Asian Journal of Sports Medicine

Published by Tehran University of Medical Sciences
Online ISSN: 2008-7209
Print ISSN: 2008-000X
Mean (SD) differences in the anthropometric variables and TV and video playing daily time among BMI categories
Mean (SD) differences in the physical fitness parameters and physical activity scores among BMI categories 
The purpose of this study was to examine the differences in physical fitness, physical activity, and sedentary activities among 7 to 11 year old boys with varying body mass index in Ardabil, Iran. The sample consisted of 766 boys who participated in eight weight bearing (1 mile walk/run, sit ups, standing long jump, vertical jump, shuttle run 4 × 10 m, 30-meter sprint, pull ups, pushups) and four non-weight-bearing physical fitness tests (flamingo balance, handgrip; sit and reach and finger reaction time). Physical activity and sedentary activities were assessed by questionnaires. Body mass index (BMI) was computed to classify participants into normal weight, underweight, overweight and obese groups. The prevalence of underweight, overweight and obesity was 10.7%, 14.1% and 4.2% respectively. Cardiorespiratory fitness (VO(2max)) decreased progressively as the BMI increased and differences among the all body mass index categories were significant (P<0.01). Obese subjects performed worse in all weight bearing fitness tests than normal weight subjects (P<0.01). Moreover, overweight subjects performed worse in one mile, pushups and pull ups than normal weight subjects (P<0.01). Underweight subjects had significantly lower Pushups than normal weight subjects (P<0.01). Obese subjects had significantly higher sedentary activities and lower physical activity than other counterparts (P<0.01). This study showed that weight bearing physical fitness, cardiorespiratory fitness and physical activity progressively decreased as the BMI increased and conversely, sedentary activities increased as the BMI increased.
Characteristics of the subjects according to the attendance groups 
changes in 1RM bench press in relation to training attendance 
Training attendance is an important variable for attaining optimal results after a resistance training (RT) program, however, the association of attendance with the gains of muscle strength is not well defined. Therefore, the purpose of the present study is to verify if attendance would affect muscle strength gains in healthy young males. Ninety two young males with no previous RT experience volunteered to participate in the study. RT was performed 2 days a week for 11 weeks. One repetition maximum (1RM) in the bench press and knee extensors peak torque (PT) were measured before and after the training period. After the training period, a two step cluster analysis was used to classify the participants in accordance to training attendance, resulting in three groups, defined as high (92 to 100%), intermediate (80 to 91%) and low (60 to 79%) training attendance. According to the results, there were no significant correlations between strength gains and training attendance, however, when attendance groups were compared, the low training attendance group showed lower increases in 1RM bench press (8.8%) than the other two groups (17.6% and 18.0% for high and intermediate attendance, respectively). Although there is not a direct correlation between training attendance and muscle strength gains, it is suggested that a minimum attendance of 80% is necessary to ensure optimal gains in upper body strength.
Descriptive results of phosphorus, magnesium, creatinine and creatine kinase in all athletes
This study tested the clinical utility and relevance of serum phosphorus and magnesium as markers possibly useful to monitor training in athletes. Phosphorus and magnesium serum concentrations of 130 elite track and field athletes (65 males and 65 females, age range 20-30 years) from the National Athletics Sports Medicine Center database in Thessaloniki, Greece were measured. Abnormal results were found in 61 (47%) athletes (32 men and 29 women). In male athletes, serum phosphate was higher than normal in 18% and decreased in 1.5%, whereas serum magnesium concentration was higher in 26%, and lower in 3%. Regarding female athletes, higher serum phosphate and magnesium levels were detected in 26% and 17% respectively, whereas decreased serum magnesium was found in 3%. The most common alterations were higher serum phosphate (29/61, 47%) and magnesium concentrations (28/61, 46%). Abnormalities of serum phosphorus and magnesium concentrations were detected in almost half of the athletes. Hyperphosphataemia and hypermagnesaemia were the most common abnormalities. The reference intervals used for general population cannot be used for athletes. Given the lack of pathological manifestations, the physiopathological significance of these findings is uncertain. Further studies on the interpretation of reported ion concentrations in athletes should take in account the type of sport practiced and also the possible variations during the training and competition season.
Research on the effects of exercise on immune function, has a wide range of sporting activities. Study on the long-term effects of regular exercise on serum levels of cytokines such as interleukin-17 have shown that moderate and regular exercise, has an important role in the prevention and treatment of many diseases. Exhaustive exercise has a deep effect on cellular, humoral, innate immunity and the amount of cytokines of an athlete's immune system. So this study was designed to compare the effect of one course of exhaustive exercise on serum levels of interleukin (IL)-17 in different groups of athletes. Forty professional athletes with a mean age of 25.1 ± 5.0 years, divided equally in 4 groups (handball, volleyball, Sepak-takraw and climbing) were selected for this purpose. 30 second Wingate test for each athlete was used to assess anaerobic power. Blood samples before, immediately after and 2 hours after exercise was collected and the amount of serum IL-17 was measured. The results showed that the level of IL-17 in the study groups before and after the two hours exercise did not significantly change in all four groups. The results showed that short anaerobic exercise has no effect on the level of IL-17.
The Prevalence and Gender Ratio of Limb Injuries 
Overall and Subgroups' age and Sex Distribution Curves 
Basic epidemiological data can provide estimates when discussing disease burden and in the planning and provision of healthcare strategies. There is little quantitative information in the literature regarding prevalence of traumatic injuries from developing countries. The aim of the current preliminary study was to reveal the prevalence and age and gender distribution of various traumatic injuries in a tertiary referral orthopedic hospital in Iran. In a prospective descriptive study, all traumatic injured patients attending the Orthopedic Trauma Unit of our center in a five year period were included. Demographic details, the cause of injury, injury classification and treatment were recorded. For each of the five-year age groups and each gender we calculated the numbers with fractures, dislocations, soft tissue injuries, ligamentous injuries and lacerations and derived average age and gender-specific prevalence as well as seasonal variations. A total of 18890 adults were admitted, 13870 (73.4%) males and 5020 (26.6%) females. There were 8204 (43.4%) fractures. The male fracture age distribution curve was unimodal and there was a detectable bimodal pattern in females. Under 65 years males are 3 times more likely to sustain a fracture than females which decreases to equal risk over the age of 65. The most common fracture site was distal radius/ulna (13.8%), followed by tibial diaphysis (8.8%), proximal femur (7.8%), finger phalanges (6.4%), metacarpals (6%) and metatarsals (5.9%). There were seasonal variations in fracture incidence with peaks in February, March and October. The least number of fractures occurred in June. The risk of traumatic injuries is higher among specific age groups with different patterns emerging for men and women. Thus, the descriptive epidemiology will provide useful information for treatment or injury prevention strategies, resource allocation, and training priorities.
Cine cardiovascular magnetic resonance (CMR) examination with gadolinium application (Panels A-D).  
The self-administration intake of anabolic-androgenic steroids (AAS) is a widespread practice in competitive bodybuilders. Structural changes within the myocardium following AAS abuse including hypertrophy, restricted diastolic function as well as systolic dysfunction and impaired ventricular inflow have been reported. We present the case of a 39-year-old bodybuilder with a more than 20-year history of anabolic-androgenic steroids (AAS) abuse presenting with increasing exertional dyspnoea and fatigue. Diagnostic work-up of the patient's current symptoms included a cine cardiovascular magnetic resonance (CMR). Using a T1-weighted inversion-recovery sequence 10 minutes after application of 0.1 mmol/kg gadolinium with diethylenetriaminepentaacetic acid (gadolinium DTPA), patchy midwall enhancement in the septal and posterolateral region of the left ventricle was demonstrated. This enhancement pattern is different from the enhancement pattern found in patients with ischemic heart disease. The present case illustrates for the first time, by CMR, myocardial scarring with severe left ventricular hypertrophy in a patient with normal coronary arteries after long lasting abuse of AAS. With that finding we could demonstrate a link between AAS abuse and the occurrence of myocardial scarring in humans. This finding may help raise awareness of the consequences of AAS use.
