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PubMed1999

The gastrointestinal system--an essential target organ of the athlete's health and physical performance.

An athlete's ability to reach maximum performance is a direct result of physical and muscular performance, muscular and systemic stress tolerance, control and regulation of immune function, and adaptation to physical stress. In this complex sense, the gastrointestinal (GI) tract is also part of the system that controls and regulates adaptation and regeneration of the athlete. A well-balanced GI immune system and an optimized immune competence may protect the athlete from harmful pathogens; it may also protect against dietary as well as inhaled antigens. However, under conditions of mechanical and biochemical stress, the integrity of the GI mucosal block, particularly the epithelial hood, can be damaged, leading to a pathological uptake of toxic or immunogenic substrates. This may occur in endurance athletes, since gut symptomatology, nausea, vomiting, pain, bloating, diarrhea, cramping, and bleeding can be observed in up to half of all participants in endurance events. In addition, composition of stool and fecal microflora in endurance athletes has shown that there may be a specific need for nutritional support for mucosal immunity in highly trained but chronically stressed athletes. Proper diet during training and competition is a significant factor in guarding against GI symptoms and exercise-induced gastrointestinal side effects that may compromise immune competence and physical performance. The present review presents some important suggestions on the possible role of the GI tract in human performance and stress tolerance, and offers new insights about the influence of food quality on the immune system of the gut.

Digestive System↗
PubMed1999

[Association of physical performance and falls among the community elderly in Japan in a five year follow-up study].

Since falling is one of the main causes of morbidity and mortality among the elderly, attention should be paid to prevention. The purpose of the present study was to investigate the risk factors for falls among the elderly by a 5-year longitudinal observation. The subjects were the elderly aged 65 years and over living in a rural community in the eastern part of Honshu, Japan. Of the 852 eligible subjects, 685 persons (278 males and 407 females) received the multidimensional medical examination including physical performance as the baseline of TMIG-LISA (Tokyo Metropolitan Institute of Gerontology, Longitudinal and Interdisciplinary Study on Aging) in 1992. From baseline medical examinations, the following variables were adopted to investigate risk factors for falls (2 or more times during the 5-year follow-up): self-rated health, experience of falling, TMIG-index of competence, visual deficit, anthropometric measurements (height, weight, BML total skinfold thickness), lumbar bone mineral density, and physical performance tests (grip strength, finger-tapping rate, one leg standing time with eyes open or closed, preferred and maximum speed walking for 5 meters). A total of 108 subjects experienced falls two or more times during the 5-year follow-up period (43 men and 65 women). There were significant differences in grip strength, preferred and maximum walking speeds between those who fell and those who did not. Multiple logistic regression analysis controlled for age, sex and other variables adopted in this study revealed the following variables were significantly and independently related to falling: experience of falling within one year preceding the baseline survey (directly, p < 0.0001), preferred walking speed (inversely, p < 0.005) and total skinfold thickness (inversely, p < 0.01). These results suggest that the walking test as well as the experience of falling have discriminant and predictive validity for assessing the future occurrence of falls among the elderly.

Accidental Falls↗
PubMed2004

Prediction of development of fatigue during a simulated ambulance work task from physical performance tests.

The aims of this study were (1) to identify which physical performance tests could best explain the development of fatigue during a simulated ambulance work task, (2) to investigate the effect of height and weight and (3) to investigate in what respects these findings differ between female and male ambulance personnel. Forty-eight male and 17 female ambulance personnel completed a test battery assessing cardio-respiratory capacity, muscular strength and endurance, and co-ordination. The subjects also completed a simulated ambulance work task -- carrying a loaded stretcher. The work task was evaluated by development of fatigue. Univariate and multiple regression analyses were used to investigate to what extent the tests in the test battery were able to explain the variance of developed fatigue. The explained variance was higher for female than for male ambulance personnel (time > 70% of HRpeak: R2 = 0.75 vs 0.10, accumulated lactate: R2 = 0.62 vs 0.42, perceived exertion: R2 = 0.75 vs 0.10). Significant predictors in the models were VO2max, isometric back endurance, one-leg rising, isokinetic knee flexion and shoulder extension strength. Height, but not weight, could further explain the variance. The high physical strain during carrying the loaded stretcher implies the importance of investigating whether improved performance, matching the occupational demands, could decrease the development of fatigue during strenuous tasks.

Adult↗
PubMed1997

Relationships between spinal mobility, physical performance tests, pain intensity and disability assessments in chronic low back pain patients.

