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Sports medical examinations of juvenile athletes provide an opportunity for preventive measures against sports-related diseases. Determining the leg axis deviation as a risk factor for future constraints may offer approaches for such measures. Data were obtained from 789 youth athletes: 166 with coronal plane knee misalignment and 623 without. After a seven-year period, 64 participants (m: 33, f: 31) from both groups were reassessed for the incidence of nonspecific chronic low back pain (CLBP). To distinguish participants with increased risk for CLBP, contingency tables for comparison of expected and joint frequency distribution testing and receivers operating characteristic (ROC) analyses for the weekly training time were conducted. Subjects with an initial diagnosed knee misalignment showed increased risk for the development of CLBP (CHI2 = 4.2, p < .05, OR = 3.4) compared to participants without knee misalignment. In athletes with knee misalignment, ROC analysis revealed an optimal cut-off of 6.75 h/w (AUC = 0.8; Chi2 = 4.2, p < .05, OR = 8.0). In athletes without leg axis deviation, no association to training volume was detected. Our results suggest a predictive value of knee misalignment on the later occurrence of CLBP in young competitive athletes and underline the importance of an examination of the motor system during sports medical assessments in youth athletes. Training volume of almost more than 7 h a week enhances this risk.

Sportliche Aktivitaten konnen die Nierenfunktion beeinflussen. So ist es fur den Ausdauersportler wichtig, die geeignete Trinkmenge zu sich zu nehmen, um Elektrolytstorungen wie Hyponatriamien zu vermeiden. Auch konnen Belastungen das Filtrationsvermogen der Nieren verandern. Eine Hamaturie (Blut im Urin) kann unter Umstanden eine Folge sein. Muskelverletzungen sind keine Seltenheit im Sport. Im Schwerstfall kann eine Rhabdomyolyse ein akutes Nierenversagen auslosen. Haufig sind diesen Krankheitsbildern starke korperliche Beanspruchungen vorausgegangen. Dennoch profitiert auch der Nierenkranke von einer Bewegungstherapie. Im Fokus stehen vor allem chronisch niereninsuffiziente Patienten mit oder ohne Dialysetherapie. Hier gilt es, Angste gegenuber einer Bewegungstherapie zu uberwinden. Unter Supervision kann dadurch die korperliche Fitness gesteigert und die Muskelmasse erhalten werden. Der protektive Effekt von Bewegung in Bezug auf Nierensteine wird kontrovers diskutiert. Letztlich uberwiegen auch im Allgemeinen die positiven Effekte einer Bewegungstherapie auf den Stoffwechsel.

Sportmedizinische Vorsorgeuntersuchungen dienen der gesundheitlichen Absicherung von sportlichen Aktivitaten. Einerseits lassen sich Erkrankungen und Risiken im Bezug zum Sport erkennen, andererseits bieten diese Untersuchungen die Gelegenheit zur praventiv-medizinischen Einflussnahme. Von Fachgesellschaften empfohlen, orientiert sich ihr Umfang an den gesundheitlichen Risikofaktoren, dem Alter und der angestrebten korperlichen Belastung. Neben dem Herz-Kreislauf-System stellt das Bewegungssystem einen Fokus der sportarztlichen Untersuchung dar. Apparative Untersuchungen, insbesondere das EKG, erganzen die Untersuchungen und sind bei bestimmten Voraussetzungen obligate Bestandteile. Zur Einschatzung korperlicher Belastbarkeit dienen sportmotorische Tests. Sie konnen im Rahmen der Belastungsevaluation, Trainingssteuerung und Leistungsdokumentation eingesetzt werden. Im Rahmen der Vorsorgeuntersuchungen fungiert der Arzt als Gesundheitsberater und kann entsprechend den Leitlinien gesundheitsforderliche Bewegung zur Pravention lebensstilbedingter Volkskrankheiten empfehlen sowie etablierte Angebote (z. B. »Rezept fur Bewegung«) konkretisieren. Basis fur gesundheitsorientierte Bewegungsangebote stellen in Deutschland vor allem die Sportvereine, aber auch Fitnessstudios und andere Anbieter dar. Die Angebote (insbesondere Rehabilitationssport und Funktionstraining) besitzen teilweise Qualitatssiegel und werden von den Kostentragern des offentlichen Gesundheitssystems unterstutzt.

