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Biomedical subjects

W van Mechelen

Publications and source records attributed to W van Mechelen.

At least 55 records · Page 3Linked to original sources

The effect of tape, braces and shoes on ankle range of motion.

Sport injuries are unwanted adverse effects accompanying participation in sports. In a wide variety of sports the most common location of injury is the ankle, frequently resulting from a forced plantar flexed inversion of the foot exceeding the physiological range of motion (ROM). Historically the purpose of external support systems is to prevent acute ankle injuries by restricting abnormal ankle ROM. It is believed that a superior restrictive effect also implies a superior preventive effect. The purpose of this review was to examine the literature regarding the restricting effect of adhesive taping, prophylactic ankle stabilisers (PAS) and high-top shoes on ankle ROM. It has been found that tape restricts ankle eversion and inversion ROM significantly following application. However, tape loosens significantly following standardised exercise and sports activities. Studies regarding PAS reported that both semi-rigid and nonrigid stabilisers give a significant post-application restriction of ankle inversion motion. The nonrigid stabilisers show loosening over time during exercise, while the semi-rigid stabilisers maintain their restrictive effect over the same time span. High-top shoes in comparison to low-top shoes are more effective in restricting mechanically imposed ankle inversion ROM. Low-top shoes, however, also limit mechanically imposed ankle inversion stress with the ankle in the position in which ankle injury occurs most frequently. One must keep in mind, however, that a superior mechanical restriction of ankle ROM does not necessarily imply a superior preventive effect. Only well-controlled randomised studies can show such an effect, and these studies have shown a reduction of ankle injury incidence for all 3 prophylactic measures reviewed.

Ankle Injuries↗

Psychosocial work characteristics and psychological strain in relation to low-back pain.

OBJECTIVES: This study investigated the relationship between psychosocial work characteristics and low-back pain and the potential intermediate role of psychological strain variables in this relationship. METHODS: The research was part of a prospective cohort study of risk factors for musculoskeletal symptoms. The study population consisted of 861 workers from 34 companies in The Netherlands who had no low-back pain at baseline and for whom data on the occurrence of low-back pain were obtained with annual questionnaires during a 3-year follow-up period. Information on psychosocial work characteristics and psychological strain variables was collected using a questionnaire at baseline. Cases of low-back pain were defined as workers who reported, in at least one of the annual follow-up questionnaires, that they had had regular or prolonged low-back pain in the previous 12 months. RESULTS: After adjustment for individual factors and quantified physical load at work, nonsignificant relative risks ranging from 1.3 to 1.6 were observed for high quantitative job demands, high conflicting demands, low supervisory support, and low co-worker support. Decision authority and skill discretion showed no relationship with low-back pain. In general, the estimated relative risks for the psychosocial work characteristics were scarcely influenced by additional adjustment for job satisfaction, emotional exhaustion, and sleeping difficulties. CONCLUSIONS: It can be concluded that low social support, from either supervisors or co-workers, appears to be a risk factor for low-back pain. Some indications of a relationship between high quantitative job demands and high conflicting demands and low-back pain were also found. Little evidence was found for an intermediate role for the psychological strain variables under study.

Cohort Studies↗

A fifteen-year longitudinal study in young adults on the relation of physical activity and fitness with the development of the bone mass: The Amsterdam Growth And Health Longitudinal Study.

