| 1. |
- Askling, Carl
(författare)
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Hamstring muscle strain
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Acute hamstring strains are common injuries in different sports. They are often serious, causing long rehabilitation times and a proneness for re-injury. Preliminary observations indicate that the injuries can be of at least two types, one occurring during high-speed running and the other during motions where the hamstring muscles reach extreme lengths.Aims: To investigate the possible existence of different types of acute hamstring strains in two specific athletic groups, namely sprinters and dancers, as well as the generality of these findings in other sports.Methods: In the first project, 18 sprinters and 15 dancers with acute first time hamstring strains were prospectively included. All subjects were examined, clinically and with magnetic resonance imaging (MRI), on 4 occasions after injury: at day 2-4, 10, 21 and 42. The follow-up period was 2 years. In the second project, 30 subjects from 21 different sports were prospectively included. All subjects were examined clinically and with MRI. The follow-up period lasted until the subjects returned to sport or finished their sport activity due to the injury.Results: All sprinters sustained their injuries during competitive high-speed running. In contrast, all dancers encountered their injuries during slow-speed stretching type of exercises. The initial loss of strength and flexibility was significantly greater in sprinters than in dancers. At 42 days after injury, both groups could perform more than 90% of the test values of the uninjured leg. All the sprinters’ injuries were primarily located in biceps femoris long head, whereas the dancers’ injuries were mainly (87%) involving the proximal free tendon of semimembranosus. For the sprinters, involvement of the proximal free tendon, as estimated by MRI, and proximity to the ischial tuberosity, as estimated both by palpation and MRI, were associated with significantly longer time to return to pre-injury level. In the dancers, there were no significant correlations between clinical or MRI parameters and time to return to per-injury level. The time to pre-injury level was significantly longer (median 50 weeks, range 30-76) for the dancers compared to the sprinters (16, 6-50). In the second project, all injuries occurred during movements reaching a position with combined extensive hip flexion and knee extension. They were all located close to the ischial tuberosity and 83% involved the proximal free tendon of semimembranosus. Fourteen subjects (47%) decided to end their sport activity and for the remaining 16 subjects the median time back to sport was 31 (range 9-104) weeks. There were no significant correlations between clinical and MRI parameters and time to return to sport.Conclusions: There seems to be a link between the injury situation and the two types of acute hamstring strain in sprinters and dancers with respect to clinical findings, injury location, muscles and tissues involved, and time to return to pre-injury level. Proximity of the injury to the ischial tuberosity, as estimated both by palpation and MRI, is associated with longer recovery time. Also in other sports, an injury situation where the hamstrings reach extensive lengths caused a specific injury to the proximal posterior thigh similar to that described in dancers. Due to the prolonged recovery time associated with this type of injury, correct diagnosis based on history, clinical and MRI investigation, and adequate information to the athletes are essential.
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| 2. |
- Askling, Carl M, et al.
(författare)
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Acute first-time hamstring strains during high-speed running: a longitudinal study including clinical and magnetic resonance imaging findings
- 2007
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Ingår i: The American journal of sports medicine. - : SAGE Publications. - 0363-5465 .- 1552-3365. ; 35:2, s. 197-206
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Tidskriftsartikel (refereegranskat)abstract
- Hamstring muscle strain is one of the most common injuries in sports. Still, knowledge is limited about the progression of clinical and magnetic resonance imaging characteristics and their association with recovery time in athletes. Hypothesis Knowing the anatomical location and extent of an acute first-time hamstring strain in athletes is critical for the prognosis of recovery time. Study Design Case series (prognosis); Level of evidence, 2. Methods Eighteen elite sprinters with acute first-time hamstring strains were prospectively included in the study. All subjects were examined, clinically and with magnetic resonance imaging, on 4 occasions after injury: at day 2 to 4, 10, 21, and 42. The clinical follow-up period was 2 years. Results All sprinters were injured during competitive sprinting, and the primary injuries were all located in the long head of the biceps femoris muscle. There was an association between the time to return to pre-injury level (median, 16; range, 6-50 weeks) and the extent of the injury, as indicated by the magnetic resonance imaging parameters. Involvement of the proximal free tendon, as estimated by MRI, and proximity to the ischial tuberosity, as estimated both by palpation and magnetic resonance imaging, were associated with longer time to return to pre-injury level. Conclusion Careful palpation during the first 3 weeks after injury and magnetic resonance imaging investigation performed during the first 6 weeks after injury provide valuable information that can be used to predict the time to return to pre-injury level of performance in elite sprinting.
