14±6 and 18±5, respectively (P>0.05), lasting from <1s to 5s each. Total fighting activity phase was lower during official compared to simulated matches (21.0±8.2s vs 30.4±9.9s, P<0.01, respectively). Effort (10.0±2.8s) to rest (11.9±2.7s) ratio (E:R) was 1:1 and high-intensity actions (1.6±0.3s) to rest (11.9±2.7s) ratio was higher than 1:7 during simulated combat. During official karate match, the activity and rest duration were 10.0±3.4s and 16.2±4.1s, respectively (E:R ratio 1:1.5), while high-intensity actions were 1.5±0.3s, resulting in an E:R ratio of 1:11. Blood lactate concentration was higher during official (11.14±1.82 mmol.l-1) compared to simulated karate combat (7.80±2.66 mmol.l-1) (P<0.05). Subjective perceived exertion differed significantly between official and simulated combat (14±2 vs. 12±2; P<0.05, respectively). The majority of karatekas’ perceived exertion was higher in the lower limb muscle groups irrespective of the karate combat condition.
Official and simulated matches differ considerably, therefore coaches should create new strategies during training sessions to achieve the same effort and pause profile of competitive matches and/or that athletes should be submitted to frequent competitions to adapt themselves to the profile of this event.
Karate; Combat Sport; Time-motion Analysis; Physiological Responses
The aim of this study was to compare the effect of resistance exercise with three different methods on integrated electromyography (IEMG) and metabolic responses in recreational athletes.
Twenty four males (mean 23.59±0.87 years) were randomly assigned to three experimental groups. Participants performed knee extension exercises: Slow (SL: 3-3, 3s for each concentric and eccentric action with 50% of 1 RM), Normal (NH: 1-1, 1 s for each concentric and eccentric action 80% of 1 RM) and Traditional (TH: 2-4, 2s for concentric and 4s for eccentric action with 80% of 1 RM). Plasma lactate, glucose and triglyceride concentration and IEMG was measured before and immediately after performing four sets of resistance exercise.
Each method significantly decreased IEMG (P<0.05), but there was no significant difference between groups. Lactate was increased following TH and NH more than SL method (P<0.05). Each method significantly increased plasma glucose (P<0.05). Work considering time under tension (workTUT) was higher (P<0.05) during TH method than the other methods and during SL it was higher than NH method (P<0.05). Volume load was higher (P<0.05) during NH than the other two methods and during TH it was higher than SL method (P<0.05).
These results indicate that exercise intensity during the resistance exercise is important for the enhancement of lactate responses, but the slow resistance exercise method could induce acute neuromuscular response as much as high intensity methods. It seems that this method will be advantageous for those who want to increase acute neuromuscular changes with low exercise intensity and volume.
Lactate; Recruitment; Motor Unit; Resistance Exercise; Metabolic Stress Response
Air pollution has remained a major health concern in Kolkata. The present study was carried out to analyze the association between the levels of air pollutants and pulmonary function of youngster footballers living in two different air pollutant zones of Kolkata, West Bengal.
Air pollution data of the two ambient air quality-monitoring stations located at Rabindrabharati and Victoria Memorial was collected for the period from January 2012 to March 2012. Study was conducted on two hundred and twenty boys of the age range 14-16 years living within 3km radius of the two monitoring stations. Sample consisted of 60 footballers (30 from Rabindrabharati and 30 from Victoria Memorial) and 160 sedentary boys (80 from Rabindrabharati and 80 from Victoria Memorial). They were investigated for their spirometric lung functions by the method and technique recommended by American Thoracic Society. Results were expressed as mean ± SD and independent samples T test was conducted to compare between two groups.
Results revealed that particulate matter (PM10), oxides of sulfur (SO2) concentrations were significantly higher in Rabindrabharati zone, whereas no significant differences were noted in oxides of nitrogen (NO2) and carbon monoxide (CO) concentrations though values were higher at Rabindrabharati than Victoria Memorial. Forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), forced mid expiratory flow (FEF25-75%), maximum voluntary ventilation (MVV) were significantly lower both in footballers (P<0.05) and sedentary boys (P<0.01) of Rabindrabharati zone.
Exposure to high air pollutant concentration might be associated with reduced pulmonary function in both sedentary and trained boys in spite of the fact that regular participation in training program may improve pulmonary function.
Air Pollution; Pulmonary Function Test; Forced Vital Capacity; Footballers
The aim of the present study was to examine the variation in physical activity of elite soccer players within successive prolonged periods of fixture congestion over 5 months of competition during the competitive season 2011-2012.