Correlations between the Oswestry Disability Questionnaire (ODQ), the Pain Disability Index (PDI), PDI subscales PDI factor 1 (PDI 1), PDI factor 2 (PDI 2) and visual analogue scale (VAS) pain intensity on the one hand and spine range of motion measures and static and dynamic functional performance tests on the other, were studied in 52 chronic low back pain patients. Comparable groups of male and female patients were studied. A moderately significant (p < 0.01) inverse correlation was observed between the ODQ and rotation to the left even after correction for age, but not when men and women were studied separately. A significant (r = -0.480, p < 0.001) inverse correlation was observed between the repeated squatting test and pain intensity and in men both pain intensity and disability correlated (r = -0.607, p < 0.001) with this particular test. Only for the women were there moderately significant (p < 0.01) inverse correlations between disability assessments and all the physical performance tests with the exception of the static back muscle test. In the women only the isometric lifting test showed a moderately significant inverse correlation (r = -0.504, p < 0.01) with pain intensity. Such apparent gender differences in the overlap between physical performance tests and self-report disability assessments and pain intensity may be clinically relevant. The results will, however, require confirmation on larger groups of chronic low back pain patients.

Adult↗
PubMed1998

Decreased physical performance of congenic mice with mismatch between the nuclear and the mitochondrial genome.

Maternal transmission of mitochondrial DNA (mtDNA) allows us to generate mtDNA congenic strain by repeating backcrosses of female mice to male mice of an inbred strain, which carries different mtDNA haplotype from that of the female progenitor. Since genetic backgrounds of inbred strains commonly used (e.g., C57BL/6J [B6] and BALB/c) are mainly derived from an European subspecies of Mus musculus domesticus, congenic strains, in which mtDNA originated from an Asian subspecies M. musculus musculus or an European species M. spretus, give in vivo condition that mismatch occurs between the mitochondrial and the nuclear genome. So far, little has been known how the mismatch condition affects the physiological phenotype of the mice. To address this question, we established two mtDNA congenic strains, C57BL/6J(B6)-mtSPR and BALB/c-mtSHH, which carry M. spretus- and M. m. musculus-derived mtDNAs, representing the conditions of interspecific and intersubspecific mitochondrial-nuclear genome mismatch, respectively. Using these congenic strains, we examined their physical performance by measuring their running time on a treadmill belt until exhaustion. The result clearly showed that the mtDNA congenic strains manifested a significant decrease in the level of physical performance, when compared with their progenitor strains. It also appeared that the congenic mice manifested growth rate. Thus, all results indicated that mismatch between the mitochondrial and the nuclear genome causes phenotypic changes in individuals of mice.

Animals↗
PubMed1999

The effect of intramuscular iron injections on serum ferritin levels and physical performance in elite netballers.

The purpose of this study was to determine the effect of iron supplementation by intramuscular injection on both serum ferritin (SF) levels and exercise performance in iron depleted, non-anaemic elite female netballers. Fifteen iron depleted (Serum Ferritin <40 ug x L(-1). Haemoglobin >125 g x L(-1)) subjects (19+/-3 y) first performed their routine test battery: a vertical jump test, a 10s power and 5x6s repeat sprint test on a cycle ergometer and a 20m multi-stage shuttle run. Subjects were matched on the basis of height, mass, and playing position and then assigned to either a Ferritin Group (FG) or Placebo Group (PG) (single blind design). Subjects then underwent a course of 5x2ml intramuscular injections of either Ferrum H (FG) or normal saline (PG) over a period of 8-10 days before repeating the blood and physical performance tests. Five and 10 days following supplementation, SF levels in the FG increased significantly from baseline levels (P<0.05) and were also significantly greater than levels measured in the PG (P<0.01). Haemoglobin levels remained unchanged in both groups. All test scores remained unchanged from baseline values and were not different between the two groups. These results demonstrate that a course of 5x2ml intramuscular iron injections significantly increased SF concentration within 2 weeks without increasing Hb levels, but this rapid elevation did not enhance the physical performance in selected tests of iron depleted, non-anaemic athletes.

Adolescent↗
PubMed2003

Effect of alendronate and exercise on bone and physical performance of postmenopausal women: a randomized controlled trial.

