Medicine and sport science最新文献

Repair of rotator cuff tears (RCT) is challenging. In RC tears, a partial (PTRCTs) or full (RCTs) discontinuation of one or more of the muscles or tendons and may occur as a result of traumatic injury or degeneration over a period of years. Many factors seem to contribute to the final outcome and a considerable number of variations during the decision-making process of patients with RCTs exist. Accurate diagnosis is fundamental to guide correct management, and the tear pattern should be carefully evaluated to plan the appropriate repair. Both non-operative and operative treatments are used to relieve pain and restore movement and function of the shoulder. Different surgical options are available. The present review describes the current evidence about diagnosis and management of partial and complete rotator tears.

The purpose of this report is to review the available literature to provide an epidemiological overview of skateboarding injuries, as well as to suggest possible areas for future research. A literature search was performed with the databases of PubMed, Sport Discus, Google and Google Scholar using the search terms 'skateboard', 'skateboarding', 'injury' and 'injuries', with all articles published in refereed journals in the English language being considered. An ancestry approach was also used. Articles from non-juried journals were also infrequently included to provide anecdotal information on the sport. Comparison of study results was compromised by the diversity of different study populations and variability of injury definitions across studies. The majority of injuries affect young males although conflicting arguments arise over the issues of age and experience in relation to injury severity. Most injuries are acutely suffered, and the most commonly affected body part was the wrist and forearm, with lower leg and ankle injuries also common. The incidence was relatively high but reports on severity differed. Clear conclusions could not be drawn on environmental location and risk factors. Most injuries tend to occur from a loss of balance leading to a fall, in more recent times due to a failed trick. Research on injury prevention is not conclusive although protective equipment and skatepark use are recommended. Further research using more rigorous study designs is required to gain a clearer picture of the incidence and determinants of injury, and to identify risk factors and viable injury countermeasures.

Para- and hang-gliding are modern air sports that developed in the 20th century. Performers should possess technical skills and manage certified equipment for successful flight. Injuries may happen during the take-off, flight and landing. PubMed was searched using the search terms 'paragliding' and/or 'hang-gliding'. The reference lists of articles identified in the search strategy were also searched for relevant articles. The most common injuries are fractures, dislocations or sprains in the extremities, followed by spinal and head traumas. Multiple injuries after accidents are common. Collision with electrical wires may cause burn injuries. Fatal outcomes are caused by brain injuries, spinal cord injuries at the cervical level or aorta rupture. Accidents happen because of risk-taking behavior, lack of education or use of self-modified equipment. Observational studies have suggested the need for protection of the head, trunk and lower extremities. The measures proposed are often based on conclusions of observational studies and not proven through randomized studies. Better education along with focusing on possible risk factors will probably diminish the risks of hang- and paragliding. Large denominator-based case series, case-control and population-based studies are needed for assessment of the risks of hang- and paragliding.

The participation of girls in elite sport has increased exponentially over the past 30 years. Despite these increases a tradition for recruiting boys for exercise studies persists and our knowledge of the physiologic response to exercise in girls remains limited. Girls' physiology varies with age and maturation and is underpinned by a divergent hormonal milieu which begins early in foetal life. Sexual dimorphism underlies much of the physiologic response to exercise, and becomes most acute during adolescence when boys become taller, heavier, less fat and are more muscular than girls. Young girl athletes are not simply smaller, less muscular boys. The widening sex disparity in responses to exercise during puberty cannot always be accounted for by size. The woeful number of studies on girls and our prior inability to non-invasively study the complexity of the cellular metabolic response to exercise means an integrative understanding of girls' physiological responses to exercise remains elusive. Success in elite sport requires intense training, which for a long time was thought to cause disruption to normal growth and maturation. It would appear that exercise training, without other predisposing factors, is unlikely to cause aberrations to either growth or maturation. Nevertheless, there is clear evidence of a boundary between healthy and unhealthy levels of exertion when coupled with caloric limitation. Sports in which intense training is combined with the need for leanness may predispose girls to increased risk of skeletal and reproductive health problems, and ensuring risk is minimised should be a priority.

Children and adolescents are becoming increasingly involved in competitive sport and, as a consequence, are engaging in specialized training with the objective of enhancing their sporting performance. An important aspect of achieving this goal is to ensure young athletes receive appropriate and on-going physiological assessment and support. Moreover, as young athletes require unique consideration (e.g. impact of biological maturity) compared to senior athletes, the challenge is for the exercise physiologist to adopt appropriate methods of assessment. This paper reviews field-and laboratory-based assessment of young athletes' aerobic fitness and performance during maximal intensity exercise. However, as studies of elite young athletes in their sporting environment are limited, the extant sport literature is complemented with data from untrained young people. The most appropriate variables to measure, which methodology and protocol to use, and how best to interpret the results of relevant tests are addressed. Key measurement issues relating to the specificity, validity and reliability of the physiological measures are examined and where possible, sport-specific measures are presented. The unique issues and considerations of providing continued physiological support to young athletes are discussed.