Mean and Standard Deviation of Echocardiographic Findings 
Anabolic androgenic steroids (AAS) abuse for improving physical appearance and performance in body builders is common and has been considered responsible for serious cardiovascular effects. Due to disagreement about cardiovascular side effects of these drugs in published articles, this case control study was designed to evaluate the echocardiographic findings in body builder athletes who are current and chronic abusers of these drugs. Body builder athletes with continuous practice for the preceding two years and were training at least twice weekly were selected and divided into AAS abuser and non user and compared with age and BMI matched non athletic healthy volunteers (15 cases in each group). There was no significant difference in left ventricular size or function either systolic or diastolic in comparison to cases and control groups. The only difference was in diastolic size of septum and free wall but observed differences were only significant (P = 0.05) between first (athletic with AAS abuser) and third group (non athletic and nonuser). The difference between the above-mentioned indexes were not significant between two groups of athletes. Observed differences in diastolic size of septum and free wall is in favor of that long term abuse of anabolic steroid results in accentuation of physiologic hypertrophy due to long term sport most probably due to higher rate pressure product. Furthermore long term abuse and supra pharmacologic doses do not have significant effect in size and left ventricular function.
The strike acceleration of the subjects according to body weight with and without the presence of safety pads on the model
THE OBJECTIVES OF THIS STUDY INCLUDE: (1) Determination of the attenuation of strike acceleration that Tae Kwon Do sparring safety pads provide from kicks from Olympic style TKD fighters, (2) The sex and weight differentiation in acceleration achieved within the thorax model with the roundhouse kicks. This prospective, observational study utilized 15 Olympic style fighters from an "elite" team kicking a water core heavy bag thorax model with roundhouse kicks. The model was fitted with a tri-axial accelerometer (GCDC, model X250-2) to measure g acceleration from strikes to the bag. The bag was kicked in three, 10 kick phases by all subjects: kicks without padding; kicks with hogu on heavy bag, and kicks with hogu and instep guards on feet. The g acceleration readings were recorded in all phases. Kolmogorov-Smirnov failed for all variables. There were 8 female subjects: median age 14 years, median weight 53.4 kg and 7 male subjects: median age 17 years, median weight 70.45 kg. The ANOVA on ranks of the acceleration from kicks against the bag achieved significance, P=0.001. Spearman rank order correlation between the weights of players and acceleration of strike against the hogu without and with insteps pads was significant, P=0.035/r=0.54 and P=0.018/r=0.59, respectively. Heavier and male subjects tend to produce more force in strikes. Protective chest guard reduces acceleration to the thorax model, but the utility of instep guards is questionable.
Questionnaire investigation, Report of the questionnaire investigation 
Physical Activity Level expressed as daily and weekly duration time 
Echocardiographic parameters at the beginning (T0) and after 3 months of exercise (T3) 
Sedentary habits are strongly associated with increase of cardiovascular risk factors. The present study aimed to verify the role of accelerometry in identifying sedentary behavior, and the possible short term positive effect of this intervention on some anthropometric variables in a group of patients with cardiovascular risks factors. To quantify daily Spontaneous Motor Activity (SMA) levels and identify sedentary behavior, an accelerometer was employed, in addition to a simple questionnaire, in a group of overweight, hypertensive subjects. A personalized unsupervised 3 month long physical exercise program was planned. After this time, acceleroometry was again undertaken to analyze the impact of the intervention on some life style parameters, including the number of the steps taken daily, and Physical Activity Level (PAL). In addition, body water balance, weight, and Body Mass Index (BMI) were also evaluated. Assessment of physical activity by accelerometry identifies sedentary behaviors in a larger number of individuals. After three months of regular unsupervised aerobic exercise, PAL improved from 1.56 ±0.1 to 1.68±0.2 with P<0.005, weight (kg) reduced from 85.13 ± 20 to 83.10 ± 19 (P<0.05), BMI from 29.58 to 28.7 (P<0.05). Accelerometry allows to objectify PAL, and can be used to monitor improvement of variables strongly related to cardiovascular risk.
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. 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.
Anthropometric data of participants (mean values with standard deviation in brackets) 
Body composition of participants (mean values with standard deviation in brackets) 
Somatotype of participants (mean values with standard deviation in brackets) 
Although the contribution of physique and body composition in soccer performance was recognized, these parameters of physical fitness were not well-studied in adolescent players. Aim of this study was to investigate physique and body composition across adolescence. Male adolescents (N=297 aged 12.01-20.98 y), classified into nine one-year age-groups, child (control group, N=16 aged 7.34-11.97 y) and adult players (control group, N=29 aged 21.01-31.59 y), all members of competitive soccer clubs, performed a series of anthropometric measures (body mass, height, skinfolds, circumferences and girths), from which body mass index (BMI), percentage of body fat (BF%), fat mass (FM), fat free mass (FFM) and somatotype (Heath-Carter method) were calculated. Age had a positive association with FM (r=0.2, P<0.001) and FFM (r=0.68, P<0.001), and a negative association with BF (r=-0.12, P=0.047). Somatotype components changed across adolescence as well; age was linked to endomorphy (r=-0.17, P=0.005), mesomorphy (r=0.14, P=0.019) and ectomorphy (r=-0.17, P=0.004). Compared with age-matched general population, participants exhibited equal body mass, higher stature, lower body mass index and lower BF. During adolescence, soccer players presented significant differences in terms of body composition and physique. Thus, these findings could be employed by coaches and fitness trainers engaged in soccer training in the context of physical fitness assessment and talent identification.
Baseline characteristics of the participants
Ankle pain and swelling severity on the first and follow-up day
Adverse event rates between the two groups
The sampling scheme of participants
This study was conducted to compare the efficacy and safety of naproxen 500 mg twice daily (BID) versus naproxen 500 mg as needed (PRN) for treatment of ankle sprain. In this seven-day, randomized, parallel group trial, 135 patients with ankle sprain occurring less than 48 hours prior to the first dose of study medication were randomized to receive naproxen 500 mg BID (67 patients) and naproxen 500 mg as needed (PRN) (68 patients). The ankle pain was assessed at rest and on full weight bearing using Numeric Rating Scale (NRS) from 0 (no pain) to 10 (the worst imaginable pain). Ankle swelling was assessed as a 4-point scale ranging from 0 (no swelling) to 3 (severe swelling) rated by the investigator. The primary efficacy end point was the patient's assessment of ankle pain via NRS and the degree of swelling on day seven. Results showed a significant decrease in pain on weight bearing, pain at rest and the extent of swelling (P<0.001) in both groups, but there was no substantial difference between the two groups (P>0.05) after seven days. Assessing the safety profile of the two different dosing, 13.3% of the naproxen BID group and 6.7% of the as needed group had adverse events, showing that the as needed regimen was safer (P<0.001). Results showed that naproxen as needed may reduce the pain and edema of the sprained ankle with no significant difference compared to the BID regimen, while it possesses better safety profile and lower total drug use.