In this randomized, double-blind, placebo-controlled 12-month trial we evaluated effects of weight- bearing jumping exercise and oral alendronate, alone or in combination, on the mass and structure of bone, risk factors for falling (muscle strength and power, postural sway, and dynamic balance), and cardiorespiratory fitness in postmenopausal women. A total of 164 healthy, sedentary, early postmenopausal women were randomly assigned to one of four experimental groups: (1) 5 mg of alendronate daily plus progressive jumping exercise, (2) 5 mg alendronate, (3) placebo plus progressive jumping exercise, or (4) placebo. The primary endpoint was 12-month change in bone mass and geometry (measured with dual-energy X-ray absorptiometry and peripheral computed tomography at several axial and limb sites) and physical performance; the secondary endpoint was change in biochemical markers of bone turnover. The jumping exercise was conducted an average 1.6 +/- 0.9 (mean +/- SD) times a week. Alendronate daily was effective in increasing bone mass at the lumbar spine (alendronate vs placebo 3.5%; 95% CI, 2.2-4.9%) and femoral neck (1.3%; 95% CI, 0.2-2.4%) but did not affect other bone sites. Exercise alone had no effect on bone mass at the lumbar spine or femoral neck; it had neither an additive nor an interactive effect with alendronate at these bone sites. However, at the distal tibia the mean increase of 3.6% (0.3-7.1%) in the section modulus (that is, bone strength) and 3.7% (0.1-7.3%) increase in the ratio of cortical bone to total bone area were statistically significant in the exercise group compared to the nonexercise group, indicating exercise-induced thickening of the bone cortex. Bone turnover was reduced in alendronate groups only. Alendronate had no effect on physical performance while the jumping exercise improved leg extensor power, dynamic balance, and cardiorespiratory fitness. As conclusion Alendronate is effective in increasing bone mass at the lumbar spine and femoral neck, while exercise is effective in increasing the mechanical properties of bone at some of the most loaded bone sites, as well as improving the participants' muscular performance and dynamic balance. Together alendronate and exercise may effectively decrease the risk of osteoporotic fractures.

Alendronate↗
PubMed2000

Evaluation of physical performance of a scintillation dosemeter for patient dosimetry in diagnostic radiology.

The physical performance of the patient scintillation dosemeter Skin Dose Monitor (SDM) was evaluated for use in diagnostic radiology. The SDM response was found to be linear, with output air kerma and output air kerma rate having a reproducibility in time lower than +/- 2.4%) (one standard deviation). A calibration protocol taking into account the more significant parameters, such as radiation quality dependence and the relative sensitivity of SDM detectors of the same batch, can be applied so that the maximum overall uncertainty is +/- 18% at the 95% confidence level. The SDM detectors did not show any loss of sensitivity during the 5-month period of evaluation. SDM performance was evaluated against thermoluminescent dosemeters (TLDs) (GR200A) by monitoring chest X-rays in 18 adult patients. The difference in entrance surface dose (ESD) values between the SDM and TLDs was less than 10%, but a lack of accuracy in ESD values of less than 0.3 mGy was observed. The main benefit of the SDM device compared with TLDs is the real-time read-out of dose combined with a better flexibility and rapidity of use for approximately the same cost per measurement. The SDM device is a good candidate for regular measurement of patient doses in diagnostic imaging departments as required under implementation of the European Council Medical Exposure Directive of 30 June 1997.

Adult↗
PubMed1999

Long-term effects of heart transplantation: the gap between physical performance and emotional well-being.

The purpose of our study was to assess physical and emotional factors in heart transplant patients. A prospective design was used to compare patients' physical symptoms, emotional complaints, and restrictions at admission to the waiting list, immediately after, and 1 and 5 years after heart transplantation. Thirty-three patients were included (30 male, 3 female) in the study. Their mean age at admission was 48 +/- 10.2 years. Of these, 23 suffered from cardiomyopathy, 8 from coronary heart disease, and 2 from valvular insufficiency. At admission, the patients suffered from symptoms of cardiac insufficiency, and were restricted in sports, gardening, hobbies, sexual life, job, food-intake, and mobility. More than three-fourths rated their physical and emotional status as moderate to poor. Emotionally, they suffered from irritability, restlessness, depression, psychic lability, lowered drive, lack of social contact, low self-esteem, and anxiety. At the end of rehabilitation (4-8 weeks after the operation), all physical and emotional complaints, as well as restrictions had significantly decreased (p < 0.0001 to p < 0.001), except for trembling, numbness of hands/feet, and food-intake. One year postoperatively, patients reported even fewer physical complaints (p < 0.01). Three-fourths rated their physical and emotional status good or excellent. Five years postoperatively--in contrast to physical status, restrictions, and physical complaints--the emotional complaints had increased significantly (p < 0.0001). Patients reported excellent physical performance up to 5 years postoperatively. On the other hand, the study revealed that their emotional well-being had significantly deteriorated from 1 to 5 years postoperatively. Attention should, therefore, not only be paid to the good physical health of the survivors, but also to the worsening of their emotional status.

