Thursday-Abstracts
Thursday-Abstracts
Thursday-Abstracts
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<strong>Thursday</strong>, May 30, 2013<br />
S176 Vol. 45 No. 5 Supplement<br />
C-15 Thematic Poster - Diet, Exercise, and<br />
Glycemic Response<br />
May 30, 2013, 8:00 AM - 10:00 AM<br />
Room: 104<br />
983 Chair: Jill A. Kanaley, FACSM. University of Missouri,<br />
Columbia, MO.<br />
(No relationships reported)<br />
984 Board #1 May 30, 8:00 AM - 10:00 AM<br />
Effect of a high Protein Breakfast on Glycemic Control in<br />
Individuals with Type 2 diabetes<br />
Young-Min Park, Timothy D. Heden, Ying Liu, Lauryn M.<br />
Nyhoff, Heather J. Leidy, John P. Thyfault, Jill A. Kanaley,<br />
FACSM. University of Missouri, Columbia, MO.<br />
(No relationships reported)<br />
Considerable research has focused on carbohydrate (CHO) content of the breakfast<br />
meal on the second meal effect, but very little research has focused on protein-rich<br />
breakfast meals in individuals with type 2 diabetes (T2D).<br />
PurPOsE: To determine whether a high protein breakfast provides better glycemic<br />
control following both the breakfast and lunch meal compared to a high CHO<br />
breakfast.<br />
METhOds: Seven subjects with T2D completed two, 7-day conditions in random<br />
order in which they consumed either a 500 kcal high protein (PRO: 40% CHO, 40%<br />
protein, 20% fat) or high CHO (CHO: 65% CHO, 15% protein, 20% fat) breakfast<br />
for 6 days of acclimatization. On the 7th day, they underwent mixed meal testing in<br />
which they consumed the respective breakfast followed by a standard lunch meal (500<br />
kcal, 65% CHO, 15% protein, 20% fat). Blood samples were collected over the 9-h<br />
period and analyzed for glucose, insulin, c-peptide, and glucagon. The area under the<br />
curve (AUC) for the 4-h post-breakfast and -lunch was used to quantify and compare<br />
postprandial responses between conditions.<br />
rEsuLTs: The glucose AUC was not significantly different between conditions for<br />
either meal. The condition x meal effect for the insulin AUC approached significance<br />
(p=0.058), such that there was a slightly greater insulin AUC after the lunch meal in<br />
the PRO compared to the CHO (PRO +31% vs. CHO +12%). The c-peptide AUC after<br />
the lunch meal was greater compared to the breakfast meal (+12%, p
Official Journal of the American College of Sports Medicine<br />
oxidation were calculated using stoichiometric equations (Frayn, 1983) with the<br />
assumption that urinary nitrogen was negligible.<br />
rEsuLTs: Paired t test showed that mean (pre 2.27±0.6 V post 1.73±0.62 g.min-1)<br />
rate of CHO metabolism during submaximal runs was significantly lower (p0.05).<br />
CONCLusIONs: The results of this study indicate that a 4 weeks dietary intervention<br />
with LGI CHO may lower the rate of CHO without<br />
altering other cardiorespiratory parameters and the energy cost of exercise.<br />
988 Board #5 May 30, 8:00 AM - 10:00 AM<br />
Glycemic response after Exercise and Ingestion Of dextrose<br />
In Type 2 diabetics<br />
Gisela Arsa1 , Laila J. Lima2 , Daisy M. Santos3 , Wesley S.<br />
Almeida2 , Carmen Sg Campbell2 , Herbert G. Simões2 . 1Federal University of Mato Grosso, Cuiabá - MT, Brazil. 2Catholic University of Brasilia, Brasília - DF, Brazil. 3Federal University<br />
of Minas Gerais, Belo Horizonte - MG, Brazil.<br />
(No relationships reported)<br />
PurPOsE: The presence of type 2 diabetes (T2D) increases the risk of developing<br />
coronary arterial diseases. This study aimed was to determine if exercise prior to<br />
dextrose intake minimizes the increase in blood glucose.<br />
METhOds: Nine DB2 individuals (54.9 ± 1.8 years, 30.7 ± 1.9 kg·m2-1 , 5.5 ± 1.3<br />
years diagnostic T2D) underwent one session comprising twenty minutes of exercise<br />
(EX) at moderate intensity (workload corresponding to 90% of Lactate Threshold)<br />
on a cycle ergometer, and a control session (CT) in randomized order. After the<br />
exercise or control period the individuals remained seated for 135 min. At 45<br />
minutes of post-exercise recovery (R0), a dextrose solution (DS; 0.5g/kg) was<br />
administered and blood glucose levels were monitored every fifteen minutes for<br />
90 min. Repeated measures ANOVA and t-test were used for comparisons within and<br />
between sessions, respectively.<br />
rEsuLTs: Blood glucose increased (p 0.05).<br />
CONCLusIONs: Thus, increases in blood glucose after a DS ingestion has not been<br />
minimized by prior exercise.Supported by CAPES/PROCAD grant 0216054.<br />
989 Board #6 May 30, 8:00 AM - 10:00 AM<br />
Comparing Interval and Continuous Exercise on Glycemic<br />
Control, affect, Enjoyment and Preference in Inactive Obese<br />
adults<br />
Amy E. Wright, Mary E. Jung, Wendi L. Wright, Michelle<br />
Sawatsky, Jonathan P. Little. University of British Columbia,<br />
Kelowna, BC, Canada.<br />
(No relationships reported)<br />
Exercise improves glycemic control, yet comparisons between acute high-intensity<br />
interval training (HIT) and continuous moderate-intensity exercise (CMI) are limited.<br />
There is also limited research comparing affective and enjoyment responses to these<br />
two exercise modalities.<br />
PurPOsE: To examine the acute effects of HIT versus CMI on glycemic control,<br />
in-task exercise affect, enjoyment, and preference.<br />
METhOds: Ten inactive adults (n=8 female, 41±3 yrs, 36±2 kg/m 2 ) completed<br />
one bout of HIT and CMI, separated by seven days in a randomized counterbalanced<br />
fashion. HIT consisted of 10 x 1-min cycling intervals eliciting ~90% maximal<br />
heart rate (HR max ) separated by 1-min recovery. CMI was matched for total work<br />
output and involved 30 minutes of steady-state cycling at ~65% HR max . Exercise was<br />
performed two hours after a standardized breakfast. Feeling Scale (FS), rating of<br />
perceived exertion (RPE) and HR were recorded at 20%, 50% and 90% of exercise<br />
bout completion. Exercise enjoyment was assessed immediately post-exercise. Upon<br />
Vol. 45 No. 5 Supplement S177<br />
completion of the study, preference for HIT or CMI was assessed. Individualized diets<br />
were provided 24-hr before and after each exercise bout. Blood glucose (BG) levels<br />
for 24-hr following HIT and CMI were measured using continuous glucose monitoring<br />
(CGM) and comparisons were made to a non-exercise control day under identical diet<br />
conditions.<br />
rEsuLTs: Mean 24-hr BG was unaffected by either exercise modality (p>0.05).<br />
However, AUC for breakfast on the following day was significantly reduced following<br />
HIT (p=0.01) but not CMI. Similarly, pre-to-post meal glucose spikes for dinner<br />
(p
<strong>Thursday</strong>, May 30, 2013<br />
S178 Vol. 45 No. 5 Supplement<br />
regular physical activity and healthy eating behaviors. One outcome of the program is<br />
maximal aerobic capacity. The purpose of this study was to determine the relationship<br />
between predicted and measured peak oxygen consumption (VO 2 peak) in overweight<br />
and obese breast cancer survivors.<br />
METhOds: To date, 23 women (mean age 53.6 yrs) who were at least 12 months<br />
after completion of treatment for hormone-receptor negative breast cancer with a BMI<br />
> 25 (mean 31.3 kg/m 2 ) have been enrolled into the study. At baseline, all women<br />
underwent full cardiopulmonary exercise testing to volitional maximal levels using<br />
a modified Balke treadmill protocol with measured expired gas analysis. Measured<br />
VO 2 peak was compared to VO 2 peak predicted from standard equations utilizing<br />
treadmill speed and grade. A t-test was performed to determine difference and<br />
significance was set at p < 0.05.<br />
rEsuLTs: At baseline, mean measured VO 2 peak was 19.9 ml/kg/min (SD = 4.9),<br />
which was significantly (p
Official Journal of the American College of Sports Medicine<br />
exercise training at 60 minutes a day; 3 days per week. The intervention consisted of<br />
progressive cardiovascular and whole-body strength training. Participants were then<br />
reassessed following the intervention.<br />
rEsuLTs: There were significant increases in pre to post VO2peak[[Unsupported<br />
Character - Codename ­]] (19.1 to 23.4 mL·kg-1·min-1; p=.006), chest press (50.3<br />
to 62.0 lbs.; p=.016), and leg press (143.2 to 190.8 lbs.; p=.000). CRF significantly<br />
decreased (4.37 to 2.97; p=.006) from pre to post exercise. A negative correlation was<br />
observed between CRF and leg press (p= .07, r= -.430) and VO2peak (p = .36, r=<br />
-.23), however, a positive correlation was seen with chest press (p=.55, r= .15). This<br />
suggests that lower body exercises may have a greater effect on the reduction of CRF<br />
than cardiovascular fitness.<br />
CONCLusIONs: Cancer treatment-related side-effects lengthen the recovery process<br />
post treatment for cancer survivors. The results of this study demonstrate that exercise<br />
interventions increase strength and cardiovascular fitness while decreasing CRF.<br />
Cardiovascular fitness and lower body strength correlate with a reduction in CRF.<br />
Lower body strength was shown to have a higher correlation with decreased CRF than<br />
upper body strength or cardiovascular fitness. Therefore, rehabilitation programs for<br />
cancer survivors with a goal of reducing CRF should incorporate lower body strength<br />
training.<br />
997 Board #7 May 30, 8:00 AM - 10:00 AM<br />
Moderate Intensity acute aerobic Exercise Effect on Natural<br />
Killer Cell Counts in Breast Cancer survivors<br />
Claudio Battaglini, Elizabeth Evans, Robert McMurray, FACSM,<br />
Scott Randell, Hyman Muss, A.C. Hackney, FACSM. University<br />
of North Carolina at Chapel Hill, Chapel Hill, NC.<br />
(No relationships reported)<br />
Current research examining the effect of acute aerobic exercise on immune responses<br />
in cancer survivors is limited.<br />
PurPOsE: To examine the effect of one acute bout of aerobic exercise on natural<br />
killer (NK) cell counts in breast cancer survivors (BCS) and healthy controls (C).<br />
METhOds: Participants included 9 women who had completed major treatments<br />
for Stage I-III invasive breast cancer within 3-6 months of enrollment and 9 sedentary<br />
women without a history of cancer. Subjects completed a 30-minute bout of exercise<br />
on the cycle ergometer at 60% of VO2peak. Blood samples were taken pre-exercise,<br />
immediately post-exercise, 2 hours post-exercise, and 24 hours post-exercise.<br />
Complete blood counts were obtained at each time point. Proportions of lymphocytes<br />
that carry the NK cell phenotype (CD3-CD16+CD56+) were obtained via flow<br />
cytometric analysis. NK cell counts were compared between groups across time points<br />
using a 2x4 mixed model ANOVA.<br />
rEsuLTs: NK cell counts rose significantly from pre-exercise to immediately postexercise<br />
in both the BCS and C groups (70.3 ± 37.9 cells/μL to 214.3 ± 132.0 cells/<br />
μL, p = 0.003 and 108.9 ± 51.7 cells/μL to 357.5 ± 171.1 cells/μL, p = 0.001). At 2<br />
hours post-exercise, NK cell counts tended to remain elevated in the BCS group (92.1<br />
± 62.4 cells/μL) relative to pre-exercise (p = 0.096). At 24 hours post-exercise, NK cell<br />
counts also tended to be elevated in the BCS group (106.3 ± 66.8 cells/μL, p = 0.052)<br />
and in the C group (142.3 ± 74.6, p = 0.097) relative to pre-exercise. When comparing<br />
between groups, NK cell counts were somewhat lower in the BCS group compared to<br />
the C group pre-exercise (p = 0.09) and immediately post-exercise (p = 0.064).<br />
CONCLusIONs: Although some lower in NK cell counts, recent BCS seem to<br />
exhibit a normal NK cell response to acute moderate intensity aerobic exercise as<br />
compared with similar women without a history of cancer.<br />
Supported by UNC Lineberger Comprehensive Cancer Center and Petro Kulynych<br />
Foundation<br />
998 Board #8 May 30, 8:00 AM - 10:00 AM<br />
The utility of Exercise or Pharmacological stress in<br />
Identifying Cardiac damage in Breast Cancer survivors<br />
Amy A. Kirkham, Kristin L. Campbell. University of British<br />
Columbia, Vancouver, BC, Canada.<br />
(No relationships reported)<br />
The addition of myocardial stress to cardiac imaging techniques may increase<br />
sensitivity in identifying breast cancer treatment (BCT) related cardiac damage.<br />
PurPOsE: To systematically review whether cardiac imaging with exercise or<br />
pharmacologic stress (SI) can better identify cardiac damage in breast cancer survivors<br />
(BCS) than imaging at rest (RI).<br />
METhOds: Medline, Embase and CINAHL were searched using (breast cancer)<br />
AND (keywords related to cardiac imaging) AND (keywords related to cardiotoxic<br />
BCT or related cardiac issues). All experimental or observational studies including ≥2<br />
cardiac imaging techniques/parameters and BCS only, were searched to identify studies<br />
that used both SI and RI. Studies were also excluded if they did not report the SI data<br />
for ≥10 BCS or included cancer treatments no longer used for BCS. Ten studies were<br />
included in the review and relevant data extracted. The results of SI were compared to<br />
those of RI, and each study was labeled as “no benefit,” “some benefit,” or “benefit,”<br />
based on whether the SI identified cardiac damage that was not detected by the RI.<br />
rEsuLTs: Overall, 3 studies showed “no benefit”, 2 showed “some benefit” and<br />
5 showed a “benefit” of SI over RI. The use of exercise or pharmacologicals to<br />
Vol. 45 No. 5 Supplement S179<br />
induce myocardial stress was evenly split amongst the studies showing “benefit”<br />
or “some benefit” (1 study used both). Six of the 7 studies showing at least some<br />
benefit were long-term follow-up (LTFU) studies of 34 months to 18 years posttreatment<br />
(chemotherapy and/or radiation), and the other followed patients through<br />
chemotherapy up to 18 months later. All of the studies with LTFU of radiation<br />
treatment (n=5) (some included chemotherapy as well), showed at least some benefit of<br />
SI over RI, with the exception of one study reporting no damage with SI or RI. These<br />
studies all used myocardial perfusion imaging (MPI) techniques. Other techniques<br />
showing the benefit of SI were echocardiography (n=2, 1 during and 1 LTFU to<br />
chemotherapy) and ECG (n=2, both LTFU to radiation and/or chemotherapy).<br />
CONCLusIONs: MPI with exercise or pharmacological stress appears to be<br />
beneficial for detection of cardiac damage in LTFU to radiation treatment for breast<br />
cancer. Both ECG and echocardiography with stress merit further research to<br />
determine their utility in identifying BCT-induced cardiac damage.<br />
C-17 Thematic Poster - Perceptual and Cognitive<br />
Response to Heat Exposure<br />
May 30, 2013, 8:00 AM - 10:00 AM<br />
Room: 207<br />
999 Chair: Alan Utter, FACSM. Appalachian State University,<br />
Boone, NC.<br />
(No relationships reported)<br />
1000 Board #1 May 30, 8:00 AM - 10:00 AM<br />
skin Temperature and heart rate Estimate Physiological<br />
strain during Exercise In The heat<br />
John Cuddy1 , Mark Buller2 , Walter Hailes1 , Brent Ruby,<br />
FACSM1 . 1The University of Montana, Missoula, MT. 2US Army<br />
Research Institute of Environmental Medicine, Natick, MA.<br />
(No relationships reported)<br />
Skin temperature and heart rate have previously been used to predict physiological<br />
strain during exercise in the heat.<br />
PurPOsE: To evaluate the previously developed physiological strain index model<br />
using heart rate and skin temperature to provide further insight into the detection and<br />
estimation of thermal and physiological heat strain indices. A secondary aim was to<br />
characterize individuals who excel in their performance in the heat compared to those<br />
who perform poorly.<br />
METhOds: 56 male participants (22 ± 3 yrs, 181 ± 9 cm, 81 ± 12 kg, 4.2 ± 0.6<br />
L•min-1) completed the study. Participants completed 2 trials using a randomized,<br />
counterbalanced cross-over design in a temperature and humidity controlled<br />
environmental chamber in ambient conditions of 43.3°C and 40% relative humidity,<br />
and 15.5°C and 40% humidity. Core and skin temperature, along with heart rate and<br />
physiological strain index, were continually monitored during exercise. Additionally,<br />
participants completed a United States Marine Corps (USMC) physical fitness test.<br />
rEsuLTs: Based on the highest PSI achieved during the 90 minute walk, 23<br />
participants were classified in the “At Risk” group while 33 participants were classified<br />
in the “Not at Risk” group. The logistic regression model exhibited 4 false positives and<br />
1 false negative at the 40% decision boundary. The “Not at Risk” group had higher body<br />
weight (84 ± 13 vs. 77 ± 10 kg, respectively) and fat free mass (71 ± 9 vs. 64 ± 8 kg,<br />
respectively) compared to the “At Risk” group, p
<strong>Thursday</strong>, May 30, 2013<br />
S180 Vol. 45 No. 5 Supplement<br />
perceived exertion and thermal comfort. Although the PeSI may be useful in the field<br />
when HR/Tc are unavailable, previous research has found discrepancies between the<br />
indexes.<br />
PurPOsE: To assess the correspondence between PSI and PeSI under two<br />
environmental conditions.<br />
METhOds: Participants (n=18) completed a heat tolerance test (HTT; 40°C/40%RH)<br />
and thermoneutral tolerance test (TTT; 20°C/40%RH) by walking at 5km/h, 2% grade<br />
for 120 min; they provided ratings for PeSI every 20min. Percent body fat (skinfold<br />
analysis), VO2max (maximal aerobic power test) were measured and sweat rate (SW),<br />
Max HTT/TTT HR and Tc were assessed during the tests. Data were analyzed first by<br />
correlating all PeSI/PSI values across time points for HTT/TTT. Then we correlated<br />
max PeSI/PSI for HTT alone. Lastly, participants were grouped by calculating PSI-<br />
PeSI discrepancies during HTT into poor (Pest: Max PSI - max PeSI > 1) vs. good<br />
(Gest: Max PSI - max PeSI ≤ 1) estimators.<br />
rEsuLTs: Combining 247 PeSI ratings, the PeSI correlated with PSI (r = 0.51).<br />
As expected, PeSI and PSI values were lower during TTT than HTT, but the strength<br />
of the relation between PSI and PeSI did not differ by test. The most common PeSI<br />
values were -1 to 3, and corresponded with these average PSI values: PeSI = -1, PSI<br />
of 2.1±1.1; PeSI: 0, PSI 2.1±1.1 / PeSI 1, PSI 1 2.6±1.1 / PeSI: 2, PSI 3.1±1.3 / PeSI:<br />
3, PSI 2.9±1.3. HTT max PeSI (3.4±1.3) did not correlate with max PSI (4.6±1.5) (r<br />
= 0.37, p = 0.13). Individuals categorized as Pest (n=9) had significantly higher HTT<br />
max Tc (38.2±0.3 vs 37.7±0.4C, p < 0.01) and max HR (140.1±11.8 vs 113.8 ±21.0) as<br />
compared to Gest; HTT max PeSI, TTT values, %body fat, VO2 max did not differ by<br />
estimator group.<br />
dIsCussION: Across temp conditions under a mild exercise challenge, PeSI<br />
correlated with PSI. However PeSI values did not map onto the same PSI values.<br />
Participants who were poor at estimating their heat strain had higher HR and Tc<br />
responses to HTT. Future work might focus on accurately assessing thermal comfort in<br />
addition to perceived exertion prior to environmental exposure.<br />
1002 Board #3 May 30, 8:00 AM - 10:00 AM<br />
Perceptual responses in Predicting Physiological Measures<br />
of heat stress While Wearing Three Work Clothing<br />
Ensembles<br />
Rebecca M. Lopez, Jason Martuscello, Candi D. Ashley, Eric<br />
Coris. University of South Florida, Tampa, FL. (Sponsor:<br />
Douglas J. Casa, FACSM)<br />
(No relationships reported)<br />
Protective equipment is commonly used in athletic, military and occupational settings.<br />
Despite its effectiveness in protecting individuals from collisions or harmful chemicals<br />
and environments, protective clothing can unintentionally lead to uncompensable heat<br />
stress. Adequately assessing an individual’s physiological state may be difficult due to<br />
stressful environments, protective clothing, or other obstacles.<br />
PurPOsE: To investigate the efficacy of using a modified Environmental Symptoms<br />
Questionnaire (ESQ) and thirst (TST) and thermal (THM) responses in predicting body<br />
temperature (TGI) while wearing 3 ensembles.<br />
METhOds: Fifteen healthy subjects (8 males; 7 females; 24.1 ± 4.7 yr, 76.0 ± 19.2<br />
kg, 170.9 ± 9.3 cm, BSA 1.87 ± 0.26 m2) volunteered in a crossover, randomized<br />
design study. Subjects first completed a familiarization heat stress trial (HST) in<br />
shorts and t-shirt then in WORK (135 g m-2 cotton shirt and 270 g m-2 cotton pants),<br />
WATER (water-barrier, vapor-permeable coverall; NexGen), and VAPOR (vaporbarrier<br />
coverall; Tyvek). HST consisted of treadmill walking in 35 oC and 50% RH at<br />
160 w/m2 for 120 min or until volitional exhaustion or TGI reached 39 oC. Data were<br />
analyzed using a repeated measures 2-way (ensembles x time) ANOVA. The grouped<br />
Pearson product moment correlation was used to analyze relationships between TGI<br />
and perceptual measures.<br />
rEsuLTs: TGI in VAPOR (38.57 ± 0.12 oC) was greater at finish than WORK (37.72<br />
± 0.09 oC; p = .001), and WATER (37.64 ± 0.16 oC; p = .001). Trial time for VAPOR<br />
(91.4 ± 7.7 min) was shorter than all other trials (F1,14= 13.811, p = .002). Significant<br />
correlations were found between TGI and ESQ at 30-min (r = .26, p = .042), 60-min<br />
(r = .41, p = .042), 90-min (r = .26, p = .05), and finish (r = .34, p = .008). Significant<br />
correlations between TGI and TST were found at 90-min (r = .29, p = .032) and finish<br />
(r = .28, p= .031), while relationships between TGI and THM were found at 60-min (r<br />
= .56, p = .000) and finish (r = .33, p = .010).<br />
CONCLusION: Positive relationships between TGI and perceptual measures and<br />
ESQ indicate a potential use for these measures as prevention tools when working in<br />
the heat with various work ensembles. Although physiological measures of heat strain<br />
should supersede perceptual measures, the modified ESQ and other measures can help<br />
ensure workplace safety and health.<br />
MEDICINE & SCIENCE IN SPORTS & EXERCISE ®<br />
1003 Board #4 May 30, 8:00 AM - 10:00 AM<br />
The Effect of ad Libitum hydration on Cognitive Function<br />
Following Exercise in the heat<br />
Matthew T. Wittbrodt1 , Christopher C. Cheatham1 , Ross A.<br />
Sherman2 , YuanLong Liu1 . 1Western Michigan University,<br />
Kalamazoo, MI. 2Grand Valley State University, Allendale, MI.<br />
(Sponsor: Mindy Millard-Stafford, FACSM)<br />
(No relationships reported)<br />
Cognitive decrements are reported with dehydration of ≥ 2% body mass (BM). Since<br />
ad libitum hydration (AL) may fail to fully replace sweat loss during exercise in a<br />
hot environment and result in dehydration, the influence of AL on cognitive function<br />
following exercise is unclear.<br />
PurPOsE: To quantify the effect of an AL strategy on physiological responses and<br />
post-exercise cognitive function following exercise in the heat.<br />
METhOds: Twelve unacclimatized and recreationally active males (22.2 ± 2.4 yr)<br />
completed three 50 min cycling tests (60% VO2peak) in the heat (32 °C; 65% RH)<br />
with three hydration strategies: no fluid (NF), AL, and full fluid replacement to match<br />
sweat loss during NF (FR). Physiological responses were examined every 5 min. A<br />
cognitive battery assessing working memory, pattern recognition, perceptual speed,<br />
sustained attention, visual search and scanning speed, and executive function was<br />
administered pre- and post-exercise.<br />
rEsuLTs: Fluid loss during NF was greater than AL and FR (NF: -1.5 ± 0.6; AL: -0.3<br />
± 0.8; FR: -0.1 ± 0.3 % Body Mass; p < 0.001). Greater increases in core temperature,<br />
mean skin temperature, heart rate, rating of perceived exertion, and thermal sensation<br />
were observed after 35-50 min with NF compared to AL and FR (p < 0.05). No<br />
differences in cognitive measures were observed between hydration strategies but<br />
overall mean response time decreased (p < 0.05) in post- vs. pre-exercise measures for<br />
perceptual speed, working memory, and pattern recognition.<br />
CONCLusIONs: AL was as effective in mitigating thermoregulatory strain as FR<br />
and both were better than NF. Cognitive function was not impaired with or without<br />
fluid replacement but improved following moderate intensity exercise in the heat.<br />
1004 Board #5 May 30, 8:00 AM - 10:00 AM<br />
Effects of relative humidity on Thermoregulation and<br />
Perception during Low Intensity Exercise in the heat<br />
Nicole E. Moyen, Carolyn L.V. Ellis, Anthony B. Ciccone,<br />
Taylor S. Thurston, Kristen C. Cochrane, Lee E. Brown,<br />
FACSM, Jared W. Coburn, FACSM, Daniel A. Judelson,<br />
FACSM. California State University, Fullerton, Fullerton, CA.<br />
(No relationships reported)<br />
Limited research demonstrates increasing relative humidity (RH) impairs high intensity<br />
exercise performance in hot environments. As some athletes, military personnel,<br />
and day laborers work extended hours in hot humid climates, investigating RH’s<br />
independent effects during prolonged, low intensity exercise also merits attention.<br />
PurPOsE: To study how RH affected thermoregulation and perception during low<br />
intensity exercise in the heat.<br />
METhOds: Thirteen healthy male recreational exercisers (age = 23 ± 2 y, mass =<br />
83.1 ± 13.3 kg, height = 179.9 ± 5.9 cm, VO2max = 55.6 ± 7.3 ml/kg/min, body fat =<br />
12.6 ± 4.4%) walked for 90 min at 35% VO2max in 35 °C, completing trials at 40%<br />
RH (40RH), 55% RH (55RH), 70% RH (70RH), and 85% RH (85RH). Investigators<br />
obtained 1) heart rate, rectal temperature (Tre), skin temperatures, rating of perceived<br />
exertion, thermal sensation, thirst sensation, and environmental conditions every five<br />
min, 2) pulmonary ventilation and oxygen consumption every 25 min, and 3) pre and<br />
post nude body masses.<br />
rEsuLTs: No differences existed between 40RH and 55RH or between 70RH and<br />
85RH in sweat rate (40RH = 0.79 ± 0.21 L/h, 55RH = 0.83 ± 0.22 L/h, 70RH = 0.97<br />
± 0.29 L/h, 85RH = 1.07 ± 0.40 L/h) or hydration state (40RH = -0.61 ± 0.43%, 55RH<br />
= -0.62 ± 0.36%, 70RH = -0.93 ± 0.46%, 85RH = -0.98 ± 0.56%), but the higher RH<br />
trials elicited significantly greater sweat rate and percent hypohydration than the lower<br />
RH trials. Incremental RH increases caused non-linear increases in Tre such that: 1)<br />
40RH and 55RH equaled throughout trials, 2) 70RH exceeded 40RH and 55RH from<br />
35-90 min, and 3) 85RH exceeded all other trials from 40-90 min. Increases in Tre<br />
subsequently appeared to catalyze changes in skin temperatures, heart rate, pulmonary<br />
ventilation, oxygen consumption, rating of perceived exertion, and thermal sensation,<br />
which demonstrated similar patterns as Tre with minor temporal variations. Thirst<br />
behaved differently, with 85RH exceeding all other trials after 40 min and no other<br />
differences among trials.<br />
CONCLusIONs: In these conditions, a RH threshold for sufficient evaporative heat<br />
loss plausibly occurred between 55-70% RH and at a Tre of ~37.7 ± 0.3 °C. Exceeding<br />
this RH threshold overwhelmed thermoregulatory abilities, resulting in potentially<br />
dangerous physiological stress and higher perceptual ratings.<br />
ACSM May 28 - June 1, 2013 Indianapolis, Indiana
Official Journal of the American College of Sports Medicine<br />
C-18 Thematic Poster - Resistance Training<br />
May 30, 2013, 8:00 AM - 10:00 AM<br />
Room: 208<br />
1005 Chair: Matthew J. Delmonico. University of Rhode Island,<br />
Kingston, RI.<br />
(No relationships reported)<br />
1006 Board #1 May 30, 8:00 AM - 10:00 AM<br />
The Effect Of high-speed Power Training On Peak Power<br />
Production In Older adults<br />
Stephen P. Sayers, Gibson Kyle. University of Missouri -<br />
Columbia, Columbia, MO.<br />
(No relationships reported)<br />
PurPOsE:The production of muscle power requires both force and velocity, and<br />
maximizing the velocity component of power is critical to maintaining safety in<br />
older adults. For example, sufficient high-speed power could help move the lower<br />
limb quickly to stabilize the body and prevent a fall. The purpose of this study was to<br />
examine whether resistance training (RT) at high speed reduced the external resistance<br />
(and increased the velocity) at which peak power is produced.<br />
METhOds: 72 older adults (22m, 50f; Age=70.6±7.3yrs) participated in a lower<br />
extremity leg press RT program for 12 weeks. Participants were randomized to highspeed<br />
power training at 40% one-repetition maximum (1RM) (HSPT: n=25; 3 x 12-14<br />
reps), slow-speed strength training at 80%1RM (SSST: n=25; 3 x 8-10 reps) or control<br />
(CON: n=22; stretching) 3 times/week for 12 weeks. Leg press 1RM, Peak power (PP;<br />
the highest value obtained from 40%-90% 1RM) and the corresponding peak power<br />
velocity [PPV] and peak power force [PPF] were obtained at baseline and 12 weeks.<br />
A 3 x 2 repeated measures ANOVA was used to compare changes from baseline to 12<br />
weeks. Statistical significance was accepted at p
<strong>Thursday</strong>, May 30, 2013<br />
S182 Vol. 45 No. 5 Supplement<br />
training session of each week by multiplying sets, repetitions, and weight lifted. Blood<br />
was drawn at pre- and post-training and 30 minutes prior to each strength training<br />
session to analyze the time course of changes in testosterone and cortisol levels. TV<br />
was analyzed using a 2x6 (group x time) repeated measures ANOVA, while hormonal<br />
response was analyzed using a 2x8. Significance was set at p
Official Journal of the American College of Sports Medicine<br />
rEsuLTs: The muscule strength of 3 groups subjects have significantly<br />
improved (p
<strong>Thursday</strong>, May 30, 2013<br />
S184 Vol. 45 No. 5 Supplement<br />
1018 Board #4 May 30, 8:00 AM - 10:00 AM<br />
Effects Of stair Climbing Training On Balance, Gait,<br />
strength and submaximal Endurance In healthy seniors<br />
Lars Donath, Lukas Zahner, Ralf Roth, Martin Zwingli, Philipp<br />
Steiner, Oliver Faude. University of Basel, Basel, Switzerland.<br />
(No relationships reported)<br />
Stair climbing has been shown to induce a health-relevant additional energy<br />
expenditure and increase leg strength as well as maximal oxygen uptake in young<br />
adults. Data on effects of regular stair climbing on selected fall-risk factors in seniors<br />
are lacking.<br />
PurPOsE: To examine the effects of a guided stair-climbing intervention on balance,<br />
gait, strength and submaximal endurance in seniors with particular emphasis on<br />
differences between a 1- and 2-step ascending strategy.<br />
METhOds: 48 healthy seniors were randomly assigned (strata: age, gender, BMI)<br />
to either a 1-step strategy (INT1), a 2-step strategy (INT2) or a control group (CON).<br />
Nine seniors dropped out (health complaints, insufficient training compliance). Thus,<br />
39 seniors (females: n=22, males: n=17; age: 70.5 (SD 5.1) y; BMI: 25.8 (3.1) kg/m2)<br />
completed the 8-week training intervention (3 sessions per week, attendance 83%).<br />
The amount of stairs climbed per session progressively increased from 256 to 640<br />
stairs. The overall climbed altitude (INT1: 1659 (349) m, INT2: 1556 (235) m, p=0.38)<br />
and total vertical work (INT1: 1144 (290) kJ, INT2: 1126 (201) kJ, p=0.85) was<br />
similar for both groups. We assessed standing balance, spatio-temporal gait, maximal<br />
and explosive strength as well as submaximal endurance before and after the training<br />
period.<br />
rEsuLTs: We found a large effect for center-of-pressure path length displacement<br />
during right leg stance (np²=0.14, p=0.10, INT1: -14%; INT2: -9%, CON: +1%).<br />
Spatio-temporal gait parameters did not relevantly change. Large effects in favor of<br />
INT1 and INT2 were present for peak force during leg press (np²=0.16, p=0.04) as well<br />
as rate of torque development during right leg plantar flexion (np²=0.14, p=0.06). We<br />
found relevant decreases in heart rate (p=0.04, np²=0.16; INT1: -8 min-1, INT2: -10<br />
min-1, CON: -1 min-1), perceived exertion (p=0.01, np²=0.22; INT1: -1.2 (10-point<br />
Borg scale), INT2: -2.5, CON: +0.2) and lactate concentration (p=0.06, np²=0.14;<br />
INT1: -0.4 mmol/L, INT2: -0.5 mmol/L, CON: +0.1 mmol/L) during submaximal<br />
uphill (8% inclination) walking.<br />
CONCLusION: Independent of the ascending strategy, a guided stair climbing<br />
intervention beneficially affects cardio-metabolic endurance and selected strength<br />
parameters. The transfer to standing balance and gait characteristics seems restricted.<br />
1019 Board #5 May 30, 8:00 AM - 10:00 AM<br />
Physical Function In Nursing home residents as a Function<br />
Of Grip strength and Gender<br />
Sandra M. Matsudo 1 , Rafael Mancini 1 , Timoteo L. Araujo 1 ,<br />
Vagner Raso 2 , Victor KR Matsudo 1 . 1 CELAFISCS, São Caetano<br />
do Sul, Brazil. 2 2 Bandeirante University of Sao Paulo,<br />
UNIBAN, 3 UNOESTE, São Caetano do Sul, Brazil.<br />
(No relationships reported)<br />
PURPOSE To examine relationships between body composition and functional<br />
capacity according to grip strength and gender in nursing home residents.<br />
METHOD We measured body composition (body mass and body mass index), physical<br />
function (body balance, chair rise during 30 seconds, flexibility, time to up and go test<br />
[TUGT] and usual walking [WALK]) and grip strength in 147 nursing home residents<br />
(male [N=59], age equals to 71.5 ± 1.2 years-old and BMI equals to 24.9 ± 0.6 kg•m2;<br />
female [N=88], age equals to 76.1 ± 1.5 years-old and BMI equals to 26.5 ± 0.7<br />
kg•m2). Cognitive function was also estimated by mini-mental state examination.<br />
RESULTSWhen grip strength values were used to classify subjects into upper and<br />
lower halves of a fitness continuum, fitter subjects had a higher body mass (female,<br />
P=.023), body height (male, P=.010; female, P=.006), body balance (male, P=.017)<br />
and chair rise (male, P=.017; female, P=.041), but a lower velocity (male: TUGT,<br />
P=.041 and WALK, P=.011; female: TUGT, P=.001 and WALK, P=.005). Our multiple<br />
regression analyses demonstrated that TUGT (female, adjusted R2=.23, P=.001, no<br />
mediating effect), body balance (male, adjusted R2=.14, P=.038, mediated by age),<br />
WALK (female, adjusted R2=.17, P=.007, mediated by age and body mass) and<br />
chair rise (male, adjusted R2=.22, P=.006, mediated by cognitive function) were<br />
significantly predicted by grip strength.<br />
CONCLUSIONS Present data provide support for using grip strength as an overall<br />
indicator of physical function (about 20 percent of the explained variance) in nursing<br />
home residents. Nevertheless, this phenomenon appears to be explained by distinct<br />
variables in both genders.<br />
MEDICINE & SCIENCE IN SPORTS & EXERCISE ®<br />
1020 Board #6 May 30, 8:00 AM - 10:00 AM<br />
The Effects Of Velocity Of Movement On strength, Peak<br />
Power, and average Power In The Elderly<br />
Paul D. House, Melissa Powers, Kristin Bogda. University of<br />
Central Oklahoma, Edmond, OK.<br />
(No relationships reported)<br />
INTrOduCTION: As our aging population grows, it is important to gain a greater<br />
understanding of how this population responds to various exercise interventions. Aging<br />
is accompanied by a loss of strength and power resulting in a decline in functionality.<br />
PurPOsE: The purpose of this study was to determine if there is a difference in<br />
velocity of resistance training and maximal strength and power gains.<br />
METhOd: Fourteen adults (63-79 yrs) participated in one of two resistance training<br />
groups designated low velocity (LV) and high velocity (HV). Both groups resistance<br />
trained two non-consecutive days/week for 12 weeks consisting of eight different<br />
exercises. Both groups performed 3 sets of 8 repetitions at 60% of their 1RM for each<br />
exercise. The subjects in the LV group (n=5) were instructed to perform the concentric<br />
and eccentric phases of each repetition over a 2-3 second time intervals. Conversely,<br />
participants in the HV group (n=9) were instructed to lift the weights concentrically as<br />
fast as possible while lowering the weight over a 2-3 second period. Pre-training (Pre)<br />
and post-training (Post) 1 RM’s were measured for both groups. Average and peak<br />
powers were measured for both groups Pre and Post using a chair stand test.<br />
rEsuLTs: The Multivariate ANOVA test revealed significant strength increases over<br />
time for the, knee curl, lateral raises, and the bent over rows with p=0.014, p=0.009,<br />
and p=0.011 respectively. There was a significant group x time interaction for the LR<br />
as well (p=0.028) with the LV and HV means increasing 22% (SD=10.35) and 2.7%<br />
(SD=2.7%) respectively. Average power significantly improved overtime for both<br />
groups (p=0.043) however, there was not a significant interaction. Furthermore, there<br />
were no significant increases in peak power for either group (p=0.182).<br />
CONCLusION: These results indicate that either slow or high velocity resistance<br />
training result in increases in average power and 1RM strength in most lifts but not in<br />
peak power with the aged population. It would appear that slower lifting might result<br />
in moderately greater increases in strength compared to the faster lifting at the same<br />
intensity. The possible reason for this is the greater time under tension in the slow<br />
lifting group.<br />
C-20 Free Communication/Slide - Anterior Cruciate<br />
Ligament<br />
May 30, 2013, 8:00 AM - 10:00 AM<br />