Nutrition can play an essential role in the health of elite young athletes as well as exercise performance. Children and adolescents need adequate energy intake to ensure proper growth, development, and maturation. In addition, the requirements may further increase with increasing exercise training. There are, however, several metabolic differences that result in slightly different advice for young versus adult athletes. For example, younger athletes generally rely more on fat as a fuel, have smaller glycogen stores and have a limited glycolytic capacity. This would imply reduced carbohydrate requirements but a greater capacity to oxidize fat. There are also differences in thermoregulation, although the exact impact on fluid requirements is not clear. The limited evidence suggests that acute energy and fluid imbalances can be detrimental to performance and there may be benefits of ingesting carbohydrate and fluid during exercise, especially during more prolonged exercise. Exogenous carbohydrate oxidation rates have been reported to contribute more to energy expenditure in children. This may, however, simply be a reflection of the fact that the oxidation of this carbohydrate is not limited by body size, but by absorption. Absorption rates are likely to be similar in children and adults and therefore exogenous carbohydrate oxidation rates should be comparable. The relative contribution will therefore be higher because of the lower absolute intensities in children. There are a large number of questions still unanswered and sports nutrition advice to the elite young athlete is largely extrapolated from the adult population. Therefore, more research is needed in the years to come to give better advice to these young athletes.

Strategies for preventing sudden cardiac death in young athletes are predicated on the assumption that: (1) these events reflect pre-existing, clinically silent heart disease, and (2) means for detecting these abnormalities on the pre-participation evaluation are both feasible and accurate. Recent controversy has surrounded both of these presumptions. Some evidence suggests that the myocardial hypertrophy accompanying sports training itself might serve as a substrate for fatal arrhythmias. As well, vigorous debate has arisen over the optimal content of the pre-participation evaluation, particularly regarding the inclusion of routine screening electrocardiograms. As the rarity of these fatal events does not lend itself to an experimental approach, such disagreements are not easily resolved. Consequently, it is expected that decisions regarding approaches to prevention of sudden death in athletes will be dictated largely by region-specific financial, political, and cultural factors. This chapter examines the aetiologies of sudden cardiac death in young athletes as well as the controversies surrounding the prevention of these tragedies.

In comparison to adults, our knowledge of the overtraining syndrome in elite young athletes is lacking. The evidence indicates an incidence rate of ∼20-30%, with a relatively higher occurrence seen in individual sport athletes, females and those competing at the highest representative levels. The most commonly reported symptoms are similar to those observed in over trained adult athletes: increased perception of effort during exercise, frequent upper respiratory tract infections, muscle soreness, sleep disturbances, loss of appetite, mood disturbances, shortness of temper, decreased interest in training and competition, decreased self-confidence, inability to concentrate. The association between training load and overtraining is unclear, and underlines the importance of taking a holistic approach when trying to treat or prevent overtraining in the young athlete so that both training and non-training stressors are considered. Of particular relevance to the issue of overtraining in the elite young athlete are the development of a unidimensional identity, the lack of autonomy, disempowerment, perfectionist traits, conditional love, and unrealistic expectations. Overtraining syndrome is a complex phenomenon with unique and multiple antecedents for each individual; therefore, an open-minded and comprehensive perspective is needed to successfully treat/prevent this in the young athlete.

Performance in sport takes place within a matrix of bio-cultural characteristics but boys' success in elite youth sport is underpinned by a range of age-and maturity-related physical and physiological variables which act in a sport-specific manner to influence performance. Stature, body mass, and muscle mass increase with growth and maturation and earlier maturing boys are generally taller, heavier, and more muscular than boys of the same chronological age who mature later. Earlier maturing boys also benefit from changes in body shape which are advantageous in many sports. Marked increases in muscle strength and muscle power are expressed during adolescence. The muscle enzyme profile needed to promote the anaerobic generation of energy is enhanced as children move through adolescence into young adulthood. Aerobic fitness benefits from age and/or maturation-related increases in stroke volume, haemoglobin concentration, and muscle mass. These individual differences are most pronounced at 12-15 years when participation in elite youth sport is at its peak. Many boys fulfil their potential, gain great pleasure from elite youth sport and become elite adult sportsmen. Other equally talented boys are denied access to elite youth sport through selection policies which are influenced by stage of maturation or age relative to the beginning of the selection year. Others drop-out prematurely through early specialisation in a sport inappropriate for their late adolescent or adult physique. Boys are not mini-men and coaches and parents should focus on providing opportunities for all boys and on nurturing talent irrespective of the ticking of individual biological clocks.