Abwechslungsreiche regelmasige Belastungen des Bewegungs- und Herzkreislaufsystems sowie aktivitatsbedingte Anforderungen an das Nervensystem und die inneren Organe trainieren eine hohe Anpassungs- und Leistungsfahigkeit des kindlichen und jugendlichen Organismus. Im Kleinkindalter dominieren spielerische Aktivitaten. Schnelligkeits- und Ausdaueraspekte im Schulkindalter sowie Kraftausdauer und Maximalkraft im weiteren Entwicklungsverlauf komplettieren die Bewegungsmuster. Praventive Aspekte durch Bewegung sind bereits im Kindesalter nachweisbar und entfalten ihre Wirkung insbesondere am Bewegungsapparat und bei der Pravention von Stoffwechselerkrankungen (incl. Ubergewicht). Die Intensitat und Dauer eines Ausdauertrainings sollte altersentsprechend durchgefuhrt werden und motivationale Aspekte des Kindes beachten. Beim Krafttraining, welches bereits im Schulkind- und Jugendalter durchgefuhrt werden kann, ist auf eine technisch korrekte Ausfuhrung durch Anleitung und Betreuung zu achten, um langfristig die Strukturen des Bewegungsapparates zu stabilisieren. Schmerzen, vegetative Symptome, sportliche Stagnation sowie Leistungseinbusen in anderen Lebensbereichen sind typische Warnsignale fur eine Uberlastung. Chronische Krankheiten im Kindesalter stellen keinen Hinderungsgrund fur Bewegung und Sport dar. Korperliche Aktivitat kann im Gegenteil supportiv wirksam sein und die medizinische Therapie unterstutzen, mindestens aber die Lebensqualitat verbessern.

The peripheral blood stem cell transplantation (PBSCT) represents a specific, but stressful therapy for hemato-oncological diseases. While for adults, data suggest positive eff ects for a supportive sport therapy, this question is not evaluated sufficiently for children. The objective of this study was to examine the integration of sports activity into pediatric PBSCT and to indicate attainable results. This 2-step case-control-study included 23 children and adolescents from the PBSCT: During the isolation phase 13 patients trained 3 times per week on a cycle ergometer and passed a course with different sports equipment. Apart from recording physiologic adaptations, quality of live was inquired in a pre-post design using questionnaires. Guided interviews according to necessity and requirements for sports activity at the PBSCT unit completed the evaluation and were used for the intervention as well as for the control group (n = 10) without sports therapy. On the ergometer, patients trained average 25 min with 0.6 watt / kg. In the majority, a loss of muscular power could be avoided. Quality of life and fatigue symptoms improved by trend. Interview analysis showed general acceptance of physical activity during PBSCT. After initial skepticism due to the additional burden, our implementation study showed the feasibility of supportive sports therapy in PBSCT. Quality and flexibility of the equipment should be higher than normal and different physical and psychological conditions of the patients should be anticipated and integrated into the training program.

The promotion of sport talents in Germany is federally standardised. Apart from the training and management support, annual sports-medical investigations with standardised procedures are mandatory for athletes' health and safety. For the first time, this study evaluates the prevalence ratio of medical findings in Hessian top athletes. The data of all athletes presenting in one of the 27 licenced examination centres in Hesse during the period of investigation were evaluated for age, sex and sports discipline as well as medical findings and a trinomial classification of the sports-related health status. The completeness of this collection in the relevant period from November 2006 to October 2007 was assured by cross-checking the application charts of all related sports associations. Data of 1620 (m: 904, 14.8 +/- 2.5 years; w: 716, 14.3 +/- 2.6 years) of all 1713 athletes presenting during the evaluation period were used for analysis. Medical findings (e. g., resulting in follow-up evaluation or further consultations) were seen in 83.5 % of all athletes. A small group (3.6 %) was temporarily, and one single athlete was completely exempted from sports participation. These results underline (additionally to the preventive capability of sports-medical investigations) the need for an annual medical consultation of juvenile athletes. Further investigations should be extended to other districts and classes and might evaluate the direct and indirect costs of diseases. Language: en

This study was done to investigate the effects of a standardized acupuncture treatment on symptoms and muscle function in exercise-induced delayed-onset muscle soreness (DOMS).A prospective, randomized, controlled, observer and subject-blinded trial was undertaken. Twenty-two (22) healthy subjects (22-30 years; 10 males and 12 females) were randomly assigned to three treatment groups: real acupuncture (deep needling at classic acupuncture points and tender points; n = 7), sham-acupuncture (superficial needling at nonacupuncture points; n = 8), and control (no needling; n = 7). DOMS of the nondominant elbow-flexors was experimentally induced through eccentric contractions until exhaustion. The outcome measures were pain perception (visual analogue scale; VAS; range: 0-10 cm), mechanical pain threshold (MPT; pressure algometer), and maximum isometric voluntary force (MIVF; force transducer). Treatment was applied immediately, 24 and 48 hours after DOMS induction. Measurements of MPT and MIVF were made prior to DOMS induction as well as before and after every treatment session. VAS data were acquired after DOMS induction as well as pre- and post-treatment. Final pain, MPT, and MIVF measurements were performed 72 hours after DOMS induction.Following nonparametric testing, there were no significant differences between groups in outcome measures at baseline. After 72 hours, pain perception (VAS) was significantly lower in the acupuncture group compared to the sham acupuncture and control subjects. However, the mean MPT and MIVF scores were not significantly different between groups.Although acupuncture seemed to have no effects on mechanical pain threshold and muscle function, it proved to reduce perceived pain arising from exercise-induced muscle soreness.