Max Power changes in time series and among groups. Values represent means ± SD (n = 7)
*Values indicate Max Power decline at third time compared with first and second time in P group (P<0.05). # Value indicates decline of Max Power in P group compared with GM groups (P< 0.05).
Min Power changes in time series and among groups. Values represent means ± SD (n = 7)
* Values indicate Min power decline at third time compared with first and second time in P group (P<0.05). # Value indicates decline of Min Power in P group compared with GM group (P< 0.05).
The aim of this study was to investigate whether supplementation of carbohydrate together with peptide glutamine would prevent anaerobic power decrease during repeated competitions. Twenty eight physical education male students voluntarily participated in the study. Subjects were randomly divided on a maximal power (Max power) output value basis into four groups: 1) G group (oral ingestion of glutamine at the dose of 0.25 g/kg body mass in 250 ml of water), 2) M group (a single carbohydrate at a concentration of 50g of maltodextrin in 250 ml of water), 3) GM group (carbohydrate at a concentration of 50g of maltodextrin + glutamine at the dose of 0.25 g/kg body mass in 250 ml of water) and, 4) P group (just 250 ml of water and 30 gram sweetener). Each subject performed three times Running-based Anaerobic Sprint Test (RAST) with intervals of 1 hour. Max power, Minimal power (Min power) and fatigue were calculated for each participant. There was a significant decrease in Max and Min power in P group in time series (P<0.05). Furthermore, regarding the Max and Min power, there was significant difference between P and GM group in third bout indicating stronger influence of combination of maltodextrin and glutamine in comparison with pure consumption of glutamine and maltodextrin (P< 0.05). It seems acute supplementation of glutamine and maltodextrin combination, 2 hours before exercise is more efficient in prevention of anaerobic power decrease than consumption of a pure carbohydrate or glutamine in repeated bouts of RAST protocol. Thus, supplementation with both carbohydrate and peptide glutamine improved the physical performance of athletes during repeated competitions. Obviously, it is necessary to do further studies.
Student circus artists train as both artists and athletes with their bodies holding the key to professional success. The daily training load of student circus artists is often associated with maximum physical and psychological stress with injuries posing a threat to a potential professional career. The purpose of this study is the differentiated analysis and evaluation of work accidents in order to initiate the development of injury preventive programs. The 17 years of data were obtained from standardized anonymous work accident records of the Berlin State Accident Insurance (UKB) as well as a State Artist Educational School (n = 169, Male: 70; Female: 99) from student artists. Evaluation and descriptive statistics were conducted with Excel 2007 and PASW Statistics 18. The injury risk seems to be relatively low (0.3 injuries/1000h). There are gender specific differences as to the location of injuries. Only 7% of the accidents demand a break of more than 3 days. Injury patterns vary depending on the activity and the employment of props/equipment. 75.2% of work accidents have multifactorial and 24.8% exogenous causes. Because physical fitness is all important in the circus arts there are numerous options for injury prevention programs that should be realized subject to gender-specific differences. Follow-ups on chronic complaints and a more individual approach are indispensable due to the very specific activities in the circus arts.
Effect of brief maximal exercise on plasma concentrations of IL-12. The plasma concentration of IL-12 was significantly increased immediately after a Wingate test during the period of Ramadan and after Ramadan. * Significant difference with before exercise; ¥ significant difference with after Ramadan 1WR: The first week of Ramadan / 4WR: The fourth week of Ramadan: AR: After Ramadan  
Mean (SD) Values for Daily Nutrient Consumption in the first week of Ramadan (1WR), in the fourth week of Ramadan (4WR) and after Ramadan (AR)
Mean (ES) values for P peak and Pmean (n=12) in the first week of Ramadan (1WR), in the fourth week of Ramadan (4WR) and after Ramadan (AR)
The purpose of this study was to examine the effects of Ramadan fasting on circulating levels of interleukin-12 (IL-12) after a brief maximal exercise. NINE SUBJECTS PERFORMED A WINGATE TEST ON THREE DIFFERENT OCCASIONS: (i) the first week of Ramadan (1WR), (ii) the fourth week of Ramadan (4WR), and (iii) three weeks after Ramadan (AR). Blood samples were taken before, immediately and 60 min after the exercise. Plasma concentrations of IL-12 were measured using enzyme-linked immunosorbent assay. Variance analysis revealed no significant effect of Ramadan on P(peak) and P(mean) during the three testing periods. Considering the effect of Ramadan on plasma concentrations of IL-12, analysis of the variance revealed a significant Ramadan effect (F((2,) (16))=66.27; P < 0.001) as well as a significant time effect (F((2,) (16))= 120.66; P < 0.001). However, no significant (Ramadan × time) of test interaction (F((4,) (32))=2.40; P>0.05). For all measures, IL-12 levels were lower during 1WR and 4WR in comparison with AR (P < 0.05). Considering the exercise effects, IL-12 levels measured immediately after the exercise were significantly higher than those measured before and at 60 minutes after the exercise (P < 0.001). These results suggest that an acute intense exercise-induced IL-12 response is modified by daytime fasting and modifications in sleep schedule during Ramadan.
Original BRUMS 6-factor Model Note: TEN = Tension; DEP = Depression; ANG = Anger ; VIG = Vigour; FAT = Fatigue; CONF = Confusion  
Goodness of fit indices of the tested models
7-Factor Model Note: TEN = Tension; DEP = Depression; ANG = Anger ; VIG = Vigour; FAT = Fatigue; CONF = Confusion  
Pearson r for BRUMS subscale scores
The present study investigated the psychometric properties of a Malaysian adapted Brunel Mood Scale. The questionnaire was administered to 355 young sport athletes with a mean age of 14.69+1.70 years. Confirmatory factor analysis (CFA) and Cronbach's alpha were used to determine the factorial validity and the internal consistency of the questionnaire respectively. CFA results revealed adequate model fit, best represented by a 6-factor model with one of the items removed (item 24). Internal consistency of the questionnaire was marginally supported through alpha reliability method. Alpha coefficients of 0.72, 0.64, 0.73, 0.69, 0.65, and 0.58 were obtained for tension, depression, anger, vigour, fatigue and confusion subscales respectively. Closer inspection of items for confusion revealed a 'problematic' item (item 24/uncertain). Removing this item increased the alpha coefficient to 0.67 for this subscale. It was concluded that this questionnaire may be used to measure differentiated negative and positive mood states among Malaysian adolescent athletes. However, further analyses involving independent samples are needed to confirm the present findings.
Competition injury rates per 1,000 athlete-exposures in taekwondo athletes 
The objective of this study was to compare the Iranian taekwondo-in statistically in terms of total injury rates to international counterparts as gleaned from the extant literature. The Iranian sample consisted of 204 male taekwondo-in participating in the national championship. The international sample included the participants in national and international tournaments. Validated standard questionnaires were employed at all tournaments to collect injury data that were always diagnosed by the respective tournament physicians. An injury was defined as any circumstance for which assistance was sought from the medical personnel. In addition to injury rates, 95% confidence intervals (CIs) around the rates were computed. To assess which group was at higher risk, odds ratios were calculated, including the 95%CIs. Compared to Greek counterparts, the injury rate for the Iranian taekwondo-in was statistically significantly higher. The Iranians were also at a higher risk to incur an injury: OR = 11.2 (95%CI: 6.60-18.88, P<0.001, CLR = 2.86). When comparing the Iranian taekwondo-in to their colleagues competing at the 1999 World Championships, the former recorded a statistically significantly lower injury rate but the latter were not at a higher risk (OR = 0.61, 95%CI: 0.41-0.91, P=0.014, CLR = 2.20). A statistical comparison of total injury rates in Iranian and international taekwondo-in revealed no difference between the two groups. However, what is of concern is that the total injury rate across taekwondo studies is significantly higher than those reported for American football.