Adaptation, Psychological↗
PubMed2000

Access to pedestrian roads, daily activities, and physical performance of adolescents.

STUDY DESIGN: A cross-sectional study using a questionnaire and physical tests was performed. OBJECTIVE: To study how access to pedestrian roads and daily activities are related to low back strength, low back mobility, and hip mobility in adolescents. SUMMARY OF BACKGROUND DATA: Although many authorities express concern about the passive lifestyle of adolescents, little is known about associations between daily activities and physical performance. METHODS: This study compared 38 youths in a community lacking access to pedestrian roads with 50 youths in nearby area providing excellent access to pedestrian roads. A standardized questionnaire was used to obtain data about pedestrian roads, school journeys, and activities from the local authorities and the pupils. Low back strength was tested as static endurance strength, low back mobility by modified Schober techniques, and hip mobility by goniometer. For statistical analyses, a P value of 0.05 or less determined significance. RESULTS: In the area using school buses, the pupils had less low back extension, less hamstring flexibility, and less hip abduction, flexion, and extension than pupils in the area with pedestrian roads. Multivariate analyses showed no associations between walking or bicycling to school and anatomic function, but regular walking or bicycling to leisure-time activities associated positively with low back strength, low back extension, hip flexion, and extension. Distance by school bus associated negatively with hip abduction, hip flexion, hip extension, and hamstring flexibility (P<0.001). Time spent on television or computer associated negatively but insignificantly with low back strength, hamstring flexibility, hip abduction, and flexion (P<0.1). CONCLUSION: The results indicate that access to pedestrian roads and other lifestyle factors are associated with physical performance.

Adolescent↗
PubMed1975

The effects of smoking marihuana on physical performance.

The purpose of the present investigation was to determine the effects of marihuana on physical performance as determined by six variables: heart rate, blood pressure, muscular strength, physical work capacity, forced vital capacity, flow rate of expiration. Twenty volunteer human marihuana smokers took part in three experimental testing sessions. Each subject reported to a laboratory on three different days. Day one was used as their control testing sessions. Day two and three were the placebo and marihuana sessions. On day three the subject smoked marihuana if he had placebo on day two, and vice versa. The test batter measures consisted of resting heart rate, resting systolic and diastolic blood pressure, grip strength, forced vital capacity and flow rate and a submaximal bicycle ergometer test. There were significant differences between the marihuana treatment group and the other treatment groups in heart rate, systolic and diastolic blood pressure and physical work capacity.

Adult↗
PubMed2004

Effects of physical training on physical performance in institutionalised elderly patients (70+) with multiple diagnoses.

OBJECTIVE: the positive effect of physical training in healthy elderly people is well documented. The aim of this systematic review was to describe the effect of physical training on physical performance in institutionalised elderly patients with multiple diagnoses. DESIGN: systematic literature review of randomised controlled trials regarding effects of physical training of elderly (70+) subjects. METHODS: the randomised controlled trials were evaluated using a modified version of an evaluation form originally developed by the Cochrane Collaboration. It is based on a weighted scale of 0-100 points, and ranks the studies as high, moderate or low methodological quality. A total of 16 randomised controlled trials were included in the review. RESULTS: six studies scored as high quality, eight as moderate and two as low. There was a large heterogeneity in the studies concerning sample size, types of interventions and types of assessments. There is strong evidence for a positive effect of physical training on muscle strength and mobility; moderate evidence for an effect on range of motion; and contradictory evidence regarding gait, activities of daily living, balance and endurance. CONCLUSION: more studies are required, with larger sample sizes, higher specificity as to the types of interventions and assessments, greater focus on clinically relevant outcomes such as endurance and activities of daily living, and also, for example, quality of life and mortality.

Activities of Daily Living↗
PubMed2004

Physical performance, depression, immune status and fatigue in patients with hematological malignancies after treatment.