Korperliche Bewegung bei Heranwachsenden stellt wegen der in den industrialisierten Landern zunehmenden Adipositas und den damit verbundenen Risiken einen wichtigen Fokus praventivmedizinischer Beratung dar. Sportmedizinische Untersuchungen bestehen immer aus Anamnese, korperlicher Untersuchung und Ruhe-EKG. Neben fakultativen apparativen Tests sind bei Auffalligkeiten weitere Untersuchungen, v. a. bildgebende Verfahren, notwendig. Zur Unfallprophylaxe konnen Visus- und Horprufung sinnvoll sein. Der Motivation zu einer sportmedizinischen Untersuchung liegen oft die Vereins- und Kaderzugehorigkeit oder die Initiative der Eltern zugrunde. Die Sportler stellen sich meist ohne wesentliche Krankheitssymptome vor. Die Untersuchung berucksichtigt daher die Belastungssituation der ausgeubten Sportarten oder sollte ein Beratungsangebot zum Einstieg in den Sport und mehr Bewegung sein. Insgesamt liefert sie eine umfassende Analyse gesundheitlicher Ressourcen, belastungsassoziierter Schadigungen und latenter oder vorhandener Krankheiten. Aus praventivmedizinischer Perspektive ist sie gleichzeitig wichtiger Bestandteil einer langfristig optimalen Ausubung korperlicher Aktivitat fur jeden Sporttreibenden.

Sportmedizinische Untersuchungen im Kindes- und Jugendalter basieren auf Anamnese, korperlicher und apparativer Untersuchung. Letztere konnen neben obligatorischen Diagnostiken auch fakultative Tests insbesondere bildgebende Verfahren fur notwendige individuelle Untersuchungen beinhalten. Der Atemapparat, das Herz-Kreislauf und das Bewegungssystem stellen Schwerpunkte dieser praventiven Untersuchung im Sinne eines Sportgesundheitstestes dar, sodass sich teilweise Schnittpunkte zu den regularen kinderarztlichen Vorsorgen („U-Untersuchung“, „Mutter-Kind-Pass“) ergeben. Eine bundeslandumfassende Untersuchung zu den erhobenen Befunden einer sportmedizinischen Konsultation von Landeskaderathleten (n= 1713) ergab bei uber 80 % der Athleten beobachtungswurdige Befunde. Bei ca. 4 % aller Untersuchten fuhrte dies zu einer Einschrankung der Sportteilnahme. Die Resultate betonen zusatzlich zu dem praventiven Potential sportmedizinischer Konsultationen die Notwendigkeit regelmasiger Untersuchungen bei jungen Sportlern.

Functional Overreaching During Preparation Training of Elite Tennis Professionals This case study evaluated the response of objective and subjective markers of overreaching to a highly demanding conditioning training mesocycle in elite tennis players to determine 1) whether players would become functionally or non-functionally overreached, and 2) to explore how coherently overreaching markers would respond. Performance, laboratory and cardiac autonomous activity markers were evaluated in three experienced male tennis professionals competing at top 30, top 100 and top 1000 level before and after their strength and conditioning training was increased by 120, 160 and 180%, respectively, for 30 days. Every week, subjective ratings of stress and recovery were evaluated by means of a questionnaire. After 74, 76 and 55 h of training, increases in VO2max (+8, +5 and +18%) and speed strength indices (+9, +23 and +5%) were observed in all players. Changes of maximal heart rate (-5, -6, +4 beats per minute), laboratory markers (e.g. insulin-like growth factor -26, -17, -9%; free testosterone to cortisol ratio -63, +2, -12%) and cardiac autonomous activity markers (heart rate variability -49, -64, -13%) were variable among the players. Improved performance provides evidence that overreaching was functional in all players. However, several overreaching markers were altered and these alterations were more pronounced in the two top 100 players. The response of overreaching indicators was not coherent.

The present case report assesses the individual performance-related workload in three male children with left ventricular outflow tract (LVOT) obstruction during alpine skiing. Spirometric data (VO(2)) and heart rate (HR) were monitored during alpine skiing in various terrains according to the subject's performance level. A portable spirometric device was used for on-slope data sampling. Relative workload was calculated in relation to peak cardiorespiratory values, obtained during an incremental laboratory cycle test. On the slope the subjects reached 78% to 103% of their peak ergometric HR and a VO(2peak) of 65% to 100%. Young beginners and intermediates with LVOT obstruction seem to face a high cardiorespiratory stress during alpine skiing. For the beginner, an additional load is seen during uphill sidestepping with skis. In children suffering from congenital heart disease, physiological aspects of sports activities such as skiing should not be viewed separately from the possibilities of sports participation and social interactions.

The physical demands upon players in professional tennis have been increasing over the past few years. Currently, average intensities range between 60% and 70% of maximum oxygen uptake.1 Tennis can be classified as a mainly anaerobic activity with emphasis on glycolysis and glycogenolysis.2 However, taking into consideration incomplete physiological regeneration between points, as well as between matches and tournaments, a high cardiorespiratory capacity may help to avoid fatigue3 and aid in recovery, thus promoting continuous success in professional tennis.1 4 The relative importance of aerobic capacity may depend on an individual athlete’s preferred strategy, as the proportion of playing time versus total match time varies with playing style.5 Average point duration may reach more than 15 seconds when baseline players are in control of a rally, as opposed to