Patellofemoral pain syndrome (PFPS) is a very common disorder of the knee. Due to multiple forces influencing the patellofemoral joint, clinical management of this ailment is particularly intricate. Patellofemoral pain syndrome has a multifactorial nature and multiple parameters have been proposed as potential risk factors, classified as intrinsic or extrinsic. Some of the intrinsic risk factors are modifiable and may be approached in treatment. A number of modifiable risk factors have been suggested, including quadriceps weakness, tightness of hamstring, iliopsoas and gastrosoleus muscles, hip muscles dysfunction, foot overpronation, tightness of iliotibial band, generalised joint laxity, limb length discrepancy, patellar malalignment and hypermobility. In general, the routine approach of physicians to this problem does not include assessment and modification of these risk factors and therefore, it may negatively affect the management outcomes. Changing this approach necessitates an easy and practical protocol for assessment of modifiable risk factors and effective and feasible measures to address them. In this review, we aimed to introduce assessment and intervention packages appropriate for this purpose.
Descriptive characteristics of the subjects 
Optimal training intensity and the adequate exercise level for physical fitness is one of the most important interests of coaches and sports physiologists. The aim of this study was to investigate the validity of the Narita et al target heart rate equation for the adequate exercise training level in sedentary young boys. Forty two sedentary young boys (19.07±1.16 years) undertook a blood lactate transition threshold maximal treadmill test to volitional exhaustion with continuous respiratory gas measurements according to the Craig method. The anaerobic threshold (AT) of the participants then was calculated using the Narita target heart rate equation. Hopkin's spreadsheet to obtain confidence limit and the chance of the true difference between gas measurements and Narita target heart rate equation revealed that the Narita equation most likely underestimates the measured anaerobic threshold in sedentary young boys (168.76±15 vs. 130.08±14.36) (Difference ±90% confidence limit: 38.1±18). Intraclass correlation coefficient (ICC) showed a poor agreement between the criterion method and Narita equation (ICC= 0.03). According to the results, the Narita equation underestimates the measured AT. It seems that the Narita equation is a good predictor of aerobic not AT which can be investigated in the future studies.
Demographic characteristics of the population according to BMI status 
Waist circumference and blood pressure of the population 
The relation between parents' obesity and offspring's obesity 
Multivariate logistic regression analysis on risk factors of adolescent obesity 
This study was conducted to investigate risk factors of obesity and its associated health problems in adolescence in Taiwan. We enrolled 559 adolescent volunteers with equal numbers of females and males in 2008. Participants were divided into two groups: obese (body mass index [BMI] ≧95th percentile) and normal-weight adolescents (BMI: 15th ∼ 85th percentile). Each of them completed a questionnaire about lifestyle and parents' stature. Obese mother had high likelihood of having obese girls and boys (P=0.001). Obese girls spent more time in watching TV (P=0.03) and had higher frequency of having sweetened soft drinks (P=0.016) than normal-weight group. Girls spent more time in TV watching associated higher frequency of having sweetened soft drinks (P=0.012). In boys, this associated with higher frequency of eating snick (P=0.018) and larger waist circumference (P=0.011). Boys who had more frequent effective exercise had lower frequency of eating outside (P=0.01) and more services of vegetables (P=0.002). There was no relation between hypertension and adolescent physical activity. Regardless of gender, obese group had higher waist circumference and blood pressure than normal-weight group (P<0.001). There was a strong association between obese mother and adolescent obesity. More physical activity in adolescents associated with healthier dietary behaviors. Obese adolescents have higher waist circumference and blood pressure.
Percentage of normal children and adolescents by sex and puberty stages based on the reference centiles 
Bivariate correlation of anthropometric measures by sex and pubertal stage 
Degree of agreement between four body composition indices for detecting thinness by sex and puberty stage 
This study investigated the agreement of four anthropometric-based measurements including weight-for-height (WH), body mass index-for-age (BMI), mid-upper arm circumference-for-age (MUAC) and triceps skinfold thickness-for-age (TST) to identify underweight and overweight children and adolescents. Two data sets were used in this research. The first one was a multistage random sample of 2397 healthy school children in pre-pubertal stage in Shiraz. The second data set consisted of 487 healthy students in pubertal stage and 558 students in post-pubertal stage. The parametric LMS method was used to construct reference centiles curves for each measure. The Kappa statistic was applied to examine the pairwise agreement of the four indices for detecting thinness and obesity. Generally, the pairwise agreement of adiposity measures was higher for identifying obesity than thinness. There was an excellent agreement between WH and BMI for detecting both thin and obese children in almost all subgroups (P<0.001). MUAC had an excellent agreement with BMI in pre-pubertal individuals (P<0.001). However, TST had a weak agreement with the other three indices for detecting thinness and weak to good agreement for classification of obesity. The performance of the four anthropometric-based measurements varied by sex and maturity level. MUAC as a simple and low-cost screening tool can also be used as an alternative to BMI for obesity assessment among pre-pubertal groups.
The last hormonal profile of the case
Illustration of the Tanner scale for females
Congenital Adrenal Hyperplasia (CAH) refers to a group of congenital conditions characterized by disordered cortisol synthesis. The correlation between CAH and sports performance has been less studied before and there is very limited information regarding the impacts of this congenital disease on sports performance. Probably, there are some limitations for patients who suffer from CAH in sports, but at the same time, they may enjoy some advantage due to the probable effect of endogenous hyperandrogenism on their exercise performance. The case is a 14 - year old girl with male phenotype who is a known case of congenital adrenal hyperplasia. She plays in the women's national soccer team of under 16. She has been in the first division league of indoor soccer for 4 years and was also selected in the preparation training camp of women's football team for Singapore's youth Olympic Games. Her illness and dependence on corticosteroid have caused some concerns for her participation in the international competitions of women. However, following consultations with the Therapeutic Use Exemption (TUE) Committee of games organization, she received TUE to use corticosteroid only within the games period. Despite all her problems, she is now playing in the Second Division League of indoor soccer. A female adolescent with CAH may compete at the high level of outdoor and indoor soccer. However, there are many questions regarding the advantages and disadvantages of this congenital disorder and its treatment on sports related issues.
Physiological characteristic of subjects 
Arterial stiffness increases with age and is related to an increased risk of coronary artery disease. Poor trunk flexibility has been shown to be associated with arterial stiffness in middle-aged subjects. The purpose of our research study was to measure arterial stiffness and flexibility in healthy middle-aged martial artists compared to age and gender matched healthy sedentary controls. Ten martial artists (54.0 ± 2.0 years), who practice Soo Bahk Do (SBD), a Korean martial art, and ten sedentary subjects (54.7 ± 1.8 years) for a total of twenty subjects took part in this cross-sectional study. Arterial stiffness was assessed in all subjects using pulse wave velocity (PWV), a recognized index of arterial stiffness. Flexibility of the trunk and hamstring were also measured. The independent variables were the martial artists and matched sedentary controls. The dependent variables were PWV and flexibility. There were significant differences, between the SBD practitioners and sedentary controls, in PWV (P = 0.004), in trunk flexibility (P= 0.002), and in hamstring length (P= 0.003). The middle-aged martial artists were more flexible in their trunk and hamstrings and had less arterial stiffness compared to the healthy sedentary controls. The flexibility component of martial art training or flexibility exercises in general may be considered as a possible intervention to reduce the effects of aging on arterial stiffness.
