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Scott J. Montain, Samuel N. Cheuvront and Henry C. Lukaski

Context:

Uncertainty exists regarding the effect of sustained sweating on sweat mineral-element composition.

Purpose:

To determine the effect of multiple hours of exercise-heat stress on sweat mineral concentrations.

Methods:

Seven heat-acclimated subjects (6 males, 1 female) completed 5 × 60 min of treadmill exercise (1.56 m/s, 2% grade) with 20 min rest between exercise periods in 2 weather conditions (27 °C, 40% relative humidity, 1 m/s and 35 °C, 30%, 1 m/s). Sweat was collected from a sweat-collection pouch attached to the upper back during exercise bouts 1, 3, and 5. Mineral elements were determined by using inductively coupled plasma-emission spectrography.

Results:

At 27 °C, sweat sodium (863 [563] µg/mL; mean [SD]), potassium (222 [48] µg/mL), calcium (16 [7]) µg/mL), magnesium (1265 [566] ng/mL), and copper (80 [56] ng/mL) remained similar to baseline over 7 h of exercise-heat stress, whereas sweat zinc declined 42–45% after the initial hour of exercise-heat stress (Ex1 = 655 [362], Ex3 = 382 [168], Ex5 = 355 [288] µg/mL, P < 0.05). Similar outcomes were observed for sweat zinc at 35 °C when sweat rates were higher. Sweat rate had no effect on sweat trace-element composition.

Conclusions:

Sweat sodium, potassium, and calcium losses during multiple hours of sustained sweating can be predicted from initial sweat composition. Estimates of sweat zinc losses, however, will be overestimated if sweat zinc conservation is not accounted for in sweat zinc-loss estimates.

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Sally A. Perkins and John E. Massie

Objective:

To determine whether patients were satisfied after thermal shrinkage on the capsule of the glenohumeral joint (GHJ).

Design and Setting:

The affected shoulder was assessed preoperatively and 2 months postoperatively. The assessment evaluated pain on activities of daily living (ADLs), physical activity level, satisfaction with shoulder function, and a modified UCLA pain scale.

Subjects:

Eight athletes, 4 men and 4 women, with a mean age of 21 years, participated. Each had sustained a traumatic injury to the GHJ resulting in multidirectional instability.

Measurements:

Subjects were evaluated preoperatively and 2 months postoperatively for GHJ laxity and labral deformity. Goniometric measurements of flexion/extension, abduction/adduction, and internal/external rotation of the GHJ were completed.

Results:

Six of the 8 subjects had reduced pain. Active extension increased significantly in 7. ADLs were all improved. All 8 subjects were satisfied with the thermal-shrinkage procedure.

Conclusions:

Thermal shrinkage of the capsule of the GHJ results in patient satisfaction and reduced pain.

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Michael Ra, Michael Sitler, Jeff Ryan, Raymond Moyer, Paul Marchetto, John Kelly and Iris Kimura

Chondral lesions often occur in the knee as isolated defects or part of more complex injuries. Articular cartilage defects decrease the ability of the knee to sustain weight-bearing loads and may accelerate degeneration of the joint when left untreated. The purpose of this study was to determine the clinical, functional, and radiographic outcome of arthroscopic abrasion chondroplasty of the knee. The Articular Cartilage Rating System was used to assess the location, size, depth, and description of the articular lesion. The Standard Knee Evaluation Form and Cincinnati Knee Rating Scale were used to assess the clinical, functional, and radiographic outcome of the procedure. Average time to postsurgery follow-up was 46 ± 26.69 months. Within the constraints of the present study, arthroscopic abrasion chondroplasty of the knee had a favorable clinical, functional, and radiographic outcome. However, more study is needed with larger samples and longer follow-up before definitive conclusions about the efficacy of the procedure can be made.

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Barry Braun

The concept that participation in exercise/physical activity reduces the risk for a host of chronic diseases is undisputed. Along with adaptations to habitual activity, each bout of exercise induces beneficial changes that last for a finite period of time, requiring subsequent exercise bouts to sustain the benefits. In this respect, exercise/physical activity is similar to other “medications” and the idea of “Exercise as Medicine” is becoming embedded in the popular lexicon. Like other medications, exercise has an optimal dose and frequency of application specific to each health outcome, as well as interactions with food and other medications. Using the prevention of type-2 diabetes as an exemplar, the application of exercise/physical activity as a medication for metabolic “rehabilitation” is considered in these terms. Some recommendations that are specific to diabetes prevention emerge, showing the process by which exercise can be prescribed to achieve health goals tailored to individual disease prevention outcomes.