Although positive effects of physical activity are often reported, there are still uncertainties about the type, intensity, duration, and frequency of these activities that are most effective for (re)modeling bone mass during youth. In the Amsterdam Growth and Health Longitudinal Study, daily physical activity and fitness were monitored from age 13 to 29 years in a group of 182 males and females. At a mean age of 28 years, bone mineral density (BMD) was measured at three sites with dual X-ray absorptiometry (DXA): in the lumbar region (lumbar BMD), the femoral neck (hip BMD), and the distal radius (wrist BMD). Physical activity (PA) was estimated from a cross-check activity interview taking in consideration all daily physical activities during the last 3 months; PA was scored in two different ways: (1) metabolic physical activity score (METPA) by weighting the intensity (multiples of basic metabolic rate [METs]) and duration (minutes per week); and (2) mechanic physical activity score (MECHPA) by weighting the peak strain (ground reaction forces as multiples of body mass) irrespective of frequency and duration of the physical activities. Physical fitness was measured with a neuromotor fitness test (composite of six strength, flexibility, and speed tests) and as cardiopulmonary fitness (maximal oxygen uptake). The physical activity and fitness scores were calculated over two age periods: during adolescence (13-16 years) and during adulthood (21-27 years). The standardized regression coefficients (corrected for gender, biological age, body composition, and calcium intake) show that weight, physical activity (both METPA and MECHPA), and neuromotor fitness during adolescence and in young adulthood are significantly and positively related with the lumbar BMD (beta = 0. 11-0.40) and hip BMD (beta = 0.18-0.26), measured at the mean age of 28 years. This was not the case for cardiorespiratory fitness. No significant correlations at all are found with wrist BMD, a bone site that is less involved in physical activity and fitness. It can be concluded that daily physical activity during adolescence and in the young adult period is significantly related to the BMD at the lumbar spine and femoral neck at age 28 of males and females. Only neuromotor fitness and not cardiopulmonary fitness during adolescence and young adulthood is related to the BMD of males and females at age 28 years.

Adolescent↗

Tracking of activity and fitness and the relationship with cardiovascular disease risk factors.

PURPOSE: To analyze tracking of daily physical activity and physical fitness (both cardiopulmonary [VO2max] and neuromotor fitness) and the longitudinal relationship with biological risk factors for cardiovascular disease (CVD), i.e., total serum cholesterol (TC), high-density lipoprotein (HDL), the TC:HDL ratio, systolic and diastolic blood pressure, and the sum of four skinfolds. METHODS: Data were obtained from the Amsterdam Growth and Health Study; an observational longitudinal study with six repeated measurements over a period from 13 to 27 yr of age (N = 181). The statistical analyses were carried out with generalized estimating equations. RESULTS: Low to moderate tracking (both stability and predictability of early measurements) was observed for daily physical activity and VO2max, whereas good tracking was observed for neuromotor fitness. Daily physical activity was positively related to HDL (P < 0.01), and inversely to the TC:HDL ratio (P < 0.05) and to the sum of four skinfolds (P < 0.01). VO2max was also inversely related to the TC:HDL ratio (P < 0.01) and to the sum of four skinfolds (P < 0.01). In addition, VOmax was also inversely related to TC (P < 0.01). Neuromotor fitness was inversely related to the sum of four skinfolds (P < 0.01), and positively to systolic blood pressure (P < 0.01). CONCLUSIONS: The longitudinal development of physical activity and VO2max were related to a healthy CVD risk profile. For the development of neuromotor fitness, the picture was less clear. The relationships among physical activity, physical fitness, and lipoproteins and blood pressure were highly influenced by body fatness.

Adolescent↗

Physical activity of young people: the Amsterdam Longitudinal Growth and Health Study.

PURPOSE: To describe the natural development of habitual physical activity behavior (HPA) of young Dutch male and female subjects between the ages of 13 and 27, using data from the Amsterdam Longitudinal Growth and Health Study. METHODS: HPA was measured by means of a structured interview at ages 13, 14, 15, 16, 21, and 27 and concerned all activities (at work, school, during leisure, organized and nonorganized sports, and active transportation) exceeding a level of intensity of 4 METs. Complete longitudinal data concern 98 female and 83 male subjects. MANOVA for repeated measurements were done for total HPA (expressed in min x wk(-1) and in METs x wk(-1)). Similar analyses were done for organized sports activities, leisure time activities, and all "other" activities separately (also min x wk(-1) and METs x wk(-1)), as well as for weekly time at three different levels of intensity of HPA, i.e. 4-7 MET (moderate), 7-10 MET (vigorous), and >10 MET (very vigorous). RESULTS: Our data showed regarding total HPA (min x wk(-1)) in male, but not in female, subjects a significant decrease in weekly time spent on HPA between the ages of 13 and 27. Regarding the three different levels of intensity in male and female subjects, a significant increase was found in time spent on moderate activities, where female subjects were spending significantly more time on moderate activities than male subjects; both in male and female subjects, a significant decrease was found in time spent on vigorous activities: in male subjects a significant decrease was found in time spent on very vigorous activities, whereas in female subjects time spent at this level of activity remained more or less stable. For the total weighted activity score (METs x wk(-1)), a significant decrease was found for both male (42%) and female subjects (17%). This decrease was significantly greater for male than for female subjects. Regarding more specific activities, it was found that in the course of time organized sports activities became relatively more important contributors to both weekly HPA time and energy expenditure, both in male and female subjects. CONCLUSIONS: Our data show a considerable decrease in HPA over a 15-yr period of time, both in male and female subjects. Differences between male and female subjects are predominantly caused by differences in time spent in moderate and very vigorous activities. In the course of time, organized sports activities became a relatively more important contributor of weekly HPA.