Descriptive statistics (mean and standard deviations) in the test group participants at month 1 
Changes over time in systolic BP for ASU and KI participants  
Changes over time in diastolic BP for ASU and KI participants  
The aim of this study was to assess the effects of a six-month pedometer-based workplace intervention on changes in resting blood pressure (BP) and cardiorespiratory fitness (CRF). A subsample of ASUKI Step participants (n= 355) were randomly selected to have changes in their BP and CRF monitored during the intervention. Pedometers were used to monitor steps taken with a goal of walking more than 10,000 steps/day. Systolic and diastolic BP were taken using an Omron automated BP cuff. Estimated VO2 max was obtained using the Åstrand-Rhyming cycle ergometer test. A multi-level growth modeling approach, and a mixed model ANOVA were used to predict changes in systolic and diastolic BP, and estimated VO2 max over time by steps, age, gender, and university site. Steps/day averaged 12,256 (SD = 3,180) during month 1 and steadily decreased to month 6. There were significant linear and quadratic trends in systolic and diastolic BP over time. Age was positively related to initial starting values for systolic and diastolic BP, and approached significance for systolic BP changes over time. Steps/day approached significance for linear changes in systolic BP. There was a significant difference between ASU and KI participants' estimated VO2 max. There was a significant change over time in the estimated VO2 max. The number of steps taken was significantly related to changes in estimated VO2 max over time. The results of the present study indicate that healthy individuals who took part in a pedometer intervention improved several cardiovascular disease risk factors.
Correlations between maximum oxygen consumption (VO2max), peak treadmill speed (Speak), and Yo-Yo intermittent recovery test level 1 (Yo-Yo IR1) performance
To evaluate the relationship between aerobic and intermittent capacities in a team of professional futsal players. FIFTEEN FUTSAL PLAYERS FROM BRAZILIAN FIRST DIVISION (AGE: 25.9±5.1 yrs; height: 1.77±0.04 m, body mass: 74.37±6.02 kg) performed in random order a ramp test and the Yo-Yo intermittent recovery test level 1 (Yo-Yo IR1) at the start of the season for determination of maximum oxygen consumption (VO2max), peak running speed (Speak), and intermittent running ability. Mean VO2max was of 57.25±6.35 ml·kg(-1)min(-1) with a Speak of 17.69±1.88 km·h(-1). Yo-Yo IR1 performance was of 1,226±282 m. There was no correlation between VO2max and Yo-Yo performance while Speak and Yo-Yo IR1 performance were correlated (r=0.641; P=0.007). From the current results, it may be suggested that both continuous and intermittent physical evaluations are necessary for obtaining a complete fitness profile of futsal players. The low Yo-Yo IR1 performance of Brazilian futsal players when compared to other elite team sport athletes warrants further investigation.
The soccer specific track adapted from Höff et al. (2002)  
Heart rate kinetics during the fourth sets of the two intermittent exercises, the HTE and the 15s/15s (n=7)
Total oxygen consumption in liter for the four sets of the two intermittent exercises, the HTE and the 15s/15s (n=7)
The study aimed to compare the physiological and perceptual responses of two high intensity intermittent aerobic exercises (HIIE), i.e. the 15s/15s exercise and an exercise on the Hoff track (HTE). In this within-subject repeated measures study, seven high-level soccer players (Age: 24.1± 4.5yr; Height: 175± 0.04cm; Body mass: 67.9± 9.0kg;% Body fat: 14.2± 2.4%) performed the two exercises with same total duration (25 minutes) in a randomized order: 1) a 15s/15s protocol at 120% of maximal aerobic speed (MAS), and 2) HTE. Heart rate (HR) and oxygen uptake (VO2) were measured continuously throughout both exercises. The rating of perceived exertion (RPE) was measured 15 min after the end of each exercise. Blood lactate concentration ([La]) was measured at rest before each exercise, between and at the end of each set. The mean VO2 during HTE was significantly higher than 15s/15s exercise (39.3±2.3 vs. 36.8±1.9 mL/min/kg, P<0.05. The total O2 consumed was significantly higher (P<0.05) during HTE (66.8±7.6 L) than during the 15s/15s (62.3±8.6 L). Blood lactate [La] after the first set of HTE was significantly higher than the 15s/15s (12.5±2.0 vs. 10.6±2.0 mmol/L, P<0.05). However, RPE provided by players suggested that the 15s/15s was more intense than the HTE (13±1.8 vs. 11.7±1.4, P<0.05). Our results demonstrate that VO2 and [La] were higher during HTE than during the 15s/15s when matched with duration. However, HTE was perceived less intense than 15s/15s. Thus, the use of HTE appears as an effective alternative for fitness coaches to develop aerobic endurance in soccer players.
Baseline characteristics of the patients in the intervention and control groups 
The estimates of blood pressure reduction with 95% confidence interval 
Estimates of blood pressure reduction based on age, BMI and stage of hypertension 
Bayesian interpretation of P value and its effect on the probability of null hypothesis 
To investigate the effects of a 10-week water aerobic exercise on the resting blood pressure in patients with stage 1 or 2 hypertension referring to Tehran University Clinics. Forty men with stage 1 or 2 essential hypertension were assigned to two groups of intervention [n = 12; aged 48.33±10.74 years (mean±SD)] and control [n = 28; aged 46.96±11.58 years (mean±SD)]. Subjects in the intervention group participated in a supervised 10-week water aerobic training program of 55 min sessions, 3 days per week on alternate days, while those in the control group were not involved in any regular training program during this period. Blood pressure of the participants was recorded and compared at the beginning and at the end of the study (48 hours after the last training session). Exercise lowered systolic blood pressure and mean arterial pressure by 11.71 (95% confidence interval: 5.07 to 18.35) and 5.90 (95% confidence interval: 1.17 to 10.63) mm Hg respectively. The lowering effect of exercise on diastolic blood pressure was neither statistically significant nor clinically important (0.55 mm Hg; P. value = 0.8). There was no significant effect of age, baseline body mass index and stage of hypertension on the exercise-induced changes in blood pressure. A 10-week course of water aerobic exercise markedly reduced the systolic and mean arterial blood pressure of patients with essential hypertension and is especially recommended for the obese and the elderly who have orthopedic problems or bronchospasm.
Means and standard deviations of the measured variables
An example of the slope of the linear regression line between swimming different distance (D) and its swimming time (T)
Relationship between the CV and the mean velocity of each swimming distance in females
Relationship between the CV and the mean velocity of each swimming distance in male
Finswimming is a speed competition sport practiced on the surface or underwater, by using monofins or two fins. In surface events (SF), competitors should surface within 15 m after the start and any turns. The aim of this study was to investigate the gender differences in the aerobic contribution to SF performances in finswimming, using the critical velocity (CV) concept in the analysis. The participants were sixteen monofin swimmers (eight males and eight females; 24±6 years). During a two-day period, participants performed maximal effort swimming at five test distances (100 m, 200 m, 400 m, 800 m and 1500 m), and mean swimming velocity (V) of each distance was calculated. CV was calculated as the slope of the regression line between time and distance in the 400 and 800 m SF tests. Although CV was significantly correlated with V800 m and V1500 m for males, it was significantly correlated with V200 m, V400 m, V800 m and V1500 m for females. The present results suggest that although the aerobic performance might contribute to SF performance for events from medium distance (i.e. 200m) to long distance (i.e. 1500m) in female participants, it might contribute to the long distance SF performances in male participants.