Room: Wabash 3<br />
1021 Chair: Robin M. Queen. Duke University, Durham, NC.<br />
(No relationships reported)<br />
1022 May 30, 8:00 AM - 8:15 AM<br />
aCL Loading and Jump Performance are decreased With<br />
Increased Knee Flexion Landing and soft Landing<br />
Boyi Dai 1 , William E. Garrett, FACSM 2 , Michael T. Gross 3 ,<br />
Darin A. Padua 3 , Robin M. Queen 2 , Bing Yu 3 . 1 University<br />
of Wyoming, Laramie, WY. 2 Duke University, Durham, NC.<br />
3 University of North Carolina at Chapel Hill, Chapel Hill, NC.<br />
(No relationships reported)<br />
Anterior cruciate ligament (ACL) injuries usually occur during landing. One strategy<br />
to prevent ACL injuries is to adopt landing patterns that decrease ACL loading. Both<br />
landing with increased knee flexion and soft landing have been associated with decreased<br />
ACL loading. However, the effects of these two landings on performance remain unclear.<br />
PURPOSE: To determine the effects of landing with increased knee flexion and soft<br />
landing on ACL loading and jump performance during a stop-jump task.<br />
METhOds: Eighteen male and 18 female recreational athletes performed a stopjump<br />
task with three instructed techniques. The three techniques involved 1) jump<br />
as high as possible, 2) land with increased initial knee flexion and then jump as high<br />
as possible, 3) land softly and then jump as high as possible. Three-dimensional<br />
kinematic and ground reaction force data were collected for the dominant limb. Peak<br />
ACL force during landing was estimated from a musculoskeletal model. Performance<br />
variables included jump height, approach speed, stance time, and lower extremity<br />
mechanical work.<br />
rEsuLTs: Landing with increased knee flexion landing (0.64 body weight (BW))<br />
and soft landing (0.71 BW) both decreased peak ACL forces compared to regular<br />
landing (0.88 BW, p< 0.001). Landing with increased knee flexion (0.45 m) and soft<br />
landing (0.45 m) both decreased jump height compared to regular landing (0.48 m,<br />
p< 0.001). Soft landing (2.1 m/s) decreased approaching speed compared to regular<br />
landing (2.3 m/s, p< 0.001). Landing with increased knee flexion (0.45 s) and soft<br />
landing (0.39 s) both increased stance time compared to regular landing (0.32 s, p<<br />
0.001). Landing with increased knee flexion (0.37 J/BW/body height (BH)) and soft<br />
ACSM May 28 - June 1, 2013 Indianapolis, Indiana
Official Journal of the American College of Sports Medicine<br />
landing (0.31 J/BW/ BH) both increased mechanical work compared to regular landing<br />
(0.28 J/BW/ BH, p< 0.001). CONCLUSION: Landing with increased knee flexion<br />
landing and soft landing both decreased ACL loading, but also decreased movement<br />
speed and jump height while increasing mechanical work indicating a decrease in<br />
performance. Simply instructing individuals to land with increased knee flexion or land<br />
softly might have limited application in athletic competition because of the decrease<br />
in performance. Long-term training may be necessary to modify movements without<br />
compromising performance.<br />
1023 May 30, 8:15 AM - 8:30 AM<br />
aCL Injury alters Pre-injury Coordination Of The hip and<br />
Knee: The JuMP aCL study<br />
Benjamin M. Goerger 1 , Stephen W. Marshall 2 , Anthony I.<br />
Beutler 3 , J. Troy Blackburn 2 , John H. Wilckens 4 , Darin A.<br />
Padua 2 . 1 George Mason University, Manassas, VA. 2 The<br />
University of North Carolina at Chapel Hill, Chapel Hill,<br />
NC. 3 Uniformed Services University of the Health Sciences,<br />
Bethesda, MD. 4 Johns Hopkins University, Baltimore, MD.<br />
(No relationships reported)<br />
Those with anterior cruciate ligament (ACL) injury and reconstruction (ACLR) display<br />
movement coordination that may predispose them to subsequent ACL injury and<br />
osteoarthritis. There is limited evidence regarding whether these factors are induced by<br />
ACLR or existed prior to injury.<br />
PurPOsE: The purpose of this study was to compare joint coordination prior to and<br />
following ACL injury and reconstruction in both the injured and noninjured limb.<br />
METhOds: Sixty-nine participants of the JUMP ACL study, a multi-year prospective<br />
study conducted at the United States service academies to identify risk factors for<br />
noncontact ACL injury, completed testing for this analysis, 31 that suffered an ACL<br />
injury (Cases), and 38 that did not. Because unilateral biomechanics were collected<br />
during initial testing the Cases were further divided into those that injured the tested<br />
limb (ACLR-INJ: n = 12 (8 m, 4 f), Age = 21.42 ± 0.79 years, Height = 174.29 ± 7.56<br />
cm, Mass = 76.25 ± 9.95 kg) and those that injured the non-tested limb (ACLR-NINJ:<br />
n = 19 (9 m, 10 f), Age = 21.47 ± 0.77 years, Height = 170.05 ± 9.13 cm, Mass = 72.87<br />
± 12.78 kg). Participants that never suffered an ACL injury (CON: n = 38 (19 m, 19 f),<br />
Age = 20.95 ± 0.73 years, Height = 172.16 ± 8.71 cm, Mass = 72.35 ± 12.37 kg) were<br />
matched based on cohort year, academy and gender. Average coupling angles during<br />
a double leg jump landing between the hip and knee were calculated using a vector<br />
coding technique prior to (Baseline) and following ACL injury and ACLR (Follow-<br />
Up). A 2x3 (Time: Baseline, Follow-Up; Group: ACLR-INJ, ACLR-NINJ, CON)<br />
mixed model ANCOVA (Gender) was performed for each dependent variable.<br />
rEsuLTs: We observed a significant change in the average coupling angle of the hip<br />
and knee in the transverse plane for the ALCR-INJ group (F(2,65)=4.40, p = 0.016).<br />
The change indicated the ACLR-INJ group had more equal relative motion between<br />
the hip and knee in the transverse plane following ACL injury and ACLR (Baseline:<br />
54.85 ± 6.96; Follow-Up: 47.97 ± 6.64).<br />
CONCLusION: Based on our observations, it appears ACL injury and/or ACLR<br />
caused altered coordination of hip and knee rotation, possibly due to decreased<br />
independence of knee rotation. Our findings may provide important insights into the<br />
specific dysfunction underlying the increased risk of recurrent ACL injury in those<br />
with prior ACL injury.<br />
1024 May 30, 8:30 AM - 8:45 AM<br />
adaptation Of Quadriceps and hamstring Co-contraction<br />
Following Landing Instruction In Patients With acl<br />
reconstruction<br />
Audrey RC Elias, Curt D. Hammill, Ryan L. Mizner. University<br />
of Montana, Missoula, MT.<br />
(No relationships reported)<br />
A growing body of evidence suggests the ACL reconstructed knee exhibits<br />
compromised ability to accept weight and attenuate force during high demand<br />
activities, which can be mitigated with instruction and training. Controversy exists<br />
surrounding the desired agonist-antagonist relationship of the hamstrings and<br />
quadriceps in landing tasks, particularly in ACL injury prevention and end-stage ACLR<br />
rehabilitation programs.<br />
PurPOsE: To explore adaptations in neuromuscular control of the quadriceps and<br />
hamstrings to instruction for improved knee performance during weight acceptance.<br />
METhOds: Thirty physically active subjects with unilateral ACLR and good clinical<br />
results participated in a one-time session analyzing single leg landing of the involved<br />
limb off a 20 cm platform using 3-D motion analysis system with force plates.<br />
Vertical ground reaction force (VGRF) and peak knee flexion served as measures of<br />
performance. Vastus lateralis and biceps femoris recruitment were analyzed using<br />
surface EMG and normalized to maximal voluntary isometric contraction(MVIC).<br />
Testing was repeated after 5 minutes of instruction in desired landing patterns.<br />
Hamstring/quadriceps co-contraction indices were integrated over the weight<br />
acceptance phase of landing, and results were analyzed with paired t-tests.<br />
rEsuLTs: Landing performance improved with training, with increased peak knee<br />
Vol. 45 No. 5 Supplement S185<br />
flexion (mean±SD; pre: 55±11°; post: 78±11°; p
<strong>Thursday</strong>, May 30, 2013<br />
S186 Vol. 45 No. 5 Supplement<br />
rEsuLTs:There was a statistically significant interaction for the peak knee extension<br />
moment (p.12). There<br />
was no main effect of graft types for all measures (p>.12); Knee Flexion Excursion<br />
(KFE) (Allo: 16.49°+1.09°; Auto: 17.00° + 1.34°, p=0.78), external knee flexion<br />
moment at Peak Knee Extension (PKE) (Allo: 0.12+0.19 Nm/kg*m, Auto: 0.11 + 0.03<br />
Nm/kg*m, p=0.962). There was a main effect of limb for KFE (OP: 14.7° + 0.95°,<br />
NONOP: 18.79° + 0.91°, p
Official Journal of the American College of Sports Medicine<br />
Anterior Drawer limited due to guarding. Posterior Drawer negative. McMurray<br />
positive. Patellar Apprehension and Varus/Valgus Stress Test negative.<br />
dIFFErENTIaL dIaGNOsIs:<br />
1. Meniscal Tear<br />
2. ACL Rupture<br />
3. Juvenile Idiopathic Arthritis<br />
4. Infectious Arthritis<br />
5. Reactive Arthritis<br />
6. Lyme Disease<br />
7. Malignancy<br />
TEsT aNd rEsuLTs:<br />
Left knee Xray: Large joint effusion without bony abnormality<br />
Left knee joint aspiration: 60ml yellow slightly cloudy synovial fluid, no crystals, 1545<br />
RBC, 3700 nucleated cells, 3 Segs, 1 Eos, 47 Lymphs, 19 Monos, 30 Macrophages.<br />
Gram Stain: no organisms. Aerobic, anerobic, chocolate agar cultures: no growth<br />
CBC: WBC 7.8, Hgb 15.6, Plt 156<br />
ANA Neg<br />
CRP 0.5, ESR 4<br />
Rheumatoid Factor 8.6<br />
Lyme Disease Serology Positive, Lyme Disease Western Blot Negative.<br />
Left Knee MRI without contrast: Large joint effusion with small to moderate intraarticular<br />
debris. Meniscus and ACL intact.<br />
Rheumatology Consult: Unlikely to be JIA, most likely traumatic injury to knee.<br />
Cannot exclude systemic cause.<br />
Urine Amplified DNA: Chlamydia positive, Gonorrhea negative<br />
FINaL WOrKING dIaGNOsIs:<br />
Reactive arthritis secondary to Chlamydia trachomatis infection<br />
TrEaTMENT aNd OuTCOMEs:<br />
1. Azithromycin 1 g PO X 1<br />
2. Ceftriaxone 250 mg IM X 1<br />
3. Repeat urine GC/CT testing in 3 weeks<br />
4. Tested for HIV, Hepatitis B & C, Syphilis: Negative<br />
5. Safer sex counseling; Notify, test all sexual contacts<br />
6. Naproxen for knee pain & swelling<br />
7. Upon further questioning, patient reports sexual intercourse several months<br />
preceding injury and condom use with every encounter.<br />
1034 May 30, 8:20 AM - 8:40 AM<br />
Exercise Induced hemoptysis: a hemodynamic Intervention<br />
Case report<br />
Miranda E. Contursi, Aaron L. Baggish, Gregory D. Lewis.<br />
Massachusetts General Hospital, Boston, MA.<br />
(No relationships reported)<br />
hIsTOry: A 47-yo male presented with recurrent episodes of exercise-induced<br />
hemoptysis (EIH) that consisted of 1-3 tbsp of bright red blood following intense bouts<br />
of aerobic exercise. He had no known history of heart or lung disease.<br />
PhysICaL EXaMINaTION:1.8m, 97kg, HR=77, BP=132/86, jugular venous<br />
pressure 5cm, regular S1 and S2 without murmurs, rubs or gallops, lungs clear to<br />
auscultation and percussion, no clubbing, cyanosis, or edema.<br />
PhysICaL EXaMINaTION: Bronchitis, bronchiectasis, malignancy, foreign<br />
body, infectious processes, inflammatory disorders, pre- or post-capillary pulmonary<br />
hypertension, pulmonary embolism.<br />
TEsT aNd rEsuLTs: Chest CT scan: mild mosaic attenuation with non-specific<br />
peripheral ground glass opacities; no nodules, pulmonary embolism, or pleural<br />
thickening/effusion. Bronchoscopy: petechiae on bronchial surfaces with slight<br />
hemorrhage when he coughed against the bronchoscope. Bronchoalveoloar lavage<br />
and coagulation studies: unremarkable. Incremental, upright cycle ergometery<br />
cardiopulmonary exercise testing (CPX) was performed with continuous invasive<br />
hemodynamic monitoring by radial and pulmonary arterial catheters: Normal peak<br />
VO2 (30.6 mL·min-1·kg-1, 112% predicted), peak cardiac output (17L/min), and<br />
resting hemodynamics but marked elevation in systemic BP (peak BP=261/134) and<br />
pulmonary capillary wedge pressure (peak PCWP=28mmHg) with normal pulmonary<br />
vascular resistance (exercise PVR = 1 Wood unit).<br />
FINaL WOrKING dIaGNOsIs: Exaggerated systemic BP response and diastolic<br />
dysfunction during exercise, leading to increased hydrostatic pressure transmitted to<br />
the lung, which increased the patient’s propensity to develop hemoptysis.<br />
TrEaTMENT aNd OuTCOMEs: Following the invasive CPX, we tested the<br />
hypothesis that pre-exercise nitrate therapy would attenuate systemic hypertension<br />
and elevation in PCWP in response to exercise. Repeat serial non-invasive CPXs<br />
before and after isosorbide dinitrate 10mg showed that nitrates reduced exercise BP<br />
(peak BP 188/80 vs. 230/110). We inferred dual contributions to EIH: pulmonary<br />
vascular fragility coupled with dynamic pulmonary venous hypertension, which was<br />
successfully attenuated by pre-exercise nitrate therapy. The patient was able to resume<br />
regular training without further hemoptysis.<br />
Vol. 45 No. 5 Supplement S187<br />
1035 May 30, 8:40 AM - 9:00 AM<br />
General Medicine-unusual Cause of Thoracic Pain<br />
Wade M. Rankin, Ryan Sprouse. University of Kentucky,<br />
Lexington, KY.<br />
(No relationships reported)<br />
hIsTOry:A 33y African American male, with past medical history significant for<br />
familial adenomatous polyposis, presented with mid-back paraspinal muscle pain/<br />
tightness intermittently for 8 months. Initially patient was diagnosed with paraspinal<br />
muscle spasms and managed conservatively with ibuprofen, heat therapy, physical<br />
therapy, and posture correction. Patient reported the pain/tightness is worse with<br />
activity and radiated to his lower back. He denied any injury/trauma to the area. He<br />
denied any radicular symptoms, extremity weakness, shortness of breath, or fever/<br />
chills. The pain/tightness became acutely worse and he has recently noticed a mass in<br />
the paraspinal musculature between the right scapula and spine.<br />
PhysICaL EXaM: Well appearing, thin male with no lymphadenopathy or masses<br />
noted to his neck, lungs clear to auscultation, non-labored breathing, heart RRR, equal<br />
pulses bilaterally. Two firm palpable 5x5cm non fluctuant masses with ill-defined<br />
borders over the mid-thoracic area with obvious visual malformations. Minimally<br />
tender to palpation over the spinous process between the two masses. Strength 5/5 in<br />
bilateral upper extremities. No sensory deficits.<br />
PhysICaL EXaMINaTION:<br />
Muscle spasm<br />
Muscle strain<br />
Myositis<br />
Tumor/mass<br />
Lipoma<br />
Scapulothoracic bursitis<br />
Vertebral fracture<br />
Hyperkyphosis<br />
Hematoma<br />
Abscess<br />
TEsTs aNd rEsuLTs<br />
Wbc 5.9, Hgb12.8, Hct 37.5<br />
US Chest: avascular solid mass measuring 7.3x2.1cm between right scapula and mid<br />
thoracic spine. MRI T-spine: 10x8x3 cm mass lesion within the bilateral erector spinae<br />
musculature, T6-T9 levels. Lesion effectively replaces the mulfidus and longissimus<br />
thoracis muscles at that level. Likely represents myositis of the longissimus thoracis<br />
and multifidus muscles with focal myonecrosis and/or a chronic hematoma.<br />
Biopsy: Non-atypical fibroproliferative process infiltrating skeletal muscle with mild<br />
chronic inflammation and rare possible regenerating myofibers. No evidence of<br />
metastatic carcinoma is seen on the touch prep slides or within the core biopsies.<br />
Possible diagnostic considerations include fibromatosis (desmoids tumor).<br />
FINaL/WOrKING dIaGNOsIs:<br />
Desmoid Tumor<br />
TrEaTMENT aNd OuTCOMEs<br />
1. Radiotherapy noted to lesion<br />
2. Adjuvant chemotherapy<br />
3. Patient currently undergoing above treatment<br />
1036 Withdrawn<br />
1037 May 30, 9:00 AM - 9:20 AM<br />
skin Infection in an Offensive Lineman<br />
Kyle E. Geissler, James Borchers, FACSM. Ohio State<br />
University, Columbus, OH.<br />
(No relationships reported)<br />
hIsTOry: 18 year old male presented with the complaint of left buttock pain<br />
and drainage. He is a lineman and started practice the week prior. He popped what<br />
appeared to be a pimple on his left buttock three days ago. The patient had increased<br />
pain, buttock erythema, intermittent fevers, nausea, and malaise for the two days<br />
prior to evaluation. He denied vomiting, dysuria, hematuria, or diarrhea. The patient<br />
reported having a history of a skin infection on his face while wrestling in high school,<br />
but did not know if he had MRSA. He was not on any prescribed medications.<br />
PhysICaL EXaM: In general, the patient appeared ill but was in no acute distress.<br />
Vital signs: temperature 100.6, pulse 97, blood pressure 148/55. His left buttock<br />
contained significant induration with a central area that was draining serosanguinous<br />
fluid. There was an area of fluctuance around the draining area. The erythema was<br />
approximately 10cm in size and extended to the rectum and perineum, but not to the<br />
scrotum. The rest of the external genitalia was normal in appearance.<br />
PhysICaL EXaMINaTION: Cellulitis, Perirectal abscess, Colorectal fistula,<br />
Fournier’s gangrene, Vascular occlusion syndromes, Necrolytic migratory erythema<br />
TEsTs/rEsuLTs: Labs: WBC 20K, BUN/Cr 11/1.25. The rest of the CBC and<br />
Chem 7 were within normal limits. CT scan of the pelvis revealed soft tissue stranding<br />
in the left ischiorectal fossa and medial aspect of the left buttock that courses towards<br />
the canal.<br />
FINaL dIaGNOsIs: Perirectal abscess progressing to Fournier’s gangrene<br />
<strong>Abstracts</strong> were prepared by the authors and printed as submitted.<br />
<strong>Thursday</strong>, May 30, 2013
<strong>Thursday</strong>, May 30, 2013<br />
S188 Vol. 45 No. 5 Supplement<br />
TrEaTMENT/OuTCOME: The patient was admitted to the hospital and started<br />
on IV Vancomycin. Pain and nausea were treated symptomatically. An infectious<br />
disease consult was obtained and Daptomycin, ciprofloxacin, and Flagyl were started<br />
to additionally cover for enteric bacteria. Colorectal surgery was consulted, and they<br />
peformed a bedside incision and drainage. On day 3 of admission, the erythema had<br />
spread to the scrotum. The next day, the patient was taken for surgical debridement<br />
and drainage of a perirectal abscess. Following debridement, a diagnosis of Fournier’s<br />
gangrene was made. IV antibiotics were continued and the patient was discharged<br />
home on day 6 on oral ciprofloxacin and Flagyl, in addition to daily wet to dry dressing<br />
changes. He was able to return to play six weeks after discharge.<br />
C-22 Clinical Case Slide - Lower Extremity I<br />
May 30, 2013, 8:00 AM - 10:00 AM<br />
Room: 117<br />
1038 Chair: David Olson. University of Minnesota, St. Paul, MN.<br />
(No relationships reported)<br />
1039 discussant: Brian M. Babka. Lutheran General Hospital,<br />
Elmhurst, IL.<br />
(No relationships reported)<br />
1040 discussant: Elizabeth E. Rothe. Maine Medical Center Sports<br />
Medicine, Portland, ME.<br />
(No relationships reported)<br />
1041 May 30, 8:00 AM - 8:20 AM<br />
Leg Pain- rowing<br />
Kathryn Miller, Aurelia Nattiv, FACSM. UCLA, Los Angeles, CA.<br />
(No relationships reported)<br />
hIsTOry: 21 year old NCAA Division 1 female rower with prior rib stress fracture<br />
with right leg pain x 3 weeks starting in August 2012. Pain started during sprint<br />
intervals on track. Pain was aching pain along posterior, lateral thigh. Injury initially<br />
managed as quad strain by ATC, but pain continued to worsen despite relative rest.<br />
Over the summer, she had been running 60-70 miles weekly.<br />
Past medical/surgical History: None Except, Rib Stress Fracture (Spring 2012),<br />
Eumenorrheic, Menarche Age 12, No History Of Disordered Eating, Weight Stable<br />
Meds: None<br />
Family History: No History Of Osteoporosis Or Fractures<br />
Social History: Full Time Student, Junior, No Tobacco, Occasional Binge Drinking, No<br />
Milk, 6 Oz Yogurt/Week, No other sources dietary calcium<br />
ROS: Negative 14-point system review<br />
PhysICaL EXaMINaTION: 5’9”; 163 lbs. Healthy appearing. Normal gait, pes<br />
planus. No palpable masses, erythema, edema, ecchymosis over right thigh. Mild<br />
tenderness to palpation over lateral right thigh. Hip ROM full bilaterally. No pain<br />
with active/passive ROM of hip. No pain over spinous processes, paraspinal muscles,<br />
hamstrings, IT band insertion. On right +hop test, + fulcrum test, -FABER, -FADIR,<br />
+OBERS, -SLR bilaterally.<br />
PhysICaL EXaMINaTION:<br />
1.Femoral stress reaction/fracture<br />
2.Quad strain<br />
3.IT Band Syndrome<br />
4.AVN of femoral head<br />
5.Referred pain<br />
TEsTs aNd rEsuLTs:<br />
Plain Radiographs of Right Femur and AP Pelvis: Normal<br />
MRI Right Femur: Periosteal edema along medial aspect of proximal femur with bone<br />
marrow edema for 4.4 cm along insertion of site of adductor longus. Also, small linear<br />
area of cortical signal visualized consistent with a small cortical stress fracture.<br />
Labs: TSH 1.2, PTH 20, Calcium 9.8, vitamin D 25-OH 56<br />
DXA: Spine Z-score +0.5; Total Hip Z-score +0.3; Femoral Neck Z-score -0.2. Normal<br />
BMD for age.<br />
Final Working Diagnosis: Femoral stress fracture<br />
TrEaTMENT aNd OuTCOMEs:<br />
1.Non-weight bearing x 3 weeks<br />
2.Transitioned to full weight bearing over 1 additional week<br />
3.Started swimming 4 weeks after diagnosis with increased pain with breaststroke kick<br />
4.Able to resume full pool workouts 5 weeks after diagnosis<br />
5.Light stationary bike without pain 8 weeks after diagnosis<br />
6.No impact activity for at least 10 weeks<br />
7.Plan to gradually add erging prior to running<br />
8.Referred to sports dietitian for consult<br />
MEDICINE & SCIENCE IN SPORTS & EXERCISE ®<br />
1042 May 30, 8:20 AM - 8:40 AM<br />
rugby Player sustains Lower Extremity Injury during a<br />
Tackle<br />
Hamish A. Kerr. Albany Medical Center, Albany, NY.<br />
(No relationships reported)<br />
hIsTOry: 15 minutes into the 1st home game of the season, a 21 year old rugby<br />
player goes down in the center of the field. He does not get up. The athletic trainer and<br />
physician covering run on to evaluate. The player is in a great deal of discomfort, but<br />
cannot localize what hurts. He says he tried to get up but couldn’t weight bear on his<br />
right leg. Past Medical History: Acromio-clavicular sprain of his left shoulder. Denied<br />
any current medications and has no known drug allergies. He is a college student and<br />
this is his 2nd year playing rugby. He is a forward. He denied any contributory family<br />
history. On review of systems, he denied any back pain, or any paresthesiae in the<br />
lower extremity. He denied any trauma to his head, neck, or spine. He denied losing<br />
consciousness.<br />
PhysICaL EXaMINaTION (Er): BP 143/109, HR 64, RR 20; SpO2 100%;<br />
Height 175cm, Weight 94.35kg, BMI 30<br />
Generally he appeared in some distress. He was alert and oriented to time, place and<br />
person. His right leg was being held in a flexed position at the knee and hip. He had<br />
very large, muscular thighs. He had a palpable dorsalis pedis pulse. He was able to<br />
wiggle his toes on command. His sensory function of the distal right extremity was<br />
intact for light touch. Manipulation of his right thigh and hip provoked pain. He could<br />
flex his knee. There appeared to be deformity of his right buttock and the right leg<br />
appeared shorter than the left.<br />
dIFFErENTIaL dIaGNOsIs<br />
Fractured right femur<br />
Dislocated patella<br />
Dislocated right hip<br />
TEsTs aNd rEsuLTs: Patient was transported via EMS to the Emergency<br />
Department where initial X-ray imaging confirmed a posterior hip dislocation.<br />
FINAL WORKING DIAGNOSIS: Right Hip Dislocation<br />
TrEaTMENT aNd OuTCOMEs: The patient required conscious sedation with<br />
propofol and fentanyl to relocate the hip. He underwent computed tomography (CT) of<br />
the hip, confirming relocation and noting a small anterior, superior acetabular fracture.<br />
He was immobilized and maintained non-weight bearing. He was provided oral opiate<br />
analgesia. He was seen in follow-up at 48 hours and 3 weeks post-injury, when he was<br />
able to partially weight bear, had regained 90 degrees of hip flexion and 30 degrees of<br />
internal/external rotation. He understood he was not going to be able to return to rugby<br />
that season.<br />
1043 May 30, 8:40 AM - 9:00 AM<br />
hip Pain-Water skiing<br />
Christopher S. Karam1 , Andrew H. Gordon2 , Arthur J. De Luigi1 .<br />
1MedStar National Rehabilitation Network, Washington, DC.<br />
2The Johns Hopkins Hospital, Baltimore, MD. (Sponsor: Stuart<br />
Willick, FACSM)<br />
(No relationships reported)<br />
hIsTOry: A 42-year-old woman injured her right hip while waterskiing. She waterskied<br />
with one ski on her left lower extremity. She rested her right lower extremity, not<br />
placed into the ski, posteriorly on the ski attached to the left foot. When performing<br />
a twisting motion while skiing, she felt a deep pressure in her right hip while<br />
keeping balance on the ski. She initially rated her pain as 4/10, having some success<br />
using conservative measures of oral anti-inflammatory medications (diclofenac)<br />
and anesthetic patches (lidocaine) in combination with physical therapy and home<br />
exercise program. No imaging was obtained during the course of her initial injury.<br />
Approximately six months later, she aggravated her right hip injury while snow-skiing.<br />
She reported a constant 6/10 deep aching hip pain. Her right hip pain especially<br />
worsened with exercise, so she then stopped exercising.<br />
ACSM May 28 - June 1, 2013 Indianapolis, Indiana
Official Journal of the American College of Sports Medicine<br />
PhysICaL EXaMINaTION: Initial examination of the hip demonstrated<br />
tenderness to palpation over the right adductor muscle at its insertion point on the<br />
pubic rami. No tenderness to palpation of the lumbar paraspinals, anterior-superior<br />
iliac spine, iliac crest, sacroiliac joint or trochanteric bursas were noted. Provocative<br />
maneuvers with FADIR (Flexion Adduction Internal Rotation) test in her right hip.<br />
PhysICaL EXaMINaTION:<br />
1. Osteoarthritis.<br />
2. Hip labral tear.<br />
3. Femoroacetabular impingement.<br />
TESTS AND rEsuLTs:<br />
Ultrasound of the right hip revealed an anterior-superior acetabular labral tear<br />
Magnetic Resonance Arthrogram (MRA) of the right hip confirmed anterior-superior<br />
labral tear<br />
FINaL/WOrKING dIaGNOsIs:<br />
Anterior-Superior Labral Tear of the Right Hip<br />
TrEaTMENT aNd OuTCOMEs:<br />
1. Failed repeat conservative management with oral diclofenac, transdermal lidocaine<br />
and physical therapy<br />
2. Advanced imaging obtained revealing pathology<br />
3. Surgery evaluation, patient opted for non-surgical management<br />
4. Ultrasound-guided platelet-rich plasma (PRP) of the hip was then performed for the<br />
anterior-superior labral tear of the right hip<br />
5. Four weeks post-injection she reported no pain, resumed waterskiing daily for the<br />
next three months with no recurrence of the hip pain at 6 months post procedure.<br />
1044 May 30, 9:00 AM - 9:20 AM<br />
Knee Injury-basketball<br />
Danielle G. Hirsch, Dilip Patel, FACSM, Vani Sabesan. Western<br />
Michigan University School of Medicine Clinics, Kalamazoo,<br />
MI. (Sponsor: Robert J Baker, FACSM)<br />
(No relationships reported)<br />
hIsTOry: A 15-year-old male presented to the clinic for evaluation of right knee<br />
pain that has been ongoing for the past year. The patient can recall two injuries to the<br />
knee directly both occurring while playing basketball. The first injury one month prior<br />
to presentation occurred during a basketball game when he “bumped knees” with<br />
another player requiring him to sit out of the game for about 5 minutes then returning<br />
to play where he had to stop because he reported his leg gave out upon return to play.<br />
He was evaluated by his team trainer and was given crutches which he used for a short<br />
time. The second injury occurred one week prior to presentation to the clinic where<br />
he reports that upon attempting a lay-up he felt his knee give out and had to stop<br />
playing. He reports a limp now and for the pain and swelling he has been using ice and<br />
ibuprofen inconsistently without much relief.<br />
PhysICaL EXaM: Right knee: 2+ effusion. Lachman test was positive with a soft<br />
end point. McMurray Negative, Varus-Valgus stress negative. Patellar apprehension<br />
negative. ROM: Pain and limited flexion of the right knee. Straight leg raise<br />
reproduced pain in the right knee and hip. Upon squatting on the right knee there was a<br />
noted loss of balance. There was no pain or tenderness to touch along the joint lines or<br />
patella. His gait is remarkable for a limp.<br />
PhysICaL EXaMINaTION:<br />
1.ACL tear<br />
2.Tibial spine avulsion<br />
3.Osteochonral fracture<br />
4.Osteochondritis dissecans<br />
5.Medial meniscus tear<br />
TEsT aNd rEsuLTs:<br />
MRI of Right knee:<br />
1.ACL tear<br />
2.Vertical peripheral posterior horn tears of the medial/lateral meniscus<br />
3.Osseous contusions of the lateral condyles<br />
4.Large effusion<br />
FINaL/WOrKING dIaGNOsIs:<br />
ACL, medial, and lateral meniscal tears<br />
TrEaTMENT aNd OuTCOMEs:<br />
1.ACL reconstruction with medial and lateral meniscal repair<br />
2.Physical therapy for range of motion and quad strengthening<br />
3.Post-op placed in a gravity flow cryotherapy on the right knee for ROM<br />
4.Weight bearing by 6 weeks post-op<br />
1045 May 30, 9:20 AM - 9:40 AM<br />
Exercise Induced arterial Compression<br />
Rick Morgan. Steadman Hawkins Clinic of the Carolinas,<br />
Greenville, SC. (Sponsor: Kyle Cassas, FACSM)<br />
(No relationships reported)<br />
hIsTOry: 22 year old elite level professional cyclist presents with left leg cramping<br />
and loss of power for several months. He denies injury, numbness or pain. The onset<br />
has been gradual but progressively worsening. He has never had this problem before.<br />
The feeling is similar to a cramp, but not as intensely painful, and it involves the entire<br />
Vol. 45 No. 5 Supplement S189<br />
leg. He denies back pain. He did change bike position over the winter and had some fit/<br />
equipement issues with that including some mild low back pain that resolved. He had<br />
been the age group national champion the year prior, and despite more rigorous training<br />
and team support, had been unable to replicate that type of performance in the current<br />
season. At times he struggled with seasonal allergies and exercise induced asthma, both<br />
more significant in Europe than his native Utah. He was concerned about the fact that he<br />
had a series of mild viral illnesses throughout the early racing season and at one point<br />
was tested for EBV/mono and left Europe for several weeks to recover.He seemed to<br />
recover well at that point, but upon returning to Europe to race he noted more consistent<br />
and problematic left leg cramping sensation and loss of power.<br />
PhysICaL EXaMINaTION: Gen--well, NAD. Slender but athletic build. MSK-normal<br />
gait. ROM in the ankles, knees, hips and lumbar spine is normal. No swelling<br />
or bruising noted in B LE. Toe walk, heel walk and single leg stand are normal<br />
bilaterally. EHL intact. DTR 2+ bilateral patella and achilles. Sensation grossly intact<br />
to LT in all LE dermatomes. Negative SLR and x SLR. He has mild discomfort with<br />
FABER on the L, but not c/w his presenting complaint<br />
PhysICaL EXaMINaTION: EIAC, lumbar disk with radiculopathy, SI<br />
dysfunction, Mono syndrome<br />
TEsT aNd rEsuLTs: Baseline CBC, ferritin (1/2012) wnl, EBV titers revealing<br />
exposure to Mono (4/2012) but normal CBC, CMP, presumed subacute. Then in June,<br />
ABI (abnormal), CT angiogram (negative), MRA (abnormal), power study cycling<br />
FINaL WOrKING dIaGNOsIs: L internal iliac compression due to exercise<br />
TrEaTMENT aNd OuTCOMEs: L iliac artery graft, 8 cm bovine patch.<br />
Hospitalization for 5 days, 2 weeks of limited activity (walks) followed by a gradual<br />
increase in activity. Return to cycling at 8 weeks. Currently has returned to training,<br />
offseason, and will be racing professionally again in 2013.<br />
1046 May 30, 9:40 AM - 10:00 AM<br />
Proximal Thigh swelling Precipitates Numbness, Tingling<br />
and swelling In a 38yo stunt rider<br />
Ryan S. Wagner. Avita health System, Bucyrus, OH.<br />
(No relationships reported)<br />
hIsTOry: 38yo male presents to the clinic in mid-August 2012 with a complaint<br />
of a large hematoma over his proximal right thigh and focal swelling over his right<br />
patella after wrecking his motorcycle during a stunt-riding event on four weeks prior.<br />
He was diagnosed with hematoma and pre-patellar bursitis. The pre-patellar bursa<br />
was aspirated under ultrasound guidance and fully drained with prescription for<br />
prophylactic antibiotics. The bursitis resolved.<br />
Two months later he returned with persistent swelling to the proximal, anterolateral<br />
right thigh. He had developed constant numbness and tingling over the anterolateral<br />
aspect of his thigh progressing to just superior to the knee accompanied by severe<br />
burning pain.<br />
PhysICaL EXaMINaTION: Inspection: Discrete, fluctuant mass overlying the<br />
proximal anterolateral thigh, 10cm distal to inguinal crease, 10x7cm in dimension. No<br />
associated erythema, ecchymosis or wound. Otherwise unremarkable.<br />
Palpation: Burning pain is provoked with palpation of the medial third of the mass.<br />
Otherwise no specific tenderness.<br />
Neurologic: Normal strength and reflexes, diminished sensation in the distribution of<br />
the anterior branch of the Lateral Femoral Cutaneous Nerve (LCFN).<br />
Special maneuvers: +Tinel’s over the medial third of the fluctuant mass.<br />
PhysICaL EXaMINaTION: 1) Seroma, organized hematoma, soft tissue mass; 2)<br />
HNP/Radiculitis, meralgia paresthetica.<br />
TEsT aNd rEsuLTs: Diagnostic US of the lesion demonstrated a fluid filled<br />
mass with delineation between the muscular fascia and the sub-cutaneous tissue. A<br />
structure is visualized traversing the lumen located in the medial third of the lesion<br />
in the anatomic location of the LCFN, tented. The lesion was aspirated and 90mL of<br />
serosanguinous fluid was removed.<br />
<strong>Abstracts</strong> were prepared by the authors and printed as submitted.<br />
<strong>Thursday</strong>, May 30, 2013
<strong>Thursday</strong>, May 30, 2013<br />
S190 Vol. 45 No. 5 Supplement<br />
FINaL WOrKING dIaGNOsIs: Morel-Lavallee lesion causing Meralgia<br />
Paresthetica<br />
TrEaTMENT aNd OuTCOMEs: The patient continued a compression wrap for<br />
3 days after which the lesion recurred. Pain returned 4-5 days later. He requested a<br />
second aspiration. This was performed with 60mL of serosanguinous fluid removed<br />
and 100mg of Doxycycline reconstituted in 10mL of sterile water was injected back<br />
into the lesion for sclerodesis. He was instructed on continuing the compression wrap<br />
for 3-4 weeks. At 2 weeks the lesion has not yet recurred.<br />
C-23 Clinical Case Slide - Running Issues I<br />
May 30, 2013, 8:00 AM - 10:00 AM<br />
Room: 123<br />
1047 Chair: Karl Bert Fields. Moses Cone Health System, Greensboro, NC.<br />
(No relationships reported)<br />
1048 discussant: Irene Davis, FACSM. Harvard Medical School,<br />
Boston, MA.<br />
(No relationships reported)<br />
1049 discussant: George Chiampas. Northwestern University,<br />
Chicago, IL.<br />
(No relationships reported)<br />
1050 May 30, 8:00 AM - 8:20 AM<br />
Leg swelling - runner<br />
Melody Hrubes. Schwab Rehabilitation Hospital, Chicago, IL.<br />
(Sponsor: Terry Nicola, FACSM)<br />
(No relationships reported)<br />
hIsTOry: A 23-year-old collegiate runner first noticed a bump on the anterior aspect<br />
of his left tibia 13 months prior. There was no known trauma or previous injury to the<br />
area. He competed his entire senior season and even set personal bests, although the<br />
bump grew in size over the year. It was painful only if he pressed on it after running,<br />
so he did not seek medical attention. He came into the Sports Medicine Clinic at the<br />
conclusion of his running season for further evaluation<br />
PhysICaL EXaMINaTION: Swelling was noted on the anterior-lateral aspect<br />
of the left tibia, approximately 2cm in diameter. It was non-tender, non-edematous,<br />
and non-blanching. Distal strength, pulses and reflexes were within normal limits and<br />
symmetric when compared to the right side.<br />
PhysICaL EXaMINaTION:<br />
1. Enchondroma<br />
2. Tibial fracture with ossification center<br />
3. benign tumor<br />
TEsT aNd rEsuLTs:<br />
MEDICINE & SCIENCE IN SPORTS & EXERCISE ®<br />
Left Tibia/Fibula anterior-posterior and lateral radiographs:<br />
-Dense periosteal reaction is seen along the anterior medial aspect of the tibia that is<br />
focally greatest in the proximal third of the diaphysis. A horizontal lucency suggestive<br />
of a fracture is present through approximately 50% of the outer cortex.<br />
FINaL/WOrKING dIaGNOsIs:<br />
Dreaded black line (anterior tibial stress fracture)<br />
TrEaTMENT aNd OuTCOMEs:<br />
1. Immobilization with air cast<br />
2. Bone stimulation<br />
3. Non weight-bearing with crutches for six weeks<br />
4. Follow-up imaging at six weeks demonstrated interval healing and callous formation<br />