Adolescent↗

The effect of preventive measures on the incidence of ankle sprains.

OBJECTIVE: To critically review the current data concerning the efficacy of preventive measures described in the literature, on the incidence of lateral ankle ligament injuries. DATA SOURCES: MEDLINE, Sportdiscus, and EMBASE were searched for papers published between 1980 and December 1998. Keywords used in the search were "prevention" in combination with "ankle," "ankle taping," "ankle bracing," "orthosis," "shoes," and "proprioception." Additional references were reviewed from the bibliographies of the retrieved articles. STUDY SELECTION: A study was included if: 1) the study contained research questions regarding the prevention of lateral ankle ligament injuries; 2) the study was a randomized controlled trial, a controlled trail, or a time intervention; 3) the results of the study contained incidence rates of lateral ankle ligament injuries as study outcome; and 4) the study met the cut-off score set for quality. DATA EXTRACTION AND SYNTHESIS: Two reviewers reviewed relevant studies for strengths and weaknesses in design and methodology, according to a standardized set of predefined criteria. Eight relevant studies met the criteria for inclusion and were analyzed. MAIN RESULTS: Overall, all studies reported a significant decrease in incidence of ankle sprains using the studied preventive measure. There was a great variety in methodology and study design between the eight analyzed studies, and every study had one or more drawbacks. Therefore, between studies only general results could be compared. CONCLUSIONS: The use of either tape or braces reduces the incidence of ankle sprains. Next to this preventive effect, the use of tape or braces results in less severe ankle sprains. However, braces seem to be more effective in preventing ankle sprains than tape. It is not clear which athletes are to benefit more from the use of preventive measures: those with or those without previous ankle sprains. The efficacy of shoes in preventing ankle sprains is unclear. It is likely the newness of the footwear plays a more important role than shoe height in preventing ankle sprains. Proprioceptive training reduces the incidence of ankle sprains in athletes with recurrent ankle sprains to the same level as subjects without any history of ankle sprains.

Ankle Injuries↗

Physical risk factors for neck pain.

To identify physical risk factors for neck pain, a systematic review of the literature was carried out. Based on methodological quality and study design, 4 levels of evidence were defined to establish the strength of evidence for the relationship between risk factors and neck pain. Altogether, 22 cross-sectional studies, 2 prospective cohort studies, and 1 case-referent study were eligible for determining the level of evidence. The results showed some evidence for a positive relationship between neck pain and the duration of sitting and twisting or bending of the trunk. A sensitivity analysis was carried out excluding 3 items of the quality list, the importance of which seemed doubtful. On the basis of this sensitivity analysis, it was concluded that there is some evidence for a positive relationship between neck pain and the following work-related risk factors: neck flexion, arm force, arm posture, duration of sitting, twisting or bending of the trunk, hand-arm vibration, and workplace design.

Evidence-Based Medicine↗

Changes in daily hassles and life events and the relationship with coronary heart disease risk factors: a 2-year longitudinal study in 27-29-year-old males and females.

To investigate the relationship between changes in daily hassles and life events and biological (lipoproteins, blood pressure, body fat, and body fat distribution) and lifestyle (physical activity, smoking and alcohol consumption) risk factors for coronary heart disease (CHD) 166 subjects were measured twice, at 27 and 29 years of age. The results showed that changes in daily hassles were positively related to changes in lipoprotein levels, daily physical activity, and to smoking behavior. These relationships were more pronounced for subjects with a "rigid" coping style and subjects with type A behavior. Changes in life events were also positively related to lipoprotein levels, but only for subjects with a "rigid" coping style and only when the subjective appraisal of life events was taken into account. It was concluded that the relationships seemed to be mediated by different coping styles and type A behavior, that daily hassles were more important in these relationships than life events, and that the relationships with biological CHD risk factors were not influenced by lifestyle.