Biochemical characteristics (mean ± SD) of the subjects before and after training 
The purpose of this study was to examine the effects of 8 weeks moderate intensity aerobic exercise on serum retinol binding protein 4 (RBP4) levels in female athletes. Twenty female karate athletics were randomly assigned to one of the exercise group (n = 10) or control group (n = 10). The training group performed endurance training 3 days a week for 8 weeks at an intensity corresponding to 50-60% individual maximum oxygen consumption for 45 min. Body mass and body mass index increased (P < 0.05) after 8 weeks aerobic exercise compared to the control group. For waist to hip ratio (WHR), body fat percentage and maximal oxygen consumption there were no significant differences between the exercise group and the control group. There were virtually no changes in body fat percentage, fasting glucose, insulin, insulin resistance and RBP4 levels after 8 weeks training. Serum RBP4 level was not affected by 8-week moderate aerobic exercise in female athletes.
General characteristics of the subjects 
Changes in V O2max , BMI, and fat percentage following aerobic exercise and whole body vibration compared to the control group 
Aerobic exercise has been identified as the main treatment for type 2 diabetic patients. Such an exercise, however, is usually repined by some of patients who suffer from lack of stamina. Therefore, whole body vibration has recently been introduced as a passive intervention. The present study aimed at comparing how aerobic exercise and whole body vibration affect glycaemia control in type 2 diabetic males. Thirty diabetic males were divided into three groups, namely aerobic exercise (AE), whole body vibration (WBV), and control. Aerobic exercise schedule consisted of three walking sessions a week, each for 30-60 minutes and in 60-70% of maximum stock heartbeat. Vibration exercise was composed of 8-12-min stand-up and semi-squat positioning in frequency of 30 Hz and amplitude of 2 mm. Concentrations of fasting glycosylated hemoglobin, fasting glucose, and insulin were measured in the beginning of the trial, after the fourth week, and after the eighth week. After 8 weeks of exercise, no significant difference was detected in concentrations of fasting glycosylated hemoglobin and insulin between the groups (P=0.83, P=0.12). There were no significant differences in any of the variables between AE and WBV (P>0.05). But a more significant decrease in fasting glucose was observed in exercise groups (AE and WBV) compared with control group (P=0.02). The present study showed that AE and WBV identically stimulate metabolic system. Thus, it can be concluded that type 2 diabetic patients lacking stamina for aerobic exercise can opt for vibration exercise as an effective substitute.
Physical, anthropometric and lung functions measurements of the three groups 
Ventilatory threshold and maximal physiological responses of the three groups 
Pearson correlation values (r) between anthropometric variables and lung function parameters 
The aim of this study was to compare the impact of the practice of football and judo on lung function and aerobic performance of prepubertal boys. A total of ninety six prepubertal boys were studied. They assessed a measure of body composition using the skin folds method. They performed lung plethysmography at rest, followed by an incremental exercise test. There was no significant difference in baseline spirometry between all groups (P>0.05). The maximal oxygen uptake [VO2max] and the VO2 at the ventilatory threshold [VT] were similar between all groups (P>0.05). The maximal minute ventilation [VEmax] of judokas was significantly higher than footballers (P<0.01) and similar at the [VT]. The Heart rate [HR] at [VT] of footballers and judokas was similar and significantly higher than control group (P<0.01). VO2max was significantly related to LM and negatively associated with FM. At the [VT] there was a significant relationship between P[VT] and LM and mainly with VE to VO2 [VT], P[VT] and HR[VT] in all groups. Training in football and judo does not affect lung volumes and capacities, VO2max and VO2 at the [VT].
The t-values and 95% confidence intervals of variables in all three groups 
The mean, SD, t-value and p-value and 95% confidence interval of aerobic and resistance groups 
The mean, SD, t-value and p-value of aerobic and resistance groups 
The present study was designed to evaluate the effects of aerobic and strength training on cardiac variables such as blood pressure, heart rate (HR), and metabolic parameters like cholesterol, high density lipoprotein (HDL), triglycerides and anthropometric parameters of obese women of Punjab. This study was performed as an experimental study, in which subjects were randomly selected. There were thirty obese women, aged between 35-45yrs with body mass index (BMI) of above 30. Subjects were grouped into control (n=10), aerobic training (n=10) and resistance training (n=10). Aerobic training was given for three days a week at 60-70% of maximum HR for 6 weeks. Resistance training (Delorme and Watkins Technique) was given for alternate days for 6 weeks. HR and blood pressure were measured before and after the exercise. Recovery HR was also measured. The findings of the study indicate statistically significant differences in recovery heart rate [Pre-exercise: 97.40± 5.378 (mean±standard deviation (SD)), post-exercise: 90.70±4.599, t=8.066, P<0.001] and in post-diastolic blood pressure [Pre-exercise: 85±3.265, post-exercise: 86.20±2.820, P<0.001] in aerobic training and in systolic blood pressure [Pre- and post-exercise] in both training groups (P<0.001). Significant differences were observed in very low-density lipoprotein [pre-exercise: 28.10±1.415, post-exercise: 26.86±0.760, t=5.378] and HDL [pre-exercise: 45.40±3.533, post-exercise: 53.60±3.134, t=6.318] levels in aerobic training group with P<0.001. BMI and body fat percentage showed significant improvements in both training groups. Aerobic training is more beneficial and can be used as a preventive measure in patients who are at risk of developing cardiovascular diseases due to obesity.
A comparison of age, anthropometric characteristics and training between the three groups 
The aim of the present study was to investigate associations between skeletal muscle mass, body fat and training characteristics with running times in master athletes (age > 35 years) in half-marathon, marathon and ultra-marathon. We compared skeletal muscle mass, body fat and training characteristics in master half-marathoners (n=103), master marathoners (n=91) and master ultra-marathoners (n=155) and investigated associations between body composition and training characteristics with race times using bi- and multi-variate analyses. After multi-variate analysis, body fat was related to half-marathon (β=0.9, P=0.0003), marathon (β=2.2, P<0.0001), and ultra-marathon (β=10.5, P<0.0001) race times. In master half-marathoners (β=-4.3, P<0.0001) and master marathoners (β=-11.9, P<0.0001), speed during training was related to race times. In master ultra-marathoners, however, weekly running kilometers (β=-1.6, P<0.0001) were related to running times. To summarize, body fat and training characteristics, not skeletal muscle mass, were associated with running times in master half-marathoners, master marathoners, and master ultra-marathoners. Master half-marathoners and master marathoners rather rely on a high running speed during training whereas master ultra-marathoners rely on a high running volume during training. The common opinion that skeletal muscle mass affects running performance in master runners needs to be questioned.
Details of exercises used for I-Repetition Maximum estimation 
Characteristics of untrained type 2 diabetic patients before study
The 1-repetition maximum (1-RM) test is the gold standard test for evaluating maximal dynamic strength of groups of muscles. However, safety of actual 1-RM testing is questionable in clinical situations such as type 2 diabetes (T2D), where an estimated 1-RM test is preferred. It is unclear if acceptable test retest reliability exists for the estimated 1-RM test in middle aged T2D patients. This study examined the reliability of the estimated 1-RM strength test in untrained middle aged T2D subjects. Twenty five untrained diabetic males (n=19) and females (n=6) aged 40.7+0.4 years participated in the study. Participants undertook the first estimated 1-RM test for five exercises namely supine bench press, leg press, lateral pull, leg extension and seated biceps curls. A familiarisation session was provided three to five days before the first test. 1-RM was estimated for all participants by Brzycki 1-RM prediction equation. Another identical 1-RM estimation procedure occurred one week after first test. Intraclass correlation coefficients (ICC), paired t-test, standard error of measurement (SEM), Bland-Altman plots, and estimation of 95% CI were used to assess reliability. Test-retest reliability was excellent (ICC(2,1)=0.98-0.99) for all measurements with the highest for leg extension (ICC(2,1)=0.99). The SEM was lowest for lateral pull and leg extension exercises. Paired t-tests showed non-significant differences between the means of 2 sessions across three of five exercises. The study findings suggest that estimation of 1-RM is reliable for upper and lower body muscular strength measurement in untrained middle aged T2D patients.