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| 3. |
- Askling, Carl M, et al.
(författare)
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Acute first-time hamstring strains during slow-speed stretching: clinical, magnetic resonance imaging, and recovery characteristics
- 2007
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Ingår i: The American journal of sports medicine. - : SAGE Publications. - 1552-3365 .- 0363-5465. ; 35:10, s. 1716-1724
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Tidskriftsartikel (refereegranskat)abstract
- Hamstring strains can be of 2 types with different injury mechanisms, 1 occurring during high-speed running and the other during stretching exercises. Hypothesis A stretching type of injury to the proximal rear thigh may involve specific muscle-tendon structures that could affect recovery time. Study Design Case series (prognosis); Level of evidence, 2. Methods Fifteen professional dancers with acute first-time hamstring strains were prospectively included in the study. All subjects were examined, clinically and with magnetic resonance imaging, on 4 occasions after injury: at day 2 to 4, 10, 21, and 42. The clinical follow-up period was 2 years. Results All dancers were injured during slow hip-flexion movements with extended knee and experienced relatively mild acute symptoms. All injuries were located proximally in the posterior thigh close to the ischial tuberosity. The injury involved the semimembranosus (87%), quadratus femoris (87%), and adductor magnus (33%). All injuries to the semimembranosus involved its proximal free tendon. There were no significant correlations between clinical or magnetic resonance imaging parameters and the time to return to preinjury level (median, 50 weeks; range, 30-76 weeks). Conclusion Stretching exercises can give rise to a specific type of strain injury to the posterior thigh. A precise history and careful palpation provide the clinician enough information to predict a prolonged time until return to preinjury level. One factor underlying prolonged recovery time could be the involvement of the free tendon of the semimembranosus muscle.
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| 4. |
- Askling, Carl M, et al.
(författare)
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Proximal hamstring strains of stretching type in different sports: injury situations, clinical and magnetic resonance imaging characteristics, and return to sport
- 2008
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Ingår i: The American journal of sports medicine. - : SAGE Publications. - 1552-3365 .- 0363-5465. ; 36:9, s. 1799-1804
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Tidskriftsartikel (refereegranskat)abstract
- Hamstring strains can be of at least 2 types, 1 occurring during high-speed running and the other during motions in which the hamstring muscles reach extreme lengths, as documented for sprinters and dancers. Hypothesis Hamstring strains in different sports, with similar injury situations to dancers, also show similarities in symptoms, injury location, and recovery time. Study Design Case series (prognosis); Level of evidence, 4. Methods Thirty subjects from 21 different sports were prospectively included. All subjects were examined clinically and with magnetic resonance imaging (MRI). The follow-up period lasted until the subjects returned to or finished their sport activity. Results All injuries occurred during movements reaching a position with combined extensive hip flexion and knee extension. They were located proximally in the posterior thigh, close to the ischial tuberosity. The injuries were often complex, but 83% involved the semimembranosus and its proximal free tendon. Fourteen subjects (47%) decided to end their sports activity. For the remaining 16 subjects, the median time for return to sport was 31 weeks (range, 9-104). There were no significant correlations between specific clinical or MRI parameters and time to return to sport. Conclusions In different sports, an injury situation in which the hamstring muscles reach extensive length causes a specific injury to the proximal posterior thigh, earlier described in dancers. Because of the prolonged recovery time associated with this type of injury, correct diagnosis, based on history and palpation, and adequate information to the subject are essential.
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| 5. |
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| 6. |
- Bakkman, L., et al.