Adaptation, Psychological↗

Longitudinal relationships between lifestyle and cardiovascular and bone health status indicators in males and females between 13 and 27 years of age; a review of findings from the Amsterdam Growth and Health Longitudinal Study.

UNLABELLED: The Amsterdam Growth and Health Longitudinal Study is longitudinal co-hort study on 181 males and females initially aged 13 years, with follow-up measurements at ages 14, 15, 16, 21 and 27 years. METHODS: Anthropometrical, biological and lifestyle parameters, and age 27 also bone mineral density (BMD) of the lumbar spine (L2-L4), were measured repeatedly. Adolescent dietary intake and physical activity was related to adult cardiovascular and bone health status indicators by MLR; longitudinal relationships between physical activity and dietary intake, and cardiovascular health status indicators were assessed hy GEE-analysis. RESULTS: Adolescent physical activity was not related to most of the indicators of adult cardiovascular health status, with the exception of a positive relationship with the waist-to-hip in females; in males 'energetic' adolescent physical activity contributed significantly to adult BMD; both in males and females, when taking the entire longitudinal period into account, peak strain physical activity was a relatively more important predictor of adult BMD than 'energetic' physical activity; calcium intake during adolescence was not a significant predictor of bone health status measured at age 27, both in males and females; a consistent significant positive longitudinal relationship was found between physical activity and serum HDL-cholesterol and significant negative longitudinal relationships were found with the subscapular skinfold and with body fat mass; a positive longitudinal relationship was found between serum total cholesterol (TC) and cholesterol intake, saturated fat (SFA) intake and the Keys-score; a negative longitudinal relationship was found between TC and polyunsaturated fit and total energy intake; for HDL a positive longitudinal relationship was found with SFA intake; low tracking was found for physical (in-) activity and dietary intake variables.

Adolescent↗

Lifestyle and obesity in adolescence and young adulthood: results from the Amsterdam Growth And Health Longitudinal Study (AGAHLS).

OBJECTIVE: To investigate if there is a longitudinal relationship between the development of fat mass in males and females (aged between 12-28 y) and their lifestyle, with respect to diet and physical activity. DESIGN: In the Amsterdam Growth And Health Longitudinal Study (AGAHLS), a group of 500 boys and girls are being followed from the age of 13 y (mean age 13.5 y), over a period of 20 y until the age of 32 y (mean age 32.5 y). SUBJECTS AND MEASUREMENTS: Data from AGAHLS are analysed of six repeated measurements of growth (body height, body mass, four skinfolds), health parameters with respect to cardiovascular disease (CVD) (obesity, hypertension, hypercholesterolaemia) and two important lifestyle tractors: physical activity (PA) (weighted energy output) and dietary intake (DI) (total energy intake, contribution of fat, carbohydrate and protein) of about 200 males and females between the ages of 13-27 y. RESULTS: The longitudinal results of PA show a steep decrease in the energy expenditure from the age of 13 y from about 4500 Mets per week to 3000 Mets per week at the age of 27 y in both sexes. The longitudinal results of DI also show a decrease in energy intake per kilogram body mass from about 225 kJ per day at the age of 13 y to about 155 kJ at the age of 27 y. During adolescence, boys show a 15% higher energy intake and a 20% higher energy expenditure than girls. At the age of 27 y, the difference between the sexes in energy intake is reduced to 10% and the difference in energy expenditure disappears. Results of tracking analyses over the period of 15y indicate a low stability coefficient of PA (0.34; 0.19-0.49), but higher coefficients of DI (0.55; 0.45-0.64) and fat mass (0.63; 0.56-0.71). The search for important lifestyle factors that can discriminate high- from low-risk participants for a high fat mass, estimated from the sum of four skinfolds and body mass (BM), resulted in an Odds Ratio (OR) of 1.5 (1.2-1.8) with daily intake of proteins and an OR of 0.81 (0.69-0.96) with PA. Surprisingly the fat mass is negatively related with the daily intake of energy per kg BM (OR: 0.37; 0.28-0.49). The longitudinal relation between fat mass and PA (corrected for DI) between the ages of 13-27 y, showed a significant inverse relationship (P<0.01) if fat mass was estimated from the sum of four skinfolds, but not if estimated from the body mass index (BMI). CONCLUSIONS: Over the adolescent and young adult period from 13-27 y, fat mass indicates a fairly good predictability. A high PA in both sexes is related with a low fat mass. Therefore promotion of habitual physical activity in the adolescent period seems effective in the early prevention of obesity.