Basic data in each phase 
Distance on standing five-step jump in each phase 
To investigate the possibility of a delay in the super-compensation phase due to aging in jump practice. This study evaluated records in three phases (approximately every five years) of a man who had been participating in Masters Athletics for over 20 years. After correcting for air temperature, which would influence the distance on a standing five-step jump using simple regression analysis, the performance curve of the super-compensation phase was calculated at each phase by curvilinear estimation to assess the relationship between the training interval and distance on the standing five-step jump. A peak distance on the standing five-step jump was achieved after a training interval of 60 hours in the first phase; 75 hours in the second phase; and 88 hours in the third phase. That is, the peak distance tended to delay with aging. It may be suggested that the super-compensation period would be delayed by aging in jump practice. We would like master athletes to refer this result and improve their performance.
Research setting of jump-landing directions. Subjects jumped from starting position in each direction and landed on the center of force platform
Average angular displacement of knee joint in the frontal plane. In Y-axis, positive value represents varus and negative value represents valgus. X-axis exhibits the time period from 100 ms prior to landing to 300 ms after foot contact
Comparison of peak knee valgus angle during landing between four directions. Asterisks indicate statistical significance between jump-landing directions (P<0.05)
Excessive knee valgus during landing tasks is a contributing factor to knee injuries. Most studies have examined lower extremity biomechanics during the forward direction of a jump-landing task. Athletes perform many movements in the air and land in multi-directions. Therefore, the purpose of this study was to assess the peak knee valgus angle (PKVA) during one leg jump-landing in various directions. Eighteen male basketball and volleyball athletes participated in the study. Participants performed one leg jump-landing tests from a 30 cm height platform in four directions. Knee valgus motion was measured using Vicon™ motion system. The data were analyzed with repeated measures ANOVA. Direction significantly (P<0.001) influenced the PKVA during landing. Significantly higher PKVA was observed for the lateral (8.8°±4.7°) direction as compared to forward (5.8°±4.6°) direction (P<0.05). The PKVA in 30° diagonal (7.5°±4.6°) and 60° diagonal (7.7°±5.7°) directions was higher than in the forward direction (P<0.05). One leg jump-landing in lateral and diagonal directions results in a higher PKVA compared to landing in a forward direction and could lead to a higher risk of knee injury.
Passive Straight Leg Raise Range of Motion 
Active Straight Leg Raise Test 
Leg Lowering Test 
Trendelenburg Test 
Prone Instability Test 
Low back pain (LBP) is a common cause of lost playing time and can be a challenging clinical condition in competitive athletes. LBP in athletes may be associated with joint and ligamentous hypermobility and impairments in activation and coordination of the trunk musculature, however there is limited research in this area. To determine if there is an association between altered lumbar motor control, joint mobility and low back pain (LBP) in a sample of athletes. Fifteen athletes with LBP were matched by age, gender and body mass index (BMI) with controls without LBP. Athletes completed a questionnaire with questions pertaining to demographics, activity level, medical history, need to self-manipulate their spine, pain intensity and location. Flexibility and lumbar motor control were assessed using: active and passive straight leg raise, lumbar range of motion (ROM), hip internal rotation ROM (HIR), Beighton ligamentous laxity scale, prone instability test (PIT), observation of lumbar aberrant movements, double leg lowering and Trendelenburg tests. Descriptive statistics were compiled and the chi square test was used to analyze results. Descriptive statistics showed that 40% of athletes with LBP exhibited aberrant movements (AM), compared to 6% without LBP. 66% of athletes with LBP reported frequently self-manipulating their spine compared to 40% without LBP. No significant differences in motor control tests were found between groups. Athletes with LBP tended to have less lumbar flexion (63 ± 11°) compared to those without LBP (66 ± 13°). Chi-Square tests revealed that the AM were more likely to be present in athletes with LBP than those without (X2 = 4.66, P = 0.03). The presence of aberrant movement patterns is a significant clinical finding and associated with LBP in athletes.
Description of the reported fatalities sustained during high-altitude outdoor activities in Iran from 2006 to 2010 
Possible contributing factors to fatality among Iranian high altitude outdoor enthusiasts (total of 29 cases) 
This study was performed to determine the possible causes and mechanisms of fatalities among Iranian mountaineers during climbing. By contacting several sources, deceased mountaineers were identified. Data about the causes and mechanism of death was retrospectively obtained using a standard questionnaire for each case. A total of 29 deaths were identified from March 2006 to June 2010. Deceased subjects had a mean age of 39 years (SD: 12.8, Range: 20-67). Falling was the most common accident leading to death of outdoor enthusiasts (n = 14, 48%). Asphyxia (n = 6, 24%) was the most common cause of death among the subjects, followed by heart attack, internal bleeding, cerebral hemorrhage and hypothermia (17%, 17%, 17% and 10%, respectively). Our findings suggest that education of medical service providers of the climbing groups on facing victims in high altitude areas, where they have limited resources, can be particularly helpful. In addition, a national program to educate mountaineers might help to reduce fatalities.
The aim of this study was to determine the effect of one night's sleep deprivation on anaerobic performance and Reaction time of subjects in the morning of the following day. Eighteen male college student athletes were studied twice in a balanced, randomized design. Subjects were measured for peak power, mean power and Reaction time. The performance showed no significant difference in both tests of anaerobic power (peak power, mean power) over the sleep deprivation period (P= 0.3; P= 0.4 respectively), but reaction time differed significantly from baseline (P=0.003). Results support the hypothesis that sleep serves a function of cognitive restitution, particularly in the maintenance of attentional mechanisms. In the light of the above considerations. It was concluded that short-term sleep deprivation is not effective on anaerobic performance, but adversely affects cognitive function such as Reaction Time.
Angular deformities of the lower limbs are common during childhood. In most cases this represents a variation in the normal growth pattern and is an entirely benign condition. Presence of symmetrical deformities and absence of symptoms, joint stiffness, systemic disorders or syndromes indicates a benign condition with excellent long-term outcome. In contrast, deformities which are asymmetrical and associated with pain, joint stiffness, systemic disorders or syndromes may indicate a serious underlying cause and require treatment. Little is known about the relationship between sport participation and body adaptations during growth. Intense soccer participation increases the degree of genu varum in males from the age of 16. Since, according to some investigations, genu varum predisposes individuals to more injuries, efforts to reduce the development of genu varum in soccer players are warranted. In this article major topics of angular deformities of the knees in pediatric population are practically reviewed.
