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Biomedical subjects

U M Kujala

Publications and source records attributed to U M Kujala.

At least 19 recordsLinked to original sources
PubMed2006

Adolescent flexibility, endurance strength, and physical activity as predictors of adult tension neck, low back pain, and knee injury: a 25 year follow up study.

OBJECTIVE: To examine whether adolescent flexibility, endurance strength, and physical activity can predict the later occurrence of recurrent low back pain, tension neck, or knee injury. METHODS: In 1976, 520 men and 605 women participated in a sit and reach test (flexibility) and a 30 second sit up test (endurance strength). In 1976 and 2001 (aged 37 and 42 years) they completed a questionnaire. Lifetime occurrence and risk of self reported low back pain and self reported, physician diagnosed tension neck and knee injury were calculated for subjects divided into tertiles by baseline results of strength and flexibility tests. RESULTS: Men from the highest baseline flexibility tertile were at lower risk of tension neck than those from the lowest tertile (odds ratio (OR) 0.51, 95% confidence interval (CI) 0.28 to 0.93). Women from the highest baseline endurance strength tertile were at lower risk of tension neck than those from the lowest tertile (OR 0.60, 95% CI 0.40 to 0.91). Men from the highest baseline endurance strength tertile were at higher risk of knee injury than those from the lowest tertile (OR 1.96, 95% CI 1.05 to 3.64). Men who at school age participated in physical activity were at lower risk of recurrent low back pain (OR 0.61; 95% CI 0.42 to 0.88) than those who did not. CONCLUSIONS: Overall good flexibility in boys and good endurance strength in girls may contribute to a decreased risk of tension neck. High endurance strength in boys may indicate an increased risk of knee injury.

Adolescent↗
PubMed2005

Associations between self-estimated and measured physical fitness among 40-year-old men and women.

The aim was to evaluate whether 40-year-old men and women are able to estimate their level of fitness compared with actual measured physical fitness. Twenty-nine men and 35 women first completed a questionnaire at home and then their physical fitness was measured at laboratory. The index of self-estimated physical fitness was calculated by summing up the scores of self-estimated endurance, strength, speed and flexibility. The index of self-estimated endurance was calculated by summing up the scores of self-estimated endurance and those of the self-estimated distance they could run, cycle, ski and walk. The index of measured physical fitness was calculated by summing up the z-scores of a submaximal bicycle ergometer test, ergojump tests (counter-movement jump and jumping in 15 s), a 30-s sit-up test, hand-grip tests and a sit-and-reach test. The correlation (Spearman) between the indices of self-estimated and measured physical fitness was 0.54 for both sexes, and that between self-estimated endurance and measured endurance was 0.53 for both sexes. Maximal oxygen uptake estimated based on submaximal ergometer test was higher among those with longer self-estimated distance of running, cycling, skiing and walking (P for linear trend <0.001). Our study shows that 40-year-old adults can estimate at group level their fitness according to different categories moderately well. They can also estimate at group level their endurance moderately well by estimating the distance they can run, cycle, ski or walk. However, in some individuals self-estimation of fitness is not in agreement with the results of fitness tests.

Adult↗
PubMed2004

Patellofemoral relationships and cartilage breakdown.

We evaluated the association between patellofemoral relationships and cartilage lesions in patients (age range 15-49) with anterior knee pain without patellar dislocation (n = 24) and in patients with isolated meniscal rupture without a high energy trauma (n = 21). The position of the patella was assessed from knee radiographs, and cartilage lesion was graded and mapped at arthroscopy. In subjects with lateral patellar cartilage lesion the patella tilted laterally (p < 0.01) and was clearly laterally displaced (p < 0.001), compared to those without patellar cartilage lesion. In subjects with central patellar cartilage lesion the patella located high according to the Insall-Salvati index (p < 0.01) and was somewhat laterally displaced (p < 0.05). Compared to subjects without cartilage lesion in the femoral trochlea, the patella was laterally displaced in subjects with lesion in the lateral trochlea (p < 0.001). In conclusion, our results suggest that specific malalignments predispose to patellofemoral cartilage lesion, but prospective studies are needed to confirm the finding.

Adolescent↗
PubMed2002

Stability of leisure-time physical activity during adolescence--a longitudinal study among 16-, 17- and 18-year-old Finnish youth.