but continued visualization of fracture line, so continued crutches for five more weeks<br />
(11 weeks total).<br />
5. Progressed to walking without air cast or crutches after 11 weeks. Fracture<br />
successfully healed without need for surgical intervention. He is currently advancing<br />
his exercise demands while wearing the air cast and continues to be asymptomatic.<br />
6. Successful recovery from unstable fracture despite prior unrestricted competition for<br />
one year.<br />
1051 May 30, 8:20 AM - 8:40 AM<br />
Exertional Leg Pain - runner<br />
Neil Sparks, Mark Rogers, Delmas Bolin, FACSM. Edward Via<br />
College of Osteopathic Medicine, Blacksburg, VA.<br />
(No relationships reported)<br />
hIsTOry: A 19-year-old female ROTC cadet presented with one year of progressive<br />
right lower extremity pain, tightness, and parasthesias with running. Pain localized<br />
to the medial and anterior third of the tibia and the proximal third of her calf. Calf<br />
tightness noted diffusely. Parasthesias described circumferentially around the distal 2/3<br />
of the tibia and fibula to the toes. Symptoms possibly related to an increase in running<br />
intensity. Symptom onset within 8 to10 minutes of running, progresses to a 10/10<br />
severity, and improves within 30 minutes to two hours of rest. Past history positive for<br />
ACL reconstruction with revision 2010 on symptomatic leg.<br />
PhysICaL EXaMINaTION: Right lower extremity examination revealed no<br />
edema or ecchymosis. Sensation to light touch and vibration decreased over the<br />
middle third of the tibia. Fibular head motion restricted and the right tibia internally<br />
rotated relative to the femur. Tenderness at the medial head of the gastrocnemius,<br />
anterior middle and medial third of the tibia, medial aspect of the tibialis anterior,<br />
and cuneiforms. Fascial compartments soft without palpable masses. Subtalar motion<br />
restricted. 20 toe raises reproduced symptoms. Tinel’s was positive at the common<br />
peroneal and sural nerves. Tibialis anterior strength 4/5.<br />
PhysICaL EXaMINaTION:<br />
1.Tibial Stress Fracture<br />
2.Medial Tibial Stress Syndrome<br />
3.Popliteal Artery Entrapment Syndrome<br />
4.Exertional Compartment Syndrome<br />
TEsTs aNd rEsuLTs:<br />
Tibia and fibula anterior-posterior and lateral radiographs:<br />
- Negative for stress fracture<br />
Lower extremity MRI:<br />
- Negative for stress fracture or mass<br />
Popliteal artery sonography:<br />
- No evidence of artery entrapment<br />
Compartment Pressure Testing of Two Compartments:<br />
- Elevated anterior compartment pressures at rest and increased with exertion.<br />
- Normal posterior compartment pressures<br />
Gait analysis:<br />
- Weak core with bilateral trendelenberg, limited external rotation of right tibia, lateral<br />
weight distribution throughout gait cycle<br />
FINaL/WOrKING dIaGNOsIs:<br />
Exertional (Anterior) Compartment Syndrome<br />
TREATMENT PLAN:<br />
1.Surgical consultation to discuss fasciotomy; considered early given patient’s need to<br />
maintain military status.<br />
2.Osteopathic manual treatment.<br />
3.Physical therapy to include gait training<br />
1052 May 30, 8:40 AM - 9:00 AM<br />
Finger Injury - running<br />
Fariba Shah, Monica Rho, Joel Press, FACSM. Rehabilitation<br />
Institute of Chicago, Chicago, IL.<br />
(No relationships reported)<br />
hIsTOry: A 37-year-old female runner sustained a finger injury when grasping her<br />
smart phone while running. At the end of her 3.5-mile run, she looked down at her<br />
phone to track her mileage, when she tripped and fell face forward to the ground. Her<br />
right hand was firmly grasping the phone, with her thumb on one side and her third<br />
and fourth digit wrapped around the back of the phone. The screen of the smart phone<br />
shattered on impact. She felt immediate pain with movement of her right fourth digit<br />
ACSM May 28 - June 1, 2013 Indianapolis, Indiana
Official Journal of the American College of Sports Medicine<br />
and reported numbness of the palmer surface of her hand. Her smart phone was still in<br />
her grip.<br />
PhysICaL EXaMINaTION:<br />
Examination of her right hand revealed localized tenderness and bruising of<br />
the fingertip of her fourth digit. She had decreased active flexion at the distal<br />
interphalangeal joint. She had normal sensation, reflexes and strength of her upper<br />
extremities bilaterally.<br />
PhysICaL EXaMINaTION:<br />
1.Jersey finger, partial tear of flexor digitorum profundus tendon<br />
2.Distal phalanx fracture<br />
3.Mallet Finger<br />
TEsT aNd rEsuLTs:<br />
Anterior-posterior and lateral X-ray views of the right hand:<br />
--Normal, no fracture or dislocation noted<br />
Dynamic ultrasound examination while flexing and extending the right fourth digit to<br />
evaluate the tendon ends:<br />
--Partial avulsion of the flexor digitorum profundus<br />
FINaL WOrKING dIaGNOsIs:<br />
Jersey finger, partial tear of flexor digitorum profundus tendon<br />
TrEaTMENT aNd OuTCOMEs:<br />
1.Immobilization with finger splint for 6 weeks.<br />
2.Passive range of motion exercises started twice a day from day one.<br />
3.Ice to reduce pain and inflammation, 20 to 30 minutes every 3 to 4 hours.<br />
4.Strengthening exercises using items such as putty and hand therapy balls started 6<br />
weeks post injury when pain free.<br />
5.Return to unrestricted activities when she has full, painless range of motion and<br />
normal strength.<br />
1053 May 30, 9:00 AM - 9:20 AM<br />
Knee Injury _ distance running<br />
Dwan R. Perry, Robert Hosey. University of Kentucky,<br />
Lexington, KY. (Sponsor: Mary Lloyd Ireland, FACSM)<br />
(No relationships reported)<br />
hIsTOry: A 37 year old male, former college cross country athlete noticed insidious<br />
onset of medial-sided right knee pain with his runs over the past month. He has<br />
participated in several 5Ks per year, including marathons. He recently increased his<br />
mileage to 12 miles per day in preparation for a half marathon. He describes his pain<br />
as sharp, intermittent, without radiation or swelling of the calf. He runs in his usual<br />
shoes and has not changed running style or surfaces. Cryotherapy and over-the-counter<br />
analgesics has provided mild relief.<br />
PhysICaL EXaMINaTION:<br />
Right Knee: No visible effusion. Palpation revealed tenderness to palpation over the<br />
medial tibial plateau just above the pes anserine tendon insertion. There was no medial<br />
joint line tenderness. There was full range of motion at the knee with a negative bounce<br />
home test. No instability on varus or valgus stress testing at 0° and 30°. Ligamentously<br />
stable with negative Lachman’s test. McMurray’s test was also negative. There was no<br />
fullness in the popliteal space. The extremity was neurovascularly intact.<br />
PhysICaL EXaMINaTION:<br />
1. Medial Meniscus Tear<br />
2. Medial Tibial Stress Fracture<br />
3. Articular Cartilage Defect of the Medial or Patellofemoral Compartment<br />
4. Pes Anserine Bursitis<br />
5. Tibial Bone Bruise<br />
TEsT aNd rEsuLTs:<br />
Radiographs of the Bilateral Knee, standing 30° flexed PA views, patellar views, and<br />
lateral views obtained:<br />
1. No evidence of fracture.<br />
2. No joint space narrowing.<br />
3. No osseous loose bodies.<br />
MRI of the Right Knee without Contrast:<br />
1. Reactive bone marrow edema in the medial tibial plateau.<br />
2. Irregular edema within the fibular head indicative of early arthrosis affecting the<br />
proximal tibiofibular articulation.<br />
3. Normal appearing medial meniscus and articular cartilage.<br />
FINaL/WOrKING dIaGNOsIs:<br />
Medial Proximal Tibial Plateau Stress Fracture<br />
TrEaTMENT aNd OuTCOMEs:<br />
1. Cessation of the painful activities.<br />
2. As symptoms resolved, it was recommended to have a gradual return to running<br />
once asymptomatic.<br />
3. The patient began running again after pain subsided. This was followed by a<br />
recurrence of pain which prompted another period of rest from running.<br />
4. After resolution of pain, the patient was able to return to running pain free at one<br />
year after initial presentation and without need for further imaging.<br />
Vol. 45 No. 5 Supplement S191<br />
1054 May 30, 9:20 AM - 9:40 AM<br />
Knee Pain - runner<br />
Maria E. Reese, Monica Rho. Rehabilitation Institute of<br />
Chicago, Chicago, IL. (Sponsor: Joel Press, FACSM)<br />
(No relationships reported)<br />
hIsTOry: A 39-year-old male recreational runner presented with 3 week history of<br />
left anterior knee pain that started on mile 15 of an 18 mile run. He denied trauma,<br />
swelling, bruising, or prior knee pain. Pain was a dull ache progressing to sharp severe<br />
pain, 6/10, precluding running. For the next 3 days, pain progressively worsened<br />
and became present with walking. Pain was worse with weight bearing, especially<br />
descending stairs, and prolonged sitting. Pain was better with rest and stretching<br />
(quadriceps, hip flexors, and hamstrings). He denied clicking, popping, catching yet<br />
confirmed a feeling that his knee would “give out”. Pain improved with rest and he was<br />
able to walk pain free. He ran 3 miles during which he had mild left knee pain, yet the<br />
severe pain returned the following day. For the next 2 weeks, he decreased his running<br />
to 1 mile per week. The elliptical machine and stationary bicycle were non painful yet<br />
stairs continued to cause pain. He had not taken medications nor used ice.<br />
PhysICaL EXaMINaTION: Examination revealed mildly increased fullness of<br />
left tibial tuberosity when compared to right with full range of motion of the bilateral<br />
knees with mild discomfort at end range of left knee flexion. No bony tenderness<br />
to palpation bilaterally. Tenderness of the left distal patellar tendon, especially the<br />
medial aspect just superior to the tibial tuberosity yet no tenderness to palpation of<br />
the proximal and mid portions of the left patellar tendon. Hip exam and neurological<br />
testing were normal. He was unable to complete left single leg squat due to significant<br />
anterior knee pain.<br />
PhysICaL EXaMINaTION:<br />
1. Left patellar tendonopathy<br />
2. Stress reaction of left tibial tuberosity<br />
3. Calcific tendonopathy of the left patellar tendon<br />
4. Patellofemoral syndrome<br />
TEsT aNd rEsuLTs:<br />
Left knee ultrasound:<br />
- Tender 8.1mm x 3.4mm x 1.7mm hyperechoic structure located at distal medial<br />
aspect of left patellar tendon with acoustic shadowing<br />
- Minimal effusion underlying patellar tendon in area described above<br />
- No increased blood flow appreciated on Doppler imaging<br />
FINaL WOrKING dIaGNOsIs:<br />
Calcific tendonopathy of the distal medial left patellar tendon<br />
TrEaTMENT aNd OuTCOMEs:<br />
1. Ibuprofen 600mg p.o. TID with food<br />
2. Ice as needed, especially following activity<br />
3. Eccentric strength training of quadriceps<br />
4. Return to running gradually<br />
1055 May 30, 9:40 AM - 10:00 AM<br />
Conservative Treatment of Plantar Fascia Pain in a<br />
recreational running athlete<br />
Noelle Selkow, Jeffrey G. Williams. Illinois State University,<br />
Normal, IL. (Sponsor: Kevin Laudner, FACSM)<br />
(No relationships reported)<br />
hIsTOry: A 24-year-old, female, recreational running athlete (height: 167.6<br />
cm, weight: 61.4 kg) reported with right plantar foot pain while training for a half<br />
marathon. Her pain was insidious and persistent for 7-weeks prior to presenting<br />
for evaluation and treatment. The patient’s symptoms began as minor pain at rest,<br />
discomfort and tightness in the plantar aspect of the foot, particularly upon waking in<br />
the morning. Patient stated that her pain progressed to feeling as if her plantar fascia<br />
was going to “tear in two pieces” while running.<br />
PhysICaL EXaMINaTION: The patient presented with right plantar foot pain.<br />
A pea–sized nodular deformity along the middle 1/3 of her medial longitudinal arch<br />
was identified and tender to palpate. Examination of range of motion (ROM) revealed<br />
limited active dorsiflexion in her affected ankle when compared bilaterally. Manual<br />
muscle testing revealed no deficiencies in surrounding foot, ankle, and lower leg<br />
musculature when compared bilaterally. Neurologic examination was negative. Initial<br />
sonographic images of the nodule revealed a 0.44 cm2 fibroma.<br />
PhysICaL EXaMINaTION:<br />
1. Plantar fasciitis<br />
2. Chronic fascial rupture<br />
3. Inclusion cyst<br />
4. Foreign body granuloma<br />
5. Nerve sheath tumor<br />
TEsT aNd rEsuLTs:<br />
Sonographic examination:<br />
-- Initial transverse sonographic images indicated a 0.44 cm 2 fibroma within the plantar<br />
fascia.<br />
Standard Goniometry:<br />
-- Lacking 3° of active dorsiflexion in the affected ankle.<br />
<strong>Abstracts</strong> were prepared by the authors and printed as submitted.<br />
<strong>Thursday</strong>, May 30, 2013
<strong>Thursday</strong>, May 30, 2013<br />
S192 Vol. 45 No. 5 Supplement<br />
FINAL WORKING DIAGNOSIS:<br />
Plantar fibromatosis (fibroproliferative condition on the plantar fascia tissue)<br />
TrEaTMENT aNd OuTCOMEs:<br />
1. Immediate reduction of running workouts to within a pain free range.<br />
2. Two treatment sessions per week for four weeks within an athletic training facility<br />
incorporating an instrument-assisted-soft-tissue mobilization technique.<br />
3. Low intensity strengthening exercises and passive stretching were performed during<br />
treatment sessions.<br />
4. A home exercise program was prescribed on days when the patient was not treated<br />
by the clinician.<br />
5. Returned to full participation in running at week four of treatments with full, pain<br />
free ROM, pain free running gait and decreased size of the plantar fibroma by 17%<br />
(0.37cm 2 ).<br />
6. Patient successfully completed the half-marathon race, pain free and at goal pace<br />
1-month following the conclusion of treatment.<br />
C-24 Free Communication/Poster - Advances in<br />
Exercise Immunology<br />
May 30, 2013, 7:30 AM - 12:30 PM<br />
Room: Hall C<br />
1056 Board #1 May 30, 8:00 AM - 9:30 AM<br />
Endurance-training Effects On Intracellular Calcium and<br />
Iron In Cd4 + Lymphocytes In young and Old Men<br />
Suzanne Broadbent. Southern Cross University, Lismore NSW,<br />
Australia.<br />
(No relationships reported)<br />
Intracellular calcium (Ca 2+ i )and iron (Fe 3+ i) are critically involved in intracellular<br />
signalling within CD4 + cells yet little is known of long-term exercise effects on these<br />
variables in relation to CD4 + activation and proliferation.<br />
PurPOsE: To investigate the effects of 12 months of aerobic/endurance exercise<br />
on Ca2+i and Fe3+i concentrations within CD4+ lymphocytes in old and young men<br />
compared to sedentary controls.<br />
METhOds: We compared young (30±5 yr) trained (TRY, n=14) and sedentary (UTY,<br />
n=12) men to older (69±5 yr) trained (TRO, n=14) and sedentary (UTO, n=10) men for<br />
12 months. The TRY group completed daily endurance training (60-120 min day, 60-<br />
80% VO 2peak ) while the TRO group cycled for three 60 min sessions per week (60-75%<br />
VO 2peak ). Venous blood was analysed every month for resting lymphocyte counts. CD4 +<br />
cells were separated and stimulated with thapsigargin to quantify Ca 2+ i, using Fluo-3<br />
AM and flow cytometry. Further CD4 + lymphocytes were incubated with Calcein AM<br />
to assess Fe 3+ i.<br />
rEsuLTs: The TRY group had a significantly higher CD4+ concentration than<br />
UTY for 4 months (37±7%, p
Official Journal of the American College of Sports Medicine<br />
1059 Board #4 May 30, 8:00 AM - 9:30 AM<br />
Length Of systemic Cytokine response after an ultramarathon<br />
race In Men<br />
Stephen M. Cornish1 , Jennifer L. Copeland2 . 1Athabasca University, Athabasca, AB, Canada. 2University of Lethbridge,<br />
Lethbridge, AB, Canada.<br />
(No relationships reported)<br />
Prolonged intensive exercise is known to cause a systemic inflammatory response,<br />
most likely due to micro-structural damage to muscle fibers, but how long this<br />
response persists is unclear.<br />
PurPOsE: To evaluate the inflammatory response for one week after an ultramarathon<br />
and to determine if the inflammatory response is associated with delayed<br />
onset muscle soreness (DOMS) and peak knee extensor torque.<br />
METhOds: Six male participants in a 50 km race volunteered for the study (Age:<br />
45.3±9.4 yrs; VO2max: 55.7±6.3 mL/kg/min; BMI: 25.7±2.4 kg/m2; % Body Fat:<br />
16.5±4.6 %). The race was primarily on trails with approximately 1300 metres of<br />
elevation gain and loss. Baseline measurements were taken one day before the race<br />
and measurements were repeated immediately post-race as well as 24 hours and 7 days<br />
after the race. Blood was sampled from the antecubital vein and was used to analyze<br />
interleukin-6 (IL-6), IL-10, and IL-1β via ELISA. DOMS was measured using a visual<br />
analogue scale. Peak isometric knee extensor torque was measured with an isokinetic<br />
dynamometer at baseline, 24 hours post race and 7 days post race. The dependent<br />
variables were analyzed using a one factor repeated measures ANOVA.<br />
rEsuLTs: IL-6 was elevated immediately post race (1.20±1.18 to 13.84±3.16 pg/<br />
mL, p 30 kg/m2) or non-obese (N=15; BMI < 30 kg/m2). PBMCs (106<br />
cells/ml) were stimulated with leptin at 18.75 and 250 ng/ml in the presence of synthetic<br />
GC dexamethasone (DEX; 0, 10-8, 10-7, and 10-6 M) for 24 h at 37°C in 5% CO2.<br />
rEsuLTs: Leptin at the higher level induced greater IL-6 production in the obese<br />
than non-obese subjects (p
<strong>Thursday</strong>, May 30, 2013<br />
S194 Vol. 45 No. 5 Supplement<br />
(treatment: p
Official Journal of the American College of Sports Medicine<br />
ANOVA, controlling for age, weight, calcium and compliance.<br />
rEsuLTs: Six young adults (4F, 2M, age 23 ± 2.4 years) volunteered to participate.<br />
All bone, muscle and fat parameters improved over the training period, except tibial<br />
density at the 4% site, with greater improvements in the barefoot limb; however, no<br />
effect reached statistical significance. A 4.5% increase in lower extremity lean mass<br />
(p=0.01) and 10.1% decrease in fat mass (p=0.002) was observed in the barefoot limb<br />
only.<br />
CONCLusIONs: Power was low in this pilot trial, thus positive footwear-specific<br />
skeletal responses to the osteogenic training program did not reach statistical<br />
significance. By contrast, greater increases in lean mass and decreases in fat mass were<br />
detected in the lower extremity wearing the barefoot shoe during training. The novel<br />
within-subject design was an effective control of individual variation with no adverse<br />
effects.<br />
1069 Board #14 May 30, 9:00 AM - 10:30 AM<br />
Estrogen receptor-alpha Genotype affects Exercise-related<br />
Bone density In Japanese young Women<br />
Hiroyo Kondo 1 , Hidemi Fujino 2 , Shinichiro Murakami 3 ,<br />
Naoto Fujita 2 , Fumiko Nagatomo 4 , Akihiko Ishihara 4 . 1 Nagoya<br />
Women’s University, Nagoya, Aichi, Japan. 2 Kobe University,<br />
Kobe, Japan. 3 Himeji Dokkyo University, Himeji, Japan. 4 Kyoto<br />
University, Kyoto, Japan.<br />
(No relationships reported)<br />
Osteoporosis is a systemic skeletal disease characterized by low density and fragile in<br />
bone. Estrogen is essential for mechanotransduction, and estrogen receptor alpfa (ER1)<br />
is one of genetic candidates for a prime regulator of bone metabolism.<br />
PurPOsE: The purpose of this study was to assess the interactive effects of habitual<br />
exercise, calcium intake and ER1 gene polymorphisms on bone density in young<br />
women.<br />
METhOds: 160 Japanese healthy young women (20-23 years old) were<br />
recruited in this study. Habitual exercise and nutrient intake were assessed using a<br />
questionnaire. Bone mass was measured by quantitative ultrasound measurement. The<br />
polymorphisms of ER1 at intron I (rs2234693 and rs9340799) was genotyped using the<br />
TaqMan probe-based SNP method.<br />
rEsuLTs: The subjects with habitual exercise and high milk intake were significantly<br />
higher bone density than those with non-habitual exercise and low milk intake. The<br />
subjects with ER1 genotype CC of rs2234693 had lower bone density than those<br />
with ER1 genotype TT in non-habitual exercise group. Interestingly, the subjects<br />
with ER1 allele C, or both CT and AG of rs9340799 in the habitual exercise group<br />
had significantly higher bone density than those in the non-habitual exercise group<br />
although the subjects without ER1 allele C or both CT and AG were no significant<br />
bone density between the habitual exercise group and the non-habitual exercise group.<br />
CONCLusIONs: These results suggest that habitual exercise is more important for<br />
bone mass metabolism in young women carrying C allele and/or AG genotype in ER1<br />
polymorphisms.<br />
Supported by Grants-in-Aid for Science Research from the Japanese Ministry of<br />
Education, Culture, Sports, Science and Technology.<br />
1070 Board #15 May 30, 9:00 AM - 10:30 AM<br />
relationship Between The sarcopenic Index, Body<br />
Composition and Muscular strength in Breast Cancer<br />
survivors<br />
Takudzwa A. Madzima1 , Emily Simonavice2 , Pei-Yang Liu3 ,<br />
Jasminka Z Ilich1 , Jeong-Su Kim1 , Michael J. Ormsbee1 , Carla<br />
M. Prado1 , Lynn B. Panton, FACSM1 . 1Florida State University,<br />
Tallahassee, FL. 2Georgia College & State University,<br />
Milledgeville, GA. 3The University of Akron, Akron, OH.<br />
(No relationships reported)<br />
Breast cancer survivors (BCS) encounter side effects from cancer treatments that<br />
negatively affect body composition, particularly muscle loss which may lead to<br />
sarcopenia. Additionally, this may result in osteosarcopenia, the concurrent loss of<br />
bone and muscle mass. Appendicular skeletal muscle adjusted by squared height (ASM<br />
index; kg/m2) has been used to define sarcopenia.<br />
PurPOsE: To evaluate the relationships between the ASM index, strength, and total<br />
and regional bone mineral density (BMD) in BCS.<br />
METhOds: Forty-four (60±9 yrs) BCS participated. Body composition and BMD of<br />
the total body, lumbar spine (L1-L4), hip (femur), radius, ulna and total forearm were<br />
measured by DXA. Upper and lower body strength was measured via one-repetition<br />
maximum (1RM) on chest press and leg extension machines. Handgrip (HG) strength<br />
was assessed using a HG dynamometer. The BCS were separated into two groups<br />
comprised of those that fell above (>) and below ( 6.39<br />
Vol. 45 No. 5 Supplement S195<br />
kg/m2 (total body: >1.182±0.135 g/cm²; : 0.518±0.059<br />
g/cm²; : 0.474±0.064 g/cm²; : 0.499±0.059 g/cm²;
<strong>Thursday</strong>, May 30, 2013<br />
S196 Vol. 45 No. 5 Supplement<br />
1073 Board #18 May 30, 9:00 AM - 10:30 AM<br />
Excess Body Fat has Negative Impacts on hip strength in<br />
Competitive athletes with Menstrual dysfunction<br />
Sheng-An Lo 1 , Kuei-Hui Chan 2 , Yi-Ting Lin 3 , Chien-Wen Ho 3 .<br />
1 Graduate Institute of Coaching Science, Taoyuan, Taiwan.<br />
2 Graduate Institute of Coaching Science, Taoyaun, Taiwan.<br />
3 Laboratory of exercise Biochemistry, Taipei, Taiwan.<br />
(No relationships reported)<br />
Hip strength (HS) analysis is measures of proximal femur strength in axial<br />
compression or bending. Fat mass (FM) and lean body mass (LBM) are positively<br />
related to bone mass in young athletes with eumenorrhea. However, the relation in<br />
ones with menstrual dysfunction is less known.<br />
PurPOsE: To determine effects of body composition (BC) on bone health in athletes<br />
with menstrual dysfunction.<br />
METhOds: Thirty-one athletes with MD (20.1±1.9 yrs) were selected by a<br />
questionnaire from 134 collegiate female athletes. They did not take any menstrual<br />
regulators during the past a year. Blood samples were collected during day-3 to<br />
day-5 of menses to assess sex hormones of luteinizing hormone, follicle-stimulating<br />
hormone, and estradiol. BC and bone mineral density (BMD) of hip, femoral neck,<br />
and Ward’s triangle were assessed by dual-energy X-ray absorptiometry. BC variables<br />
included LBM, FM in whole body (FMWB), wasit (FMW), and hip (FMh) and body<br />
fat percentage in the same parts (BF%WB, BF%w, and BF%h). HS variables of crosssectional<br />
area (CSA), cross-sectional moment of inertia (CSMI), hip axis length, and<br />
femur strength index (FSI) were assessed by the HS analysis program. All subjects<br />
were divided into normal (Nor) and high body fat (H) groups by BF% ≤25%. Pearson’s<br />
correlations and independent t-tests were used to analyze all continuous variables.<br />
rEsuLTs: Between the Nor and the H groups, there were significant differences in<br />
BMI, BF%WB, BF%W, BF%h, and FMWB (12.5±1.7 vs. 20.1±5.8 kg, p
Official Journal of the American College of Sports Medicine<br />
1077 Board #22 May 30, 9:00 AM - 10:30 AM<br />
The Vertebral Curvature Of dancesport and Track and<br />
Field athletes<br />
Helena Liiv, Katre Maasalu, Jarek Mäestu, Toivo Jürimäe, Jaak<br />
Jürimäe. University of Tartu, Tartu, Estonia.<br />
(No relationships reported)<br />
Dancers have beautiful posture and keeping a straight spine line is typical not only<br />
during competitions, but in everyday life also. In dancesport athletes are training for<br />
many years to develop the right posture and dance hold. This raises the question:<br />
does keeping a nice posture becomes a habit and does the spine changes too? To<br />
investigate the influence of the specific training of dancesport to the spinal curvatures<br />
we compared dancers´ spinal curvatures with track and field athletes. We decided to<br />
compare dancesport with other sports to exclude the influence of sedentary lifestyle.<br />
The reason for choosing precisely track and field athletes was that both sports are<br />
having continues and various movements.<br />
PurPOsE: The aim of the current study was to evaluate lumbar lordosis and thoracal<br />
kyphosis of the international level dancesport dancers and to compare it with track and<br />
field athletes.<br />
METhOds: Participants: Thirty competitive dancesport couples (males 22.8±6.6 yrs<br />
and females 22.0±6.4 yrs) and 16 male (age 26.8±4.4 yrs) and 13 female (age 21.5±4.1<br />
yrs) track and field athletes served as subjects for this study. The track and field and<br />
dancesport groups were selected to match the age and gender profile. Spinal curvatures:<br />
Thoracal kyphosis, lumbar lordosis angle were measured in lateral view VFA scan using<br />
a Lunar DPX-IQ densitometer (Lunar Corporation, Madison, WI, USA).<br />
rEsuLTs: Male (5.7±4.7°) and female dancers (8.7±5.9°) had significantly smaller<br />
(p
<strong>Thursday</strong>, May 30, 2013<br />
S198 Vol. 45 No. 5 Supplement<br />
associations between L foot and any DXA parameters.<br />
CONCLusIONs: It appears that there are significant relationships between bone<br />
health values from QUS and DXA. The association existed only for the R foot, which<br />
may be related to R-side dominance. These data suggest that QUS of the R Os Calcis<br />
may be sensitive to measuring the same bone health parameters as those elicited by the<br />
DXA giving cautious support for using QUS for intervention research. Further study<br />
using larger sample sizes and a more diverse population is needed to determine the<br />
validity and sensitivity of QUS to changes in bone health parameters over time and to<br />
test its application beyond fracture screening.<br />
1082 Board #27 May 30, 9:00 AM - 10:30 AM<br />
using Peripheral Quantitative Computed Tomography<br />
(pQCT) to Estimate soft Tissue Characteristics in Patients<br />
with Knee Osteoarthritis<br />
Dana L. Judd, Vanessa D. Sherk, Emily R. Rogers, Wendy M.<br />
Kohrt, FACSM, Jennifer E. Stevens-Lapsley. University of<br />
Colorado Anschutz Medical Campus, Aurora, CO.<br />
(No relationships reported)<br />
Patients with knee osteoarthritis (OA) have reduced quadriceps strength in the painful<br />
limb. Estimating muscle size and its contribution to strength loss is challenging but<br />
important for optimizing rehabilitation. Peripheral Quantitative Computed Tomography<br />
(pQCT) measures thigh muscle size but analysis is challenging due to noise in images<br />
of large limbs. Filtering decreases signal noise, but strategies vary. The effect on soft<br />
tissue quantification in those with poor muscle quality or larger limb size is unclear.<br />
PurPOsE: To determine if noise filtering affects the quantification of soft tissue in<br />
an OA cohort.<br />
METhOds: 28 patients with knee OA were enrolled (age 64.5 ± 8.0 y; BMI 28.6 ±<br />
4.3 kg/m2). pQCT scans were acquired at 33% of the femur length proximal to the<br />
lateral epicondyle. Scans were analyzed with 4 median filter methods (No filter, weak<br />
filter (F03F05), medium filter (F03F05F05), strong filter (F01F06U01)). Total area<br />
(TA), muscle area and density (MA, MD), and fat area and density (FA, FD) were<br />
measured. Repeated measures ANOVA with post hoc paired t-tests were performed.<br />
rEsuLTs: TA, MA, FA, FD and MD values were filter dependent. Each filtering<br />
method was significantly different from each other (Table 1; p
Official Journal of the American College of Sports Medicine<br />
32.8 [Nm] and Achilles tendon elongation ICC: 0.89; TRV: 14.4 ± 8.6 %; Bias ± LoA:<br />
0.0 ± 0.5 cm.<br />
CONCLusION: Data suggests that the defining variables are reliable for the<br />
calculation of Achilles tendon stiffness and Young’s modulus. However, the relatively<br />
high test-retest variability of Achilles tendon elongation and muscle torque may lead<br />
to an increase in measurement error in the calculation of both tendon stiffness and<br />
Young’s modulus.<br />
1086 Board #31 May 30, 9:00 AM - 10:30 AM<br />
Intra- and Inter-observer Variability Of a retrospective<br />
analysis Of achilles Tendon ultrasound scans<br />
Monique Wochatz, Michael Cassel, Niklas Koenig, Katja<br />
Froehlich, Frank Mayer. University Outpatient Clinic Potsdam,<br />
Potsdam, Germany.<br />
(No relationships reported)<br />
Ultrasonography is commonly used in clinical practice to examine Achilles tendon<br />
(AT) structural alterations. Due to time and practical reasons, ultrasound investigations<br />
and the subsequent analyses of the respective scans are often done by two different<br />
examiners. Nevertheless, it is unclear whether those retrospective analyses are reliable.<br />
PurPOsE: To evaluate the intra- and inter-observer variability of AT thickness and<br />
cross-sectional area (CSA) analysis on pre-captured ultrasound scans done by an<br />
experienced (EI) and inexperienced investigator (II).<br />
METhOds: Both Achilles tendons of 12 asymptomatic subjects (29±6yrs,<br />
1.77±0.10m, 74±13kg) were investigated by ultrasound. Longitudinal and transversal<br />
ultrasound scans were captured at 20 mm proximal the calcaneal insertion by an EI.<br />
The scans were further retrospective analyzed, once by the EI and twice with one day<br />
in between by an II. Achilles tendon thickness was assessed on longitudinal scans and<br />
CSA on transversal scans by a freehand selection tool. To evaluate intra- and interobserver<br />
reliability, test-retest variability (TRV), intra-class correlation coefficient 2.1<br />
(ICC), Bias and 95% limits of agreement (LoA) were calculated.<br />
rEsuLTs: The Intra-observer AT-thickness values were 4.7±0.6mm (Mean±SD)<br />
(TRV: 3%; ICC: 0.95; Bias: -0.1mm; LoA: -0.4, 0.3mm) for the first (A1) and second<br />
analysis (A2) assessed by the II. CSA were 58.6±15.5mm² (A1) and 56.6±15.4mm²<br />
(A2) (TRV: 8%; ICC: 0.96; Bias: 1.9mm²; LoA: -5.9; 9.7mm²). The inter-observer<br />
AT-thickness values were 4.7±0.6mm for the II and 5.0±0.6mm for the EI (TRV: 8%;<br />
ICC: 0.81; Bias: -0.4mm; LoA: -0.6, -0.2mm). CSA were 58.6±15.5mm² for II and<br />
60.6±15.6mm² for the EI (TRV: 8%; ICC: 0.92; Bias: -2mm²; LoA: -13.7, 9.7mm²).<br />
CONCLusIONs: Intra-observer reliability was shown to be excellent on ATthickness<br />
and CSA analysis, even when performed by an II. Inter-observer reliability<br />
was good to excellent. The retrospective analysis of ultrasound scans done by<br />
differently experienced investigators was shown to be a practical and reliable method.<br />
1087 Board #32 May 30, 9:00 AM - 10:30 AM<br />
Mechanical Characteristics of younger and Older subjects’<br />
Patellar Tendon via acoustoelasticity analysis of ultrasound<br />
Images<br />
Michele LeBlanc, Kyle Evans, Steven A. Hawkins, FACSM.<br />
California Lutheran University, Thousand Oaks, CA.<br />
(No relationships reported)<br />
Acoustoelasticity has been used to obtain non-invasive mechanical measures of in-vivo<br />
tendon from ultrasound images.<br />
PurPOsE: To use the acoustoelasticity-based software program, EchoSoft<br />
(Echometrix, Madison, WI), to compare strain developed in the patellar tendon during<br />
an isometric contraction between younger and older participants and to determine the<br />
behavior of the tendon’s strain-signal change (stiffness) curve.<br />
METhOds: Moderately active Younger subjects (n=14, age = 22.6 ± 3.8 years) and<br />
Older subjects (n=13, age = 82.2 ± 5.6 years) were recruited from the local community.<br />
The two groups’ activity level, height and mass were not significantly different.<br />
Graded isometric knee extensions were performed on an isokinetic dynamometer<br />
while ultrasound data was collected at 25 Hz. Ultrasound DICOM files were uploaded<br />
to the EchoSoft software to obtain strain and stiffness information for a region of<br />
interest 175 mm2 proximal to the tibial attachment site. One trial with increasing strain<br />
and stiffness for at least 800 ms was chosen for each subject’s leg for analysis. Four<br />
different types of curves were fit to each trial’s strain-stiffness data.<br />
rEsuLTs: There was no difference in the maximum strain experienced in the 800<br />
ms timeframe between the Younger and Older groups (8.4 ± 6.0% versus 8.7 ± 5.3%,<br />
respectively). There was a difference between the maximum strain values between legs<br />
for the Older group (p = 0.007), but not the Younger group. There was a significant<br />
relationship between the maximum strain and maximum torque values for the Younger<br />
group (r = 0.525; p = 0.004), but not the Older group (r = -0.030). The exponential<br />
curve and general linear model fits were best and nearly identical for both groups<br />
(R2 = 0.937 ± 0.045 for both curve types for the Younger group and R2 = 0.956 ±<br />
0.032 and 0.955 ± 0.032 for the Older group). The quadratic curve also fit well (R2<br />
= 0.925 ± 0.114 for the Younger group and R2 =0.949 ± 0.055 for the Older group)<br />
but individual curves differed in their concavity direction. The linear model through<br />
the origin did not fit as well as the other curves (R2 = 0.856 ± 0.119 and R2 = 0.898 ±<br />
0.071, respectively).<br />
Vol. 45 No. 5 Supplement S199<br />
CONCLusIONs: These observations support that the strain-stiffness curve is best<br />
described with an exponential or general linear model.<br />
1088 Board #33 May 30, 9:00 AM - 10:30 AM<br />
acl Failure Locus: a subject specific simulation-based<br />
Investigation<br />
Ruben Goebel. Qatar University, Doha, Qatar.<br />
(No relationships reported)<br />
PurPOsE: A full/partial tear of the anterior cruciate ligament (ACL), occurs<br />
approx. 250000 times annually in the U.S. An epidemiology study of athletic injuries<br />
determined that out of 19,530 injuries, 20% were ACL injuries. It is shown that ACL<br />
injury occurs when the athlete lands with knee close to full extension, in valgus, and<br />
the femur in external rotation. These studies assume that an ACL injury occurs only in<br />
certain combinations of loading. Aim of this study was to perform a parametric study<br />
based on knee joint movement, under different varus and valgus (V/V) ramping rates,<br />
to highlight which movement combinations are most detrimental to ligaments and soft<br />
tissues of knee joint.<br />
METhOds: Using a 3D FE knee joint model (bones modeled as rigid-, ligaments<br />
modeled as multi-bundled 3D solid structures) by using a transversely isotropic viscohyperelastic<br />
material model, our study provides a spectrum of injury propensity based<br />
on internal/external femoral rotation and (V/V) angle. Our models are based on subject<br />
specific geometrical models of the knee joint and accounts for bundle specific prestrain<br />
in 3D ligaments.<br />
rEsuLTs: ACL tears were monitored over a spectrum of motion combinations, at<br />
three relevant V/V ramping rates of 0.1 sec., 0.05 sec. and 0.01 sec. The results show<br />
negligible differences between failure angles for all movements. The largest difference<br />
for one axial rotation value was 0.42°. The results highlight external rotation combined<br />
with valgus angle as detrimental movement combination. Moreover, varus angle<br />
simulation requires less relative angle for ACL tear initiation when compared to valgus<br />
angle simulation. The posterolateral bundle (plACL) was shown to be more susceptible<br />
to rupture in 17 of 22 orientations. External femoral rotations are more susceptible to<br />
ligament failure than internal femoral rotation. plACL shows more injury susceptibility<br />
compared to the anteromedial bundle.<br />
CONCLusIONs: External rotation combined with valgus angle is determined as<br />
detrimental movement combination for knee joint injury. The current results will<br />