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Jennifer J. Mancuso, Kevin M. Guskiewicz and Meredith A. Petschauer

Stress fractures, particularly those in the lower extremity, are disabling and time-consuming injuries commonly seen in athletes. A stress fracture of the posterior talus is rare and presents with signs and symptoms similar to those of soft-tissue injuries in the rear foot. This case study involves a Division-I collegiate female field-hockey athlete who developed a stress reaction in her posterior talus approximately 6 weeks after sustaining a mild eversion ankle sprain. Her chief complaint was pain with forceful plantar flexion during running and cutting. Clinicians must be cautious when an athlete presents with posterior foot pain, being sure to properly assess and rule out differential diagnoses such as tendinitis, os trigonal fracture, and muscle strains. This athlete was able to remain weight bearing during healing, so her rehabilitation protocol allowed for a variety of exercise options.

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Dobromir G. Dotov and Till D. Frank

A novel method for the analysis of repetitive limb behavior oscillation is presented. It is based on a model used to account for self-sustained limit cycles that involve energy pumping compensating for dissipative processes. The experiment involved a uni-manual pendulum swinging task paced at five frequencies. The median frequency corresponded to the resonant one for the chosen pendulum and hand parameters. We applied the model-based analysis to explore the relationship between behavioral observables and model parameters not available from previous methods. Oscillation amplitude and energy, and motor variability were the behavioral observables we focused on while energy pumping, attractor strength, and noise amplitude were the model parameters. As expected, energy pumping was found to increase with pacing frequency. Noise amplitude did not change and stability decreased.

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Joanna L. Morrissey, Joseph A. Beckett, Ross Sherman and Lisa J. Leininger

As undergraduate students prepare to enter the workforce and become engaged members in their communities, it is necessary for universities to provide students with opportunities and resources to develop the knowledge, skills, and attitudes needed to be successful in their professional, personal, and social pursuits. Experiential learning is one approach that may be used to facilitate and strengthen the learning process for undergraduate students. Grounded in experiential learning, Kinesiology-specific service learning and internship programs can help students develop the skillset needed to be successful in their major and future careers. To best facilitate students’ learning, it is imperative that such academic programs build collaborative, sustainable and genuine campus-community partnerships. This paper presents a series of practical and successful partnership-building strategies from three unique institutions.

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David A. Shearer, Stephen D. Mellalieu and Catherine R. Shearer

While posttraumatic stress disorder (PTSD) is most commonly associated with survivors of traumatic events (e.g., combat), PTSD can occur after any situation in which victims perceive that their life or safety is threatened. In sport, athletes often place themselves in dangerous situations and are also exposed to the same lifestyle dangers as the general population. The literature on PTSD among athletes is sparse, and consequently, it is possible that many (non-clinical) sport psychologists would fail to recognize the symptoms and may subsequently fail to refer the athlete to the appropriate professional for clinical assistance. In the following case study, we present an example of an athlete suffering from PTSD following a serious bicycle accident in which she sustained head and facial injuries. We briefly detail the nature of PTSD and discuss how sport psychology services can be implemented alongside a parallel clinical intervention program. Finally, we offer recommendations for practice when working with athletes with PTSD.

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Michael J. Axe, Katherine Linsay and Lynn Snyder-Mackler

The purpose of this study was to determine whether there was a relationship between knee hyperextension and intra-articular pathology in 100 consecutive patients whose sole ligament injury was an arthroscopically confirmed anterior cruciate ligament (ACL) rupture. Hyperextension of both knees was measured using a supine heel-height measurement of high reliability. There was more articular damage to the total joint, lateral joint, and lateral meniscus in patients who hyperextended than in those who did not. There was more articular damage to the total joint and medial joint in patients who were chronically ACL deficient than in those who were acutely or subacutely ACL deficient. The results demonstrate that individuals with ACL injuries whose knees hyperextend 3 cm or more sustain significantly more joint damage at the time of injury than in those whose knees hyperextend less than 3 cm. This study further defines the role of knee hyperextension in ACL injuries and offers a useful and reliable means of measuring knee hyperextension.

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Bryan L. Riemann and Kevin M. Guskiewicz

Mild head injury (MHI) represents one of the most challenging neurological pathologies occurring during athletic participation. Athletic trainers and sports medicine personnel are often faced with decisions about the severity of head injury and the timing of an athlete's return to play following MHI. Returning an athlete to competition following MHI too early can be a catastrophic mistake. This case study involves a 20-year-old collegiate football player who sustained three mild head injuries during one season. The case study demonstrates how objective measures of balance and cognition can be used when making decisions about returning an athlete to play following MHI. These measures can be used to supplement the subjective guidelines proposed by many physicians.