Participation in physical activity during childhood and adolescence is frequently mentioned as one factor likely to promote a more active lifestyle in adulthood with its health benefits. We studied the changes in leisure-time physical activity pattern and self-reported fitness during a three-year period in adolescence and investigated whether the type of sports has an effect on stability of physical activity at leisure. A questionnaire with identical physical activity items was sent to Finnish twins on their 16th and 17th birthdays and 6 months after the 18th birthday. A total of 1338 boys and 1596 girls responded to all three questionnaires, with response rates of 73.6% and 86.5%. The proportions of very active adolescents and adolescents with very good self-reported fitness seem to be alike at each age. Among girls, 23.7% to 27.7% reported being very active (4-5 times a week) and 13.7% to 15.1% considered their physical fitness to be very good at the ages of 16, 17 and 18. Among boys, the comparable percentages were 31.5% to 35.5% and 30.6% to 34.4%. However, the longitudinal three-year follow up showed substantial changes over time among individuals from one physical activity group to another. Only 19.1% of boys and 11.2% of girls were persistent exercisers (i.e., very active on all three years) and 15.6% of boys and 5.1% of girls were persistently fit (i.e., very good self-reported fitness on all three years). Stability of leisure-time physical activity was highest among those who participated in several different types of sports. Among boys the proportion of persistent exercisers was highest for those who participated in cross-country skiing, jogging and body-building (22.0-41.5%) and among girls for those who participated in ball games (11.9-28.6%). Those who participated in organised sports were more often persistent exercisers than those who did not (odds ratio = 13.2 for boys (CI 9.4-18.7) and 8.9 for girls (CI 6.4-12.5)). Also, those who participated in organised sports were more often persistently fit (odds ratio = 7.3 for boys (CI 5.2-10.2) and 10.4 for girls (CI 6.4-16.9). Adolescents are recommended to participate in and try different types of sports, and especially for girls ball games would appear to favour long-term maintenance of leisure-time physical activity.

Adolescent↗
PubMed2002

Long-term vigorous training in young adulthood and later physical activity as predictors of hypertension in middle-aged and older men.

500 and 69 male former elite athletes and 319 male controls completed a health questionnaire in 1985 and in 1995. Register data on the subjects were also collected. Subjects were aged 65 years or less and had no history of hypertension in 1985, and they had been healthy at the age of 20 years. The athletes were grouped into endurance and mixed sports (n = 386), and power sports (n = 183). The cumulative 10-year incidence of hypertension up to 1995 was significantly lower in the endurance and mixed sports group (23.6 %) compared to the power sports group (33.3 %) or the control group (32.0 %). The difference between the endurance and mixed sports group and the two other groups was still significant after adjustment for age, but not after further adjustment for body mass index, alcohol consumption, and later physical activity. However, the trend of reduced risk remained. In conclusion, a history of being an elite athlete in endurance or mixed sports predicts a lower risk of hypertension in working age men, while a history of being an elite athlete in power sports appears to confer no benefit. Later physical activity was also associated with lower risk.

Adult↗
PubMed2001

Is it possible to prevent sports injuries? Review of controlled clinical trials and recommendations for future work.

Sports injuries are one of the most common injuries in modern western societies. Treating sports injuries is often difficult, expensive and time consuming, and thus, preventive strategies and activities are justified on medical as well as economic grounds. A successful injury surveillance and prevention requires valid pre- and post-intervention data on the extent of the problem. The aetiology, risk factors and exact mechanisms of injuries need to be identified before initiating a measure or programme for preventing sports injuries, and measurement of the outcome (injury) must include a standardised definition of the injury and its severity, as well as a systematic method of collecting the information. Valid and reliable measurement of the exposure includes exact information about the population at risk and exposure time. The true efficacy of a preventive measure or programme can be best evaluated through a well-planned randomised trial. Until now, 16 randomised, controlled trials (RCT) have been published on prevention of sports injuries. According to these RCT, the general injury rate can be reduced by a multifactorial injury prevention programme in soccer (relative risk 0.25, p < 0.001, in the intervention group), or by ankle disk training, combined with a thorough warm-up, in European team handball [odds ratio 0.17; 95% confidence interval (CI) 0.09 to 0.32, p < 0.01]. Ankle sprains can be prevented by ankle supports (i.e. semirigid orthoses or air-cast braces) in high-risk sporting activities, such as soccer and basketball (Peto odds ratio 0.49; 95% CI 0.37 to 0.66), and stress fractures of the lower limb by the use of shock-absorbing insoles in footwear (Peto odds ratio 0.47; 95% CI 0.30 to 0.76). In future studies, it is extremely important for researches to seek consultation with epidemiologists and statisticians to be certain that the study hypothesis is appropriate and that the methodology can lead to reliable and valid information. Further well-designed randomised studies are needed on preventive actions and devices that are in common use, such as preseason medical screenings, warming up, proprioceptive training, stretching, muscle strengthening, taping, protective equipment, rehabilitation programmes and education interventions (such as increasing general injury awareness among a team). The effect of a planned rule change on the injury risk in a particular sport could be tested via a RCT before execution of the change. The most urgent needs are in commonly practised or high-risk sports, such as soccer, American football, rugby, ice hockey, European team handball, karate, floorball, basketball, downhill skiing and motor sports.