(författare)
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Quantitative and qualitative adaptation of human skeletal muscle mitochondria to hypoxic compared to normoxic training at the same relative work rate
- 2007
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Ingår i: Acta Physiologica Scandinavica. - : Wiley. - 0001-6772 .- 1365-201X .- 1748-1708 .- 1748-1716. ; 190:3, s. 243-251
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To investigate if training during hypoxia (H) improves the adaptation of muscle oxidative function compared with normoxic (N) training performed at the same relative intensity.Method: Eight untrained volunteers performed one-legged cycle training during 4 weeks in a low-pressure chamber. One leg was trained under N conditions and the other leg under hypobaric hypoxia (526 mmHg) at the same relative intensity as during N (65% of maximal power output, Wmax). Muscle biopsies were taken from vastus lateralis before and after the training period. Muscle samples were analysed for the activities of oxidative enzymes [citrate synthase (CS) and cytochrome c oxidase (COX)] and mitochondrial respiratory function.Results: W max increased with more than 30% over the training period during both N and H. CS activity increased significantly after training during N conditions (+20.8%, P < 0.05) but remained unchanged after H training (+4.5%, ns) with a significant difference between conditions (P < 0.05 H vs. N). COX activity was not significantly changed by training and was not different between exercise conditions [+14.6 (N) vs. -2.3% (H), ns]. Maximal ADP stimulated respiration (state 3) expressed per weight of muscle tended to increase after N (+31.2%, P < 0.08) but not after H training (+3.2%, ns). No changes were found in state four respiration, respiratory control index, P/O ratio, mitochondrial Ca2+ resistance and apparent Km for oxygen.Conclusion: The training-induced increase in muscle oxidative function observed during N was abolished during H. Altitude training may thus be disadvantageous for adaptation of muscle oxidative function.
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| 7. |
- Berg, Ulrika, et al.
(författare)
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Lack of sex differences in the IGF-IGFBP response to ultra endurance exercise.
- 2008
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Ingår i: Scandinavian Journal of Medicine and Science in Sports. - : Wiley. - 0905-7188 .- 1600-0838. ; 18:6, s. 706-714
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Tidskriftsartikel (refereegranskat)abstract
- The insulin-like growth factor (IGF)-IGF binding proteins (BP) and the pituitary-gonadal axes were investigated during ultra endurance exercise in 16 endurance-trained athletes (seven women). Median duration of the race was 6.3 days. Although food and drink were ad libitum, energy balance was negative. Blood samples were drawn before (PRE), at the end of (END) and 24 h after (POST24h) the race. Serum concentrations of total IGF-I (t-IGF-I) and free IGF-I (f-IGF-I) decreased by 33 (SD 38)% and 54 (19)%, respectively. The decrease in t-IGF-I appeared to be associated to the total energy deficit during the race. At END, the IGFBP-3 fragmentation and IGFBP-1 were increased but these changes did not predict changes in f-IGF-I. An increase in POST24h IGFBP-2 levels in women was the only sex difference. Testosterone was decreased by 67 (12)% in the men and estradiol became undetectable in the women without any detectable increase in LH and/or FSH. In conclusion ultra endurance exercise results in similar IGF-IGFBP responses in men and women reflecting a catabolic state. IGFBP-2 was the only exception, with increased levels in women after exercise. A concomitant decrease in gonadal hormones was not related to endocrine changes in the IGF-IGFBP axis but may be related to local changes in IGF-I expression.
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| 8. |
- Berglund, B, et al.
(författare)
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The Swedish Blood Pass project.