Adolescent↗

Relationships between the development of biological risk factors for coronary heart disease and lifestyle parameters during adolescence: The Northern Ireland Young Hearts Project.

The purpose of this study was to examine relationships between the longitudinal development of biological risk factors for coronary heart disease (CHD) (namely, serum lipids, body fatness, blood pressure and cardiorespiratory fitness) and the development of lifestyles considered to be atherogenic. The study was conducted in a representative sample of adolescents from Northern Ireland, a region of high coronary mortality, and atherogenic aspects of lifestyle such as cigarette smoking, physical inactivity and selected aspects of diet were examined. Repeated measurements were made at 12 and 15 y of age on 229 boys and 230 girls. Longitudinal relations were analysed with generalised estimating equations, and the following longitudinal relations were found: for boys diastolic blood pressure was positively associated with vitamin C intake (P = 0.014), and inversely with energy intake (P = 0.006), and smoking (P = 0.048). Systolic blood pressure was inversely related to physical activity (P = 0.012), and smoking (P = 0.000). Body fatness was also inversely related to smoking (P = 0.006). Total cholesterol (TC) was positively related to physical activity (P = 0.044) and the TC:HDL cholesterol ratio positively to vitamin C intake (P = 0.008). Cardiorespiratory fitness was positively related to physical activity (P = 0.000) and inversely to smoking (P = 0.031). For girls, systolic blood pressure was positively related to vitamin C intake (P = 0.042); HDL cholesterol inversely to carbohydrate intake (P = 0.014), fat intake (P = 0.031), cholesterol intake (P = 0.042) and smoking (P = 0.035) and positively to energy intake (P = 0.035). The TC:HDL cholesterol ratio was inversely related to energy intake (P = 0.038) and finally, cardiorespiratory fitness positively to physical activity (P = 0.001). These results offer additional evidence that changes in lifestyle are associated with changes in biological risk factors in adolescents. Education and intervention at this stage, particularly in relation to cigarette smoking, physical activity and certain aspects of diet appear justified as part of a preventative strategy for CHD.

Adolescent↗

Clustering of biological risk factors for cardiovascular disease and the longitudinal relationship with lifestyle of an adolescent population: the Northern Ireland Young Hearts Project.

OBJECTIVE: To determine whether clustering of biological cardiovascular disease (CVD) risk factors exists and to investigate the longitudinal relationship between lifestyle parameters (dietary intake, physical activity and smoking behaviour) and clustering of biological CVD risk factors, which was defined as belonging to one or more sex-specific 'high-risk' quartiles for the ratio between levels of total serum cholesterol and high-density lipoprotein cholesterol, diastolic blood pressure, body fatness (sum of four skinfolds) and cardiopulmonary fitness (number of laps accomplished on a 20 m shuttle-run test). METHODS: The study was part of the Northern Ireland Young Hearts Project, a 3-year observational longitudinal study concerning adolescent boys (n=229) and girls (n=230) who were initially aged 12 years. The longitudinal relationships were analysed with generalized estimating equations. RESULTS: Significant clustering of biological CVD risk factors was observed both for boys and for girls, but the stability over time was rather low. Smoking was the only lifestyle parameter related to this clustering and was observed only among girls (rate ratio 1.5, P < 0.01); furthermore, none of the lifestyle parameters was significantly related to this clustering. CONCLUSIONS: Because biological CVD risk factors tend to cluster, it is important to investigate these risk factors together. However, for subjects in this age group, according to our analysis, lifestyle parameters were hardly related to this clustering.

Adolescent↗

The effect of ankle bracing on athletic performance.