Athletic Injuries↗
PubMed2000

Physical activity and osteoporotic hip fracture risk in men.

BACKGROUND: Physical activity has been related to reduced risk of osteoporotic hip fractures, but the evidence among men is weak. OBJECTIVE: To determine the association between baseline leisure physical activity and future risk of osteoporotic hip fracture in men. METHODS: At baseline in 1975 our prospective study cohort included 3,262 men who were 44 years or older and did not have chronic disease restricting their ability to exercise. At baseline, physical activity was assessed by a questionnaire. Hip fractures were followed for 21 years, or from the age of 50 years for subjects who were initially younger than 50 years. RESULTS: The hazard ratio of osteoporotic hip fracture, adjusted for other possible predictors (height, body mass index, baseline diseases, smoking, use of alcohol, work-related physical activity, and occupational group), in men participating in vigorous physical activity compared with men not participating was 0.38 (95% confidence interval, 0.16-0.91) (P = .03). CONCLUSION: These results provide further evidence that there is an inverse association between baseline physical activity and future hip fracture risk among men.

Accidental Falls↗
PubMed2000

Physical activity and other risk factors in male twin-pairs discordant for coronary heart disease.

BACKGROUND: Twin-pairs discordant for coronary heart disease (CHD) can be used to examine the possible contribution of genetic and other familial factors to the relationship between CHD risk factors, in particular physical inactivity at leisure, and CHD. METHODS AND RESULTS: In 1975 at baseline, 8205 men aged 25-69 years of the Finnish Twin Cohort without overt CHD responded to a questionnaire. The outcome measures were hospitalization for CHD or death from CHD before age 70 between 1977 to 1995 based on reliable nationwide registries. Among all men, the age-adjusted relative risk of CHD was 0.52 (95% confidence interval (CI) 0.39, 0.71) in men participating in conditioning exercise compared to sedentary men, based on their questionnaire responses. The age, and covariate (body-mass index, smoking, hypertension, diabetes) adjusted-relative risk was 0.68 (CI 0.50, 0.92). Among the twin-pairs discordant for CHD during follow-up (N=311), the odds ratio (OR) of having CHD was 0.54 (CI 0. 27, 1.09) for conditioning exercisers compared to sedentary men. The point estimates from discordant pairs analyses were of the same magnitude as obtained from the analyses of individuals, though statistically not significant due to smaller samples. In contrast, smoking (OR 3.21) and diabetes (OR 10.0) at baseline were also significant predictors of CHD. CONCLUSIONS: By studying twins we were able to examine genetic and other familial selection bias and found further supporting evidence that leisure conditioning physical exercise compared to sedentariness helps prevent CHD in men, but smoking was a stronger risk factor.

Adult↗
PubMed2000

Left ventricular mass, geometry and filling in elite female and male endurance athletes.

We compared echocardiographic findings in female (n=30) and male (n=30) endurance athletes to age-matched female (n=15) and male (n=15) sedentary controls. The differences between athletes and controls were similar in both sexes; only left ventricular (LV) mass and septum thickness differed slightly more in men than in women (67% vs 55%, P=0.004, and 36% vs 30%, P=0.03, respectively). LV wall thicknesses were in the normal range in all women, while four (13%) male athletes exceeded 13 mm. In conclusion, the effects of endurance training on echocardiographic findings appear to be quite similar in women and men. However, in female athletes with an abnormally thick left ventricular wall a thorough cardiac evaluation is indicated. This contrasts with male athletes, in whom LV wall thicknesses of over 13 mm are a not uncommon finding.