- 2007
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Ingår i: Scandinavian Journal of Medicine and Science in Sports. - : Wiley. - 0905-7188 .- 1600-0838. ; 17:3, s. 292-7
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Tidskriftsartikel (refereegranskat)abstract
- Manipulation of the blood's oxygen carrying capacity (CaO(2)) through reinfusion of red blood cells, injections of recombinant erythropoietin or by other means results in an increased maximal oxygen uptake and concomitantly enhanced endurance performance. Therefore, there is a need to establish a system--"A Blood Pass"--through which such illegal and unethical methods can be detected. Venous blood samples were taken under standardized conditions from 47 male and female Swedish national and international elite endurance athletes four times during the athletic year of the individual sport (beginning and end of the preparation period and at the beginning and during peak performance in the competition period). In these samples, different hematological values were determined. ON(hes) and OFF(hre) values were calculated according to the formula of Gore et al. A questionnaire regarding training at altitude, alcohol use and other important factors for hematological status was answered by the athletes. There were some individual variations comparing hematological values obtained at different times of the athletic year or at the same time in the athletic year but in different years. However, the median values of all individual hematological, ON(hes) and OFF(hre), values taken at the beginning and the end of the preparation or at the beginning and the end of the competition period, respectively, as well as median values for the preparation and competition periods in the respective sport, were all within the 95% confidence limit (CI) of each comparison. It must be mentioned that there was no gender difference in this respect. This study shows that even if there are some individual variations in different hematological values between different sampling times in the athletic year, median values of important hematological factors are stable over time. It must be emphasized that for each blood sample, the 95% CI in each athlete will be increasingly narrower. The conclusion is that there is a physiological basis for establishing an individual-based "Blood Pass" system, mainly for athletes competing at the international level. On indications of manipulations of hemoglobin concentration and red cell mass by deviations from established "Blood Pass" data, more specific methods can be applied.
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| 9. |
- Bjerkefors, Anna, et al.
(författare)
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Dynamic trunk stability is improved in paraplegics following kayak ergometer training.
- 2007
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Ingår i: Scandinavian Journal of Medicine and Science in Sports. - : Wiley. - 0905-7188 .- 1600-0838. ; 17:6, s. 672-9
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of the study was to assess whether postural stability in persons with spinal cord injury (SCI) could be affected by training. Ten post-rehabilitated persons with thoracic SCI performed 30 sessions of kayak ergometer training during a 10-week period. The ergometer was modified with a balance module adjustable in the medio-lateral direction. Before and after the training period, horizontal support-surface translations were presented randomly, either in the forward or backward direction, or to the side, while subjects sat in their own wheelchairs. The platform perturbation consisted of an unpredictable initial acceleration, followed by a constant-velocity phase and a predictable deceleration. Markers were applied on the trunk and movement data were recorded in 3D. Four kinematic responses of trunk angular and linear displacement were investigated. In general, postural stability was improved after training with smaller rotational and linear displacements of the trunk observed during both predictable and unpredictable translations in all directions. Thus, the training was able to improve the ability of persons with long-standing SCI to maintain an upright sitting posture in response to externally generated balance perturbations, which should imply an increased capacity to master similar challenges to balance in everyday life.
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| 10. |
- Bjerkefors, Anna, et al.
(författare)
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Effects of kayak ergometer training on motor performance in paraplegics.
- 2006
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Ingår i: International Journal of Sports Medicine. - : Georg Thieme Verlag KG. - 0172-4622 .- 1439-3964. ; 27:10, s. 824-9
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to assess the effects of kayak ergometer training on functional tests performed in wheelchair by persons with spinal cord injury. Ten post-rehabilitated persons with thoracic spinal cord injury volunteered for the study and performed 30 sessions of kayak ergometer training during a 10-week period. The ergometer was modified with an additional balance demand in the medio-lateral direction. Before and after the training period the subjects performed functional tests in the wheelchair: Sit-and-reach tests (distance), mounting a platform, transfer to a bench (height), propelling the wheelchair: 5 m on the rear wheels; in a figure-8; 15 m on a level surface and 50 m on a 3 degrees inclined surface (time). Test-retests were performed for all tests before the training began. A written questionnaire was distributed to evaluate the subjective experiences of the training. The test-retest resulted in coefficient of variation of 1.3 - 4.6 %. There were significant improvements in sit-and-reach (14 %), mounting a platform (7 %), transfer to a bench (10 %), propelling on level (3 %), and inclined surface (6 %). Furthermore, the training, did not cause any shoulder pain or other problems. This, and the positive subjective experience expressed by the subjects after the training indicate that this type of training is a suitable activity for persons with thoracic spinal cord injury.
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