Ankle braces in sports are used for prevention of ankle sprains. Besides restricting inversion and eversion, it is possible that an ankle brace also reduces the functional range of motion of the ankle joint. Consequently, their use could also impair athletic performance. It is unlikely that prophylactic ankle bracing will gain wide acceptance if bracing hinders athletic performance. The purpose of this paper is to review the literature on the effect of ankle bracing on vertical jump height, running speed, agility and broad jump performance. In 2 studies, 2 ankle braces negatively affected vertical jump height. Other studies did not find a significant effect on vertical jump performance when wearing an ankle brace. One study found a negative effect on running speed and broad jump performance when wearing a lace-on brace. In other studies, no effects on running speed and broad jump were found. In 1 study, agility was negatively affected when wearing an ankle brace, although agility was not significantly affected in other studies. The effect of prolonged use of an ankle brace is un-known, but could possibly influence ankle musculature and ligament function. Further research is necessary to study the effect of prolonged ankle bracing on performance.

Ankle Joint↗

Association of a central pattern of body fat with blood pressure and lipoproteins from adolescence into adulthood. The Amsterdam Growth and Health Study.

The association between the change in a central pattern of body fat and blood pressure and lipoprotein levels was investigated longitudinally in a healthy population of young males and females over 15 years. The subjects (males, n = 84; females, n = 98), participants in the Amsterdam Growth and Health Study, were measured six times between the mean ages of 13 and 27 years. As an indicator of a central pattern of body fat, subscapular/triceps skinfold ratio (S/T ratio) was used as an independent variable. Systolic blood pressure (SBP), diastolic blood pressure (DBP), total serum cholesterol (TC), high density lipoprotein cholesterol (HDL-C), and TC/HDL-C ratio were used as dependent variables. Longitudinal associations were analyzed by generalized estimating equations (GEE) in which data of the six periods of measurement were included simultaneously. Between ages 13 and 27 years, and after adjustment for the sum of four skinfolds, physical activity, smoking, and alcohol intake, the increase of the S/T ratio was significantly associated with an increase in SBP in males and females and with a decrease in level of HDL-C in males only. The change in central pattern of body fat negatively affects the change in established risk factors for cardiovascular diseases early in life.

Adipose Tissue↗

Skeletal maturation in adolescence: a comparison between the Tanner-Whitehouse II and the Fels method.

UNLABELLED: In this longitudinal study, skeletal ages assessed with the Fels method and the Tanner-Whitehouse II method (TW II) were compared for boys (n = 30) and girls (n = 30) with a mean chronological age between 12 and 16 years. The subjects, participating in the Amsterdam Growth and Health Study, were measured annually between 1977 and 1980, which resulted in four radiographs of the left hand and wrist of every individual. For boys, the mean TW II skeletal age was 0.32 years older than the mean Fels skeletal age (sd 0.50). Tested at the subsequent chronological ages, the mean TW II skeletal ages were 0.05-0.47 years older, the differences being statistically significant at the mean ages of 13, 14 and 15 years. For girls, the mean TW II skeletal age was 0.20 years younger than the mean Fels skeletal age (sd 0.69). At the subsequent chronological ages, the mean TW II skeletal ages were 0.03 to 0.35 year younger, the differences being statistically significant at the mean chronological ages of 14 and 15 years. As a consequence of the differences between the methods, application of the Fels method resulted in classifying a smaller percentage of boys (10%) as rapid maturers, and a higher percentage (6.7%) of boys as normal maturers in comparison to the TW II method. For girls, a higher percentage of female adolescents were classified as rapid (16.7%) and slow maturers (13.3%), but a smaller percentage was classified as normal mature (30%). Differences in the skeletal ages can be ascribed to differences in maturation of the reference population, but also to fundamental differences in the statistical methods of the scoring system and the scales of maturity. CONCLUSION: There is no agreement in skeletal ages assessed according to the TW II method and the Fels method in adolescence.

Adolescent↗

Coping, personality and the development of a central pattern of body fat from youth into young adulthood: The Amsterdam Growth and Health Study.