Sixteen international players, classified into 6 positions (central defenders: CD; full-backs: FB; central defensive midfielders: CDM; wide midfielders: WM; central attacking midfielders: CAM; forwards: FW), were examined during the French First League, French Cup, and UEFA Champion's League matches. The total distance covered at light (<12 km.h−1), sustained-cruising (>18-21 km.h−1), high (>21-23 km.h−1), very high (>23-25 km.h−1), sub-maximal (>25-27 km.h−1), and maximal (>27 km.h−1) intensity running (IR) were measured and analysed using a semi-automatic match analysis system (Amisco Pro™).
No differences were observed between congested and non-congested periods (two vs. one match a week, respectively) for the total distance covered at all the speed thresholds over 18 km.h−1, with no variation in physical fitness over the 5 studied months. Specifically to the playing positions, regardless of the congestion periods, FB and WM covered more distance than CDM over 21km.h−1; FB, WM and FW covered similar distances for all running intensities; and CD and CDM covered shorter distance during non-congested compared to congested periods (P<0.05) at light-IR.
The present study reveals that prolonged congested match fixture did not affect the high-intensity physical activity of top-class soccer players during official games during a 5 months fixture period.
Fitness Training; Soccer; High-Intensity Running; Motion Analysis; Work Rate; Match Congestion
L-glutamine is the most abundant amino acid found in human muscle and plays an important role in protein synthesis and can reduce the levels of inflammation biomarkers and creatine kinase (CK) after training sessions. Delayed onset muscle soreness (DOMS) develops after intense exercise and is associated with an inflammatory response. The purpose of this study was to investigate the effect of glutamine supplementation on surface electromyography activity of the vastus medialis muscle (VMM) and rectus femoris muscle (RFM) and levels of creatine kinase after an eccentric contraction.
Seventeen healthy men (age: 22.35±2.27yr; body mass: 69.91± 9.78kg; height: 177.08±4.32cm) were randomly assigned to experimental (n=9) and control groups (n=8) in a double-blind manner. In both groups, subjects were given L-glutamine supplementation (0.1g.kg-1) or placebo three times a week for 4 weeks. Median frequency (MDF) and mean power frequency (MPF) for VMM and RFM muscles and also CK measurements were performed before, 24h and 48 h after a resistance training session. The resistance training included 6 sets of eccentric leg extensions to exhaustion with 75% of 1RM.
There was no significant difference between groups for MDF or MPF in VMM and RFM. The difference of CK level between the groups was also not significant.
The results of this study indicate that glutamine supplementation has no positive effect on muscle injury markers after a resistance training session.
Mean Power Frequency; Median Frequency; Creatine Kinase; Eccentric Exercise
To perform an exploratory characterization of repeated sprint sequences (RSS) and repeated acceleration sequences (RAS) in top level soccer referees.
7 field and 7 assistant referees were monitored during 2007 America's Soccer Cup with GPS technology. Sprints of >18 km·h-1 and accelerations of >1.5 m·s-2 were considered as high intensity activities. RSS and RAS were defined as a minimum of 3 consecutive bouts interspersed with a maximum of 45 s.
Field and assistant referees performed substantially more accelerations than sprints. Neither field nor assistant referees recorded any RSS. In contrast, total distance performing RAS amounted to ∼37% and ∼20% of the total distance covered by accelerations during the entire match for field and assistant referees, respectively. Only field referees exhibited fatigue-related reductions in RAS characteristics between halves.
The results of the present study would appear to support the appropriateness of a repeated acceleration ability (RAA) concept, instead of the repeated sprint ability (RSA) concept, in soccer referees. Further studies should assess RAS in referees and athletes of different team sports for designing better training exercises and physiological testing.
Time Motion; Intermittent Sports; Global Positioning System; Performance; Fatigue
Shoulder pain is one of the most common problems in ages older than 60 years of age. Rotator cuff pathology is the most common etiology of shoulder pain. Most of rotator cuff pathologies are treated conservatively in old ages and exercise therapy is not an accepted intervention for management of rotator cuff tear yet.
The case was a man of 53 years age with shoulder pain who had total tear of supraspinatus tendon and biceps tendinitis in the right shoulder. He had regularly gone swimming, mountain climbing and running in the last 10 years. The case was managed by exercise therapy for 3 months and physical modalities for 20 sessions. Shoulder pain and his function and right shoulder range of motion increased after 3 months. Para clinical findings did not change after treatment, though. The improvements continued 15 months after the beginning of the treatment.
Exercise therapy was very effective for improving pain and function in total tear of supraspinatus tendon and tendinitis of biceps.
Exercise Therapy; Shoulder Pain; Rotator Cuff; Tendinitis
Vertigo; Benign Paroxysmal Positional Vertigo Swimming; Epley Maneuver