improve the knowledge base for injury mechanisms of the ligaments and soft tissue of<br />
the knee. In sports where ACL injuries are prevalent, our results can assist to develop<br />
training programs to address the avoidance of potentially harmful knee orientations.<br />
1089 Board #34 May 30, 9:00 AM - 10:30 AM<br />
Patients with Chronic rotator Cuff Tears have reduced<br />
supraspinatus Muscle Fiber Force Production, disordered<br />
Myofibrils and an accumulation of Fatty Macrophages<br />
Christopher L. Mendias, Stuart M. Roche, Evan B. Lynch, Max<br />
R. Davis, Caleb R. Bromley, Julie A. Harning, Elizabeth R.<br />
Sibilsky Enselman, Dennis R. Claflin, Asheesh Bedi. University of<br />
Michigan, Ann Arbor, MI. (Sponsor: John A Faulkner, FACSM)<br />
(No relationships reported)<br />
A common pathophysiological change that occurs in chronically torn rotator cuff<br />
muscles is atrophy of muscle fibers and an accumulation of intramuscular fat,<br />
collectively referred to as “fatty degeneration.” For many patients that undergo surgical<br />
repair of a torn cuff, fatty degeneration is not resolved.<br />
PurPOsE: To gain a greater understanding of the changes in muscle fiber contractility,<br />
myofibril architecture and fat accumulation in patients with rotator cuff tears.<br />
METhOds: Biopsies of the supraspinatus (SSP) and anterior deltoid were obtained<br />
from patients with chronic, full thickness SSP tears at the time of surgical repair.<br />
The contractility of permeabilized muscle fibers was measured, and force values of<br />
torn SSP and intact deltoid muscles were compared to age-matched force values of<br />
healthy fibers sampled from the vastus lateralis (VL) muscle in a previous study. N=27<br />
subjects for VL, N=8 subjects for SSP and deltoid. Differences between groups were<br />
tested using a one-way ANOVA (P
<strong>Thursday</strong>, May 30, 2013<br />
S200 Vol. 45 No. 5 Supplement<br />
1090 Board #35 May 30, 9:00 AM - 10:30 AM<br />
systematic review of Contracture reduction in the Lower<br />
Extremity using dynamic splinting<br />
F, Buck Willis1 , John Furia2 , Ram Shanmugam3 , Sarah Curran4 .<br />
1 2 McMurry University, Abilene, TX. SUN Orthopaedic,<br />
Lewisburg, PA. 3Texas State University, San Marcos, TX.<br />
4University of Wales Institute, Cardiff, Cardiff, United Kingdom.<br />
Supported by F. Willis: Salary; Landmark Medical, Dynasplint Systems<br />
Research Board Membership.<br />
Background: Joint contractures are relatively common disorders that can result in<br />
significant long term morbidity. Initial treatment is non-operative and often entails<br />
the use of mechanical modalities such as dynamic and static splints. Although widely<br />
utilized, there is a paucity of data that supports the use of such measures. The purpose<br />
of this systematic review was to evaluate the safety and efficacy of dynamic splinting<br />
as it is used to treat joint contracture, and to determine if duration on total hours of<br />
stretching had an effect on outcomes.<br />
METhOds: Reviews of Pubmed, Science Direct, Medline, AMED, and EMBASE<br />
websites were conducted to identify the term ‘Contracture reduction’ in manuscripts<br />
published from January 2002 to January 2012. Publications selected for inclusion<br />
were controlled trials, cohort studies, or case series studies employing prolonged,<br />
passive stretching for lower extremity contracture reduction. A total of 354 abstracts<br />
were screened and eight studies (487 subjects) met the inclusion criteria. The primary<br />
outcome measure was change in active range of motion (AROM).<br />
rEsuLTs: The mean aggregate change in AROM was 23.5º. The weighted hours<br />
in meta-analysis showed significant difference within the analysis, with normal<br />
distribution. Both systemic and animal studies revealed a greater difference and<br />
improvement from prolonged passive stretching versus short durations of stretching.<br />
There was also consistency between studies of prolonged passive stretching in human<br />
patients with outcome in change of AROM. (N=487, ΔAROM = 23.5°, SD=7.6). In<br />
these studies there were zero adverse events.<br />
CONCLusIONs: There was a direct, linear correlation between the total number<br />
of hours in stretching and restored AROM (P=0.002). Dynamic splinting is a safe<br />
and efficacious treatment for lower extremity joint contractures. The joint specific<br />
stretching protocols accomplished<br />
greater durations of end-range stretching which is considered responsible for<br />
connective tissue elongation.<br />
Key Words: Connective Tissue, Home Therapy, Rehabilitation<br />
1091 Board #36 May 30, 9:00 AM - 10:30 AM<br />
ultrasonographic Measurements of supraspinatus<br />
Thickness, Pain scores and Treatment<br />
Marni Hillinger, Christopher Visco. New York Presbyterian -<br />
Columbia and Cornell, New York, NY.<br />
(No relationships reported)<br />
Abstract:<br />
Shoulder injury and pain complaints are common in the primary care, orthopedic and<br />
physiatric outpatient setting. The supraspinatus tendon is a commonly involved tendon<br />
in rotator cuff injuries. Musculoskeletal ultrasound is becoming a popular tool to aid in<br />
the diagnosis of pathologic conditions of the supraspinatus tendon.<br />
PurPOsE: To determine whether a relationship may exist between supraspinatus<br />
thickness and pain scores among patients who present with a primary complaint of<br />
shoulder pain. We hypothesize that a positive correlation exists and that this could aid<br />
clinical development of targeted treatment strategies and earlier identification of those<br />
who require a more aggressive therapeutic approach.<br />
METhOds: A retrospective analysis of supraspinatus thickness was performed by<br />
analyzing ultrasonographic shoulder examinations of patients who presented to the<br />
Columbia University musculoskeletal clinic with a primary complaint of shoulder pain.<br />
This included 58 separate shoulder studies among 52 different patients. An average<br />
thickness was obtained by utilizing the DICOM ultrasonographic software ruler tool.<br />
Outpatient records were reviewed including pertinent follow-up visits. Pain scores and<br />
treatment at the time of presentation and follow-up were recorded.<br />
rEsuLTs: There was no correlation (Pearson correlation =-0.008) found between<br />
supraspinatus tendinous thickness and pain scores at the time of presentation. Average<br />
supraspinatus thickness was found to be 0.506cm ± 0.113 among women and 0.556cm<br />
±0.157 among men. Average pain score was found to be 5.4±2.2 among women and<br />
5.7±2.28 among men on initial evaluation. Of those who followed-up, an average<br />
pain score at the time of re-assessment was 3.5±2.63. 73% of patients were referred<br />
for physical therapy, 8% were referred for surgical evaluation and 27% underwent a<br />
steroid injection upon initial evaluation.<br />
CONCLusIONs: This study did not identify a correlation between<br />
ultrasonographically identified supraspinatus thickness and pain scores for patients<br />
who present with a primary complaint of shoulder pain. The majority of patients<br />
underwent conservative management. Future research should continue to distinguish<br />
ultrasonographically identifiable risk factors for the development of shoulder<br />
pathologies.<br />
MEDICINE & SCIENCE IN SPORTS & EXERCISE ®<br />
1092 Board #37 May 30, 9:00 AM - 10:30 AM<br />
Extreme Glenoid retroversion is associated with Increased<br />
rotator Cuff strength in the shoulder<br />
Kenneth L. Cameron, Scot E. Campbell, Karen Y. Peck, Richard<br />
B. Westrick, Brett D. Owens. Keller Army Hospital, United<br />
States Military Academy, West Point, NY.<br />
(No relationships reported)<br />
The rotator cuff muscles are critical secondary stabilizers in the shoulder. Increased<br />
glenoid retroversion has been associated with the risk of posterior shoulder instability;<br />
however, the impact of increased glenoid retroversion on rotator cuff strength remains<br />
unclear.<br />
PurPOsE: To examine the association between glenoid retroversion and rotator cuff<br />
strength in the shoulder.<br />
METhOds: We conducted a prospective cohort study over a four-year period<br />
within a high risk group of young athletes to identify the risk factors for shoulder<br />
instability. Subjects were 1050 freshman entering a U.S. Service Academy in June of<br />
2006. Baseline data collected upon entry into the study included MRI assessments of<br />
glenoid version. All measures of glenoid version were performed by a musculoskeletal<br />
radiologist blinded to all other baseline data. Rotator cuff strength was also assessed<br />
at baseline using a hand held dynamometer. Internal and external rotation strength was<br />
assessed with the glenohumeral joint positioned in neutral and in 45º of abduction.<br />
The current study represents a cross-sectional analysis of the baseline data from this<br />
study. The primary dependent variables of interest were the four measures of rotator<br />
cuff strength. The independent variable consisted of four levels based on quartile cut<br />
points for the degree of glenoid retroversion. Four separate one-way ANOVAs, along<br />
with Scheffe post-hoc tests, were used to examine mean between group differences in<br />
rotator cuff strength.<br />
rEsuLTs: We observed significant main effects for internal (F3,1144=11.79,<br />
p
Official Journal of the American College of Sports Medicine<br />
1094 Board #39 May 30, 9:00 AM - 10:30 AM<br />
hyaline Cartilage regeneration in Focal Cartilage defect is<br />
stimulated by an Innovative acellular Bi-Phasic scaffold<br />
Elizaveta Kon 1 , Ken Zaslav 2 , Andrew S. Levy 3 , Jonathan Shani 4 ,<br />
Vincenzo Condello 5 , Dror Robinson 6 , Nir Altschuler 6 . 1 Rizzoli<br />
Orthopaedic Institute, Bologna, Italy. 2 Advanced Orthopedic<br />
Centers, Richmond, VA. 3 The Center for Advanced Sports<br />
Medicine, Millburn, NJ. 4 Chavat Daat Veterinary Center, Kfar<br />
Saba, Israel. 5 Sacre Cuore Don Calabria Hospital, Verona, Italy.<br />
6 Cartiheal Ltd., Kfar Saba, Israel.<br />
Supported by E. Kon: Consulting Fee; CartiHeal.<br />
PurPOsE: The current study was designed to assess the ability in a caprine model<br />
of a bi-phasic cell-free scaffold to support regeneration of bone and cartilage. Results<br />
of twelve month pre-clinical study are presented as well as anecdotal results of human<br />
implantations.<br />
METhOds: The study was conducted on twenty-four Saanen goats. A critical sized<br />
focal cartilage defect measuring 6mm diameter by 10mm depth was created in the<br />
medial femoral condyle. In sixteen of the goats a bi-phasic implant was inserted<br />
into the defect the reset served as empty defect control. The goats were followed for<br />
periods of six and twelve months. In vivo the goats were assessed by ultrasonography<br />
to evaluate the quality of repair tissue using a categorical score. Following sacrifice,<br />
macroscopic evaluation by independent blinded experts (according to Fortier and<br />
ICRS), radiographs, micro CT, MRI and blinded histology evaluation (by BioMatech<br />
NAMSA) of the condyle were performed. Samples of blood, synovial tissue and<br />
synovial fluid were analyzed.<br />
rEsuLTs: In the Agili-C (CartiHeal (2009) Ltd.) implanted goats, but not in controls<br />
there was evidence of both cartilage and bone regeneration. ICRS macroscopic<br />
evaluation at six months after implantation of an Agili-C implant (n=9) were 9.57 ±1.4<br />
vs. 6.33±4.5 in the control group (n=5,<br />
and at twelve months after implantation of an Agili-C implant (n=7) 11.29±0.9 vs.<br />
7.33±0.5 in the control group (n=3, p
<strong>Thursday</strong>, May 30, 2013<br />
S202 Vol. 45 No. 5 Supplement<br />
possible attenuating effect of non weight-bearing activity on bone strength parameters<br />
between genders.<br />
1098 Board #43 May 30, 9:00 AM - 10:30 AM<br />
disc degeneration and Limbus Vertebra in Japanese<br />
Collegiate Gymnasts<br />
Koji Koyama1 , Koichi Nakazato2 , Seok Ki Min2 , Koji Gushiken2 ,<br />
Yoshiaki Hatakeda2 , Kyoko Seo2 , Kenji Hiranuma2 . 1Tokyo Ariake University of Medical and Health Sciences, Tokyo, Japan.<br />
2Nippon Sport Science University, Tokyo, Japan.<br />
(No relationships reported)<br />
Magnetic resonance imaging (MRI) studies have shown a higher frequency of<br />
radiological abnormalities such as disc degeneration (DD), and limbus vertebra (LV)<br />
among gymnasts. These 2 abnormalities seem to coexist at the same spinal level.<br />
However, their relationship remains unclear.<br />
PurPOsE: To investigate the association between DD and adjacent LV in Japanese<br />
collegiate gymnasts.<br />
METhOds: The subjects were 104 Japanese collegiate gymnasts (70 men and 33<br />
women aged 19.7 ± 1.0 years, with 11.8 ± 3.6 years of sporting experience), and<br />
included Olympic and World Championship medalists. DD and LV were evaluated<br />
using T1- and T2-weighted MRI. DD was defined as reduced signal intensity of the<br />
intervertebral discs from L1/L2 to L5/S1. The grading system for the assessment<br />
of DD was based on the Pfirrmann classification, with grades 3, 4, and 5 indicating<br />
degeneration. LV was defined as separate, sclerotic, triangular ossicles adjacent to, but<br />
separate from the vertebral endplate. MRI was performed on all the gymnasts, and the<br />
images were evaluated by 2 experienced orthopedic surgeons, blinded to the clinical<br />
status of the gymnasts.<br />
rEsuLTs: The prevalence of DD and LV in the gymnasts was 40.4% (42/104) and<br />
20.2% (21/104), respectively. The incidence of DD was significantly higher in gymnasts<br />
with LV than in those without LV, as determined by the chi-square test. By using logistic<br />
regression analysis, a significant association of DD with LV (adjusted odds ratio (OR) =<br />
8.54; 95% confidence interval (CI), 2.64-27.57) and with sporting experience (adjusted<br />
OR = 0.86; 95% CI, 0.76-0.99) was observed. In addition, we grouped DDs into those<br />
occurring in the upper (L1/2, L2/3, and L3/4 discs) and lower (L4/5 and L5/S1 discs)<br />
lumbar regions. The presence of upper DD was associated with adjacent LV (adjusted<br />
OR = 56.81; 95% CI, 8.87-363.68), and sporting experience (adjusted OR = 0.87;<br />
95% CI, 0.70-1.07). Similarly, the presence of lower DD was associated with adjacent<br />
LV(adjusted OR = 8.45; 95% CI, 1.88-38.05), but not sporting experience.<br />
CONCLusIONs: Adjacent LV is associated with both, upper and lower DD, and may<br />
be an etiological factor for DD in Japanese collegiate gymnasts.<br />
1099 Board #44 May 30, 9:00 AM - 10:30 AM<br />
Whole-Body Vibration attenuates Bone resorption Marker<br />
responses to acute resistance Exercise in young Men<br />
Pragya Sharma-Ghimire, Zhaojing Chen, Xin Ye, Tory Keeter,<br />
Kaelin Young, Eonho Kim, Christopher Poole, Daeyeol Kim,<br />
Michael Bemben, FACSM, Debra Bemben, FACSM. University<br />
of Oklahoma, Norman, OK.<br />
(No relationships reported)<br />
Bone turnover marker (BTM) responses to acute exercise is an area of growing<br />
interest, however, few studies have examined BTM responses to combined resistance<br />
exercise and whole-body vibration (WBV).<br />
PurPOsE: To investigate acute BTM responses to high-intensity resistance exercise<br />
with and without whole-body vibration in young men.<br />
METhOds: 10 men (23.1± 1.9 years) participated in this randomized crossover<br />
study. 1-RM testing was performed for 4 lower body and 2 upper body isotonic<br />
resistance exercises. Subjects performed 2 protocols in random order separated<br />
by 2-week wash out periods: 1) resistance exercise only (RE) and 2) WBV + RE.<br />
For WBV + RE, subjects stood barefoot with knees slightly flexed on the vibration<br />
platform for 5, 1-minute bouts at 20 Hz and 1.25 mm (amplitude) separated by<br />
1-minute rest intervals, followed by resistance exercise. For RE, subjects completed 3<br />
sets of 10 reps at 80% 1-RM. Fasting morning blood draws were taken before (Pre),<br />
immediately post (IP) exercise, and 30 minutes (30P) after exercise. WBV + RE also<br />
included a blood draw between the WBV exposure and resistance exercise (VibP).<br />
Blood samples were analyzed for hematocrit, bone-specific alkaline phosphatase (Bone<br />
ALP, U/L) and tartrate-resistant acid phosphatase 5b (TRAP5b, U/L).<br />
rEsuLTs: There was a significant time effect for Bone ALP (p
Official Journal of the American College of Sports Medicine<br />
point system. One point deductions were assigned on SLF for 5 knots± on airspeed,<br />
100ft± on altitude, or 5 degrees± in heading. Total time (s) for CT was recorded across<br />
3 segments.<br />
rEsuLTs: There were a higher number of total penalty points on SLF with the ED<br />
vs. the placebo (P) in the MED (ED 58.4±9.2 vs. P 34.0 ±6.6, p .05, respectively). Time to complete CT was higher for<br />
P in MED vs. HI (349.4±26.5s vs. 279.1±17.5s, p 0.05) in time to complete CT between ED and P or MED vs. HI.<br />
CONCLusIONs: With highly technical flight skills requiring precision, coordination<br />
and sequencing of movements, EDs may reduce overall performance. Athletes and<br />
pilots should cautiously interpret claims for the performance enhancing effects of<br />
energy drinks when shifting focus and technical motor skills are involved.<br />
1102 Board #47 May 30, 8:00 AM - 9:30 AM<br />
The Effects of a supplement designed to attenuate the<br />
adverse Effects of Fatigue<br />
Adam J. Wells, Adam M. Gonzalez, Gerald T. Mangine, Nadia<br />
S. Emerson, William P. McCormack, Adam R. Jajtner, Jeremy R.<br />
Townsend, Tyler C. Scanlon, Edward H. Robinson, IV, Jeffrey<br />
R. Stout, FACSM, Jay R. Hoffman, FACSM, Maren S. Fragala.<br />
University of Central Florida, Orlando, FL.<br />
(No relationships reported)<br />
Phosphatidylserine (PS) supplementation may play a role in attenuating the adverse<br />
effects of physical fatigue on cognition, mood, and motor function. However, the<br />
results from recent investigations remain equivocal.<br />
PurPOsE: To examine the effect of ingesting a supplement (S) containing PS (400<br />
mg·day-1) and caffeine (100 mg·day-1) for 14 days, on measures of cognitive function<br />
(CF), reaction time (RT), and mood (MD), following an acute exercise stress.<br />
METhOds: Twenty-one recreationally trained men and women (age: 22.5 ± 3.4<br />
yrs; height: 1.76 ± 1.0 m; weight: 77.6 ± 12.6 kg; body fat: 14.6 ± 6.6 %) volunteered<br />
for this double-blind, controlled study. Participants completed two acute bouts of<br />
resistance exercise (T1 and T2), separated by two weeks of supplementation with S or<br />
control (C). Measures of RT (Dynavision D2), CF (Serial Subtraction Test), and MD<br />
(Profile of Mood States) were assessed pre and post exercise at T1 and T2. A 2 x 2<br />
(time x treatment) repeated measures analysis of variance was used to analyze the data.<br />
rEsuLTs: When collapsed across groups, a significant decrease (p = 0.05) in RT<br />
performance (# of strikes) was seen in the 60-second reaction drill from pre to post<br />
exercise at T1. All other RT tests were similar from pre to post exercise at T1. RT was<br />
not significantly changed in response to PS (p > 0.05), and no significant between<br />
group differences were noted at T2. When collapsed across groups, a significant<br />
increase in the number of correct answers, and a significant decrease in time to answer<br />
was seen from pre to post workout at T1 (p = 0.004 and p = 0.007, respectively) and T2<br />
(p = 0.004 and 0.018, respectively) in the CF test. A significant increase in total mood<br />
score was observed for C but not for S (p = 0.034). Additionally, C experienced a 13%<br />
greater increase (p = 0.031) in pre to post exercise perception of fatigue compared to S.<br />
A significant decrease in confusion was observed in S at T2 (p = 0.041).<br />
CONCLusION: Ingestion of 400 mg·day-1 of PS and 100 mg·day-1 of caffeine for<br />
14-days appears to attenuate post-exercise MD scores and perception of fatigue, but<br />
does not improve reaction time in recreationally trained individuals following acute<br />
resistance exercise. An acute bout of resistance exercise may improve CF; however, PS<br />
provides no further benefit.<br />
1103 Board #48 May 30, 8:00 AM - 9:30 AM<br />
Physiological responses To a Thermogenic Nutritional<br />
supplement during rest, Exercise, and recovery In Women<br />
Haley C. Bergstrom 1 , Terry J. Housh, FACSM 1 , Daniel A.<br />
Traylor 1 , Robert W. Lewis Jr. 1 , Glen O. Johnson, FACSM 1 ,<br />
Richard J. Schmidt 1 , Dona J. Housh, FACSM 2 , Nathaniel D.M.<br />
Jenkins 1 , Kristen C. Cochrane 1 . 1 University of Nebraska-Lincoln,<br />
Lincoln, NE. 2 University of Nebraska Medical Center, Lincoln,<br />
NE.<br />
(No relationships reported)<br />
PurPOsE: The purpose of this study was to examine the acute physiological<br />
responses to a thermogenic nutritional supplement at rest, during low-intensity<br />
exercise, and recovery from exercise in women.<br />
METhOds: Twelve recreationally active women (mean ± SD; age, 22.9 ± 3.1<br />
years) were recruited for this randomized, double-blinded, placebo-controlled,<br />
crossover study. The nutritional supplement capsules included 200 mg caffeine, 100<br />
mg capsicum extract, 2 mg piperine, 250 mg boswellia serrate extract, 500 mg dried<br />
ginger root, 100 mg cinnamon bark, 20 mg niacin, and 500 mg macuna pruriens. The<br />
placebo capsules were matched in size and appearance and contained microcrystalline<br />
cellulose. Each testing session consisted of 4 phases: 1) 30 min of initial resting<br />
measures, followed by ingestion of the placebo or thermogenic nutritional supplement;<br />
2) 50 min of post-supplementation resting; 3) 60 min of treadmill walking (3.2 – 4.8<br />
Vol. 45 No. 5 Supplement S203<br />
km·hr-1); and 4) 50 min of post-exercise resting. Indirect calorimeter was used to<br />
measure energy expenditure (EE) and oxygen consumption rate (VO2). The EE and<br />
VO2 variables were recorded and reported as 10 min averages. During exercise, the<br />
rating of perceived exertion (RPE) was recorded every 15 min. Statistical analyses<br />
included separate 2-way repeated-measures ANOVAs (condition x time), 1-way<br />
repeated-measures ANOVAs, and paired t-tests (p < 0.05).<br />
rEsuLTs: There were no significant differences for any of the measures between<br />
the supplement and placebo groups during the initial 30 min resting or the 50 min<br />
post-supplementation time periods. During exercise, EE was 3 to 4% greater for the<br />
supplement than the placebo at each 10 min average, with no significant differences in<br />
RPE. Post-exercise, EE was 5 to 7% greater for the supplement group than the placebo<br />
group at 10, 20, and 40 min, VO2 was 5% greater at 20 min and 4% greater at 40 min.<br />
CONCLusION: The current findings<br />
indicated that the thermogenic nutritional supplement increased EE and VO 2 with<br />
no effect on RPE. These findings suggested that supplementation with the blend of<br />
ingredients in the thermogenic nutritional supplement may aid in a weight management<br />
program that includes long duration (60 min) low intensity (walking) exercise.<br />
This study was supported by a clinical trial grant from General Nutrition Corporation.<br />
1104 Board #49 May 30, 8:00 AM - 9:30 AM<br />
Effects of acute Caffeine Intake on Wingate Test<br />
Performance in a Creatine supplemented state<br />
Andrew M. Seaton1 , Charles R.C Marks1 , Mark J. Seaton1 ,<br />
Hermann J. Engels, FACSM2 , Tamara Hew-Butler, FACSM1 .<br />
1 2 Oakland University, Rochester, MI. Wayne State University,<br />
Detroit, MI.<br />
(No relationships reported)<br />
PurPOsE: This study investigated the effects of acute caffeine consumption on<br />
supramaximal exercise performance in a creatine monohydrate supplemented state.<br />
METhOds: Fourteen college age adults (age: 23.9±4.3 years; weight: 69.6±11.6<br />
kg; height: 171.9±8.1 cm) on a supplement-free diet performed a standard leg cycle<br />
ergometry Wingate test (WanT) to establish baseline (C0) performance characteristics<br />
for peak anaerobic power (watts/kg; PAP), mean anaerobic power (watts/kg; MAP),<br />
and rate of fatigue (%; RF). Participants then underwent a creatine monohydrate<br />
supplementation intervention in the form of a 6 day loading phase (20 g/day)<br />
followed by a 3 day maintenance phase (5 g/day). Using a double-blind protocol and a<br />
randomized test order, at the beginning and conclusion of the maintenance phase, each<br />
subject completed a WanT 60 min after the acute intake of a placebo (C1) or 6 mg/kg<br />
caffeine (C2). Data were analyzed with a one-way repeated measure ANOVA (alpha <<br />
.05) and using protected paired t tests (Bonferroni - Holm’s sequential adjustment) for<br />
post hoc analysis (SPSS v14.0).<br />
rEsuLTs: There was a significant main effect (p 0.05) for RF (C0 = 46.1 ± 8.0 %; C1 = 50 ± 4.9<br />
%; C2 = 51.3 ± 7.1 %) and MAP (C0 = 3.1 ± 0.6 W/kg; C1 = 3.1 ± 0.7 W/kg; C2 = 3.2<br />
± 0.6 W/kg).<br />
CONCLusION: The present data indicate 6 mg/kg acute caffeine consumption does<br />
not significantly affect creatine monohydrate loading’s impact on PAP, MAP, or RF<br />
during a WanT.<br />
1105 Board #50 May 30, 8:00 AM - 9:30 AM<br />
The Effects of Caffeine on Time to Exhaustion during<br />
Treadmill running<br />
Amanda Locke, Kevin Sartin, Danny Accola, Steve Burns.<br />
University of Central Missouri, Warrensburg, MO. (Sponsor:<br />
Michael Godard, FACSM)<br />
(No relationships reported)<br />
Caffeine is often used to enhance athletic performance. Today, committees are<br />
questioning if it should be a substance banned during competition.<br />
PurPOsE: The primary purpose of this study was to determine the effect caffeine<br />
had on the time until exhaustion while running.<br />
METhOds: Participants included 8, moderately active males (22.0 ± 1.7 years, 184.9<br />
±5.3 cm, 83.8 ±11.4 kg). Subjects reported to the lab on 3 separate occasions, with<br />
no less than 48 hours of rest in between each visit. On the first visit, subjects ran on<br />
a treadmill to determine their max heart rate. This was done by increasing the speed<br />
until volitional exhaustion; the final speed and heart rate are considered maximums.<br />
They returned to the lab two additional times and ran at 70% of their max heart rate,<br />
determined during the first visit, for 15 minutes. Immediately after the 15 minutes<br />
concluded, the treadmill speed was increased to the final speed at which exhaustion<br />
was reached during trial one. This pace was maintained until volitional exhaustion. On<br />
one occasion subjects were given water with caffeine (5mg/kg) and on the other water<br />
without caffeine 45 min prior to each run. Rate Perceived Exertion (RPE) was recorded<br />
every 5 minutes and after the exhaustive bout. Blood lactate was sampled immediately<br />
<strong>Abstracts</strong> were prepared by the authors and printed as submitted.<br />
<strong>Thursday</strong>, May 30, 2013
<strong>Thursday</strong>, May 30, 2013<br />
S204 Vol. 45 No. 5 Supplement<br />
following each test, and every minute for three minutes thereafter. Heart rate was<br />
monitored throughout all tests.<br />
rEsuLTs: A repeated measures ANOVA was conducted to determine if time until<br />
exhaustion increased due to the consumption of caffeine before exercise. No significant<br />
difference in the time to exhaustion was observed when compared to the placebo<br />
(caffeine time = 208.0±77.1 seconds, placebo time = 154.9±44.1 seconds).<br />
CONCLusION: These results suggest that caffeine does not have an effect on time to<br />
exhaustion following submaximal running.<br />
Key Words: caffeine, time to exhaustion.<br />
1106 Board #51 May 30, 8:00 AM - 9:30 AM<br />
The Influence of Caffeine on Power Output and response<br />
Time<br />
Erika Rauk, David Connor, Allison Brumet, Eric Strubeck,<br />
Karen M. Brown, John G. Seifert. Montana State University,<br />
Bozeman, MT.<br />
(No relationships reported)<br />
Athletes consume caffeine supplements (CAF) in hopes of improving endurance<br />
performance, strength performance, and a reducing RPE. Caffeine is typically dosed<br />
on a per kg BW basis before or during exercise in a research setting and usually in a<br />
fasted state. It is likely that in a real world scenario caffeinated products are typically<br />
ingested by competitive and recreational athletes per given serving size or volume,<br />
regardless of BW. Caffeine is known to be a central nervous system stimulant. It is not<br />
known, however, if CAF would affect a marker of central fatigue following endurance<br />
exercise.<br />
PurPOsE: To compare auditory response time (RT), HR, RPE, metabolic, and power<br />
output (PO) responses between the ingestion of a commercially available CAF product<br />
and a flavored, non-caloric placebo (PL) during endurance cycling.<br />
METhOds: Fourteen subjects completed a 120 min work bout which was divided<br />
into 8x15 min intervals (13 min at 70% VO2max, 2 min at 90% VO2max), and ended<br />
with a 6 min PO performance task. Caffeine was ingested at a dose of 256 mg caffeine/<br />
hr; 200 mL/hr of plain water was co-ingested with CAF and PL. Blood glucose, HR,<br />
RPE, RER, and RT were measured throughout the 120 min exercise. The PO task<br />
required subjects to cycle at their highest sustainable power output for 6 min. Cycling<br />
resistance was set at 5% BW. The CAF and PL treatments were administered in a<br />
double blind, randomly assigned protocol. All subjects exercised at 3 hrs post prandial.<br />
Data are listed as mean (+ SD).<br />
rEsuLTs: No statistical differences between treatments were observed for mean PO<br />
(p=.08, CAF: 290 +57, PL: 282 +63 W), RT (p=.06, CAF: 0.232 +.06, PL: 0.226 +.04<br />
sec), HR (CAF: 143.1 + 15.6, PL: 141.0 + 14.5 bpm), RPE (CAF: 13.5 + 1.2, PL: 13.8<br />
+ 1.9), and RER (CAF: .87 +.04, PL: .86 +.04), and BG (CAF: 4.9 +.6, PL: 4.7 +.8<br />
mM/L).<br />
CONCLusION: Ingestion of a moderate dose of CAF (~6.8 mg/kg BW) did not result<br />
in significant improvements in RT and PO when evaluated against a non-caloric PL.<br />
Additionally, CAF ingestion did not change substrate utilization, as measured by BG and<br />
RER, during exercise. These results indicate that the CAF formula used in this study has<br />
minimal influence on physiological function and performance under the given conditions.<br />
This study was supported by a grant from PacificHealth Laboratories, Inc.<br />
1107 Board #52 May 30, 8:00 AM - 9:30 AM<br />
The Influence Of Carbohydrate, Protein, and Caffeine On<br />
Power Output and response Time<br />
David A. Connor, Eric Strubeck, Karen M. Brown, John G.<br />
Seifert. Montana State University, Bozeman, MT.<br />
(No relationships reported)<br />
Caffeine has been reported to confer numerous benefits such as improved endurance<br />
and high intensity performances, reaction time and fat metabolism, and reduced RPE.<br />
The ingestion of CHO generally leads to improved endurance and high intensity<br />
performances while markers of central fatigue are mitigated with the feeding. There<br />
has been interest if combining CHO and caffeine would have a synergistic effect<br />
on response time and performance as the CHO would aid in physical performance<br />
while the caffeine would potentially improve markers of central fatigue. Purpose. To<br />
compare auditory response time (RT), power output (PO), and metabolic responses<br />
between a commercially available CHO + PRO + caffeine sports gel (GEL) and a<br />
caffeine supplement (CAF) during endurance cycling. Methods. 14 cyclists completed<br />
two cycling trials by ingesting GEL (22.5g CHO/hr, 3.75g PRO/hr, 188 mg caffeine/<br />
hr) or CAF (256 mg caffeine/hr) along with 200 mL/hr of water during the 2 hr<br />
exercise. Auditory RT was assessed by averaging stop switch times from10 beeps.<br />
Exercise was divided into 8x15 min intervals of 13 min at 70% VO2max and 2 min<br />
at 90% VO2max. Blood glucose (BG), RT, HR, RPE, and RER were also collected<br />
during the test. After the 2 hr ride, riders completed a 6 min cycling test where they<br />
attempted maintain as great of PO as possible at a resistance of 5% BW. Significance<br />
was set at p < 0.05. All data are listed as mean (+SD). Results. The GEL resulted in<br />
statistically greater mean PO (309.1 +/- 60 W vs. 290.2 +/- 57 W); RT (0.219 +/- .049<br />
sec vs. 0.232 +/- .060 sec); BG (5.5 +/- 0.8 mM/L vs. 4.9 +/- 0.7 mM/L), and lower<br />
HR (138.5 +/- 16.0 bpm vs. 143.1 +/- 15.6 bpm) and RPE (13.0 +/- 1.7 vs. 13.5 +/-<br />
1.2) than the CAF treatment. Conclusions. Co-ingestion of CHO, PRO and caffeine<br />
MEDICINE & SCIENCE IN SPORTS & EXERCISE ®<br />
significantly improved RT and PO (by 5.7% and by 6.5%, respectively) compared to<br />
CAF even though the caffeine dose was 27% lower with GEL than CAF. The present<br />
study mimicked real life conditions by having subjects fed prior to exercise, providing<br />
doses that represented what may occur in a ‘real world’ setting, and by measuring<br />
performance by a muscular PO test and a measure that may be indicative of central<br />
fatigue. These results demonstrate the synergistic effects of CHO, PRO, and caffeine<br />
and the performance benefits to athletes. Supported by a grant from PacificHealth<br />
Laboratories, Inc.<br />
1108 Board #53 May 30, 8:00 AM - 9:30 AM<br />
role of Caffeine Intake on short Bouts Frequency in Light<br />
and Moderate-to-Vigorous Physical activity Patterns<br />
Pedro B. Júdice, Catarina N. Matias, Diana A. Santos, João<br />
P. Magalhães, Luís B. Sardinha, Analiza M. Silva. Technical<br />
University of Lisbon, Lisbon, Portugal.<br />
(No relationships reported)<br />
Shifting sedentary behavior (SedB) to light intensity physical activity (LPA) by<br />
introducing short bouts (SB) into daily routine is expected to contribute to higher<br />
PA energy expenditure (PAEE). If caffeine (Caf) intake plays a role in increasing the<br />
frequency of SB during free-living conditions is unknown. Purposes: The aim of this<br />
study was twofold: i) to determine the impact of a moderate dose of Caf on daily<br />
number of SB of at least 1 up to 5 min of either LPA or moderate-to-vigorous PA<br />
(MVPA) and PAEE; ii) to analyze the association between SB and PAEE under both<br />
conditions.<br />
METhOds: Using a double-blind crossover trial (ClinicalTrials.<br />
govID;NCT01477294) with two conditions (4-day each with 3-day washout) randomly<br />
ordered as Caf (5mg/kg/day) and placebo (Plc) (malt-dextrin) administered twice a<br />
day (2.5mg/kg), a total of 21 active males, low caffeine users (
Official Journal of the American College of Sports Medicine<br />
CONCLusION: Caffeine enhanced triathlon performance, but the effect was not<br />
as pronounced as seen in previous laboratory trials. Caffeine supplementation taken<br />
45-60 minutes before an Olympic-distance triathlon exerted the greatest effect on<br />
performance in the swimming section of the triathlon, as well as on the overall time to<br />
complete the triathlon, in the whole subject group.<br />
1110 Board #55 May 30, 8:00 AM - 9:30 AM<br />
high but not Low Caffeine Ingestion augments Fluid and<br />
Electrolyte Excretion at rest<br />
Stavros A. Kavouras, FACSM1 , Costas N. Bardis2 , Petros<br />
Grigorakis2 , Georgia Georgiou2 , Anna Gavrieli2 , Mary<br />
Yannakoulia2 . 1University of Arkansas, Human Performance<br />
Lab, Fayetteville, AR. 2Harokopio University, Athens, Greece.<br />
Supported by s.a. Kavouras: Consulting Fee; Gatorade Sports Science<br />
Insitute.<br />
It is documented that at rest, large doses of caffeine have diuretic effect and in turn<br />
may lead to hypohydration. However, the acute effect of smaller caffeine doses on<br />
urine excretion is less clear.<br />
PurPOsE: The aim of the present investigation was to examine the acute effect of<br />
coffee with low (3 mg/kg; L-CAF) or high (6 mg/kg ; H-CAF) caffeine content on fluid<br />
and electrolyte urinary excretion in habitual coffee drinkers at rest.<br />
METhOds: Twenty-five healthy adult males (age: 28±5 y, body mass index: 28±5,<br />
mass: 84.6±7.7 kg, height: 1.79±0.01 m) consumed 200 ml of water (W) or coffee<br />
with 3 mg/kg caffeine (L-CAF) on two separate occasions. Nine of the 25 subjects<br />
participated in a third trial when consumed coffee high in caffeine (H-CAF). Subjects<br />
remained in the laboratory while urine samples were collected every 60 min for three<br />
hours. Mean caffeine consumption for L-CAF and H-CAF trials was 254 mg and 552<br />
mg, respectively. The subjects were habitual coffee drinkers (2-3 cups per day) who<br />
abstained from foods and drinks containing caffeine or other methylxanthines 24 h<br />
before each study. All sessions were performed at 0900 in a counterbalance, crossover<br />
manner, at least 5 days apart.<br />
rEsuLTs: Cumulative urine volume during the 3h period was significantly elevated<br />
only in the higher caffeine trial (W: 292±165 ml, L-CAF: 316±194 ml, and H-CAF:<br />
630±391 ml; P
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methods reached significant levels. 4 correlation tests reached level at 0.01 (M-mode<br />
Teichholz and 3D-STE (r=.754, p=0.000), M-mode Teichholz and 3D-AT (r=.-834,<br />
p=0.000), 2D Simpson and 3D-STE (r=.610, p=0.007), 3D-STE and 3D-AT (r=.-893,<br />
p=0.000). 2 other correlation tests reached level at 0.05 (M-mode Teichholz and 2D<br />
Simpson (r=.555, p=0.017), 2D Simpson and 3D-AT (r= -.473, p=0.480).<br />
CONCLusION: The differences of correlation levels might be due to several reasons<br />