Anthropometric characteristics of the participants
Mean (SD) skin temperature before, after and 15 minutes after water immersion (°C)
JPS scores of dorsiflexion and plantar flexion before and after water immersion (WI)
To determine whether a fifteen-minute water immersion treatment affects the normal ankle joint position sense (JPS) at the middle range of dorsiflexion and plantar flexion actively and passively. Thirty healthy female volunteers aged between 18 and 30 years were treated by a 15-minute cryotherapy (6 ± 1°C). The subject's skin temperature over antromedial aspect of dominant ankle was measured by the Mayomed device before, immediate and 15 minutes after water immersion. Ankle JPS was tested trough the pedal goniometer at 3 stages similar to the skin temperature. ANOVA (α = 0.05) was performed on each of variables using SPSS 19.0 software. Skin temperature was seen to decrease after water immersion but subjects did not return to pre-test skin temperature after 15 minutes (P<0.001). The research found no significant difference in JPS at middle range of dorsiflexion and plantar flexion actively and passively before and after cryotherapy. These findings suggest that 15-minute water immersion at 6°C dose not significantly alter the middle range of plantar flexion/ dorsiflexion JPS at the ankle and is not deleterious to JPS.
Ankle sprain is one of the most common injuries among athletes and instability and injury to this joint is responsible for long time loss of physical and recreational activity. Also, it can impose high costs to sport teams. Prevention of this injury is an important concern of practice and rehabilitation. One way of reducing the possibility of ankle joint injury is using an ankle orthosis. The present study aimed at inspecting the effects of two ankle orthoses on dynamic and semi-dynamic postural stability in athletes with chronic ankle instability (CAI). Twenty basketball players with CAI and fifteen non-injured athletes volunteered to participate in this study. Biodex Balance System was used to assess the participants' postural stability in bilateral position at level 8 and level 2. Repeated measures analysis of variance (ANOVA) was performed in order to examine the effects of ankle orthoses. Statistical significance level was determined at P< 0.05. Statistical analyses revealed the significant effect of ankle supports on dynamic and semi-dynamic postural stability in the two groups and results indicated there wasn't significant difference between groups. According to our results the orthoses improved both dynamic and semi-dynamic postural stability. Therefore, orthoses can prevent injury and its reoccurrence.
Isokinetic testing of ankle dorsi flexor-plantar flexor  
Demographic and functional characteristics of CAI and healthy groups
The aim of this study was to investigate eccentric torque production capacity of the ankle, knee and hip muscle groups in patients with unilateral chronic ankle instability (CAI) as compared to healthy matched controls. In this case-control study, 40 participants (20 with CAI and 20 controls) were recruited based on convenient non-probability sampling. The average peak torque to body weight (APT/BW) ratio of reciprocal eccentric contraction of ankle dorsi flexor/plantar flexor, ankle evertor/invertor, knee flexor/extensor, hip flexor/extensor and hip abductor/adductor was determined using an isokinetic dynamometer. All subjects participated in two separate sessions with a rest interval of 48 to 72 hours. In each testing session, the torque production capacity of the ankle, knee, and hip muscle groups of only one lower limb was measured. At first, 3 repetitions of maximal eccentric-eccentric contraction were performed for the reciprocal muscles of a joint in a given movement direction. Then, the same procedure of practice and testing trials was repeated for the next randomly-ordered muscle group or joint of the same limb. There was no significant interaction of group (CAI and healthy controls) by limb (injured and non-injured) for any muscle groups. Main effect of limb was not significant. Main effect of group was only significant for eccentric torque production capacity of ankle dorsi flexor and hip flexor muscle groups. The APT/BW ratio of these muscles was significantly lower in the CAI group than the healthy controls (P<0.05). CAI is associated with eccentric strength deficit of ankle dorsi flexor and hip flexor muscles as indicated by reduction in torque production capacity of these muscles compared to healthy controls. This strength deficit appeared to exist in both the injured and non-injured limbs of the patients.
Descriptive statistics of hand grip strength and some selected anthropometric characteristics in Indian inter-university female volleyball players 
Inter-correlation matrix of hand grip strength and some selected anthropometric variables among Indian inter- university female volleyball players
The purpose of this study was to estimate the dominant handgrip strength and its correlations with some hand and arm anthropometric variables in 101 randomly selected Indian inter-university female volleyball players aged 18-25 years (mean age 20.52±1.40) from six Indian universities. Three anthropometric variables, i.e. height, weight, BMI, two hand anthropometric variables, viz. right and left hand width and length, four arm anthropometric variables, i.e. upper arm length, lower arm length, upper extremity length, upper arm circumference and dominant right and non-dominant handgrip strength were measured among Indian inter-university female volleyball players by standard anthropometric techniques. The findings of the present study indicated that Indian female volleyball players had higher mean values in eleven variables and lesser mean values in two variables than their control counterparts, showing significant differences (P<0.032-0.001) in height (t=2.63), weight (t=8.66), left hand width (t=2.10), left and right hand length (t=9.99 and 10.40 respectively), right upper arm length (t=8.48), right forearm length (t=5.41), dominant (right) and non-dominant (left) handgrip strength (t=9.37 and 6.76 respectively). In female volleyball players, dominant handgrip strength had significantly positive correlations (P=0.01) with all the variables studied. It may be concluded that dominant handgrip strength had strong positive correlations with all the variables studied in Indian inter-university female volleyball players.
A variety of anthropometric and training characteristics have been identified as predictor variables for race performance in endurance and ultra-endurance athletes. Anthropometric characteristics such as skin-fold thicknesses, body fat, circumferences and length of limbs, body mass, body height, and body mass index were bi-variately related to race performance in endurance athletes such as swimmers in pools and in open water, in road and mountain bike cyclists, and in runners and triathletes over different distances. Additionally, training variables such as volume and speed were also bi-variately associated with race performance. Multi-variate regression analyses including anthropometric and training characteristics reduced the predictor variables mainly to body fat and speed during training units. Further multi-variate regression analyses including additionally the aspects of previous experience such as personal best times showed that mainly previous best time in shorter races were the most important predictors for ultra-endurance race times. Ultra-endurance athletes seemed to prepare differently for their races compared to endurance athletes where ultra-endurance athletes invested more time in training and completed more training kilometers at lower speed compared to endurance athletes. In conclusion, the most important predictor variables for ultra-endurance athletes were a fast personal best time in shorter races, a low body fat and a high speed during training units.
Many factors influence athletes' performance including anthropometric, physiological and environmental parameters. High altitude is characterized by adverse environmental conditions that are not found at sea level. We investigated the influence of some anthropometric and physiological factors on performance in the context of the Mount Cameroon Race of Hope. Age, height, weight, blood pressure, heart rate and breathing rate of 83 finisher athletes of both genders were collected during medical checkup, and race time was recorded at the arrival line. Measured and calculated data association with performance was assessed. The race time was significantly influenced by the area of training (p=0.0022), and gender (p=0.0036) of athletes; BMI showed significant association with race time in the overall athletes' population; this was confirmed in male (r=0.565; p=0.034) but not in female athletes (r=0.749; p=0.058). Weight class showed significant association to performance, the lighter athletes performing better than the heavier (p<0.00001). None of the investigated physiological parameters showed association to the race time. We hypothesized that high altitude training and body size are significantly influential on athletes' performance in the Mount Cameroon race of hope and similar mountain races.
Top-cited authors
Ramin Kordi
  • Tehran University of Medical Sciences
Karim Chamari
  • Aspetar - Qatar Orthopaedic and Sports Medicine Hospital
Hamdi Chtourou
  • Institut Supérieur du Sport et de l'Education Physique de Sfax, Université de Sfax, Tunisie
Nizar Souissi
  • Institut Supérieur du Sport et de l’Education Physique de Ksar-Said
Ali Vasheghani Farahani
  • Tehran University of Medical Sciences