BACKGROUND: Fatigue is a frequent and severe problem after treatment of patients with hematological malignancies. This symptom has been associated with anemia, reduced physical performance, mood, endocrine disorders and impaired nutritional status. Recently, it has been suggested that fatigue can be related to a persistent activation of the immune system with increased production of proinflammatory cytokines. However, there is no conclusive evidence regarding the role of the immune system in the origin of fatigue in cancer patients. PATIENTS AND METHODS: We evaluated the correlation of fatigue with thyroid function, markers of immune activity [interleukin (IL)-1alpha, IL-1 soluble receptor, IL-6, C-reactive protein and neopterin], liver and kidney function, mood and physical ability in 71 patients with hematological malignancies. All patients had been free of relapse and not received treatment (chemotherapy, radiotherapy or immune modulators) for at least 3 months. RESULTS: Fatigue was related to depression (r=0.84; P<0.0001) and reduced performance status (r=-0.61; P<0.0001). However, there was no correlation between fatigue and thyroid, liver and kidney function, anemia, albumin concentration or markers of immune activity (all r-values <0.20; P>0.05). CONCLUSIONS: We conclude that fatigue in relapse-free patients with hematological malignancies is associated with depressive mood and reduced physical performance, but not with impairment of thyroid function, anemia or persistent activation of the immune system.

Adult↗
PubMed1993

Physical performance evaluation of the Toshiba GCA-9300A triple-headed system.

The physical performance of the Toshiba GCA-9300A triple-headed SPECT system has been assessed. Using a water-filled cylinder containing 99mTc, the tomographic volume sensitivity was 33.8 and 34.8 kcps/(MBq/ml)/cm for the high-resolution, parallel-hole (HR-PH) collimator and the super high-resolution, lead fanbeam (SHR-FB) collimator, respectively, excluding the rotation time(s) during scanning when data are not acquired. The tomographic spatial resolution at the center, in air, with 132 mm radius of rotation was 10.2 and 7.8 mm FWHM with the HR-PH and SHR-FB collimators, respectively; in water it was 11.0 and 7.8 mm. Reconstructed relative activity concentrations were accurate for both collimator sets if attenuation correction was used. With the SHR-FB collimators, the average peak-to-valley ratio of five-line sources in water improved significantly when an asymmetric energy window was used. Using the three-dimensional Hoffman brain phantom which simulates a 4:1 grey matter-to-white matter ratio and the usual choice of acquisition and processing parameters for brain studies, the reconstructed grey matter-to-white matter ratio was only about 1.7 for total counts typically acquired in a 99mTc-HMPAO study (4.0 M counts) and only 2.3 for 40 M counts. There was a qualitative improvement with an asymmetric energy window.

Brain↗
PubMed1996

Diet and muscle glycogen concentration in relation to physical performance in Swedish elite ice hockey players.

The effects of carbohydrate (CHO) loading on physical characteristics including muscle fiber distribution, muscle glycogen concentration, and physical performance were studied in two top Swedish ice hockey teams. Players were randomly allocated to two groups: those consuming a CHO-enriched diet (CHO group) and those consuming a mixed diet (controls). Biopsies from the vastus lateralis muscle were taken three times: after Game 1, before Game 2, and after Game 2. Muscle fiber distribution averaged 50 +/- 2% slow twitch fibers (mean +/- 1 SEM). Muscle glycogen concentrations (measured in mmol glucose units . kg-1 wet muscle) were as follows: after Game 1, 43 +/- 4 (all players); before Game 2, 99 +/- 7 (CHO group) and 81 +/- 7 (controls); and after Game 2, 46 +/- 6 (CHO group) and 44 +/- 5 (controls). Distance skated, number of shifts skated, amount of time skated within shifts, and skating speed improved with CHO loading. It was concluded that individual differences in performance could be related to muscle glycogen metabolism.

Adult↗
PubMed1991

Limits of energy turnover in relation to physical performance, achievement of energy balance on a daily basis.

Limits of energy turnover in relation to physical performance were addressed in terms of upper and lower limit, changes during a training programme and how to regulate energy balance at a changing energy turnover. At the lower limit we stress the risk of energy restriction to reach a desired body size or body composition for reduced performance, early osteoporosis and weight cycling. The upper limit of energy turnover can be increased by the consumption of energy dense carbohydrate-rich foods. Training induces an increase in energy turnover which can initially be more then twice the calculated energy costs from laboratory measurements of physical activity. In the long term, training can induce a reduction in resting energy expenditure even while the active cell mass (muscle mass) of the body has increased. The regulation of energy balance on a day to day basis seems to be better at high levels of energy turnover either as a consequence of the physiological need or as a consequence of the fact that athletes performing at a high level of energy expenditure have learned to ingest as much food as possible.

Body Composition↗