such as dimensional differences, regional vs. global evaluation, resolution quality<br />
of images and individual differences of cardiac conditions. 3D Wall Motion Area<br />
Tracking can be an alternative for the evaluation of LV-EF. However, further studies<br />
with comparison to MRI are needed to evaluate a superiority over one- and twodimensional<br />
parameters.<br />
1114 Board #59 May 30, 8:00 AM - 9:30 AM<br />
Is The Vasis Classification suitable For Bradycardic<br />
Endurance athletes?<br />
Frédéric Schnell 1 , David Matelot 1 , Nima Endjah 2 , Gaelle<br />
Kervio 3 , Nathalie Thillaye du Boullay 3 , François Carré 1 . 1 LTSI<br />
INSERM U1099, Rennes, France. 2 University Hospital of Rennes<br />
- Hospital Pontchaillou, Rennes, France. 3 CIC-IT INSERM<br />
U804, Rennes, France.<br />
(No relationships reported)<br />
Currently, VASIS II (cardioinhibitory) syncope during tilt test is objectivated by a<br />
Heart Rate (HR)10 sec. However, such classification may be unadapted<br />
to bradycardic athletes. Indeed, HR during tilt test can differ a lot between subjects,<br />
depending on their resting HR and their individual HR responses to the test. Moreover,<br />
tilt test is usually stopped when subjects experience syncope, or intolerable presyncope<br />
associated with significant arterial hypotension. In this latter case, HR does<br />
not reach its lower value when the test is stopped.<br />
PurPOsE. The aim of this study was to assess if the VASIS classification is adapted<br />
for bradycardic endurance athletes.<br />
METhOd. 39 healthy endurance trained non-smoker men (18-35 years old), with<br />
various resting HR, experienced an 80° tilt test for 45 min, without provocative drugs,<br />
and with beat-to-beat hemodynamic parameters recording (Task Force Monitor).<br />
Tilt test results were blindly and independently classified by 3 investigators used<br />
to this test, according to the current VASIS classification, and were then discussed.<br />
rEsuLTs. Mean resting HR was 58.4±9.5 bpm, ranging from 40.3 to 76.8. Mean<br />
HR in the first 5 min of the tilt test was 75.3±12.1 bpm, ranging from 54.5 to 103.4.<br />
Few results raise some questions, as illustrated by the 2 following cases. A bradycardic<br />
athlete exhibited a drop of 0.5 bpm/sec (from 64 to 39 bpm in 50 sec), leading to<br />
a VASIS II classification. Inversely, a non bradycardic athlete exhibited a drop of<br />
6.6 bpm/sec (from 88 to 55 bpm in 5 sec). However, HR remained >40 bpm as the<br />
test was early stopped to avoid complications, so this case was classified VASIS I.<br />
CONCLusION. Current criteria proposed to differenciate VASIS I from VASIS II<br />
could lead to VASIS II false positive diagnostic in bradycardic athletes, and VASIS<br />
II false negative diagnostic in subjects with a high HR during the tilt test. Regarding<br />
our results, the question of a new criteria based on the severity and the velocity of the<br />
HR drop, and not only on the 40 bpm absolute value may be suggested. This criteria<br />
seems particularly relevant for endurance athletes who are both bradycardic and prone<br />
to syncope.<br />
1115 Board #60 May 30, 8:00 AM - 9:30 AM<br />
Borderline Long QT and QT Interval Prolonging<br />
Medications in adolescent athletes<br />
Christopher Hoyte 1 , Elizabeth Terhune 2 , Anthony McCanta 2 ,<br />
Rachel A. Coel 2 . 1 University of Colorado School of Medicine,<br />
Aurora, CO. 2 Children’s Hospital Colorado, Aurora, CO.<br />
(Sponsor: John Hill, DO, FACSM)<br />
(No relationships reported)<br />
PurPOsE: To determine whether adolescent athletes taking QT prolonging<br />
medications are more likely to display a borderline long or long QT interval.<br />
METhOds: Preparticipation exams consisting of physical exam, 12 Lead ECG, and<br />
health history including current prescription and over-the-counter medications were<br />
performed on 484 adolescents. ECGs with heart rate < 60 or > 100 were interpreted<br />
by a pediatric cardiologist using Bazett’s correction formula. Borderline long QT was<br />
defined as QTc of 450-500 ms in males and 460-500 ms in females. Long QT was<br />
defined as QTc > 500 ms. QT prolonging medications were identified from the Arizona<br />
Center for Education and Research on Therapeutics list. Males and females were<br />
analyzed separately using Fisher’s exact tests and multiple linear regression analysis.<br />
rEsuLTs: Zero athletes exhibited a QTc > 500 ms. Borderline long QT was seen in<br />
2.99% [95% CI: 0.98-6.85%] of females and 8.60% [95% CI: 5.74-12.26%] of males.<br />
Median QTc length was 425 ms [range: 373-478] for females and 421msec [range:<br />
358-487] for males. In both the female and male cohorts, there was no difference<br />
[p>0.999] in the proportion of subjects with borderline long QTc among subjects<br />
taking the QT prolonging medications compared to those subjects not taking the<br />
medications (Table 1). After controlling for gender, age and their interaction, there<br />
was no difference in QTc interval among subjects taking the medications compared to<br />
MEDICINE & SCIENCE IN SPORTS & EXERCISE ®<br />
those not taking the medications [mean difference -0.72 ms, 95% CI: -5.92 to 4.35 ms,<br />
p=0.8318].<br />
CONCLusION: QT prolonging medications were not significantly associated with<br />
the presence of borderline/long QT interval. Further research is needed to evaluate the<br />
effects and risks of these drugs during exercise.<br />
1116 Board #61 May 30, 8:00 AM - 9:30 AM<br />
Echocardiographic Characteristics of Freshmen NCaa<br />
division I Football athletes<br />
Dustin P. Joubert 1 , Steven E. Martin 1 , Thomas H. Meade 2 ,<br />
Freddy Cruz 2 , John P. Erwin 3 , Stephanie White 3 , David Weir 1 ,<br />
JP Bramhall 1 , Kory Gill 4 , Karl Kapchinski 1 , Stephen F. Crouse,<br />
FACSM 1 . 1 Texas A&M University, College Station, TX. 2 Scott &<br />
White Clinic, College Station, TX. 3 Scott & White Clinic, Temple,<br />
TX. 4 Texas A&M Health Science Center, College Station, TX.<br />
(No relationships reported)<br />
In the general population, increased left ventricular mass and left atrial size are<br />
cardiovascular risk factors. Some data exist describing abnormal cardiac structure in<br />
professional American football players after retirement. Less is known about earlier in<br />
their careers.<br />
PurPOsE: To determine echocardiographic characteristics of freshmen collegiate<br />
football athletes relative to reference standards.<br />
METhOds: Prior to their competitive season, standard echocardiogram procedures<br />
were performed on freshmen, Division I collegiate football athletes (n = 35, age = 18<br />
± 1 yr, height = 185.9 ± 7.0 cm, weight = 100.0 ± 20.4 kg, body composition = 15.1 ±<br />
8.9 % fat, VO2max = 49.7 ± 7.1 ml·kg-1·min-1). The following cardiac measures were<br />
compared to reference ranges for both absolute values and relative to body surface area<br />
(BSA, m2) to determine the percentage of athletes exceeding normal: Left ventricle<br />
(LV) internal diameter diastolic (LVIDd), left atrial diameter (LAD), LV end diastolic<br />
volume (LVEDV), LV end systolic volume (LVESV), interventricular septum (IVS)<br />
thickness, LV posterior wall (LVPW) thickness, LV mass (LVM), and ejection fraction<br />
(EF).<br />
rEsuLTs:<br />
Variable Athlete (n = 35) Reference Range % Above Range<br />
LVIDd cm 5.4 ± 0.4 4.2-5.9 8.6<br />
cm·m-2 2.4 ± 0.2 2.2-3.1 0<br />
LAD cm 4.2 ± 0.4 3-4 70.6<br />
cm·m-2 1.9 ± 0.2 1.5-2.3 0<br />
LVEDV ml 144.6 ± 25.8 67-155 34.3<br />
ml·m-2 64.3 ± 10.0 35-75 8.6<br />
LVESV ml 56.7 ± 13.1 22-58 48.6<br />
ml·m-2 25.3 ± 5.6 12-30 20.0<br />
IVS cm 1.0 ± 0.1 0.6-1.0 37.1<br />
cm·m-2 0.4 ± 0.1<br />
LVPW cm 1.0 ± 0.1 0.6-1.0 37.1<br />
cm·m-2 0.5 ± 0<br />
LVM g 213.8 ± 42.4 88-224 40.0<br />
g·m-2 96.6 ± 20.2 49-115 11.4<br />
EF % 60.8 ± 5.9 >55 11.4*<br />
Values represent mean ± SD.<br />
* represents % below reference range<br />
CONCLusION: Greater than 30% of the athletes exceeded reference ranges for<br />
LAD, LVEDV, LVESV, IVS, LVPW, and LVM. However when expressed relative to BSA,<br />
only LVM and LVESV were over range in more than 10% of the athletes. These<br />
observations are similar to those found previously in collegiate football players<br />
entering the NFL. It appears that cardiac structure in collegiate football athletes is<br />
not abnormal when indexed by body size.<br />
Supported in part by Huffines Institute of Sports Medicine and Human Performance<br />
ACSM May 28 - June 1, 2013 Indianapolis, Indiana
Official Journal of the American College of Sports Medicine<br />
1117 Board #62 May 30, 8:00 AM - 9:30 AM<br />
a Comparison of Topical analgesic Gels on Blood Flow and<br />
Vascular responses to Exercise<br />
Paula Papanek, FACSM, Alyson N. Cybulski, Katalin W.<br />
Skelton, Alexander V. Ng, FACSM, Robert Topp. Marquette<br />
University, Milwaukee, WI.<br />
Supported by P. Papanek: Contracted Research - Including Principle<br />
Investigator; Performance Health.<br />
It has been previously demonstrated that a common over the counter topical analgesic<br />
gel containing 3.5% menthol significantly reduced arterial blood flow similar to ice<br />
therapy even following acute muscular contraction. The formulary of this gel (OF) has<br />
been recently changed (NF) and evidence to support its useis lacking.<br />
PurPOsE: To compare vascular responses following an application of OF, or NF and<br />
acute muscle contraction.<br />
METhOds: Healthy adults (9 males and 9 females) mean age of 22.44 (SD + 1.95)<br />
with a mean BMI of 23.97 (SD+ 3.88) were recruited. Two data collection sessions,<br />
were separated by at least 5 d. OF and NF application (5 ml applied to Right upper<br />
arm) were randomized. Heart Rate (HR), right brachial artery blood flow (ml/min) and<br />
right brachial artery diameter were measured by Ultrasound Doppler (General Electric<br />
3). Measurements were collected at baseline (T1) and 5 minutes after application of<br />
treatment (T2). After T2, 5 maximal right-hand grip contractions were performed using<br />
a handgrip dynamometer (Lafayette Instrument) with measurements made immediately<br />
following exercise (T3), 2 min post-exercise (T4) and 4 min post exercise (T5).<br />
rEsuLTs: Comparisons over time and between the treatment conditions were<br />
conducted. When comparing T1 with T2 there were no changes in heart rate or vessel<br />
diameter under either treatment condition. Between T1 and T2 only NF exhibited a<br />
significant decline in blood flow (-22.6%) which was not different than declines in<br />
flow under OF (-21.8%). Flow and vessel diameter significantly increased with the<br />
OF (492% and 3.4% respectively) between T2 and T3 as a result of the exercise but<br />
not to a level greater than the nonsignificant increases in flow and diameter measured<br />
with NF (356% and 2.0% respectively). When comparing data collected at the three<br />
post exercise points (T3, T4, T5) no significant differences were detected in flow or<br />
diameter between either condition.<br />
CONCLusIONs: The OF and NF conditions resulted in similar changes in blood<br />
flow and vascular responses to exercise. These results suggest that the formulations<br />
act similarly, and are equally effective in modulating vascular responses in muscle and<br />
have equal therapeutic value. Supported by Performance Health, Akron Ohio<br />
1118 Board #63 May 30, 8:00 AM - 9:30 AM<br />
Metabolic syndrome in NCaa division I College Football<br />
Players: a Pilot study<br />
Joi J. Thomas, Enette Larson-Meyer, FACSM. University of<br />
Wyoming, Laramie, WY.<br />
(No relationships reported)<br />
Football has recently come under fire as health risks associated with the sport are<br />
increasingly highlighted by the media and addressed in medical journals. These<br />
risks include the risk of cardiovascular disease. Offensive and defensive linemen<br />
are significantly larger than athletes playing the same position over 20 years ago.<br />
With this increased mass comes the concern of increased cardiovascular disease risk.<br />
PurPOsE: The purpose of this study was to evaluate a small cohort (n=17) of NCAA<br />
division I football players for the presence of metabolic syndrome using the National<br />
Cholesterol Education Program-Adult Treatment Panel-III (NCEP-ATP III) criteria.<br />
METhOds: 17 football players on the current roster of a NCAA division I university<br />
including 13 linemen were evaluated for height, weight,<br />
waist circumference, neck circumference, and blood pressure. Fasting, venous<br />
samples of blood were drawn and analyzed for triglycerides, total cholesterol, highdensity<br />
lipoprotein, low-density lipoprotein, glucose, insulin, C-reactive protein,<br />
and leptin. Metabolic syndrome was defined as having at least three of the following<br />
manifestations: waist circumference > 102 cm in men, serum triglycerides > 150 mg/<br />
dl, high-density lipoprotein < 40 mg/dl in men, blood pressure > 130/85 mm/Hg, and<br />
serum glucose > 110mg/dl. Body composition was also assessed via Dual Energy Xray<br />
absorptiometry within several weeks of testing. Permission was obtained to access the<br />
participants’ medical history which included familial history of heart disease.<br />
rEsuLTs: Six of the thirteen linemen (46.15%) met the criteria for metabolic<br />
syndrome (at least 3 of 5 criteria). Of the four<br />
non-linemen one met the criteria for metabolic syndrome. Eleven of the thirteen<br />
linemen evaluated had a waist circumference greater than 102 cm (84.62%). Nine of<br />
the thirteen linemen and one of the four non-linemen had high-density lipoprotein less<br />
than 40 mg/dl.<br />
CONCLusIONs: We found a high incidence of metabolic syndrome<br />
in this cohort. Although athletes are often assumed to be protected from the risks<br />
of cardiovascular disease, this may be sport and position dependent. Awareness<br />
education should be encouraged for athletes, coaches, and athletic trainers. Screening<br />
and intervention programs may also help decrease the cardiovascular risk in this<br />
population.<br />
Vol. 45 No. 5 Supplement S207<br />
1119 Board #64 May 30, 8:00 AM - 9:30 AM<br />
sudden death In young Competitive athletes: analysis Of<br />
deaths In The united states, 2008-2011<br />
Russell T. Baker1 , Jeff Seegmiller2 , Mike Chisar3 , Stephanie<br />
Perez1 . 1California Baptist University, Riverside, CA. 2University of Idaho, Moscow, ID. 3Diablo Valley College, Pleasant Hill,<br />
CA. (Sponsor: Lee E. Brown, FACSM)<br />
(No relationships reported)<br />
Sudden death in young competitive athletes has recently garnered increased media<br />
attention and intensified efforts for athlete safety legislation. The frequency with which<br />
these catastrophes occur is largely unknown.<br />
PurPOsE: To develop incidence data of sudden death in young competitive athletes.<br />
METhOds: Cases of sudden athlete death (SAD) were documented through news<br />
media reports identified using internet search engines (Google, Yahoo, Ask, and Bing)<br />
and Foundation websites (Parent Heart Watch, Sudden Cardiac Arrest Association,<br />
and Hypertrophic Cardiomyopathy Association). Cases included athletes (Elementary<br />
School through College) participating in athletic practices, competitions, events, or<br />
physical education classes in the United States. Cases of SAD were verified using two<br />
different media reports. To be included, the case had to involve a school aged athlete<br />
participating in traditional athletic events without evidence of recreational drug use.<br />
Causes of death were only included when autopsy results were cited.<br />
rEsuLTs: From 2008 through 2011, 372 SAD’s were identified (mean age of 16.15).<br />
Of these, 159 (42.7%) were explained by sudden cardiac arrest, 32 (8.6%) by traumatic<br />
brain injury, and 16 (4.3%) by heat illness. Autopsy results indicating an inconclusive<br />
cause of death were reported in 18 (4.8%) cases. A cause of death could not be<br />
confirmed in two media sources in 117 (31.4%) of the cases. The most common sports<br />
involved were football (103 cases, 27.7%), basketball (102 cases, 27.4%), and track/<br />
cross-country (42 cases, 11.3%). Collapse commonly occurred during or immediately<br />
after an academic institution sponsored practice, formal athletic contest, or physical<br />
education course (227 cases, 61%). Collapse also occurred while athletes participated<br />
in recreational (youth league, intramural sport, health club, or sport camp) activities<br />
(108 cases, 29%) or during the evening following participation in an athletic event (37<br />
cases, 10%).<br />
CONCLusIONs: The incidence of SAD was higher than previous reports examining<br />
a similar population. These data support the need for mandatory reporting of SAD’s to<br />
a national registry and highlight the importance of increased awareness to reduce the<br />
risk.<br />
1120 Board #65 May 30, 8:00 AM - 9:30 AM<br />
Effect Of Whole-Body Vibration On Peripheral Blood Flow<br />
and Muscle Oxygenation: a Meta-analysis<br />
Kenneth E. Games, JoEllen M. Sefton. Auburn University,<br />
Auburn, AL.<br />
(No relationships reported)<br />
Whole-body vibration (WBV) is being used as a therapeutic and fitness modality.<br />
Two reported effects of WBV are increased peripheral blood flow and altered muscle<br />
oxygenation. The literature in this area is conflicting possibly due to the varied WBV<br />
parameters utilized by studies.<br />
PurPOsE: To quantitatively examine the literature investigating the effect of WBV<br />
on peripheral blood flow and muscle oxygenation.<br />
METhOds: PubMed and Web of Science electronic databases were searched<br />
utilizing multiple keywords. The reference lists of retrieved articles were also searched<br />
for relevant articles. Thirty-five data points from five studies met the inclusion criteria<br />
for muscle oxygenation; ninety data points from eight studies met the inclusion criteria<br />
for peripheral blood. Two weighted, random effects meta-analyses were completed.<br />
Hedges’ g and 95% confidence intervals (CI) for each analysis were calculated. A<br />
follow-up analysis on vibration type’s (vertical vs. side-alternating) influence on<br />
peripheral blood flow was also completed.<br />
rEsuLTs: Results suggest WBV increases peripheral blood flow above control<br />
measures [g = 1.179; 95% CI (0.945 - 1.416)], while WBV does not alter muscle<br />
oxygenation levels from control measures [g = -0.005; 95% CI (-0.272 - 0.261)]. Sidealternating<br />
vibration appears to increase peripheral blood flow above control measures<br />
[g = 1.906; 95% CI (1.628 - 2.184)] while vertical vibration does not appear to have an<br />
effect on peripheral blood flow [g = 0.182; 95% CI (-0.067 - 0.431)].<br />
CONCLusIONs: WBV may be a viable modality to increase peripheral blood flow<br />
in healthy adults. Vibration type appears to be a key parameter in determining WBV’s<br />
effect on peripheral blood flow. Future research should examine the effect of vibration<br />
type on the reported benefits of WBV.<br />
<strong>Abstracts</strong> were prepared by the authors and printed as submitted.<br />
<strong>Thursday</strong>, May 30, 2013
<strong>Thursday</strong>, May 30, 2013<br />
S208 Vol. 45 No. 5 Supplement<br />
1121 Board #66 May 30, 8:00 AM - 9:30 AM<br />
Prevalence Of respiratory symptoms among Judo athletes<br />
Compared With swimmers<br />
Tomoko Imai, Shumpei Miyakawa, Koichi Watanabe. University<br />
of Tsukuba, Tsukuba, Japan.<br />
(No relationships reported)<br />
Prevalence of exercised-induced bronchospasm (EIB) among Olympic athletes has<br />
been reported to be as much as five times greater than that of the general population.<br />
Judo is one of the Olympic events and played all over the ages, involving throw and<br />
ground techniques on the mat. Therefore, Judo athletes may inhale or contact with<br />
more allergens rising from the mat, whereas the prevalence of respiratory symptoms<br />
among judo athletes has not been examined.<br />
PurPOsE: The purpose of this study is to examine the prevalence of respiratory<br />
symptoms among judo athletes and to compare with those of swimmers.<br />
METhOds: 46 collegiate judo athletes participated in this study.The history of<br />
respiratory symptoms, pulmonary functions including forced expiratory volume in<br />
1 second as percent of FVC (FEV %(G)) by spirometer and fraction of exhaled<br />
1.0<br />
nitric oxide (FeNO) by a portable NINOX MINO were obtained. Additionally, the<br />
respiratory resistance at 5Hz (R5), frequency of resonance (Fres), and low-frequency<br />
reactance area (ALX) were measured by using forced oscillation technique. These<br />
data were compared with the data obtained from the 22 collegiate swimmers.<br />
rEsuLTs: Average age of judo athletes was 19.9±1.4yr and that of the swimmers<br />
was 20.5±1.2yr. Weight and BMI of judo athletes were significantly higher than those<br />
of swimmers. As to the history, 32.6% of judo athletes experienced asthma and 58.7%<br />
had allergies, while 22.7% swimmers had asthma and 54.5% with allergy. 32.6% of<br />
judo athletes and 31.8% of swimmers revealed FeNO values over 25ppb which was the<br />
normal limit. 19.6% of the judo athletes and 27.3% of the swimmers were below 80%<br />
of FEV %(G). Respiratory resistance such as Fres and ALX were significantly higher<br />
1.0<br />
in judo athletes than swimmers, which was significantly correlated with their weight<br />
and BMI.<br />
CONCLusIONs: The judo athletes also had relatively high prevalence of respiratory<br />
symptoms like swimmers.<br />
1122 Board #67 May 30, 8:00 AM - 9:30 AM<br />
relationship Between the Control of Blood Flow and the<br />
Female athlete Triad<br />
Julee A. Campbell, Anne L. Friedlander, Robert R. Roe, John E.<br />
Davis. Alma College, Alma, MI.<br />
(No relationships reported)<br />
The female athlete triad has been well documented to produce clinical conditions<br />
including disordered eating, functional hypothalamic amenorrhea, and osteoporosis.<br />
Furthermore, it has been previously reported that estrogen augments cardiac output and<br />
arterial flow velocity and decreases vascular resistance in animal testing. However, to<br />
our knowledge no studies have shown a relationship between triad components and the<br />
control of blood flow.<br />
PurPOsE: To determine the prevalence of the female athlete triad components in<br />
collegiate athletes and relate it to the control of blood flow.<br />
METhOds: Twenty-seven athletes (four swimmers, two divers, three bowlers, five<br />
basketball players, eleven runners, and two track and field athletes) and thirty-four<br />
non-athletes participated in this study after giving informed consent. The Eating<br />
Disorder Examination Questionnaire (EDE-Q) was administered to all participants<br />
to determine prevalence of the triad components. A Global Eating Disturbance Score<br />
(GEDS) was then calculated. Venous occlusion plethysmography was used to measure<br />
forearm blood flow. Reactive hyperemia was assessed by occluding the forearm to<br />
250 mmHg for 5 minutes and measuring forearm blood flow post-occlusion. The<br />
hyperemic response was then determined by calculating the area under the curve for<br />
the subsequent measurements of forearm blood flow.<br />
rEsuLTs: Athletes had a greater reactive hyperemic response than non-athletes (77.5<br />
± 6.1 mL/min.sec vs. 60.4 ± 3.0 mL/min.sec). In those with eating disturbances, the<br />
reactive hyperemic response was lower than those with normal eating behavior (48.7<br />
± 5.7 mL/min.sec vs. 77.0 ± 2.0 mL/min.sec (p < 0.05)). There was a significantly<br />
greater GEDS in those subjects reporting stress fractures (p< 0.05).<br />
CONCLusION: These data suggest that athletes with eating disturbances have a<br />
reduced reactive hyperemic response. This could be due to a reduction in estrogen<br />
that has been previously reported in female athletes with triad symptoms. There was a<br />
relationship between stress fractures and eating disturbances. This supports previous<br />
claims that eating disturbances can lead to low bone mineral density.<br />
MEDICINE & SCIENCE IN SPORTS & EXERCISE ®<br />
1123 Board #68 May 30, 8:00 AM - 9:30 AM<br />
arterial Baroreflex Control Of Muscle sympathetic Nerve<br />
activity Following Mixed Meal Ingestion: Influence Of<br />
Endurance Training<br />
Seth W. Holwerda, Daniel P. Credeur, Paul J. Fadel. University<br />
of Missouri, Columbia, MO.<br />
(No relationships reported)<br />
Recent studies have reported that physiological elevations in plasma insulin, such as<br />
following meal ingestion, increase sympathetic baroreflex sensitivity. Insulin resistance<br />
has been linked to decreases in baroreflex sensitivity, which has been attributed<br />
to a blunted transport of insulin into the brain. What remains unclear is whether<br />
improvements in insulin sensitivity, such as that which occurs with endurance training,<br />
enhance the acute effects of insulin to increase arterial baroreflex sensitivity.<br />
PurPOsE: To determine whether improvements in insulin sensitivity following<br />
chronic endurance training enhances the acute effect of insulin to increase sympathetic<br />
baroreflex sensitivity.<br />
METhOds: Muscle sympathetic nerve activity (MSNA; microneurography), arterial<br />
blood pressure (finger photoplethysmography), plasma insulin and glucose levels were<br />
obtained in 5 high fit (HF; VO2 66±2 ml/kg/min) and 6 average fit (AF; VO2 45±1 ml/<br />
kg/min) subjects before, and every 30 min after mixed meal ingestion (57% CHO, 28%<br />
Fat, 15% Protein). Sympathetic baroreflex sensitivity was assessed by determining the<br />
relationship between spontaneously occurring fluctuations in diastolic blood pressure<br />
and MSNA burst incidence.<br />
rEsuLTs: Plasma insulin was significantly elevated following mixed meal intake,<br />
and as expected, responses were greater in AF than HF (e.g., 60 min: 38±6 AF vs<br />
25±2 HF uIU/ml; P0.05). Following mixed meal<br />
intake sympathetic baroreflex sensitivity was similarly increased in both groups at 60<br />
(-4.2±0.5 AF vs -4.7±0.8 HF burst/100heart beats/mmHg; P>0.05) and 120 minutes<br />
(-5.7±0.9 AF vs -4.4±0.7 HF burst/100heart beats/mmHg; P>0.05).<br />
CONCLusION: These preliminary results suggest that increases in sympathetic<br />
baroreflex sensitivity following meal intake are similar between AF and HF subjects.<br />
However, the significantly lower increase in plasma insulin in the HF subjects suggests<br />
enhanced sympathetic baroreflex reactivity to insulin with chronic endurance exercise<br />
training.<br />
1124 Board #69 May 30, 8:00 AM - 9:30 AM<br />
Exercise related syncope In active duty soldiers<br />
Chad Asplund, FACSM. Eisenhower Army Medical Center, Fort<br />
Gordon, GA.<br />
(No relationships reported)<br />
PurPOsE: To better characterize the prevalence of exercise related syncope (ERS) in<br />
an active duty military population as well as examine possible factors associated with<br />
ERS.<br />
METhOds aNd sTudy dEsIGN: Cohort study design. The Armed Forces Health<br />
Longitudinal Technical Application (AHLTA) electronic health record was queried<br />
for all cases of syncope (780.2) seen at Eisenhower Army Medical Center in primary<br />
care clinics from 2005-2010 and charts were reviewed. Those with syncope related<br />
to exercise had charts followed prospectively until completion of specialty evaluation<br />
and diagnosis. Main outcome measure was a medical diagnosis requiring restriction<br />
from duty or from participation in sports. Demographic data analyzed with descriptive<br />
statistics and main outcome measure with multiple logistic regression.<br />
rEsuLTs: 123 total cases of syncope and 58 cases of ERS were reviewed. 40<br />
cases had witnessed collapse, 16 cases were found to have a medical etiology (6<br />
neurological, 3 pulmonary, 3 cardiac, 2 migraine, 2 heat related), 24 had unexplained<br />
etiology. Average age was 25.67 +/- 5.92 (range 18-39) years. After controlling for age,<br />
past medical history, history of collapse, and smoking, those Soldiers with a history of<br />
migraine headaches were 11.3 times more likely to have a medical etiology associated<br />
with their exercise related syncope compared to those without migraine (p
Official Journal of the American College of Sports Medicine<br />
C-28 Free Communication/Poster - Energy<br />
Expenditure<br />
May 30, 2013, 7:30 AM - 12:30 PM<br />
Room: Hall C<br />
1125 Board #70 May 30, 9:00 AM - 10:30 AM<br />
associations of Macronutrient Profiles, Energy Expenditure<br />
and Body Composition with resting Metabolic rate<br />
John C. Sieverdes1 , Robin P. Shook2 , Amanda E. Paluch2 ,<br />
Gregory A. Hand2 , Thomas G. Hurley2 , Vivek Prasad2 , Jason<br />
R. Jaggers2 , E. Patrick Crowley2 , Steven N. Blair, FACSM2 .<br />
1Medical University of South Carolina, Charleston, SC.<br />
2University of South Carolina, Columbia, SC.<br />
(No relationships reported)<br />
Various models have been used to explain the relationship of resting metabolic rate<br />
(RMR) with age, body weight, gender, and height. Recent scientific advancements<br />
have allowed more accurate measures to assess body composition, energy expenditure<br />
(EE), and dietary intake.<br />
PurPOsE: This study examines the relationship between RMR, dietary intake, EE,<br />
and body composition.<br />
METhOds: Participants completed a maximal treadmill exercise test to measure<br />
oxygen consumption (VO ) and a fasted 50-minute ventilated hood resting RMR using<br />
2<br />
a Parvo Medics TruOne® system on separate days. RMR was measured in a dark quiet<br />
room in the supine position while awake. Average oxygen consumption was measured<br />
over a 10-minute period after values stabilized. Body composition was measured using<br />
DXA scans during the RMR visit. Dietary intake was assessed by three random 24-hr<br />
dietary recalls during the 10 days following the RMR. Total EE was measured using<br />
the Bodymedia® armband during the same 10-day period.<br />
rEsuLTs: We analyzed data from 430 participants (212 men, 218 women). Mean<br />
(+/- standard deviation) age was 27.7 +/- 3.8 years (range 20 - 35) and BMI was 25.4<br />
+/- 3.8 kg/m2. Body fat measured 28.0% +/- 10.8% and RMR was 0.221 +/- 0.038<br />
L/min or 2.96 +/- 0.35 ml/kg/min. Peak VO2 resulted in a mean of 38.7 +/- 10.4 ml/<br />
kg/min and macronutrient breakdown consisted of 32.8% +/- 7.5% calories from fat,<br />
47.1% +/- 10.0% from carbohydrates, and 17.2% +/- 5.0% from protein. Pearson<br />
correlations for each macronutrient in relation to RMR (L/min) resulted in correlations<br />
-0.31 < r < 0.21 when depicted as percentages of daily caloric intake. VO2 was found<br />
to be r = 0.39. Correlations r > 0.5 included mean waist circumference (r = 0.61).<br />
Overall EE (r = 0.79), lean body mass (r = 0.85), and overall weight (r = 0.77) had<br />
higher correlations with RMR than other variables. EE was correlated and showed<br />
moderate collinearity with lean body mass (r = 0.83, VIF = 5.4). Stepwise regression<br />
found lean body mass, overall weight, and VO2 to be significant predictors for RMR<br />
(adjusted r2 = 0.78, SE = 0.018).<br />
CONCLusION: Macronutrient proportions exhibited weaker correlations and<br />
predictive value for RMR than body composition or fitness variables. Results may aid<br />
in developing energy balance strategies or assessments.<br />
Supported by an unrestricted grant from the Coca-Cola Company<br />
1126 Board #71 May 30, 9:00 AM - 10:30 AM<br />
Validation of air displacement Plethysmography’s utility in<br />
Predicting resting Metabolic rate<br />
Brian Miller1 , Chris Faciana1 , Kelsey F. O’Driscoll1 , Laura<br />
McElrath2 , Stephanie Pence2 , Ronald W. Mendel2 , Ronald<br />
Otterstetter1 . 1University of Akron, Akron, OH. 2University of<br />
Mount Union, Alliance, OH.<br />
(No relationships reported)<br />
PurPOsE: Air displacement plethysmography (ADP) is a well validated method for<br />
estimating body composition. Similarly, predictive equations derived from regression<br />
techniques on large populations are extensively utilized in estimating resting metabolic<br />
rate (RMR). The ADP system utilizes a predictive equation to estimate RMR based<br />
on the Nelson 1992 model. However, the accuracy of the predictive model being<br />
used has come into question. The aim of this study is to validate the RMR estimation<br />
model used by the ADP system against an indirect calorimetry system in addition<br />
to other predictive RMR models and to derive a model based on the specific use of<br />
measurements from the ADP system.<br />
METhOds: Sixty six apparently healthy subjects (25 men, 41 women) participated<br />
in the trial. All subjects adhered to the following instructions: Fast 12 hrs prior to<br />
the test, no strenuous exercise, nicotine, or alcohol 24 hrs prior to the test, and tight<br />
fitting clothing during ADP trial. Each subject layed in a quiet room for 30 min during<br />
measurement of RMR via metabolic cart (CART). The first 15 min of RMR data was<br />
discarded and the average VO2 of the last 15 min was used as the subject’s RMR.<br />
Immediately after the CART RMR, subjects moved directly to the ADP and underwent<br />
testing following the manufacturers standardized protocol, and an estimated RMR was<br />
Vol. 45 No. 5 Supplement S209<br />
obtained. Measures from both ADP and CART were tested against nine other validated<br />
models using ANOVA techniques with post hoc testing.<br />
rEsuLTs: The Nelson 1992 model under-predicted RMR compared to CART<br />
(p
<strong>Thursday</strong>, May 30, 2013<br />
S210 Vol. 45 No. 5 Supplement<br />
Oxygen consumption was greater in ARM and FWD compared to UR (25.59±3.91,<br />
24.98±3.81 vs. 23.51±3.90 ml/kg/min, P < 0.05), but ARM and FWD were not<br />
different from each other (P = 0.19). This similarity was in spite of the active use of<br />
additional arm musculature during ARM not present in FWD. Additional subjects will<br />
be collected to confirm these preliminary findings.<br />
CONCLusION: For this exercise modality, utilizing one’s arms or leaning forward<br />
while anchoring the upper body resulted in similar increases in heart rate and oxygen<br />
consumption relative to an unstabilized upright posture at the same machine settings.<br />
Supported by Cybex International Inc.<br />
1129 Board #74 May 30, 9:00 AM - 10:30 AM<br />
Cross-Validation of a recently Published Equation<br />
Predicting Energy Expenditure to run or Walk a Mile<br />
Cody E. Morris, Mark Loftin, FACSM, Scott Owens, Dwight<br />
Waddell, Martha Bass, John Bentley. The University of<br />
Mississippi, University, MS.<br />
(No relationships reported)<br />
PurPOsE: Establishing a caloric prediction equation based on distance walked or run<br />
rather than time is an important goal in attempting to more accurately estimate energy<br />
expenditure (EE). The primary purpose of this study was to cross-validate the recently<br />
published Loftin et al. (2010) prediction equation for walking or running a mile.<br />
METhOds: Participants consisted of 10 normal weight walkers (NWW), 10<br />
overweight walkers (OW), and 10 distance runners (DR). Gender was balanced across<br />
sub-groups. Participants walked or ran for 5 minutes at their preferred pace. Preferred<br />
walking pace was determined by six timed 50-ft trials and preferred running pace<br />
was determined by the runner’s preferred training pace. Energy expenditure (EE) was<br />
determined via indirect calorimetry and reported in absolute units (kcal), and corrected<br />
to a mile distance. Body composition was assessed via DXA. EE per mile was<br />
predicted using the Loftin, et al. (2010) equation.<br />
rEsuLTs: Absolute EE per mile for the cross-validation (CV) group was similar<br />
across sub-groups (NWW = 100.2 kcal/mile, OW = 115.6 kcal/mile, DR = 107.8<br />
kcal/mile) and did not show significant difference between groups (p > 0.05). The<br />
overall mean for the absolute EE was 107.8 + 15.5 kcal/mile. The Loftin, et al. (2010)<br />
equation yielded an overall mean for the predicted EE per mile of 99.7 + 10.9 kcal/<br />
mile. This was significantly different (p < 0.05) than the mean actual value from the<br />
cross-validation group, although the difference was within the published standard error<br />
of the estimate (SEE) of the original equation (SEE = 10.9 kcal/mile). A regression<br />
equation for the CV group produced an R2 of 0.605 and the SEE (9.8 kcal/mile) was<br />
similar to the original equation. Further, a Chow test found no significant differences<br />
(p > 0.05) between regression coefficients of the original equation and the CV group<br />
equation and the estimated shrinkage on cross-validation was 0.027; which is minimal<br />
and suggestive of no significant difference in R2 values.<br />
CONCLusIONs: The cross-validation results support the original equation (Loftin<br />
et al., 2010) as valid. We suggest the Loftin, et al. (2010) regression equation is useful<br />
for exercise prescription in that it allows for the prediction of EE for either walking or<br />
running a mile in normal weight and overweight adults.<br />
1130 Board #75 May 30, 9:00 AM - 10:30 AM<br />
Total Energy Expenditure and Energy Expenditure Per<br />
Kilogram of Body Weight Comparison among young adults<br />
Vivek K. Prasad, Gregory A. Hand, FACSM, Jason R. Jaggers,<br />
Robin P. Shook, Amanda Paluch, Stephanie Burgess, Xuemei<br />
Sui, Steven N. Blair, FACSM. University of South Carolina,<br />
Columbia, SC.<br />
(No relationships reported)<br />