OBJECTIVE: It has been suggested that coping behaviour, in particular a defeat reaction to stress, is a determinant of the central pattern of body fat. To verify this hypothesis, this study investigated if coping behaviour, and associated personality traits, are associated with a central pattern of body fat or total body fatness in a healthy population of males (n=83) and females (n=98) early in life. METHODS: Problem-focused, emotion-focused and type A behaviour were measured at the mean ages of 21 y and 27 y. Personality traits (inadequacy, social inadequacy, dominance, rigidity and debilitating anxiety), a central pattern of body fat (subscapular/triceps, (S/T) ratio) and total body fatness (sum of four skinfolds (SSF): biceps, triceps, subscapular, suprailiac) were measured six times between the ages of 13-27 y. RESULTS: In both genders, no association was found between either coping strategy and a central pattern of body fat or total body fatness. In males, type A behaviour was significantly negatively correlated with the S/T ratio (r = -0.27, P=0.01) after adjustment for total body fatness, at the mean age of 27 y. In a longitudinal analysis, adjusted for total body fatness, dominance and rigidity were negatively associated with the S/T ratio (beta = -0.09, 95% confidence interval (95% CI) (-0.17; -0.00) and beta = -0.11, 95% CI (-.19; -0.02), respectively) between the ages of 13-21 y in males. These associations of type A behaviour, dominance and rigidity, with a central pattern of body fat, were weaker and did not reach statistical significance with total body fatness. CONCLUSIONS: The results of this study justify further research on the association between coping behaviour, personality and the development of a central pattern of body fat.

Adaptation, Psychological↗

Body fatness: longitudinal relationship of body mass index and the sum of skinfolds with other risk factors for coronary heart disease.

OBJECTIVE: To analyse the longitudinal relationships between body mass index (BMI)/sum of skinfolds (SSF) and biological and lifestyle risk factors for coronary heart disease (CHD). DESIGN: An observational longitudinal study; that is, the Amsterdam Growth and Health Study. SUBJECTS: 181 males and females, initially aged 13 y. Over a period of 15 y, six repeated measurements were carried out. MEASUREMENTS: BMI and SSF, biological CHD risk factors; that is, total cholesterol (TC), high density lipoprotein (HDL), TC:HDL ratio, systolic/diastolic blood pressure (SBP/DBP) and cardiopulmonary fitness (VO2-max) and lifestyle CHD risk factors (that is, daily physical activity, dietary parameters, smoking, and alcohol consumption). The longitudinal relationships were analysed by an autoregressive model, in which the value of the outcome variable at time-point t is not only related to the value of the predictor variable at t, but also to the value of the outcome variable at t-1. RESULTS: Both BMI and SSF were positively related to TC and the TC:HDL ratio. Only BMI was positively related to SBP and only SSF was negatively related to VO2-max. Physical activity was negatively related to SSF. None of the other lifestyle parameters were related to SSF and/or BMI. CONCLUSIONS: Both BMI and SSF were related to a high risk profile regarding CHD. Different relationships for SSF and BMI are found, because BMI not only reflects body fatness, but also lean body mass. Analyses with BMI as an indicator for body fatness should therefore be interpreted cautiously.

Adolescent↗

Physical fitness and sports skills in relation to sports injuries. A four-year prospective investigation of sports injuries among physical education students.

In order to study the relationship between physical fitness/sport-specific skills and sports injuries 136 physical education students were studied during their 4-years of training in a prospective investigation. Physical fitness was measured every year using a battery of fitness tests, and the performance marks of a number of sports scored at the exams of the academy were used as parameters for the sport-specific skills. Sports injuries were recorded every 3 weeks on standard forms. Relative risk ratios were calculated between the tertile groups good, average and poor for all variables of physical fitness and sport-specific skills. Injury-proneness was defined for all and for acute and chronic injuries separately near the median number of injuries sustained. In only 6 out of 126 computed relative risks was a significant difference found. Discriminant analysis revealed an explanation of 16%, 14% and 11% of the variance for respectively all, acute and chronic injuries, at which 5 or 6 variables in varying combination were included. From our findings it may be concluded that physical fitness and sport-specific skills have little impact on sports injuries for the following two main reasons. Firstly, subjects at risk for sports injuries participate per definition in sports activities and have consequently developed their fitness and skills compared to the sedentary population. Thus, the range in physical fitness or sports skills in the population at risk is relatively small (physical education students belong to the 7th-10th decile in fitness test scores within a general college student population) and therefore an effect is hard to show. Secondly, the total number of sports injuries is very small and moreover, it should be distributed over several categories for analysis. The favourable advantages of using physical education students to study intrinsic risk factors (comparable and varied sports program, excellent compliance) appeared to be insufficient to compensate for drawbacks of selection.

Athletic Injuries↗