Adult↗
PubMed2000

Factors associated with hip joint rotation in former elite athletes.

OBJECTIVES: To study factors associated with passive hip rotation range of motion (ROM) in former elite male athletes. METHODS: Athletes were interviewed about hip pain, disability, lifetime occupational loading, and athletic training. The passive hip rotation was measured with a Myrin inclinometer in 117 former elite male long distance runners, soccer players, weight lifters, and shooters aged 45-68 years. Magnetic resonance imaging was used to detect hip osteoarthritis. RESULTS: There were no differences in passive hip rotation ROM between the four athlete groups nor between diverging lifetime loading patterns associated with occupational or athletic activities. Among the subjects without hip osteoarthritis, hip pain, and hip disability according to a stepwise linear regression analysis, the only factor that was associated with the passive hip rotation ROM was body mass index (BMI), explaining about 21% of its variation. Subjects with high BMI had lower passive hip rotation ROM than those with low BMI. There was no right-left difference in the mean passive hip rotation ROM in subjects either with or without hip osteoarthritis as determined by magnetic resonance imaging. Nevertheless, hip rotation ROM was clearly reduced in a few hips with severe caput deformity. CONCLUSIONS: Long term loading appears to have no association with passive hip rotation ROM. On the other hand, the hip rotation value was lower in subjects with high BMI than in those with low BMI. A clear right-left difference in hip rotation was found only in those subjects who, according to our magnetic resonance imaging criteria, had severe hip osteoarthritis. These findings should be taken into account when hip rotation ROM is used in the clinical assessment of hip joints.

Aged↗
PubMed2000

Natural selection to sports, later physical activity habits, and coronary heart disease.

OBJECTIVES: To investigate the associations between natural selection to sports at a young age, continuity of physical activity, and occurrence of coronary heart disease. DESIGN: Prospective cohort study. SETTING: Finland. PARTICIPANTS: Former top level male athletes participating at a young age (1920-1965) in different types of sport (endurance (n = 166), power speed (n = 235), "other" (n = 834)) and controls healthy at the age of 20 years (n = 743). MAIN OUTCOME MEASURES: Data on the occurrence of coronary heart disease were obtained from death certificates, three nationwide registers, and questionnaire studies in 1985 and 1995, and data on later physical activity were obtained from the questionnaires. RESULTS: In 1985 all groups of former athletes were more physically active than controls (p<0.001). Despite similar total volumes of physical activity, compared with power speed athletes, former endurance athletes participated more often in vigorous activity (p = 0.006) and had less coronary heart disease (adjusted odds ratio 0.34, 95% confidence interval 0.17 to 0.73; p = 0.004). In 1985 and 1995, both endurance and other athletes had less coronary heart disease than controls. From 1986 to 1995, the incidence of new coronary heart disease was lower among those who participated in vigorous physical activity in 1985. CONCLUSIONS: Both a previous aptitude for endurance athletic events and continuity of vigorous physical activity seem to be associated with protection against coronary heart disease, but an aptitude for power speed events does not give protection against coronary heart disease.

Adult↗
PubMed2000

Results of surgical treatment of unresolved Osgood-Schlatter lesion.

BACKGROUND AND AIMS: We present our experience with surgical treatment of unresolved, painful, late Osgood-Schlatter disease. MATERIAL AND METHODS: In 70 operations performed in 67 patients (in three bilaterally) an ossicle under the distal patellar tendon was removed in 62 cases. In eight cases, excision of the prominent tibial tubercle and/or drilling of the epiphysis was performed. Additional procedures, such as rasping of the uneven anterior tibial surface, excision of inflammed bursa or the devitalized portion of the tendon, were done 21 times. Most patients were athletes or physically active young people. The mean age was 19.6 years. 54 operations were done on males and 16 on females. They had been followed preoperatively for 18 months and after surgery 2.2 years. RESULTS: The final results were excellent or good in 56, moderate in 9, poor in 3 and unknown in 2 cases. CONCLUSIONS: Osgood-Schlatter's disease may leave an ossicle under the distal patellar tendon, a prominent tibial tubercle or an uneven surface of anterior superior tibia. These may lead to pain and disability due to recurrent injuries or athletic exercises. Surgical treatment gives good results in chronic unresolved cases.

Adolescent↗