PurPOsE: Total energy expenditure (EE) consists of resting EE which account<br />
for approximately 60% of total EE (mainly due to metabolic cost of processes);<br />
10% accounts for the thermal effect of feeding; and 30% accounts for nonresting EE<br />
(remaining expenditure of energy, mainly in the form of physical activity). All the<br />
above processes for EE depend upon body composition to a great extent. The present<br />
study was designed to compare overweight and normal weight participants for their<br />
total EE and EE per kilogram (KG) body weight.<br />
METhOds: A group of healthy women and men were assessed for body fat (BF)<br />
percent and BMI. BF percentage was calculated as the percentage of total weight<br />
identified as fat tissue by dual x-ray absorptiometry (DXA). BMI was calculated as<br />
measured weight in KG/ht in meters². Participants were categorized into overweight<br />
and normal weight groups according to BF percent and BMI. Overweight cut points<br />
by BF percent were ≥19.5% and ≥25.4% for men and women, respectively, where as<br />
normal weight cut points were ≤19.4% and ≥25.3% for men and women, respectively.<br />
BMI overweight and normal weight cut points were ≥25.0 and ≤24.9 KG/ht in meters²<br />
for both men and women. T-tests were used to compare means of EE (total and per KG<br />
body weight) between overweight and normal weight by gender.<br />
rEsuLTs: The study population consisted of 429 healthy young adults (212 men<br />
and 217 women; aged 21 to 35 years). In the BF percent classifications we found<br />
overweight and normal weight participants had no difference in total EE, but normal<br />
weight participants were expending significantly higher energy per KG body weight<br />
MEDICINE & SCIENCE IN SPORTS & EXERCISE ®<br />
(p < 0.001). When classified by BMI, overweight participants expended significantly<br />
higher overall energy than the normal weight group (p = 0.023 for men; and
Official Journal of the American College of Sports Medicine<br />
LR trial during both exercise (141.1 ± 20.1 vs. 124.0 ± 15.9 b•min-1, p < 0.05) and<br />
recovery (81.6 ± 10.7 vs. 68.3 ± 6.0 b•min-1, p < 0.05).<br />
CONCLusION: A decrease in RI during moderate intensity RE resulted in a twofold<br />
decrease in exercise time and a significant increase in post-exercise VO2 and energy<br />
expenditure. When body mass management is the primary goal of RE, short RI may<br />
optimize calorie expenditure and while conserving time.<br />
1133 Board #78 May 30, 9:00 AM - 10:30 AM<br />
Effects Of high Intensity Intermittent Exercise On Postexercise<br />
resting Oxygen Consumption<br />
Katsunori Tsuji, Xin Liu, Yu Zhong Xu, Izumi Tabata, FACSM.<br />
Ritsumeikan University, Kusatsu, Japan. (Sponsor: Izumi Tabata,<br />
FACSM)<br />
(No relationships reported)<br />
PurPOsE:The purpose of the present investigation is to elucidate the effects of<br />
short-lasting high intensity intermittent exercise on post-exercise resting oxygen<br />
consumption.<br />
METhOds:Seven young healthy males volunteered for the experiment. Means ±<br />
standard deviations (SDs) of the subjects’ age (yrs), height (m), body mass (kg), and<br />
V(●)O2 max (ml/kg/min) were 24±1, 1.72±0.05, 65.9±6.5, and 46.4±1.6, respectively.<br />
For the exercise (E) day, the subjects entered the metabolic chamber at 10:00. After<br />
10 min of warming up, the subjects conducted exhaustive high-intensity intermittent<br />
exercise (6 to 7 sets of 20-s exercise at an intensity of 170% V(•)O 2max with a 10-s rest<br />
between each bout). After the exercise, the subjects stayed in the metabolic chamber<br />
to the next morning. They consumed lunch and supper at fixed time of the day. For<br />
control (C) day, the subjects followed the same protocol, except for the HIIE. The<br />
order of the exercise and the control experiment were randomly assigned for each<br />
subject.<br />
rEsuLTs:Basal oxygen consumption measured in the morning before the subjects<br />
entered the chamber was not different between E and C day. After HIIE, oxygen<br />
consumption was continuously higher than that observed for C day. The difference<br />
in oxygen uptake between E day and C day (246±72 ml/kg/12hour) was positively<br />
correlated with accumulated oxygen uptake during the exercise (121±15 ml/kg, r=0.82,<br />
p0.10). These results may suggest that elevated oxygen uptake after high intensity<br />
intermittent exercise does not necessarily represent energy needs for resynthesis of<br />
anaerobic energy substrates (i.e. creatine phosphate and glycogen). Even after adding<br />
energy consumption during the HIIE, the total difference in energy expenditure<br />
between E and C day was 121±28 kcal.<br />
CONCLusIONs:Short-lasting high intensity intermittent exercise may elevate<br />
resting energy consumption. However, its quantitative contribution to weight-reduction<br />
is limited.<br />
1134 Board #79 May 30, 9:00 AM - 10:30 AM<br />
Nighttime Consumption of Protein or Carbohydrate<br />
Improves Morning resting Energy Expenditure in active<br />
College-aged Men<br />
Amber W. Kinsey, Takudzwa A. Madzima, Lynn B. Panton,<br />
FACSM, Sarah K. Fretti, Michael J. Ormsbee. Florida State<br />
University, Tallahassee, FL.<br />
(No relationships reported)<br />
Nighttime eating is an unexplored component of nutrient timing and no data exist<br />
regarding the satiating and metabolic effects of macronutrients consumed at night<br />
before sleep.<br />
PurPOsE: To investigate whether whey protein (WP), casein protein (CP),<br />
carbohydrate (CHO), or a non-caloric placebo (PLA) consumed prior to sleep alters<br />
morning appetite and resting energy expenditure (REE) in active men.<br />
METhOds: Eleven physically active men (age, 23.6 ± 3.1 years; body fat, 16.3 ±<br />
8.2%) participated in this randomized, double blind, crossover study. A single dose of<br />
WP (30g), CP (30g), CHO (33g) or PLA was consumed 30 minutes prior to sleep and<br />
each trial was separated by 48-72 hours. The next morning (0500-0800), measurements<br />
of satiety, hunger, and desire to eat (visual analog scale) and REE (indirect calorimetry)<br />
were performed. After a 30 minute equilibration period, 60 minutes of REE in the<br />
supine position was measured. Ten-minute means (total of 5) over the final 50 minutes<br />
of measurement were analyzed. Outcome variables were oxygen consumption (VO2),<br />
REE, and respiratory quotient (RQ). Statistical analyses were conducted using a 4 x<br />
5 (group x time) repeated measures ANOVA for metabolic variables and a one way<br />
ANOVA was used for changes in appetite markers. Group differences were examined<br />
by Tukey post-hoc analyses. Data are reported as mean ± SE.<br />
rEsuLTs: There were no significant differences in appetite measures among or<br />
between groups. There were no group x time interactions for VO2, REE, and RQ;<br />
however there was a main effect for group. VO2 was significantly greater for WP<br />
(3.35 ± 0.03 ml/kg/min) and CP (3.30 ± 0.03 ml/kg/min, p < 0.0001) when compared<br />
to PLA (3.16 ± 0.03 ml/kg/min), but not CHO (3.25 ± 0.03 ml/kg/min). Predicted<br />
REE was significantly greater after WP (1947 ± 16 kcal/d), CP (1941 ± 16 kcal/d)<br />
and CHO (1908 ± 16 kcal/d) compared to PLA (1843 ± 16 kcal/d, p < 0.0001). RQ<br />
was significantly lower after PLA (0.759 ± 0.003) compared to WP (0.773 ± 0.003)<br />
Vol. 45 No. 5 Supplement S211<br />
and CHO (0.773 ± 0.003, p < 0.0001) but not CP (0.764 ± 0.003). There were no<br />
significant differences between WP and CP in any metabolic measurements.<br />
CONCLusION: Nighttime consumption of WP, CP, or CHO, in close proximity to<br />
sleep, elicits favorable effects on next morning metabolism when compared to a noncaloric<br />
PLA in active young men.<br />
1135 Board #80 May 30, 9:00 AM - 10:30 AM<br />
Total Energy Expenditure approaches 4 xBMr in<br />
septuagenarians during the race across america (raaM)<br />
Brent C. Ruby, FACSM 1 , Nate Keck 1 , Tim Shriver 2 , Dale<br />
Schoeller 2 . 1 University of Montana, Missoula, MT. 2 The<br />
University of Wisconsin - Madison, Madison, WI.<br />
(No relationships reported)<br />
Previous data has demonstrated that riders in the Tour de France maintain a physical<br />
activity level (PAL) between 3.5-5.5 times basal metabolic rate (xBMR) (Westerterp et<br />
al., 1986). In contrast, the PAL for male septuagenarians has been reported to average<br />
1.7 xBMR (Manini et al., 2009).<br />
PurPOsE: To measure the total energy expenditure (TEE) and water turnover in a<br />
4-man team of septuagenarians during the Race Across America (RAAM).<br />
METhOds: Study participants included four males (70±1.6 yrs, 72.0±5.1kg)<br />
competing as a team during the 2012 RAAM bicycle event (4817 km). Participants<br />
were provided with an oral dose of doubly labeled water after a background urine<br />
sample late in the evening the night before the start. Early the following morning,<br />
a second void urine sample was collected in parallel with a measure of nude body<br />
weight. Subsequent urine samples and body weights were collected on the third<br />
and fifth morning and upon completion of the event to analyze values across three<br />
segments of the race.<br />
rEsuLTs: The four man septuagenarian team finished in 6.55 days with an average<br />
speed of 30.6 km/hr (age group course record). Body weight showed subtle changes<br />
(71.6±6.1 and 70.2±6.5 kg for pre to post race, respectively). Total energy expenditure<br />
averaged 24.8±4.2 MJ/day (5,936±995 kcal/day) (range = 19.16-30.24 MJ/day, 4,578-<br />
7,230 kcal/day) throughout the continuous event. The range of TEE expressed relative<br />
to basal metabolic rate was 2.9-4.0 xBMR. Water efflux averaged 10.5±1.4 L/day<br />
resulting in an overall turnover amounting to 1.6±0.4 times initial total body water<br />
(45.3±3.9 L).<br />
CONCLusION: Highly active septuagenarians maintain near energy balance when<br />
TEE approaches 4 xBMR. These values exceed twice those of less active, similarly<br />
aged males and are comparable to riders during portions of the Tour de France.<br />
1136 Board #81 May 30, 9:00 AM - 10:30 AM<br />
Interactions between the Thermic Effect of Food and<br />
Exercise on Total Energy Expenditure among Females<br />
Ashley Binns, Michelle Gray. University of Arkansas,<br />
Fayetteville, AR.<br />
(No relationships reported)<br />
It is well known that both diet and exercise are key components in overall maintenance<br />
of optimal health. Exercise, in both aerobic and anaerobic forms contributes to overall<br />
energy expenditure (TEE). Additionally, the thermic effect of food (TEF) has also been<br />
recognized to impact energy expenditure.<br />
PurPOsE: The aim of the present investigation was to determine the interaction<br />
between TEF and exercise on total energy expenditure (TEE) based on protein content<br />
of a meal in moderately active females.<br />
METhOds: Twelve active females of normal body composition participated in the<br />
study. Preliminary maximal aerobic capacity (VO2max) was determined. Participants<br />
returned for three additional randomized testing sessions in which a 30-minute bout<br />
of exercise was performed at 60% VO2max after consumption of a high protein (45%<br />
total kcal), low protein (15% total kcal), or in the fasted state.<br />
rEsuLTs: Repeated measures ANOVA indicated a significant main effect for the<br />
feeding protocols (α = .05). The TEF of food was 30.39% greater in the high protein<br />
meal when compared to the low protein meal (p = .006) and 98.15% greater when<br />
compared to the fasted state (p = .000). Low protein meal consumption resulted in a<br />
94.34% higher TEF when compared to the fasted state (p = .000). In combination with<br />
exercise, the TEF of food with a high protein meal was significantly greater compared<br />
to the fasted state (p = .010) but was not different compared to the low protein meal (p<br />
= .122). No significant differences were found between low protein meal consumption<br />
combined with exercise compared to the fasted state (p = .094).<br />
CONCLusION: Findings of this study suggest an effect between protein content<br />
of a meal, moderate-intensity exercise, TEF, and TEE. Acute bouts of high and low<br />
protein feedings potentiated significant increases in energy expenditure through TEF.<br />
In combination with exercise, a significant increase in TEE was only found with high<br />
protein meal consumption when compared to the fasted state. Trends for increased TEF<br />
with exercise were present for exercise performed after consumption of a low protein<br />
meal compared to the high protein meal and the fasted state, though not statistically<br />
significant.<br />
<strong>Abstracts</strong> were prepared by the authors and printed as submitted.<br />
<strong>Thursday</strong>, May 30, 2013
<strong>Thursday</strong>, May 30, 2013<br />
S212 Vol. 45 No. 5 Supplement<br />
C-29 Free Communication/Poster - Epidemiology<br />
of Physical Activity and Cardiovascular<br />
Disease and Cardio Fitness<br />
May 30, 2013, 7:30 AM - 12:30 PM<br />
Room: Hall C<br />
1137 Board #82 May 30, 8:00 AM - 9:30 AM<br />
Cardiorespiratory Fitness, Muscular strength, and<br />
Mortality<br />
Duck-chul Lee1 , Gregory J. Welk, FACSM 1 , Warren D. Franke,<br />
FACSM 1 , Xuemei Sui2 , Steven N. Blair, FACSM 2 . 1Iowa State<br />
University, Ames, IA. 2University of South Carolina, Columbia, SC.<br />
(No relationships reported)<br />
PurPOsE: To determine the independent and combined associations of<br />
cardiorespiratory fitness (CRF) and muscular strength (MS) with all-cause mortality.<br />
METhOds: Participants comprised 7,492 men aged ≥20 years (mean age 42) who<br />
had a medical examination during 1980-1989 in the Aerobics Center Longitudinal<br />
Study. They were free of cardiovascular disease (CVD), cancer, and had ≥85% of their<br />
age-predicted maximal heart rate on a treadmill test and ≥1 year of follow-up. CRF,<br />
in metabolic equivalents (METs), was estimated from a maximal treadmill test. MS<br />
was measured by 1 repetition maximums of bench and leg presses and a composite<br />
MS score was computed by combining the standardized values of both tests. We<br />
used tertiles of the age-specific METs and strength scores. Further, CRF and MS<br />
were dichotomized into either fit or strong (upper two-thirds), or unfit or weak (lower<br />
one-third) in a joint analysis of CRF and MS with mortality. Mortality follow-up was<br />
through 2003 using the National Death Index. Cox regression models included baseline<br />
age, body mass index, smoking status, alcohol drinking, medical conditions, parental<br />
CVD, and MS score for CRF or METs for MS.<br />
rEsuLTs: During an average follow-up of 18.5 years, 400 deaths occurred. The<br />
hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality were 0.82 (0.65-<br />
1.04), and 0.69 (0.52-0.93) in middle and upper CRF categories, and 0.73 (0.58-0.93)<br />
and 0.74 (0.57-0.95) in middle and upper MS categories, respectively, compared with<br />
each lower category after adjusting for confounders and MS or CRF for each other.<br />
In the joint analysis, compared with unfit and weak group, HRs (95% CIs) were 0.54<br />
(0.40-0.74) in unfit and strong group, 0.60 (0.43-0.83) in fit and weak group, and<br />
0.53 (0.41-0.69) in fit and strong group. In age-stratified analyses, the strength of the<br />
association between CRF and mortality was similar in age-groups of 40-49, 50-59,<br />
and ≥60 years. However, MS was getting more strongly associated with mortality with<br />
increasing age, especially in age groups of 50-59 and ≥60 years.<br />
CONCLusION: Both CRF and MS are independent predictors of mortality. The<br />
increased importance of MS with age should be considered when promoting exercise<br />
for seniors.<br />
Supported by NIH Grant AG06945, HL62508, DK088195, and an unrestricted<br />
research grant from The Coca-Cola Company.<br />
1138 Board #83 May 30, 8:00 AM - 9:30 AM<br />
Cardiorespiratory Fitness and Incidence Of urolithiasis:<br />
retrospective Cohort study Of Japanese Men<br />
Susumu S. Sawada, FACSM1 , Ryoko Kawakami1 , Takashi<br />
Okamoto2 , Koji Tsukamoto2 , I-Min Lee, FACSM3 , Steven Blair,<br />
FACSM4 , Motohiko Miyachi1 . 1National Institute of Health and<br />
Nutrition, Tokyo, Japan. 2Tokyo Gas Co. LTD.,, Tokyo, Japan.<br />
3 4 Harvard Medical School, Boston, MA. University of South<br />
Carolina, Columbia, SC.<br />
(No relationships reported)<br />
Physical movement with physical activity and water intake after exercise or sport<br />
may enhance the early release of urinary tract stone(s). Cardiorespiratory fitness is<br />
an objective marker of habitual physical activity or exercise/sports. However, to our<br />
knowledge, there is no paper focusing on the relationship between cardiorespiratory<br />
fitness and incidence of urolithiasis.<br />
PurPOsE: To investigate the association between cardiorespiratory fitness and<br />
incidence of urolithiasis among Japanese males.<br />
METhOds: We evaluated the cardiorespiratory fitness and incidence of urolithiasis<br />
of 4,074 Japanese men [median (IQR) age31 (28-35) years]. Participants were given<br />
a submaximal exercise test, a medical examination, and questionnaires on their health<br />
habits in 1985. Cardiorespiratory fitness was measured using a cycle ergometer test,<br />
and maximal oxygen uptake was estimated. The development of urolithiasis was based<br />
on self-reports from questionnaires at a subsequent medical examination in 2004.<br />
Relative risks and 95% confidence intervals (95%CI) for incidence of urolithiasis were<br />
obtained using Cox proportional hazard models.<br />
rEsuLTs: During follow-up period 258 participants developed urolithiasis.<br />
Following age adjustments, and using the lowest cardiorespiratory fitness (1st tertile)<br />
MEDICINE & SCIENCE IN SPORTS & EXERCISE ®<br />
group as a reference, the relative risks (95%CIs) for 2nd and 3rd tertiles were: 0.93<br />
(0.67-1.26) and 0.75 (0.54-1.03), respectively; p for trend = 0.08. After adjusting for<br />
body mass index, cigarette smoking, and alcohol intake, the relative risks (95%CIs)<br />
were: 1.01 (0.74-1.39), 0.84 and (0.59-1.19), respectively; p for trend = 0.32.<br />
CONCLusIONs: These findings suggest that cardiorespiratory fitness is not a<br />
predictor of incidence of urolithiasis in Japanese men. However, it is possible that only<br />
high-impact exercises, such as jogging, running, or jumping rope, affect the incidence<br />
of urolithiasis. Thus, research into the relationship between these specific exercises and<br />
the incidence of urolithiasis should be examined in the future.<br />
1139 Board #84 May 30, 8:00 AM - 9:30 AM<br />
relationship Between risk Factors for Cardiovascular<br />
disease in undergraduate students and Body Composition<br />
Henry H. Leon Ariza1 , Aura C. Zea Robles1 , Walter E. Rodriguez<br />
Alvarez2 . 1Universidad Santo Tomás, Bogotá, Colombia.<br />
2Louisville University, Louisville, KY.<br />
(No relationships reported)<br />
Cardiovascular disease (CVD) is the leading cause of death worldwide with<br />
approximately 17 million deaths per year. This situation is getting worse in part due<br />
to the increasing prevalence of metabolic syndrome, obesity and physical inactivity in<br />
youth.<br />
PurPOsE: to assess the prevalence of major risk factors for CVD including tobacco<br />
use, high blood pressure (BP), high blood glucose (HBG), lipid abnormalities (LA),<br />
obesity, and physical inactivity, in a population of first-year undergraduate students at<br />
the University of Santo Tomas (Colombia).<br />
METhOds: We conducted a study of prevalence of risk factors for CVD with a<br />
random sample of 192 healthy students (94 women and 99 men), who were 16 to<br />
22 years old. Participants answered a survey to assess nutritional habits, lifestyle<br />
and stress. Glucose, total cholesterol, high density lipoproteins (HDL), low density<br />
lipoproteins (LDL), and triglycerides (TG) were measured in blood to assess HBG and<br />
LA risk factors. Resting BP was measured to evaluate the risk factor of high BP. Waist<br />
circumference, height and weight were measured; and the percentages of body fat<br />
and muscle mass were calculated by bioelectrical impedance analysis (BIA). Pearson<br />
correlations were used (level of significance of p18% (50.0%) and HDL-C23%<br />
(56.3%), LDL-C ≥ 100 mg/dl (50.3%), and HDL-C 0.21. Interestingly, there was a<br />
relationship between the AIx and anthropometric factors, such as body mass index<br />
(BMI) (0.48 p
Official Journal of the American College of Sports Medicine<br />
predictor of FN-BMD. In women (R2=22.5%), weight, CRF, and physical activity<br />
were significantly and positively associated with FN-BMD; age and post-menopausal<br />
status were significantly negatively associated with FN-BMD; smoking was not<br />
significantly associated with FN-BMD. In men (R2=9.9%), weight and CRF were<br />
significantly positively associated with FN-BMD; age, physical activity and smoking<br />
were not significantly associated with FN-BMD.<br />
CONCLusION: Femoral neck bone mineral density levels are positively associated<br />
with cardiorespiratory fitness in both women and men aged 40 years and older. Further<br />
prospective studies are warranted.<br />
1141 Board #86 May 30, 8:00 AM - 9:30 AM<br />
associations of Physical activity With Cardiovascular risk<br />
Factors in Middle-aged Chinese Women<br />
Wenfei Zhu1 , Steven P. Hooker, FACSM1 , Jianmin Cao2 , Minhao<br />
Xie2 . 1Arizona State University, Phoenix, AZ. 2Beijing Sport<br />
University, Beijing, China.<br />
(No relationships reported)<br />
PurPOsE: High levels of physical activity (PA) are associated with a favorable<br />
cardiovascular (CV) risk profile. However, there has been no thorough exploration of<br />
the independent contribution of PA to CV risk factors in middle-aged Chinese women.<br />
Thus, the purpose of this study was to investigate the potential relationship between PA<br />
and CV risk factors in 40-49 years old women in Beijing.<br />
METhOds: A cross-sectional study was conducted in 204 urban communitydwelling<br />
asymptomatic women (40-49 yr). The International Physical Activity<br />
Questionnaire (IPAQ) was used to measure PA and categorize women into three groups<br />
(low, moderate and high PA). CV risk factors, including body mass index (BMI), body<br />
fat percentage (BF%), blood glucose, blood lipids, blood pressure, and pulse wave<br />
velocity (PWV) were measured at rest. Cycle ergometer exercise tests were conducted<br />
to assess cardiorespiratory fitness. Electrocardiogram and other dynamic risk factors<br />
were recorded during exercise.<br />
rEsuLTs: There were significant differences in total PA (388.2±163.1, 1798.9±607.8,<br />
6390.8±4317.6 MET*min/wk, P
<strong>Thursday</strong>, May 30, 2013<br />
S214 Vol. 45 No. 5 Supplement<br />
HOMA-IR and triglycerides (TG). However, this effect remained significant after adjusting<br />
for BMI, but not after adjusting for WC. No associations were observed in EAs.<br />
CONCLusIONs: PA affected the concentrations of several plasma proteins involved<br />
in different disease risk pathways representing possible novel links between PA and<br />
health. Our findings also support the importance of adjusting for WC instead of BMI to<br />
assess the relationship between PA and disease risk.<br />
1145 Board #90 May 30, 8:00 AM - 9:30 AM<br />
Gender differences in high sensitivity C-reactive Protein<br />
and self-reported Muscle strengthening activity among<br />
u.s. adults<br />
Michael R. Richardson, William R. Boyer, James R. Churilla,<br />
FACSM. University of North Florida, Jacksonville, FL.<br />
(No relationships reported)<br />
PurPOsE: To examine the gender differences between high sensitivity C-reactive<br />
protein (CRP) and muscle strengthening activity (MSA) in a nationally representative<br />
sample of U.S. adults.<br />
METhOds: Sample (n=4,998) included adults (>20 years of age) that participated<br />
in the 1999-2004 National Health and Nutrition Examination Survey. Three categories<br />
of MSA participation were created: no MSA (referent group), some MSA (>1 to<br />
2 days/week). The dependent variable was elevated CRP<br />
(3
Official Journal of the American College of Sports Medicine<br />
1149 Board #94 May 30, 8:00 AM - 9:30 AM<br />
Physical activity Intensity and Weight Control status among<br />
adults with diabetes<br />
Paul D. Loprinzi, Gina Pariser. Bellarmine University,<br />
Louisville, KY.<br />
(No relationships reported)<br />
Adults who are overweight or obese are at an increased risk for developing diabetes.<br />
Given that physical activity may serve as a method to help reduce adiposity and<br />
treat diabetes, increasing activity levels among adults with diabetes is important. To<br />
effectively do so, it is important to understand the activity patterns of adults with<br />
diabetes who are trying to lose or manage their weight.<br />
PurPOsE: To describe accelerometer-assessed physical activity levels by weight<br />
control status (i.e., trying to lose weight, trying to maintain weight, and neither trying<br />
to lose or maintain weight) among a nationally representative sample of adults with<br />
evidence of diabetes.<br />
METhOds: Data from NHANES 2003-2006 were used. After excluding<br />
participations with insufficient accelerometry data, missing data on the covariates,<br />
missing weight control status data, and those who did not demonstrate evidence of<br />
diabetes, 695 adults (≥ 18 years) constituted the analytic sample (367 males; 328<br />
females). Multivariate association between physical activity and weight control status<br />
was examined using a polytomous regression.<br />
rEsuLTs: Results were not significant for men, but were for women. Women trying<br />
to lose weight (329.1 min/day [305.5-352.7]) engaged in more light-intensity physical<br />
activity than those trying to maintain weight (286.3 min/day [233.8-338.7]) or those<br />
not trying to lose or maintain weight (277.8 min/day [256.1-299.5]) (p = 0.003). After<br />
adjustments, for every 60-minute increase in light-intensity physical activity, women<br />
were 45% (OR = 1.45; 95% CI: 1.09-1.92) more likely to try to lose weight than not<br />
try to lose or maintain their weight. Regardless of gender, few participants who were<br />
trying to lose weight were sufficiently active. Only 3.9% and 6.0%, respectively,<br />
of men and women who were trying to lose weight met current physical activity<br />
guidelines.<br />
CONCLusION: American adults with diabetes are not sufficiently active even when<br />
trying to lose or maintain their weight. Clinicians are encouraged to increase their<br />
patient’s awareness of the minimum level of physical activity as well as help them<br />
achieve this dose of physical activity. This is important for both genders, but may be<br />
particularly important among men as their activity patterns did not differ across the<br />
weight control practices.<br />
1150 Board #95 May 30, 8:00 AM - 9:30 AM<br />
relationship Between Physical activity and serum Testosterone<br />
Levels In us Men: results From Nhanes 1999-2004<br />
Jeremy A. Steeves 1 , Eugene C. Fitzhugh 2 , Sarah Peskoe 3 , Victoria<br />
Fairchild 3 , Gary Bradwin 4 , Katherine A. McGlynn 1 , Elizabeth A.<br />
Platz, 3 , Corinne E. Joshu, 3 . 1 National Cancer Institute, Rockville,<br />
MD. 2 University of Tennessee, Knoxville, TN. 3 Johns Hopkins<br />
Bloomberg School of Public Health, Baltimore, MD. 4 Harvard<br />
Medical School and Children’s Hospital, Boston, MA.<br />
(No relationships reported)<br />
PurPOsE: Testosterone levels and physical activity (PA) each play important roles<br />
in men’s health, but the relationship between PA and male testosterone levels remains<br />
unclear. We evaluated the association between total PA and testosterone in a nationally<br />
representative sample of healthy men.<br />
METhOds: Serum testosterone concentration was measured by<br />
electrochemiluminescence immunoassay previously for 990 men 20 years of age<br />
or older who participated in the National Health and Nutrition Examination Survey<br />
(NHANES) in 1999-2004. These analyses included 738 men who had complete<br />
information on PA and covariates, no history of prostate cancer, and no limitations to<br />
engaging in PA. PA was self-reported during interview, and tertiles of total PA were<br />
created based on MET-minutes per week. Multivariable-adjusted geometric mean<br />
testosterone concentrations across tertiles of PA were estimated using linear regression.<br />
The odds ratio (OR) and 95% confidence interval (CI) of low testosterone (≤3.46 ng/<br />
mL) were estimated comparing the middle and top tertiles of PA to the lowest tertile.<br />
Stratified analysis by age (20-49, ≥ 50 years), and obesity status (BMI 300 min/wk. Prevalence<br />
estimates and multivariable logistic regression analyses were performed. Analyses<br />
were stratified by age (18-34, 35-64, 65+ years) due to a significant age by PA<br />
interaction.<br />
rEsuLTs: Overall, 48% of adults with limitations report poor HRQOL. Across age<br />
groups we found decreasing trends in the prevalence of poor HRQOL as PA level<br />
increased. Among adults aged 35-64 and 65+, engaging in any level of PA vs. none<br />
was significantly associated with lower odds of poor HRQOL. In adults aged 18-34,<br />
lower odds were noted in those doing PA at least 150 min/wk compared to inactive<br />
adults. (Table).<br />
Table. Adjusted* Odds Ratios of Poor HRQOL among Adults with Limitations by Age Group<br />
18-34 years 35-64 years 65+ years<br />
AOR 95% CI AOR 95% CI AOR 95% CI<br />
PA Level (minutes/week)<br />
Inactive 1.00 ref. 1.00 ref. 1.00 ref.<br />
10-60 0.93 0.60,1.43 0.56 0.50,0.63 0.57 0.50,0.64<br />
61-149 0.75 0.50,1.12 0.45 0.40,0.50 0.51 0.45,0.57<br />
150-300 0.61 0.43,0.89 0.37 0.33,0.41 0.47 0.42,0.53<br />
301+ 0.59 † 0.43,0.80 0.34 †,± 0.30,0.37 0.41 †,± 0.37,0.46<br />
*Adjusted for gender, race/ethnicity, education, marital status, BMI category, smoking heavy<br />
drinking status, and age as a continuous variable.<br />
† Significant linear trend<br />
± Significant quadratic trend<br />
CONCLusION: PA is associated with HRQOL among adults with limitations.<br />
There is evidence of a dose response relationship, but the shape of the association<br />
varied by age group. Results suggest efforts to increase PA may help improve<br />
HRQOL among persons with limitations.<br />
1152 Board #97 May 30, 8:00 AM - 9:30 AM<br />
relationship Between sleep and Next day Physical activity<br />
Lendrum Morrow. Brigham Young University, Provo, UT.<br />
(No relationships reported)<br />
OBJECTIVE: The purpose of this study was to examine the effect that sleep duration<br />
and quality has on next day physical activity among a population of young adult<br />
women. Subjects: Three-hundred and seventy-five women (18-24 yrs) were recruited<br />
to participate in the study. Measurements: Each participant wore an accelerometer<br />
for 7 consecutive days and nights to measure sleep and physical activity. Sleep logs<br />
were used to verify the bedtime and wake time for each night. Actigraph data was then<br />
evaluated to determine sleep latency, efficiency, and number of awakenings. Physical<br />
activity data was also evaluated for intensity (sedentary, light, Moderate and Vigorous)<br />
and duration.<br />
rEsuLTs: Two thousand six hundred and fort one observations were collected<br />
and 2144 observations were used. There was an inverse relationship between total<br />
sleep time and next day activity (F = 102.76, p < 0.0001). However, controlling for<br />
wake time reduced the magnitude of the relationship by 92%. Wake time was the<br />
best predictor of next day physical activity (F = 202.02, p < 0.0001). There was a<br />
significant drop in physical activity for every hour after 7:30 in the morning that the<br />
participants got out of bed (F = 32.24, p < 0.0001). While sleep efficiency did not<br />
correlate with overall activity, it did show an inverse relationship with light activity (F<br />
= 48.94, p < 0.0001) and a positive relationship with sedentary activity (F = 39.73, p<br />
< 0.0001).<br />
CONCLusIONs: Sleep duration and more specifically, time getting out of bed are<br />
<strong>Abstracts</strong> were prepared by the authors and printed as submitted.<br />
<strong>Thursday</strong>, May 30, 2013
<strong>Thursday</strong>, May 30, 2013<br />
S216 Vol. 45 No. 5 Supplement<br />
related to next day physical activity. Arising earlier in the morning may significantly<br />
increase physical activity, which may be due to simply having more time to be active<br />
during the day.<br />
1153 Board #98 May 30, 8:00 AM - 9:30 AM<br />
association between Isokinetic Muscular strength and all-<br />
Cause Mortality in Males<br />
James M. Pattarini1 , Rebecca S. Blue1 , Steven N. Blair,<br />
FACSM2 , Duck-Chul Lee3 , Steven Russell4 , Xuemei Sui2 , Smith<br />
L. Johnston5 . 1University of Texas Medical Branch, Galveston,<br />
TX. 2University of South Carolina, Columbia, SC. 3Iowa State<br />
University, Ames, IA. 4Injury Reduction Technology, Inc, Pawleys<br />
Island, SC. 5National Aeronautics and Space Administration,<br />
Houston, TX.<br />
(No relationships reported)<br />
PurPOsE: Studies have demonstrated an association between declining muscle<br />
mass and increased all-cause mortality in men. Past studies are limited by predictive<br />
power as a result of subject variability, as direct strength measures of specific muscle<br />
groups do not necessarily represent a subject’s overall body strength. Isokinetic testing<br />
evaluates the resistance strength of a muscle moving at a constant rate of speed and<br />
may provide a more accurate measurement of strength. The current study identifies the<br />
prognostic value of isokinetic strength parameters on longevity in male subjects.<br />
METhOds: A prospective observational study was undertaken on male subjects that<br />
underwent isokinetic strength testing for pre-employment screening for physicallydemanding<br />
manual labor positions between 1999 and 2002. Subjects performed<br />
exercise tests on isokinetic dynanometers with flexion/extension torque measurements<br />
of knees, shoulders, and the back. A standardized algorithm adjusted for body weight<br />
and combined scores into a strength index score (SIS). SIS scores of≤2.93 were<br />
considered “low,” SIS of >2.93 to ≤3.14 “medium,” SIS of >3.14 to ≤3.37 “high,” and<br />
SIS of >3.37 “very high.”<br />
rEsuLTs: 5593 men, 41-78 years old, received isokinetic testing during preemployment<br />
screening. During 63,751 person-years of observation and an average<br />
follow-up of 11.4 years, 270 deaths occurred.After adjusting for age, Cox proportional<br />
hazards regression analysis showed a significant reduction in the hazard of death for<br />
each integer unit increase of SIS score (hazard ratio = 0.50; 95% CI (0.37,0.70); P <<br />
0.001).<br />
CONCLusIONs:A significant inverse relationship between strength and mortality<br />
was demonstrated for males, suggesting that isokinetic strength could be used as a<br />
marker of mortality risk. Further study is warranted to better evaluate the relationship<br />
between muscle strength and mortality, and whether such a relationship would hold<br />
true for a female population.<br />
1154 Board #99 May 30, 8:00 AM - 9:30 AM<br />
Behavioral Intent to Change Body Weight and actual Body<br />
Weight Change<br />
Amanda Lewis1 , Sarah Sloan1 , Jessica Peacock1 , Arupendra<br />
Mozumdar2 , Charles Fountaine3 , John Schuna, Jr. 4 , Gary<br />
Liguori, FACSM1 . 1University of Tennessee at Chattanooga,<br />
Chattanooga, TN. 2Population Health Council, New Delhi,<br />
India. 3University of Minnesota Duluth, Duluth, MN.<br />
4Pennington Biomedical Research Center, Baton Rouge, LA.<br />
(No relationships reported)<br />
PurPOsE: Behavioral choice and behavioral intent are two primary factors that<br />
influence health behaviors. This study sought to determine if behavioral intention (BI)<br />
to change body weight led to an actual change in body weight.<br />
METhOds: Students enrolled in two separate university-required general education<br />
courses were recruited to complete a health behavior survey monthly from September<br />
(T1) through December (T4), 2009. The 25-item survey included questions on body<br />
weight and body image. To identify BI, students were asked if they were trying to 1)<br />
lose weight, 2) gain weight, 3) maintain weight, or 4) do nothing about their weight.<br />
Students also had their height and weight directly measured at T1 and T4. Change<br />
in body weight by BI, and differences in mean BMI by BI at baseline were analyzed<br />
using the chi square procedure and confirmed via analysis of variance (ANOVA).<br />
Alpha was p 2 kg) and<br />
again tested for association with BI. No significant relationship was found (p = 0.66).<br />
CONCLusION: In this sample of college students, the intent to change body weight<br />
was largely unrelated to weight change, as overall there was an increase in mean<br />
MEDICINE & SCIENCE IN SPORTS & EXERCISE ®<br />
body weight. In fact, students reporting intentions to lose weight or maintain weight<br />
actually gained more than students intending to gain weight. Although college students<br />
typically do gain weight, assessing weight change based on BI has not previously<br />
been reported. These results, however, indicate that BI alone may not be sufficient<br />
for students to change their weight, at least not given the limited timeframe of this<br />
data collection period. Further research is warranted to better determine factors that<br />
influence weight change among college students.<br />
1155 Board #100 May 30, 8:00 AM - 9:30 AM<br />
Combined Impact of Lifestyle Factors on Lifetime risk of<br />
Chronic disease Mortality in Men and Women<br />
Chong-Do Lee, FACSM. Arizona State University, Phoenix, AZ.<br />
(No relationships reported)<br />
The impact of lifestyle factors on lifetime risk of chronic disease mortality in U.S.<br />
population remains less explored.<br />
PurPOsE: We investigated the combined effects of lifestyle factors on lifetime risk<br />
of chronic disease mortality at 40 years of age in US men and women.<br />
METhOds: Lifetime risks of chronic disease mortality to 80 years of age were<br />
estimated for men and women, with death free of chronic diseases as a competing<br />
event. We followed up 7848 men and women, aged 40 to 80 years, who participated<br />
in the Third National Health and Nutrition Examination Survey. All participants<br />
completed baseline lifestyle behavior questionnaires. A healthy lifestyle profile<br />
was defined as never smoking, physically active, and a healthy diet defined by the<br />
American Heart Association Strategic Committee. They were further categorized as<br />
having 0, 1, 2, or 3 combined healthy lifestyle factors.<br />
rEsuLTs: During an average of 13.2 years of follow-up (103,851 person years),<br />
there were a total of 1645 chronic disease deaths (915 CVD, 546 cancer, 281<br />
respiratory disease, 98 diabetes mellitus). At 40 years of age, lifetime risks of chronic<br />
disease mortality were 38.1% (95% CI: 35.7 to 40.5) for men and 30.7% (95% CI: 28.5<br />
to 33.0) for women. Men and women who were physically active, never smoked, and<br />
had a healthy diet had a substantially lower lifetime risk of chronic disease mortality.<br />
The lifetime risks of chronic disease mortality across 0, 1, 2, and 3 combined healthy<br />
lifestyle factors were 47.2%, 33.0%, 21.2%, and 16.2%, respectively. After adjustment<br />
for multiple risk factors, men and women with all 3 healthy lifestyle factors had a 36%<br />
(95% CI: 28% to 42%) lower risk of chronic disease mortality compared with men and<br />
women with zero healthy lifestyle factors. Persons with 0 compared with 3 healthy<br />
lifestyle factors had a shorter life expectancy by 10 years (95% CI: 7.8 to 12.1 years).<br />
Approximately 30% (95% CI: 14% to 43%) of chronic disease deaths might have been<br />
avoided if men and women had maintained all 3 healthy lifestyle factors.<br />
CONCLusION: Maintaining a healthy lifestyle is associated with lower risk of<br />
chronic disease mortality in men and women. Nationwide primordial prevention efforts<br />
are needed to support the attainment of healthy lifestyles for the lifetime.<br />
1156 Board #101 May 30, 8:00 AM - 9:30 AM<br />
hand-Grip strength and Prevalence Of diabetes,<br />
hypertension, and dyslipidemia: a Cross-sectional study<br />
among Japanese Males<br />
Ryoko Kawakami 1 , Susumu S. Sawada, FACSM 2 , Takashi<br />
Okamoto 3 , Koji Tsukamoto 3 , Noriko Tanaka 2 , Mitsuru Higuchi,<br />
FACSM 1 , I-Min Lee, FACSM 4 , Steven N. Blair, FACSM 5 ,<br />
Motohiko Miyachi 2 . 1 Waseda University, Saitama, Japan.<br />
2 National Institute of Health and Nutrition, Tokyo, Japan. 3 Tokyo<br />
Gas Health Promotion Center, Tokyo, Japan. 4 Harvard Medical<br />
School, Boston, MA. 5 University of South Carolina, Columbia, SC.<br />
(No relationships reported)<br />
Limited data are available on the relationship between muscle strength and the<br />
prevalence of type 2 diabetes, hypertension, and dyslipidemia.<br />
PurPOsE: To examine the cross-sectional relationship between hand-grip strength<br />
and the prevalence of type 2 diabetes, hypertension, and dyslipidemia among Japanese<br />
males.<br />
METhOds: We evaluated 2,517 male workers (median age 53 years) who were<br />
measured for hand-grip strength. Participants were divided into quartiles based on<br />
their relative value of hand-grip strength (hand-grip strength (kg) / body weight (kg)).<br />
Prevalence of each disease was diagnosed by means of an annual health checkup and<br />
questionnaire. Odds ratios and 95% confidence intervals (95%CI) for the prevalence<br />
of type 2 diabetes, hypertension, and dyslipidemia were obtained by using logistic<br />
regression model.<br />
rEsuLTs: 258 participants had type 2 diabetes, 1,039 had hypertension, and 1,286<br />
had dyslipidemia. Adjusting for age, cigarette smoking, alcohol intake, and family<br />
history of each disease, using the highest hand-grip strength group as reference,<br />
the odds ratios (95%CI) for the second to fourth quartiles groups were 1.32 (0.86-<br />
2.00), 0.98 (0.63-1.52), and 2.48 (1.69-3.64), P for trend < 0.001 for type 2 diabetes,<br />
1.22 (0.96-1.56), 1.33 (1.04-1.69), and 2.33 (1.83-2.97), P for trend < 0.001 for<br />
hypertension, and 1.41 (1.12-1.76), 1.92 (1.53-2.40), and 2.41 (1.91-3.03), P for trend<br />
< 0.001 for dyslipidemia, respectively. After additional adjusting for body mass index,<br />
the odds ratios (95%CI) were 1.08 (0.70-1.66), 0.68 (0.43-1.08), and 1.23 (0.78-1.94),<br />
ACSM May 28 - June 1, 2013 Indianapolis, Indiana
Official Journal of the American College of Sports Medicine<br />
P for trend = 0.671 for type 2 diabetes, 0.96 (0.75-1.24), 0.87 (0.67-1.13), and 1.07<br />
(0.80-1.43), P for trend = 0.874 for hypertension, and 1.16 (0.92-1.46), 1.35 (1.06-<br />
1.72), and 1.25 (0.96-1.64), P for trend = 0.045 for dyslipidemia, respectively.<br />
CONCLusIONs: These results suggest that hand-grip strength is associated with the<br />
prevalence of dyslipidemia among Japanese males, although its relation was attenuated<br />
after adjusting for body mass index.<br />
1157 Board #102 May 30, 8:00 AM - 9:30 AM<br />
dyspnea and all-cause Mortality: 28 year Follow-up study<br />
among Twins<br />
Katja Waller1 , Jaakko Kaprio2 , Urho M. Kujala1 . 1University of<br />
Jyväskylä, Jyväskylä, Finland. 2University of Helsinki, Helsinki,<br />
Finland.<br />
(No relationships reported)<br />
Dyspnea is defined as a respiratory discomfort and breathlessness during exercise<br />
and daily activities. In research, dyspnea is often used as pulmonary symptom among<br />
medically ill. However, among healthy people, the use of dyspnea during specified<br />
activities as a measurement of fitness has not been widely used even though it<br />
correlates well with fitness measurements.<br />
PurPOsE: The aim is to look how baseline dyspnea, assessed at baseline of a<br />
longitudinal study, and changes in it, predicts all-cause mortality during 28 year<br />
follow-up.<br />
METhOds: The study is based on a prospective Finnish Twin Cohort, which includes<br />
all same-sex twin pairs born before 1958. The number of twin pairs with both members<br />
alive was 12 069 at the beginning of the follow-up in 1975. These twins answered<br />
questionnaires in 1975 and 1981, including questions on physical activity, dyspnea,<br />
alcohol use, smoking, and physician diagnosed diseases. Dyspnea is measured by<br />
using a five item modified MRC scale. The change in dyspnea between 1975 and 1981<br />
is used as the baseline predictor for mortality. Cox proportional hazard model was used<br />
for mortality analysis, and it was started from 1.1.1982 and continued until 31.12.2010.<br />
rEsuLTs: Tendency for higher hazard ratios (HR) for mortality was observed<br />
among participants who had experienced dyspnea at both (persistent dyspnea) or<br />
either of the baseline years. Age, sex and physical activity adjusted analysis showed<br />
that participants with persistent dyspnea had higher risk for mortality (HR 1.71, 95<br />
% CI 1.57 - 1.85) compared to participants with no dyspnea. Also, participants with<br />
change in dyspnea status showed increased risk, as HR for dyspnea increasers was<br />
1.34 (1.21 - 1.48) and decreasers was 1.23 (1.11 - 1.36) compared to totally symptom<br />
free participants. Similar results are shown for a subgroup of healthy subjects as HR<br />
with same adjustments was 1.60 (1.40 - 1.83), 1.39 (1.18 - 1.64) and 1.22 (1.05 - 1.41)<br />
respectively.<br />
dIsCussION: Results show that persistent dyspnea or dyspnea even at one baseline<br />
point predicts increased mortality during 28 year follow-up also among healthy<br />
subjects. This indicates that easily measured dyspnea score, which correlate well with<br />
fitness outcomes, could have a potential as a screening tool for finding people with low<br />
levels of fitness and increased mortality risk.<br />
1158 Board #103 May 30, 8:00 AM - 9:30 AM<br />
relationship of Contraceptive use, Estrogen replacement<br />
Therapy and age on Blood Lipid Profiles in Women<br />
Kenneth R. Ecker, FACSM. University of Wisconsin, River<br />
Falls, WI.<br />
(No relationships reported)<br />
PurPOsE: The purpose of this investigation was to assess the relationship of aging,<br />
contraceptive use and estrogen replacement therapy on blood lipid profiles in women.<br />
METhOds: Six-hundred and thirty-three females ranging in age from 21 to 69 yearsof-age<br />
were obtained from a hospital wellness center database. All of the subjects had<br />
signed medical release and informed consent prior to when the tests were conducted.<br />
The females were comprised of five age groups of ten year increments. A one-way<br />
ANOVA was used to analyze the data (p < 0.05), in addition to employing post-hoc<br />
comparisons of the least significant difference (p
<strong>Thursday</strong>, May 30, 2013<br />
S218 Vol. 45 No. 5 Supplement<br />
1161 Board #106 May 30, 8:00 AM - 9:30 AM<br />
Physical activity and Benign Prostatic hyperplasia / Lower<br />
urinary Tract symptoms<br />
Kathleen Y. Wolin, FACSM1 , Robert Grubb, III1 , Ratna<br />
Pakpahan1 , Lawrence Ragard2 , Jerome Mabie3 , Gerald Andriole1 ,<br />
Siobhan Sutcliffe1 . 1Washington University School of Medicine<br />
St Louis, St Louis, MO. 2Westat, Rockville, MD. 3IMS, Inc,<br />
Calverton, MD.<br />
(No relationships reported)<br />
Benign prostatic hyperplasia (BPH) and its associated lower urinary tract symptoms<br />
(LUTS) are extremely common among middle- and older-aged American men. Few<br />
studies have investigated physical activity (PA) in relation to BPH/LUTS, with<br />
inconclusive results in cross-sectional studies suggesting a protective association.<br />
However, as this association may potentially reflect the influence of BPH/LUTS on PA<br />
rather than PA on BPH/LUTS, prospective investigations are necessary.<br />
PurPOsE: To examine the association of physical activity with incident BPH/LUTS.<br />
METhOds: Using observational data from the PLCO, a large well-characterized<br />
clinical trial sample, we examined the association of self-reported vigorous PA (current<br />
and at age 40) with incident BPH/LUTS. BPH/LUTS was measured at baseline<br />
(1993-2001) and follow-up (2006-8) using self-report of physician diagnosis, BPH<br />
surgery, finasteride use, nocturia, prostate-specific antigen (PSA) elevation, and large<br />
prostate volume. We included 4,771 men in the incident analysis. Poisson regression<br />
with robust variance estimation was used to calculate multivariable relative risks<br />
(RR) adjusted for age, follow-up time, and number of PSA tests and digital rectal<br />
examinations, as appropriate.<br />
rEsuLTs: As hypothesized, associations for incident BPH/LUTS differed from<br />
previous cross-sectional findings for prevalent BPH/LUTS. PA was not associated with<br />
elevated PSA, greater prostate volume, physician diagnosis of BPH, or finasteride use,<br />
although it was still inversely associated with nocturia. Men engaging in PA 4+ h/wk<br />
were 14% (RR=0.86, 95% CI: 0.76-0.99) less likely to report nocturia ≥2 times/wk and<br />
32% (RR=0.68, 95%CI: 0.51-0.92) less likely to report nocturia ≥3 times/wk than men<br />
who were not active. PA at age 40 was not associated with incident BPH.<br />
CONCLusIONs: The association of PA with incident BPH/LUTS differs from<br />
previous findings for prevalent BPH/LUTS. PA was not associated with incident BPH/<br />
LUTS except when defined as nocturia. Previous studies have suggested that PA may<br />
increase sleep quality, which may explain why PA was only associated with nocturia<br />
and not other dimensions of BPH/LUTS.<br />
1162 Board #107 May 30, 8:00 AM - 9:30 AM<br />
Moderate-to-vigorous Physical activity Thresholds<br />
associated with Metabolic syndrome risk Factors<br />
Tiago V. Barreira, John M. Schuna, Catrine Tudor-Locke,<br />
FACSM, Peter T. Katzmarzyk, FACSM. Pennington Biomedical<br />
Research Center, Baton Rouge, LA.<br />
(No relationships reported)<br />
Current physical activity (PA) guidelines were primarily developed from<br />
epidemiological evidence linking self-reported PA levels with chronic disease<br />
outcomes. Recently, accelerometer PA data from the National Health and Nutrition<br />
Examination Survey (NHANES) has been used to estimate the proportion of US adults<br />
meeting PA guidelines. However, PA information collected via self-report and from<br />
accelerometers may not be equivalent.<br />
PurPOsE: To determine if levels of objectively monitored moderate-to-vigorous<br />
PA (MVPA) can adequately discriminate between adults with and without metabolic<br />
syndrome (MetS) risk factors.<br />
METhOds: 2103 fasted, non-pregnant participants ≥ 20 years of age who had ≥ 4<br />
days of valid accelerometer data (≥ 10 h/dy) and non-missing data for the harmonized<br />
MetS risk factors (blood pressure [BP], triglycerides [TG], fasting blood glucose<br />
[GLU], high-density lipoprotein [HDL-C], waist circumference [WC]) were included<br />
in this analysis of the 03-06 NHANES. MVPA was defined using a threshold of 2020<br />
counts/min. Participants were classified as healthy or unhealthy using the harmonized<br />
MetS risk cut-points for each risk factor. MetS was defined as the presence of ≥ 3 risk<br />
factors. Receiver operating characteristic curve analysis was used to identify optimal<br />
MVPA thresholds to discriminate between healthy and unhealthy adults.<br />
rEsuLTs: Discriminatory MVPA thresholds for all MetS risk factors in men were<br />
identified with area under the curve (AUC) values ranging from 0.55-0.65 (all p < 0.01).<br />
MVPA thresholds were 14-16 min/day for BP, TG, and GLU, 24 min/day for WC, 25<br />
min/day for HDL-C, and 14 min/day for MetS (sensitivity 51%, specificity 72%, AUC<br />
0.63). The optimal MVPA threshold for HDL-C in women was 16 min/day however the<br />
AUC (0.55) was non-significant (p = 0.09). MVPA thresholds for all other MetS risk<br />
factors were identified, with AUC values ranging from 0.65-0.72 (all p < 0.01). Optimal<br />
MVPA thresholds were 10-11 min/day for BP, TG, GLU, and WC. For MetS the MVPA<br />
threshold was 10 min/day (sensitivity 71%, specificity 61%, AUC 0.70).<br />
CONCLusIONs: Although discriminatory thresholds of MVPA in relation to MetS<br />
risk factors were identified, all AUC, sensitivity, and specificity values were fairly low.<br />
Daily MVPA thresholds were lower than the current guidelines and different between<br />
men and women.<br />
MEDICINE & SCIENCE IN SPORTS & EXERCISE ®<br />
1163 Board #108 May 30, 8:00 AM - 9:30 AM<br />
Vitality age: Calibration Of a Modifiable risk-related age<br />
algorithm, Part of an Incentivised Wellness Program<br />
Estelle V. Lambert1 , Kolbe-Alexander Tracy1 , Maroba Josiase2 ,<br />
Mweete Naglazi1 , Deepak Patel2 , Lori Serradas3 , Rhonda<br />
Roscoe3 , Jonathon Dugas3 , Adam Noach2 . 1University of<br />
Cape Town, Newlands, South Africa. 2Discovery Health,<br />
Johannesburg, South Africa. 3The Vitality Group, Chicago, IL.<br />
(No relationships reported)<br />
PurPOsE: The primary aim of this study was to compare the Vitality Risk Age (VA),<br />
based entirely on modifiable risk factors for cardio-metabolic disease (CMD), against<br />
the Framingham Heart Score (FHS) in a cross-sectional sample of persons registered<br />
for an employee-sponsored, Vitality wellness program.<br />
METhOds: The VA algorithm is comprised of modifiable risk factors including:<br />
BMI, smoking, physical activity, alcohol, blood pressure, fasting glucose, cholesterol,<br />
depression/anxiety and dietary behavior scores. A combined relative risk was<br />
calculated (CRR), to adjust actual age to risk age, based on standardized life<br />
expectancy (VA diff %). The sample included de-identified data from all members who<br />
completed the health risk assessment (HRA) from Jan-Sept 2011 (Total N=41067, of<br />
whom, 4049 reported cardio-metabolic disease, CMD). We calculated the odds ratios<br />
for CMD, for each risk factor that contributed to the algorithm, adjusting for gender,<br />
and generated receiver operator characteristic curves (ROC) for risk scores predicting<br />
CMD, separately for men and women.<br />
rEsuLTs: The VA difference for the entire sample was 3.8+4.6 yrs (9% older<br />
by risk). The VA diff (yrs and %) were significantly correlated to the FHS scores<br />
(r=0.50,r=0.49, respectively, P<0.001). Persons meeting physical activity (PA)<br />
guidelines had significantly lower odds ratios for CMD (OR=0.65, 95%CI: 0.60-0.70,<br />
P < 0.001). For every 1mmHg increase in systolic blood pressure, there was an<br />
2% increase in the odds of CMD, and for each kg/m2 BMI and cm change in waist<br />
circumference, there was a 10% and 4% increase in the odds of CMD, respectively.<br />
The c-statistic for the ROC curves for CRR were 0.60 and 0.71, , compared to 0.49 and<br />
0.68 for the FHS, for men and women, respectively. The odds of CMD increased by<br />
1% for each 1% diff in VA diff (%), (P < 0.001).<br />
CONCLusIONs: Risk algorithms based on modifiable behaviors, such as physical<br />
activity, compare favorably to established risk scores for predicting CMD and provide<br />
useful tools to convey behavior change recommendations.<br />
1164 Board #109 May 30, 8:00 AM - 9:30 AM<br />
differential sex Effects on Lean Body Mass in response to<br />
Concurrent high Intensity Exercise Training<br />
Joshua A. Cotter 1 , Tomasz Owerkowicz 2 , Alvin M. Yu 1 ,<br />
Marinelle L. Camilon 1 , Theresa Hoang 1 , Per A. Tesch 3 , Vincent<br />
J. Caiozzo, FACSM 1 , Gregory R. Adams, FACSM 1 . 1 University<br />
of California, Irvine, CA. 2 California State University, San<br />
Bernardino, CA. 3 Karolinska Institute, Stockholm, Sweden.<br />
(Sponsor: Vincent J. Caiozzo, FACSM)<br />
(No relationships reported)<br />
General health, sporting requirements, and environments, e.g. space flight, that warrant<br />
the need for cardiovascular and musculoskeletal maintenance often incorporate both<br />
aerobic (AE) and resistance exercise (RE) training. Concurrent training has shown<br />
potential interference effects and therefore it is important to examine whether there<br />
are sex differences on lean body mass (LBM) responses to concurrent high intensity<br />
training.<br />
PurPOsE: To determine if concurrent training utilizing high-intensity interval<br />
rowing and maximal concentric/eccentric exercise on the Multi-Mode Exercise<br />
Device (M-MED), a gravity-independent flywheel exercise device, will exhibit similar<br />
changes in LBM regardless of sex.<br />
METhOds: Twelve healthy, sedentary males (n=6 , 23.0 ±4.6 yrs, 69.0 ±6.1 kg) and<br />
females (n=6, 23.8 ±2.4 yrs, 68.8 ±15.5 kg) completed 5 weeks of concurrent exercise<br />
training on the M-MED with alternating days of AE and RE training sessions. AE<br />
consisted of high-intensity interval rowing alternating 4 minutes of high intensity (HR<br />
at ≥90% VO2max) and 4 minutes of low intensity (HR at 50% VO2max) exercise. RE<br />
included maximal intensity horizontal squats, hamstring curls, and heel raises. LBM<br />
was assessed using dual energy X-ray absorptiometry (DXA) and whole muscle cross<br />
sectional area (CSA) by magnetic resonance imaging (MRI). Training and gender<br />
comparisons were made using a two-way ANOVA with repeated measures.<br />
rEsuLTs: LBM (3.3%, p
Official Journal of the American College of Sports Medicine<br />
CSA of leg musculature in both males and females with males having a greater<br />
response in the quadriceps and hamstrings.<br />
1165 Board #110 May 30, 8:00 AM - 9:30 AM<br />
Effects Of accelerometer-based Intervention To Go Beyond<br />
Physical activity reference For Japanese On The Prevalence<br />
Of Low-back Pain: a randomized Control Trial<br />
Motohiko Miyachi 1 , Haruka Murakami 1 , Ryoko Kawakami 2 ,<br />
Nobuyuki Miyatake 3 , Takeyuki Numata 4 , Izumi Tabata,<br />
FACSM 5 . 1 National Institute of Health and Nutrition, Tokyo,<br />
Japan. 2 Waseda University, Saitama, Japan. 3 Kagawa University,<br />
Takamatsu, Japan. 4 Okayama Southern Institute of Health,<br />
Oakayama, Japan. 5 Ritsumeikan University, Kusatsu, Japan.<br />
(Sponsor: Izumi Tabata, FACSM)<br />
(No relationships reported)<br />
Low-back pain is a leading symptom in the Japanese population. The evidence for an<br />
association between amount of physical activity and prevalence of low-back pain is<br />
insufficient.<br />
PurPOsE: Using a randomized-control trial design, we determined the effects of<br />
accelerometer-based intervention to go beyond the Physical Activity Reference value<br />
for Japanese (PARJ) on the prevalence of low-back pain.<br />
METhOds: A total of 821 healthy men and women, 30 to 64 years old, were<br />
divided into the active group (n=345) who met PARJ (23 METs-h/week of MVPA)<br />
or the inactive group (n=476) who did not meet PARJ. Moreover, the participants of<br />
the inactive group were randomly assigned to either the intervention group (n=239)<br />
or the control group (n=237). The control group was instructed not to alter their<br />
normal activity levels throughout the study period. The intervention group received<br />
accelerometer-based counseling to go beyond PARJ for one year. The prevalence of<br />
low-back pain was evaluated by the question: “did you have low-back pain lasting<br />
longer than 3 months during the last 12 months?” The point prevalence of low-back<br />
pain was based on that with a current episode of pain. Adjusting hazard ratio and 95%<br />
confidence intervals (95%CI) for the prevalence of low-back pain were obtained using<br />
the Cox hazard regression model.<br />
rEsuLTs: Among the 821 participants, 526 had no low-back pain at baseline and<br />
have been followed-up for more than one year. In the intervention group, the amount of<br />
physical activity significantly increased and the mean value reached 23 METs-h/week<br />
after one year of intervention. There was no such change in the control group. Seventythree<br />
participants reported low-back pain during the average 2.3-year observation<br />
period (range: 1-4 years). Using the control group as a reference, the adjusted hazard<br />
ratios (95%CI) for the intervention and active groups were 0.50 (0.27-0.94) and 0.65<br />
(0.38-1.09), respectively.<br />
CONCLusIONs: These results suggest that the accelerometer-based intervention to<br />
go beyond 23 METs-h/week defined as PARJ attenuates the prevalence of low-back<br />
pain by ~50%. (NCT00926744)<br />
C-31 Free Communication/Poster - Epidemiology<br />
of Physical Activity in Pregnancy<br />
May 30, 2013, 7:30 AM - 12:30 PM<br />
Room: Hall C<br />
1166 Board #111 May 30, 8:00 AM - 9:30 AM<br />
description of Motives for and Barriers to Exercising across<br />
Pregnancy<br />
Erin E. White1 , Karin A. Pfeiffer, FACSM2 , Claudia B.<br />
Holzman2 , Daniel R. Gould2 , James M. Pivarnik, FACSM2 .<br />
1 2 Winona State University, Winona, MN. Michigan State<br />
University, East Lansing, MI.<br />
(No relationships reported)<br />
Maternal exercise usually decreases as gestation progresses even though there<br />
are numerous benefits derived from continuing this behavior during pregnancy.<br />
Understanding motives for and barriers to maternal exercise by trimester may allow<br />
physical activity professionals to better individualize maternal exercise programs and<br />
increase adherence.<br />
PurPOsE: The purpose of this study was to describe the most frequent motives for<br />
and barriers to maternal exercise by trimester.<br />
METhOds: Women (n = 295) who belonged to a commercial fitness club and had<br />
given birth within the last five years completed a retrospective survey regarding<br />
trimester-specific motives for and barriers to exercise during pregnancy. Women chose<br />
up to three motives and barriers per trimester from a predetermined list (including 9<br />
motives and 27 barriers) based on previous literature. Descriptive statistics were used<br />
to assess the frequency of motives and barriers.<br />
rEsuLTs: Mean ± SD maternal age at delivery was 27 ± 5.1 yr. Maternal height<br />
Vol. 45 No. 5 Supplement S219<br />
and weight at the time of survey completion were 165.2 ± 6.5 cm and 79.5 ± 20.8<br />
kg, respectively. The top two primary motives in trimesters 1, 2, and 3 were to stay<br />
healthy (37.4%, 35.5%, and 32.9%, respectively) and weight control (19.8%, 27.1%,<br />
and 25.5%, respectively). The third primary motive in trimesters 1 and 2 was fitness<br />
(13.7% and 11.6%, respectively); while in trimester 3 it was to relieve stress (10.7%).<br />
The top primary barrier to exercise across all three trimesters was lack of energy<br />
(27.0%, 18.9%, and 19.4%, respectively). Other primary barriers in trimester 1 were<br />
pregnancy-related illness (18.5%) and lack of time (9.3%). Trimester 2 primary<br />
barriers included lack of time (9.6%) and lack of motivation (8.2%), while third<br />
trimester primary barriers included exercise being too uncomfortable (17.2%) and on<br />
bed rest (6.8%).<br />
CONCLusION: While the motives of exercise do not change considerably across<br />
trimesters of pregnancy, barriers do. More women may continue to exercise throughout<br />
pregnancy if they are made aware of various modalities to make exercise more<br />
comfortable for them, especially as pregnancy progresses. In addition, discussing time<br />
management skills and how to overcome a “lack of energy” may increase exercise<br />
participation.<br />
Funding: Blue Cross Blue Shield of Michigan Student Award<br />
1167 Board #112 May 30, 8:00 AM - 9:30 AM<br />
reliability and Validity of Three Physical activity<br />
Measurements during Pregnancy and Postpartum<br />
Deanna M. L. Phelan1 , Mallory R. Marshall1 , Rebecca A.<br />
Schlaff2 , Alaina K. Vince1 , Karin A. Pfeiffer, FACSM1 , James M.<br />
Pivarnik, FACSM1 . 1Michigan State University, East Lansing,<br />
MI. 2Saginaw Valley State University, University Center, MI.<br />
(No relationships reported)<br />
Quality physical activity (PA) studies during pregnancy depend on the accuracy of<br />
data collected. However, little is known about the reliability and validity of current<br />
modalities designed to measure PA during pregnancy in a free-living environment.<br />
PurPOsE: Our purpose was to assess reliability and validity of three PA measures<br />
used during pregnancy and postpartum: the Omron pedometer (PED; steps/day/<br />
hr) the SenseWear Armband (SA; kcal/kg/hr), and the Pregnancy Physical Activity<br />
Questionnaire (PPAQ; met.min/week).<br />
METhOds: Subjects (n=20) wore the PED and SA devices in free-living<br />
environments for two consecutive weeks at 20 weeks gestation, 32 weeks gestation,<br />
and 12 weeks postpartum. At the end of each week of wear, subjects completed<br />
the PPAQ recall instrument to evaluate the prior week’s PA. Intraclass correlation<br />
coefficients (ICC) and standard errors of measurement (SEM) were calculated to<br />
estimate reliability for the two weeks of wear/recall at each of the three time points.<br />
Convergent validity was assessed by averaging consecutive week values for every<br />
measure at each time point and performing Pearson correlations among the three<br />
modalities.<br />
rEsuLTs: Across the study period, PA estimates were 497±192 steps/day/hour,<br />
13.3±3.7 kcal/kg/hour, and 15853±5702 met.min/week. ICC (SEM) values for PED<br />
at 20 weeks, 32 weeks, and 12 weeks postpartum were 0.42 (126), 0.89 (53), and 0.86<br />
(93), respectively. Reliability of SA was lower than PED and PPAQ at all three time<br />
points (20 weeks=0.55 (1.3), 32 weeks=0.42 (1.2), postpartum=0.19 (2.8)). The PPAQ<br />
was more reliable across both pregnancy time points, compared to postpartum (0.88<br />
(3867) and 0.83 (3820) versus 0.57 (5592) for postpartum). Validity estimates were<br />
low and variable (-0.37-0.30).<br />
CONCLusIONs: Overall, reliability was acceptable for use of these measurement<br />
techniques to assess PA in free-living environments during pregnancy. However,<br />
convergent validity was poor among the three instruments. Poor validity could be<br />
a function of the three modalities measuring different constructs in a free-living<br />
environment. In addition, increasing the sample size of our ongoing investigation<br />
will allow further and more detailed evaluation of the relationship among these PA<br />
measurement modalities during pregnancy and postpartum.<br />
1168 Board #113 May 30, 8:00 AM - 9:30 AM<br />
Plasma Lipid Changes associated with Lifestyle Factors<br />
across Pregnancy<br />
Christina G. Campbell 1 , Courtney K. Blomme 1 , Diana R.<br />
DiFabio 1 , Kai Ling Kong 1 , Lorraine M. Lanningham-Foster 1 ,<br />
Danielle J. Richardson 1 , Katie M. Smith 1 , William G. Thorland 2 .<br />
1 Iowa State University, Ames, IA. 2 Nurse Family Partnership,<br />
Denver, CO. (Sponsor: Gregory J. Welk, FACSM)<br />
(No relationships reported)<br />
Plasma lipid values are known to increase as pregnancy progresses, however the role<br />
that lifestyle factors may have on this physiological response during pregnancy is not<br />
well defined.<br />
PurPOsE: The purpose of this study was to evaluate potential factors that may<br />
influence the change in lipid values across pregnancy.<br />
METhOds: At weeks 18 and 35 of pregnancy, 57 women provided a fasted blood<br />
sample, 3-day weighed diet record, and wore an activity armband for a 7-day, 24hour<br />
period. Multiple regression analyses were conducted to evaluate the role of the<br />
<strong>Abstracts</strong> were prepared by the authors and printed as submitted.<br />
<strong>Thursday</strong>, May 30, 2013
<strong>Thursday</strong>, May 30, 2013<br />
S220 Vol. 45 No. 5 Supplement<br />
following independent variables on lipids: body weight, pre-pregnancy body mass<br />
index (BMI), daily energy expenditure (EE), daily energy intake (EI), and weekly<br />
minutes of moderate-vigorous physical activity (MVPA) performed in ≥10-minute<br />
bouts. Measured plasma lipids included total cholesterol (TC), high-density lipoprotein<br />
(HDL), and triglycerides (TG); low-density lipoprotein (LDL) was calculated. In each<br />
regression model, the respective lipid values (TC, LDL, HDL, or TG) at week 18 were<br />
also entered as independent values to adjust for variation in the week 35 values.<br />
rEsuLTs: EI was 2145 ± 446 and 2320 ± 497 kcals/d; EE was 1714 ± 280 and 1811<br />
± 273 kcals/d; and MVPA was 171.5 ± 112.8 and 157.9 ± 143.9 min/wk at week 18<br />
and 35, respectively. While both TC (215.0 ± 36.3 and 267.1 ± 57.3 mg/dL at week 18<br />
and 35, respectively) and LDL (115.0 ± 30.5 and 154.4 ± 48.7 mg/dL at week 18 and<br />
35, respectively) levels at week 35 were related to corresponding lipid levels at week<br />
18 (P
Official Journal of the American College of Sports Medicine<br />
and shoulder and pelvis tilt angle did not change significantly in both groups. The<br />
perceived health (from 4.24±1.08 to 3.06±0.81 in YG, from 4.31±0.99 to 3.29±0.72 in<br />
CG), self-esteem (from 5.01±0.41 to 3.98±0.64 in YG, from 5.50±0.80 to 4.27±0.77<br />
in CG), and general physical concept (from 3.43±0.64 to 3.04±0.94 in YG, from<br />
3.53±0.90 to 3.54±0.96 in CG) decreased significantly (p60 min/d),<br />
moderately active (15-59 min/d) or least active (0-15 min/d).<br />
rEsuLTs: Overall, one-third of the sample was overweight (17.2%) or obese<br />
(16.1%) and 62.5% did not meet the recommendation for MVPA of 60 min/d<br />
(43.7+1.8% in boys and 30.9+1.6 in girls). Furthermore, 18.5% of the total sample<br />
spent
<strong>Thursday</strong>, May 30, 2013<br />
S222 Vol. 45 No. 5 Supplement<br />
(RT3, triaxial accelerometer) were collected for 3 days every 4 mo from age 3 to age 7 y<br />
from 2001-2006. Weather information (temperature maximum/minimum, precipitation,<br />
wind speed) from the local municipal airport was obtained from the US National<br />
Climatic Data Center and merged with 9,264 participant-days of PA data. Heating and<br />
cooling degrees, a measure used to estimate energy requirements for geographic areas<br />
in the form of degree days, were calculated using 65 degrees Fahrenheit (F) as a basis.<br />
Pearson correlation coefficients were calculated between PA variables (counts per minute<br />
(cpm), minutes Moderate/Vigorous PA) and weather variables. Multivariate regression<br />
was used to test the relationship between weather and PA.<br />
rEsuLTs: Temperatures ranged between -8 to 100 degrees F over the duration of<br />
the study. Mean daily precipitation was 0.1 inches and wind speed mean was 6 mph.<br />
Across the 5 years of the study, mean total PA was 609 ± 258 (standard deviation) and<br />
mean MVPA was 88 ± 57 minutes. Both TPA (r = -0.15) and MVPA (r = -0.16) were<br />
both significantly negatively correlated with cooling/heating degrees (P < 0.0001).<br />
They were significantly negatively associated with precipitation (r = 0.07 for both)<br />
and wind speed (r = -0.06 for both) (P < 0.0001). Heating/cooling degrees were<br />
significantly associated with TPA and MVPA independent of precipitation and wind<br />
speed. Each 10 additional heating/cooling degrees in the model was associated with 8<br />
minutes less MVPA.<br />
CONCLusIONs: More extreme weather (higher or lower temperatures, higher wind,<br />
more rain/snow) is associated with decreased physical activity in young children.<br />
As weather patterns become more extreme, PA interventions should be designed and<br />
tested with consideration of weather effects.<br />
Supported in part by grants: NIH NHLBI R01HL064022, NCATS KL2TR000078, &<br />
the CCHMC Heart Institute Research Core.<br />
1177 Board #122 May 30, 8:00 AM - 9:30 AM<br />
relationship Between Technology usage and health<br />
Behaviors among Late adolescents<br />
Bridget Melton 1 , Lauren Bigham 2 , Matthew Bird 1 , Helen<br />
Welle Bland 1 , Ciaran Fairman 1 . 1 Georgia Southern University,<br />
Statesboro, GA. 2 University of Georgia, Athens, GA.<br />
(No relationships reported)<br />
While previous literature has been limited in focus to screen time, little research has<br />
analyzed the various technology modalities in relation to specific health outcomes.<br />
PurPOsE: This study aimed to assess BMI, physical activity, sleep patterns, and<br />
nutrition with regards to technology use among adolescents in a rural southeastern<br />
region of the United States.<br />
METhOds: The study employed a quantitative, descriptive methodology that utilized<br />
non-probability, purposive sampling. On a technology-based survey, participants<br />
delineated technology usage by type and frequency, and reported on physical activity<br />
levels, sleep patterns, and specific dietary patterns (n=591). Current physical activity<br />
levels were ascertained by the IPAQ and health behaviors by questions from the<br />
American College Health Association Risk Assessment.<br />
rEsuLTs: Chi-Square analyses determined significant differences by technology use<br />
and physical activity levels and Body Mass Index. Participants reporting higher general<br />
Internet surfing were significantly more likely to be in low physical activity (p=0.014)<br />
and obese (p=0.050). ANOVA analyses found participants with lower general Internet<br />
use were significantly more likely to have higher levels of moderate (p=0.022) and<br />
vigorous (p=0.001) exercise. Walking was significantly correlated with higher social<br />
networking (p=0.005), Internet surfing (p=0.001) and television watching (p=0.013).<br />
Participants, who watched less TV, ate significantly higher daily amounts of fruits<br />
(p=0.006) and vegetables (p=0.054). Participants who used pedometers, heart rate<br />
monitors, nutrition trackers, Wii, and social networking for health and fitness reported<br />
significantly more fruit and vegetable consumption (p2.32,<br />
p
Official Journal of the American College of Sports Medicine<br />
weekend screen time was obtained by combining questions for watching TV, watching<br />
DVDs or videos, video/computer games, and internet/computer usage. Two questions<br />
asked about phone use on weekdays and weekends. Response options ranged from<br />
“none” to “6+ hours” per day and weighted averages provided average weekly screen<br />
time and phone use. Participants reported demographics and perceived neighborhood<br />
environment. Measured height and weight were used to calculate Body Mass Index<br />
(BMI) z-score. The participant’s parent/guardian completed the Physical Activity<br />
and Media Inventory to assess the home screen media environment. Geographic<br />
Information Systems software was used to create a “walkability” score for a 1-mile<br />
buffer around the participant’s home. Hierarchical regression analyses were conducted<br />
to predict follow-up screen time and phone use.<br />
rEsuLTs: The full model for screen time, which controlled for baseline screen time<br />
and demographics, indicated that the size of the primary TV significantly predicted<br />
follow-up screen time (Coeff [SE]= 84.5 (43.01), p= 0.05). Marginally positive<br />
associations were detected for the percent of children’s bedrooms with TVs (Coeff<br />
[SE]= 76.6 [42.2], p= 0.07) and having cable service (versus no cable or no TV) (45.2<br />
[25.17], p= 0.07). For females’ phone use, baseline perceived lack of neighborhood<br />
safety (7.4 [3.49]) and BMI z-score (21.7 [10.24]) were both positively associated with<br />
follow-up phone use (both p=0.04). There were no significant predictors of phone use<br />
for males.<br />
CONCLusIONs: Home environment variables significantly predicted screen time for<br />
both genders while, for phone use, the neighborhood environment was influential for<br />
females. Interventions to reduce screen time may want to focus on changing the home<br />
environment while, for reducing phone use, the safety of the larger neighborhood may<br />
be an intervention target for female youth.<br />
1181 Board #126 May 30, 8:00 AM - 9:30 AM<br />
a survey of Physical activity and Medical Expense among<br />
Chinese College Freshmen<br />
Hongjun Yu 1 , Zhu Weimo, FACSM 2 , Zhang Chenggang 1 , Jun<br />
Qiu 1 . 1 Tsinghua University, Beijing, China. 2 University of Illinois<br />
at Urbana-Champaign, Illinois, IL. (Sponsor: Weimo Zhu,<br />
FACSM)<br />
(No relationships reported)<br />
PurPOsE: To investigate the relationship between physical activity (PA) and medical<br />
expense among the Chinese college freshmen.<br />
METhOds: 7 days’ self-report PA data of the freshmen from a major China research<br />
university (N = 3085, aged 18.2±0.9 yr., male = 2063& female = 1022; height =<br />
171.4±7.8 cm; weight = 62.6±13.6 kg& BMI = 21.2±3.8) were collected and analyzed<br />
using the International Physical Activity Questionnaires (IPAQ-short version). In<br />
addition, their medical expense during the previous year was also collected through<br />
self-reporting. The data were analyzed using both correlation and t-test.<br />
rEsuLTs: The Chinese college freshmen spent 89.46±104.27 min for vigorous PA<br />
192.49±179.21 min, for moderate PA and 64.35±110.92 min for walking. The mean<br />
of medical expense was 797.10 RMB with a SD of 755.21 RMB. The correlation<br />
between medical expense and vigorous, moderate, walking and siting were r = 0.211,<br />
0.133,0.051 r=-0.039, respectively. . When classifying medical expense into Q1-Q4<br />
groups (Q1=0 RMB, Q2=1-1000RMB, Q3=1001-3000RMB, Q4=3000+ RMB), it was<br />
found that those who spent less in medicine exercised more (Table 1)<br />
CONCLusION: There is a trend that college students who exercise more, especially<br />
vigorous PA, tend to spend less in medicine.<br />
Table 1 Descriptive statistics of PA by all four medical expense groups<br />
Groups Group 1 Group 2 Group 3 Group 4<br />
Category N Mean±SD N Mean±SD N Mean±SD N Mean±SD<br />
Vigorous(minutes/week) 135 111.3±125.8 2345 89.2±105.3 475 87.2±98.1 73 79.1±90.0<br />
Moderate(minutes/week) 135 186.5±157.2 2345 194.2±182.6 475 193.8±175.1 73 162.1±183.0<br />
Walk(minutes/week) 135 54.0±102.6 2345 62.2±108.6 475 74.7±123.4 73 79.0±117.4<br />
sitting(hours/day) 128 9.0±3.0 2292 9.2±8.3 463 9.1±2.7 71 8.9±2.9<br />
1182 Board #127 May 30, 8:00 AM - 9:30 AM<br />
The College alcohol Environment’s affect on student<br />
alcohol Consumption and Physical activity<br />
Mallory M. Koenings 1 , Kendra K. Kattelmann 2 , Melissa Olfert 1 .<br />
1 West Virginia University, Morgantown, WV. 2 South Dakota State<br />
University, Brookings, SD.<br />
(No relationships reported)<br />
This is an ancillary study of YEAH Project, a randomized controlled trial to investigate<br />
the effectiveness of a web-delivered, theory-based educational intervention to prevent<br />
excessive weight gain in college students.<br />
PurPOsE:To examine 1) associations between distance to the nearest alcohol outlet<br />
(AO) and alcohol outlet density (AOD) around students’ residences and their alcohol<br />
consumption; and 2) associations between students’ alcohol consumption and physical<br />
activity (PA).<br />
Vol. 45 No. 5 Supplement S223<br />
METhOds: Students on 13 campuses in January and February 2011 provided<br />
addresses (n=1491, 465 males, 982 females). Lists of active liquor licenses were<br />
obtained from city and state government agencies. Geographic Information Systems<br />
software was used to calculate distance from students’ residences to the nearest AO<br />
and AOD at six different radii (0.1, 0.25, 0.5, 1, 2, and 5 miles) surrounding student’s<br />
residences. Alcohol consumption was measured in terms of exceeding the 2010<br />
Dietary Guidelines for Americans (DGAs) recommendation for alcohol and binge<br />
drinking. PA was measured in terms of meeting the 2008 Physical Activity Guidelines<br />
for Americans (PAGs) for moderate (MPA) and vigorous (VPA). Multiple logistic<br />
regressions were used to test the associations listed above while adjusting for gender,<br />
region of the US, age, race/ethnicity, and smoking status.<br />
rEsuLTs: Students living more than 1 mile from the nearest AO were 2.6 times more<br />
likely not to binge drink compared to students who lived less than 0.25 miles from the<br />
nearest AO (OR=2.62, 95% CI= 1.43-4.82, p
<strong>Thursday</strong>, May 30, 2013<br />
S224 Vol. 45 No. 5 Supplement<br />
by race/ethnicity, median household income and education.<br />
rEsuLTs: In urban block groups, 42.6% of U.S school-age youth had park access<br />
compared to those living in large rural (9.7%), small rural (6.5%) and isolated block<br />
groups (3.0%) Park access was higher in youth living in urban block groups, compared<br />
to those living in rural block groups, for all race-ethnic, education, and income<br />
categories (Table). Asian/Pacific Islanders had the greatest proportion of youth with<br />
park access while American Indian/Alaskan Native had the lowest proportion of youth<br />
with park access. In states with >80% of block groups classified as urban, median<br />
park access was 44.0% whereas states with
Official Journal of the American College of Sports Medicine<br />
percentage of girls meet the HFZ for BC. With AC and BC for both boys and girls,<br />
among those students in the needs improvement categories, the majority of<br />
individuals were considered high risk. The prevalences of needing improvement<br />
in AC and BC are important considering the impact of childhood health-related<br />
fitness on risk of chronic disease and mortality in adulthood.<br />
1188 Board #133 May 30, 8:00 AM - 9:30 AM<br />
relationship between Waist Circumference and Body Mass<br />
Index in Chinese Children and adolescents<br />
Xiao Jian Yin 1 , Chen Ye Ji 2 , Liu Ji 3 , Qiang Guo 3 , Shi chang<br />
Li 3 , Sadayoshi Taguchi, FACSM 4 , Toyoho Tanaka 5 . 1 Key<br />
Laboratory of Adolescent Health Assessment and Exercise<br />
Intervention, Ministry of Education,East China Normal<br />
University, Shang Hai, China. 2 Institute of Child and Adolescent<br />
Health, Peking University Health Science Center, Beijing,<br />
China. 3 Key Laboratory of Adolescent Health Assessment<br />
and Exercise Intervention, Ministry of Education, Shang<br />
Hai, China. 4 Graduate School of Sport and Health Science,<br />
Ritsumeikan University, Kusatsu, Japan. 5 School of Health and<br />
Sports Sciences, Chukyo University, Toyota, Japan. (Sponsor:<br />
Sadayoshi Taguchi, FACSM)<br />
(No relationships reported)<br />
PurPOsE: To study the distribution of normal WC and provide a reference for<br />
the screening criteria of overweight and obesity in Chinese children and adolescent<br />
utilizing the BMI criteria for children and adolescents developed by WGOC (The<br />
Working Group on Obesity in China) as a standard.<br />
METhOds: 146,306 Han primary and middle school students aged 7-18 years old<br />
from 15 provinces or cities monitored by National Student Physical Health Survey<br />
in 2008 were recruited as subjects. Using BMI criteria for children and adolescents<br />
developed by The WGOC as the reference, the WC cutoff points of overweight and<br />
obesity in children and adolescents were analyzed with ROC curve (Receiver Operator<br />
Characteristic Curve).<br />
rEsuLTs: The correlation coefficients between BMI and WC were generally beyond<br />
0.8 for boys, and were beyond 0.7 for girls (except 7-year-old girls); For overweight<br />
category, WC cutoff point of 7-12 years boys were mainly at the 70th percentile<br />
(WC :57.0-69.0cm), for13-18 years were at the 75th percentile(71.5-77.0cm) ,<br />
the sensitivities and the specificities were between 0.808-0.922 and 0.824-0.912,<br />
respectively. WC cutoff point of 7-8 years girls were mainly at the 75th percentile<br />
(56.3-58.1cm), and 9-18 years at the 80th percentile (61.5-72.4cm), the sensitivities<br />
and the specificities were between 0.770-0.905 and 0.811-0.983, respectively.<br />
For obesity category, WC cutoff point of 7-12 years boys were mainly at the 85th<br />
percentile (60.0-73.8cm), for 13-18 years at the 90th percentile (78.8-82.1cm),<br />
the sensitivities and the specificities were between 0.872-0.937 and 0.868-0.943,<br />
respectively. WC cutoff point of 7-10 years girls were mainly at the 85th percentile<br />
(59.1-65.3cm), and 11-18 years at the 90th percentile (70.1-76.5cm), the sensitivities<br />
and the specificities were between 0.789-0.936 and 0.881-0.932, respectively.<br />
CONCLusIONs: For overweight category, The WC cutoff points were proposed at<br />
the 70th percentile for 7-12 yrs boys, 75th for 13-18 yrs. The girls were proposed at<br />
the 75th percentile for 7-8 yrs, 80th for 9-18 yrs. For obesity category, The WC cutoff<br />
points before the puberty were proposed at the 85th percentile, and after the puberty<br />
(boys of 13 years old, girls of 11 years old in China) at the 90th percentile.<br />
1189 Board #134 May 30, 8:00 AM - 9:30 AM<br />
Continuous Metabolic syndrome risk score and Time<br />
Expended In Moderate To Vigorous Physical activity In<br />
adolescents<br />
Wagner De Campos1 , Antonio Stabelini Neto2 , Géssika<br />
Castilho dos Santos3 , Sergio G. da Silva1 , Oldemar Mazzardo<br />
Jr. 1 . 1Universidade Federal do Paraná, Curitiba, Pr, Brazil.<br />
2Universidade Estadual do Norte do Paraná, Jacarézinho, Pr,<br />
Brazil. 3Universidade Estadual do Norte do Paraná, Curitiba,<br />
Pr, Brazil. (Sponsor: Carlo Baldari, FACSM)<br />
(No relationships reported)<br />
PurPOsE: To associate the continuous risk score for metabolic syndrome with time<br />
spent engaging in moderate to vigorous physical activity (MVPA) among adolescents.<br />
METhOds: The study involved 391 participants, aged 10 to 18 years. Physical<br />
activity was measured by accelerometry. The counts obtained in the different activities<br />
were transformed into metabolic equivalents (METs) and classified as light (≥ 1.5 but <<br />
3.0 METs), moderate (≥ 3.0 but < 6.0 METs) and vigorous (≥ 6.0 METs) activities. The<br />
continuous risk score for metabolic syndrome was calculated using the following risk<br />
factors: waist circumference, blood pressure, blood glucose, HDL-C and triglycerides.<br />
The statistical analyses used were the t-test, Pearson correlation, ANOVA and ROC<br />
curve.<br />
rEsuLTs: Time spent in MVPA was inversely associated with the continuous risk<br />
Vol. 45 No. 5 Supplement S225<br />
score for metabolic syndrome (p 20.2 kg/m 2 in 6 th graders and BMI>23.4 kg/m 2 in 10 th graders). After four years<br />
of implementation of the CSHEC, BMI was assessed in the then 10 th grade males,<br />
and respectively, in the study and control groups 41.5% and 70.6% were categorized<br />
as either overweight or obese. To analyze the data, BMI values were converted to<br />
percentile rankings (consistent with CDC BMI-for-age-guidelines) and a statistical<br />
t-test (p
<strong>Thursday</strong>, May 30, 2013<br />
S226 Vol. 45 No. 5 Supplement<br />
compared to those with later AR, adjusting for age and gender. After adjustment for<br />
potential confounders associations weakened but still remained for BMI (very early<br />
AR β = 0.70, 95%CI 0.35 to 1.05, p=
Official Journal of the American College of Sports Medicine<br />
METhOds: Staff (N=51) from three child care centers in rural North Carolina<br />
completed a survey addressing current PA habits as well as barriers to PA and PA selfefficacy.<br />
PA questions included weekly moderate and vigorous PA participation (min/<br />
wk of each intensity calculated) and resistance training (yes/no). Participants reported<br />
their top five barriers to PA and rated their PA self-efficacy with a standard scale<br />
(summary score calculated: 0-1400). Basic demographics included education level<br />
and knowledge of PA guidelines for children and for adults. Height (cm), weight (kg),<br />
blood pressure and waist and hip circumferences (cm) were measured and disease risk<br />
classification determined. Descriptive statistics were calculated.<br />
rEsuLTs: With regards to PA, 76.9% reported any participation in moderate PA<br />
and 30.8% any vigorous PA. However, only 26.7% moderate activity participants<br />
achieved 150 minutes or more of moderate intensity activity while 73.3% vigorous<br />
activity participants achieved 75 minutes or more of vigorous PA. Additionally, only<br />
17.3% perform resistance training. The top barriers to PA participation included: not<br />
enough time, too tired, and lack of motivation. PA self-efficacy was moderate with<br />
a summary score of 910.0±274.6. While 83.7% reported having some knowledge of<br />
physical activity recommendations for children and youth, 71.2% had some knowledge<br />
of recommendations for adults. Almost half (48.1%) were classified as increased risk<br />
based on BMI and waist circumference and 51.8% were pre-hypertensive.<br />
CONCLusIONs: Child care staff are minimally active and moderately confident<br />
in their ability be physically active. In addition, while they are knowledgeable about<br />
PA recommendations they tend to struggle to participate in PA due to time constraints<br />
related to their occupation. With the increased emphasis on understanding potential<br />
influences of childhood obesity, including child care staff PA behaviors, is warranted.<br />
1197 Board #142 May 30, 8:00 AM - 9:30 AM<br />
associations between Physical activity and Other healthrelated<br />
Behaviors in a National sample of College students<br />
Mary K. Dinger, FACSM, Danielle R. Brittain, Susan R.<br />
Hutchinson. University of Northern Colorado, Greeley, CO.<br />
(No relationships reported)<br />
Understanding the relationships between sufficient amounts of physical activity<br />
(PA) and other health-related behaviors is important for professionals who design<br />
interventions to promote PA in college students.<br />
PurPOsE: The purpose of this study was to examine the associations between PA<br />
and other health-related behaviors in a national sample of college students.<br />
METhOds: College students from 157 campuses in the United States completed the<br />
National College Health Assessment during the 2008-2009 academic year. Participants<br />
were categorized as meeting the current PA recommendation if they engaged in ≥ 75<br />
minutes of vigorous PA, ≥ 150 minutes of moderate PA, or ≥ 150 minutes of moderate<br />
to vigorous PA weekly. Hierarchical binary logistic regression was used to examine<br />
the contribution of variables in predicting whether or not participants met the PA<br />
recommendation. Variables were entered into the model in three steps. Step 1 included<br />
gender, age and race; step 2 included club and intramural sports participation; and<br />
step 3 included 14 health-related behavior/characteristic variables (general health,<br />
seatbelt use, physical fighting, smoking, marijuana use, binge drinking, prescription<br />
drug misuse, number of sexual partners, fruit and vegetable consumption, depression,<br />
suicide ideation, stress, sleep and BMI). A Bonferroni-adjusted alpha of .0026 was<br />
used to assess significance.<br />
rEsuLTs: There were 67,861 students (67.6% female, 72.9% white) included in the<br />
analysis. All of the variables entered into the model at steps 1 and 2 were significant.<br />
The addition of the 14 health-related variables at step 3 resulted in a statistically<br />
significant improvement in the model, χ2 (14, N = 67,861) = 1779.23, p < .001, Cox<br />
& Snell R2 = .06. The highest adjusted odds ratios (AOR) were for fruit and vegetable<br />
consumption (AOR = 2.81) and perceived general health status (AOR = 1.75). Use<br />
of marijuana, prescription drug misuse, contemplating suicide and stress level did not<br />
contribute significantly to the model (p > .0026).<br />
CONCLusION: Demographic, sports participation and 10 of the 14 health-related<br />
variables significantly predicted meeting the PA recommendation in this national<br />
sample of college students.<br />
Vol. 45 No. 5 Supplement S227<br />
C-33 Exercise is Medicine/Poster - Exercise<br />
is Medicine - Implications for Body<br />
Composition<br />
May 30, 2013, 7:30 AM - 12:30 PM<br />
Room: Hall C<br />
1198 Board #143 May 30, 8:00 AM - 9:30 AM<br />
Behavioral Changes Laterly resulted after Lifestyle<br />
Changing: Impacts On Fitness, diet and Metabolic<br />
syndrome<br />
Roberto Carlos Burini, Edilaine Michelin, Muriel Siqueira,<br />
Fernando Moreto, Katia Cristina Portero-McLellan. UNESP, Sao<br />
Paulo, Brazil.<br />
(No relationships reported)<br />
PurPOsE:The aim of the study was to evaluate the remaining impact of 6 month<br />
of lifestyle changing program (LISC) on physical activity, fitness, dietary quality and<br />
metabolic syndrome (MetS) frequency after step down of the re-education program<br />
METhOds:From an ongoing longitudinal program of LISC 153 subjects adults<br />
(54.2 + 9.0 yrs, 71.2% < 60 yrs), 80% females, 69,2% married fullfiled the ethical<br />
and inclusion criteria for the intervention with supervised daily exercises (aerobic<br />
walking - 3x/wk and strength-2x/wk, associated with dietary counseling). Assessment<br />
included body anthropometry, clinical, blood biochemistry, physical activity (PA) by<br />
(IPAQ), fitness (VO2max, trunk flexibility and hand grip strength) healthy eating index<br />
(HEI) and MetS diagnosis (NCEP ATPIII, 2004). Moments and groups were compared<br />
statistically with p
<strong>Thursday</strong>, May 30, 2013<br />
S228 Vol. 45 No. 5 Supplement<br />
26.6% and boys in the HFZ group increased by 12.9% across the three years, whereas<br />
the number of S2 boys in the at-risk or HFZ group did not change. As for girls,<br />
although numbers of at-risk girls in both schools increased, S1 had a much smaller<br />
increase rate (10%) than S2 (50%). Finally, the ANCOVA did not identify betweenschool<br />
differences in %BF at the follow-up (p > .40) controlling for baseline data.<br />
CONCLusION: Relatively large amount of MVPA in PE classes impacts more<br />
positively on students’ %BF against FITNESSGRAM HFZ, and examining changes in<br />
%BF against HFZ is a meaningful way to track %BF for youth.<br />
1200 Board #145 May 30, 8:00 AM - 9:30 AM<br />
Effect Of Exercise Training Modality On abdominal Fat<br />
reduction In Obese Persons<br />
Haifeng Zhang1 , Tom K. Tong2 , Jingjing Wang1 , Shaosheng<br />
Liu1 , Yuxiu He1 . 1College of Physical education, Hebei Normal<br />
University, Shijiazhuang, China. 2Department of Physical<br />
Education, Hong Kong Baptist University, Hong Kong, China.<br />
(No relationships reported)<br />
High-volume continuous training (CT) program at moderate intensity is one of the<br />
fundamental strategies for obesity control. Recently, interval training (IT) program,<br />
which is a time-efficient modality, was reported to be effective to induce similar<br />
favourable metabolic adaptations associated with traditional CT. However, it was<br />
not known if the IT program could benefit obese people in fat control (visceral and<br />
subcutaneous fat) in the same way as that resulting from the CT.<br />
PurPOsE: To compare the changes in abdominal visceral (AVFA) and subcutaneous<br />
(ASFA) fat areas in obese adults resulting from an IT program and that from a CT<br />
program with equivalent training load.<br />
METhOds: 24 obese women were evenly assigned into two groups to complete a<br />
12-week (4 day/wk) exercise program. In IT group, subjects (21±1 yrs, 31.3 ±3.6%fat)<br />
performed four 4-min interval treadmill running at 85-95% of peak heart rate (HR ) peak<br />
interspersed by 3-min walking at 50-60% of HR and 7-min rest. In CT group,<br />
peak<br />
subjects (20.6±1.2 yrs, 32.0±2.4% fat) participated in training consisted of continuous<br />
run at 60-70% of HR for 33 mins representing equivalent training load as IT group.<br />
peak<br />
10-min warm-up and 5-min cool down exercise at 50-60% of HR were identical<br />
peak<br />
in the two groups. All subjects maintained their normal diet habit during the entire<br />
experiment. Computed tomography scans obtained at the L4-L5 disc-space were<br />
used to determine AVFA and ASFA. Whole-body %fat was assessed by bioelectrical<br />
impedance.<br />
rEsuLTs: Subjects’ characteristics of the two groups were similar pre-training.<br />
After training, similar reductions in body weight (IT: 66.4 ±9.3 vs 61.2 ±8.4 kg; CT:<br />
64.8 ±6.1 vs 60.3 ±5.8 kg, p 110 mg/dl and<br />
resting blood pressure > 130/85 mm Hg. Aerobic exercise participation was determined<br />
by self reported activity from a standard health history questionnaire. Subjects were<br />
classified for aerobic exercise participation as: aerobic exercise participation of less<br />
than or equal to 1 day per week (LOW), 2 to 3 days per week (MOD), and aerobic<br />
exercise participation greater than or equal to 4 days per week (HIGH).<br />
rEsuLTs: The subjects were divided into groups based on the level of weekly<br />
MEDICINE & SCIENCE IN SPORTS & EXERCISE ®<br />
aerobic activity. All data were analyzed using a Chi Square test (p < 0.05). Of the 177<br />
firefighters tested 46.3% (82) reported LOW, 48% (85) reported MOD, and 5.6% (10)<br />
reported HIGH weekly aerobic activity. The prevalence of Metabolic Syndrome for<br />
LOW was 25.6% (21) while the prevalence of Metabolic Syndrome for MOD was<br />
15.3% (13). No one in the HIGH group met the criteria for Metabolic Syndrome.<br />
CONCLusIONs: Participation in aerobic exercise appears to affect the incidence of<br />
metabolic syndrome in adult male fire fighters.<br />
1202 Board #147 May 30, 8:00 AM - 9:30 AM<br />
relationship Between site-specific Muscle Loss Of The Thigh<br />
and One-leg standing Balance In Women: The hiregasaki<br />
study<br />
Takashi Abe1 , Madoka Ogawa2 , Jeremy P. Loenneke3 , Robert<br />
S. Thiebaud3 , Mark Loftin, FACSM1 , Naotoshi Mitsukawa2 .<br />
1 2 University of Mississippi, Oxford, MS. Toyo Gakuen University,<br />
Nagareyama, Japan. 3University of Oklahoma, Norman, OK.<br />
(No relationships reported)<br />
Balance ability is a significant predictor of injurious falls. Recently, we reported<br />
that sarcopenia is observed as a site-specific loss of muscle mass, especially for the<br />
quadriceps muscles. However, it is unknown whether there is significant correlation<br />
between site-specific muscle loss of the thigh and static balance ability.<br />
PurPOsE: To investigate the relationship between age-related site-specific loss of<br />
thigh muscle and one-leg standing balance.<br />
METhOds: Fifty-two women aged 52-83 years (mean age, 66 [SD 7] years)<br />
volunteered. Muscle thickness (MTH) was measured by ultrasound at 3 sites on the<br />
anterior (30% and 50% of thigh length) and posterior (70% of thigh length) aspects of<br />
the thigh. MTH ratios were calculated to assess the site-specific sarcopenia (anterior<br />
30%:posterior 70% MTH [A30:P70 MTH] and anterior 50%:posterior 70% MTH<br />
[A50:P70 MTH]). For the one-leg standing balance test, subjects were instructed to<br />
start in a position with a comfortable base of support, with eyes open, and with arms by<br />
the side of the trunk and then to stand unassisted on any one leg. The test was timed in<br />
seconds from the time one foot was lifted from the floor to when it touched the ground<br />
or the standing leg, with a longer time (up to 120 seconds) indicating better balance<br />
ability. Maximum voluntary isometric knee extension strength was also measured.<br />
The differences between three balance ability groups (less 60 seconds [n=16, G1],<br />
60 to 120 seconds [n=10, G2], and over 120 seconds [n=26, G3]) were tested for<br />
significance using a one-way analysis of variance. Pearson product correlations were<br />
performed to determine the relationships between age, MTH ratios, isometric strength,<br />
and one-leg standing balance.<br />
rEsuLTs: Age was inversely correlated with ratios of A30:P70 MTH (r=−0.389,<br />
P
Official Journal of the American College of Sports Medicine<br />
59.8 ± 1.3% lean, p ≤ 0.03). Fat oxidation was higher for YOGA at rest vs CON (T0:<br />
58 ± 3.8 vs 46 ± 3.0%; T6M: 52.3 ± 3.1 vs 44.7 ± 3.3%, p ≤ 0.05). Dominant hand-grip<br />
strength tended to be greater for YOGA vs CON (T0: 36.3 ± 3.8 vs 30.4 ± 2.0 kg, p =<br />
0.08; T6M: 37.4 ± 3.9 vs 30.7 ± 2.4 kg, p = 0.07). Timed one leg balance was longer<br />
for YOGA on both legs compared with CON (T0: 56.0 ± 2.4 vs 45.5 ± 4.7 right leg,<br />
52.0 ± 3.8 vs 39.4 ± 5.2 sec left leg, p ≤ 0.04; T6M: 57.3 ± 2.7 vs 46.1 ± 4.0 right leg,<br />
54.7 ± 2.8 vs 43.6 ± 3.7 sec left leg, p < 0.02).<br />
CONCLusIONs: Routine vinyasa yoga appears beneficial for maintaining healthy<br />
weight and body composition. The unique finding of higher resting fat oxidation for<br />
YOGA combined with better balance and the tendency for improved upper body<br />
strength suggest that yoga may maintain function and LBM over time. Research<br />
regarding yoga’s potential as an alternative mode of exercise in models of healthy<br />
aging is warranted.<br />
1204 Board #149 May 30, 8:00 AM - 9:30 AM<br />
adopting a Modest-Intensity Exercise Program Can Improve<br />
Metabolic health in Obese adults Even Without Weight-<br />
Loss<br />
Rachael K. Nelson, Jeffrey Horowitz, FACSM. University of<br />
Michigan, Ann Arbor, MI.<br />
(No relationships reported)<br />
Many metabolic health benefits of a vigorous exercise program are evident even<br />
after the first exercise session. However, vigorous exercise is not well tolerated by<br />
many obese patients, and early adaptations in markers of metabolic health soon after<br />
adopting a more modest exercise program are not well defined.<br />
PurPOsE: To characterize key adaptations in glucose and fatty acid metabolism in<br />
the first 2 weeks of a modest-intensity exercise program in obese adults.<br />
METhOds: 9 sedentary obese adults (men/women: 3/6; 38±2 kg/m2; 30±3 yrs)<br />
participated in 3 experimental trials: 1) before beginning the exercise program<br />
(“PRE”), 2) after a single session of modest-intensity exercise (40min at 60% HRmax),<br />
and 3) after 2 weeks (6 days/wk) of this same exercise (“2WKS”). We performed<br />
a meal tolerance test (MTT) 1h after exercise (or without prior exercise in “PRE”)<br />
to calculate established indices of insulin sensitivity in liver (0-30min area-undercurve<br />
for glucose × insulin) and muscle ((Δglucose/Δtime) ÷ [Insulin]). The day after<br />
exercise, we performed a hyperinsulinemic-euglycemic clamp to assess peripheral<br />
insulin sensitivity. We also measured fatty acid (palmitate) rate of disappearance from<br />
plasma (Palm Rd) and total fatty acid oxidation (FAO).<br />
rEsuLTs: A single session of exercise did not significantly alter any of our primary<br />
outcome measures. However, by 2WKS our MTT revealed an improvement in our<br />
index of hepatic insulin sensitivity (42±16 vs. 33±11; P≤0.05) but improvement in<br />
the MTT index of muscle insulin sensitivity did not quite reach statistical significance<br />
(2.2±0.5 vs. 2.5±0.3; P=0.07). Peripheral insulin sensitivity measured the day after<br />
exercise was not different between PRE and 2WKS (8.1±1.1 vs. 9.2±1.5; P=0.75). In<br />
contrast, FAO was greater the day after exercise at 2WKS vs. PRE (4.2±0.3 vs. 3.6±0.2<br />
µmol/kgFFM/min; P=0.04), without a change in plasma fatty acid uptake (Palm Rd:<br />
3.1±0.2 vs. 2.9±0.2 µmol/kgFFM/min, P=0.66). Importantly, all adaptations were<br />
independent of any change in body mass (109±5 vs. 109±5 kg).<br />
CONCLusION: Although a single 40 min session of exercise performed at<br />
60%HRmax was not sufficient to induce any measurable changes in our metabolic<br />
markers, we did find improvements in meal tolerance in obese adults after 2 weeks of<br />
this modest exercise program without any weight loss.<br />
1205 Board #150 May 30, 8:00 AM - 9:30 AM<br />
Changes in Body Composition, Bone Mineral density,<br />
Muscle strength and Functional ability following Exercise<br />
Training in Old adults<br />
Matthew Scott 1 , Neil M. Johannsen 1 , Michael A. Welsch,<br />
FACSM 1 , Daniel P. Credeur 2 , Tim S. Church, FACSM 3 , Eric<br />
Ravussin 3 , Jason D. Allen, FACSM 4 . 1 Louisiana State University,<br />
Baton Rouge, LA. 2 University of Missouri, Columbia, MO.<br />
3 Pennington Biomedical Research Center, Baton Rouge, LA.<br />
4 Duke University Medical Center, Durham, NC.<br />
(No relationships reported)<br />
PurPOsE: To determine effects of 8 wks of progressive whole-body training (WBT),<br />
preceded by 4 wks of regional specific (RSTS) or aerobic exercise training (AE), on<br />
body composition (lean mass (LM) and bone mineral density (BMD)), muscle strength<br />
and functional ability.<br />
METhOds: Subjects (Age: 75±5yrs, n=57), who scored between 218-490 yrds on a<br />
6-min walk test, were randomized to AE or RSTS for 4 wks (Phase 1). AE consisted of<br />
45min of walking/biking at 40-60% of HRR, 3 d/wk. RSTS consisted of specific calf,<br />
thigh, buttocks, arms, shoulders, and torso exercises. Exercises were performed for 3-5<br />
min, at 40-70% of maximal strength of the muscle group of interest, for 45min, 3 d/wk.<br />
Subjects were progressed as tolerated. After Phase 1, subjects advanced to WBT using<br />
established guidelines (Phase 2). Body composition (DXA), muscle strength (Sum of<br />
chest/leg press, seated row and handgrip (TOT)) and functional ability (Senior Fitness<br />
Test (SFT)) was examined before, after 4 and 12 wks.<br />
Vol. 45 No. 5 Supplement S229<br />
rEsuLTs: Table I indicates a time effect for bodyweight (p=0.002), fat mass<br />
(p=0.09), leg LM (p=0.003), pelvic BMD (p=0.005), and SFT % rank (p=0.0001).<br />
There was a grp*time effect (p=0.006) for TOT, thoracic (p=0.02) and lumbar BMD<br />
(p=0.09). Change in TOT and pelvic BMD (r=0.32, p=0.03) were related.<br />
CONCLusION: Progressive WBT resulted in decreased body weight and fat mass,<br />
and increased leg LM and SFT scores. Both groups showed gains in strength and<br />
BMD, with the magnitude of change greater in those using RSTS during phase 1. This<br />
suggests RSTS serves as a significant local stimulus for rapid musculoskeletal gains,<br />
and the importance of WBT to improve functional ability in frail elderly.<br />
This Research was supported by NIH (1RC1AG035822-01-Dr. Jason D. Allen (PI))<br />
1206 Board #151 May 30, 8:00 AM - 9:30 AM<br />
Exercise and Bone Mineral density in Premenopausal<br />
Women: a Meta-analysis of randomized Controlled Trials<br />
George A. Kelley, FACSM 1 , Kristi S. Kelley 1 , Wendy M.<br />
Kohrt, FACSM 2 . 1 West Virginia University, Morgantown, WV.<br />
2 University of Colorado Denver, Aurora, CO.<br />
(No relationships reported)<br />
Maintaining optimal bone mineral density (BMD) during the premenopausal years is<br />
important for reducing the risk of osteoporosis and subsequent fractures during the<br />
postmenopausal years. Previous randomized controlled trials addressing the effects<br />
of joint and/or ground reaction force exercise on femoral neck (FN) and lumbar<br />
spine (LS) BMD in premenopausal women have led to conflicting and less than<br />
overwhelming results.<br />
PurPOsE: Examine the effects of exercise on FN and LS BMD in premenopausal<br />
women.<br />
METhOds: Meta-analysis of randomized controlled exercise trials >24 weeks in<br />
premenopausal women. Standardized effect sizes (g) were calculated for each result<br />
and pooled using random-effects models, Z-score alpha values, 95% confidence<br />
intervals (CI) and number-needed-to-treat (NNT). Heterogeneity was examined using<br />
Q and I-squared. Moderator and predictor analyses using mixed-effects ANOVA and<br />
simple meta-regression were conducted. Statistical significance was set at p
<strong>Thursday</strong>, May 30, 2013<br />
S230 Vol. 45 No. 5 Supplement<br />
mineral content [BMC], bone mineral density [BMD], and BMD z-score [BMDz]) of<br />
the lumbar spine, hip, and full body minus the head (body).<br />
rEsuLTs: Bivariate correlations showed that SED was negatively associated with<br />
hip BMDz (r=-0.557; p=0.016). LPA was positively associated with hip BMDz<br />
(r=0.484; p=0.042). MPA had positive associations with hip BMD (r=.569, p=.014),<br />
hip BMDz (r=.656, p=.003), and body BMDz (r=.636, p= .005). MVPA had positive<br />
influences on hip BMDz (r= .589, p=.010), hip BMD (r=.566, p=.014), body BMC<br />
(r=.509, p=.031), and body BMDz (r=.539, p=.021). VPA was positively associated<br />
with spine BMC (r=.516; p=.034).<br />
CONCLusIONs: These results show multiple positive associations between MVPA<br />
and bone density in PWS youth. Interestingly, VPA was associated with only one bone<br />
parameter, possibly due to the low amount of VPA in these PWS youth (~10 min).<br />
The negative association between activities that are sedentary and hip BMDz supports<br />
the notion that in addition to insufficient PA, excessive sitting can also negatively<br />
influence BMD. Similar to other youth, PA of moderate plus vigorous intensity must be<br />
encouraged and sedentary activities discouraged in this population despite the inherent<br />
low stamina in PWS.<br />
Supported by USAMRAA Award W81XWH-09-1-0682<br />
C-34 Free Communication/Poster - Gene<br />
Expression and Cell Signaling<br />
May 30, 2013, 7:30 AM - 12:30 PM<br />
Room: Hall C<br />
1208 Board #153 May 30, 9:00 AM - 10:30 AM<br />
Monocarboxylate Transporter-1 Expression at the Onset of<br />
skeletal Muscle regeration<br />
Dameon A. Smith, Tyrone A. Washington. University of Arkansas,<br />
Fayetteville, AR. (Sponsor: Stavros Kavouras, FACSM)<br />
(No relationships reported)<br />
Skeletal muscle is extremely plastic and has the remarkable ability to recover from<br />
injury. In diseases, such as muscular dystrophy, regeneration of skeletal muscle is<br />
impaired. Monocarboxylate transporters, or MCTs, are involved with lactate transport<br />
across the cell membrane. This transport has important implications for the energetic<br />
efficiency of skeletal muscle. MCT expression is known to be affected by skeletal<br />
muscle hypertrophy, chronic electrical stimuli, and voluntary wheel running. However,<br />
the cellular regulation of MCT1 protein expression at the onset of skeletal muscle<br />
regeneration has not been determined.<br />
PurPOsE: To determine the protein and gene expression of MCT1 at the onset of<br />
skeletal muscle regeneration.<br />
METhOds: Twelve male C57/BL6 mice (12 weeks old) were randomly assigned to<br />
either a control (uninjured) or bupivacaine (injured) group. Bupivacaine was injected<br />
into the tibialis anterior (TA) of the injured group, and phosphate buffered saline (PBS)<br />
was injected into the TA of the uninjured group. 3 days post-bupivacaine injection the<br />
TA was extracted. MCT1 protein and gene expression were determined.<br />
rEsuLTs: A 12% decrease in TA muscle mass to tibia length (2.43 ± 0.12 mg/mm vs.<br />
2.14 ± 0.19 mg/mm, p < 0.02) was observed 3 days post-bupivacaine injection. IGF-1<br />
gene expression increased 5.0-fold (p < 0.05) 3 days post-bupivacaine injection. MyoD<br />
gene expression increased 3.5-fold (p < 0.05) 3 days post-bupivacaine injection. MCT-<br />
1 gene expression was not altered 3 days post-bupivacaine injection. However, MCT-1<br />
protein was decreased 32% (p < 0.03) 3 days post-bupivacaine injection.<br />
CONCLusION: In conclusion, at the onset of skeletal muscle regeneration MCT1<br />
protein is decreased and this appears to be regulated at the post-transcriptional level.<br />
1209 Board #154 May 30, 9:00 AM - 10:30 AM<br />
Oxidative stress results In Telomere shortening In Isolated<br />
skeletal Muscle Fibers<br />
Andrew T. Ludlow, Espen E. Spangenburg, Eva R. Chin,<br />
Wen Hsing Cheng, Stephen M. Roth, FACSM. University of<br />
Maryland, College Park, MD.<br />
(No relationships reported)<br />
We have recently provided evidence that long-term voluntary exercise in rodents<br />
results in shorter skeletal muscle telomeres compared to young and age-matched<br />
sedentary animals. The mechanism of telomere shortening induced by long-term<br />
exercise is currently unknown. We hypothesized that reactive oxygen species induced<br />
by muscle contractions could induce oxidative stress and damage telomeres resulting<br />
in non-replicative based telomere shortening.<br />
PurPOsE: The purpose of our investigation was to 1) Determine the response of<br />
skeletal muscle telomeres to oxidative stress, and 2) Determine if basal telomere length<br />
influences telomere dynamics in response to oxidative stress.<br />
METhOds: Flexor digitorum brevis muscles were dissected from 15 male C57BL/6<br />
(long telomere) and 20 male CAST/Ei (wild-derived, short telomere) mice and<br />
dissociated into single fibers. Fibers were cultured in physiological oxygen (2-5%) for<br />
MEDICINE & SCIENCE IN SPORTS & EXERCISE ®<br />
5 days in the presence or absence of hydrogen peroxide (oxidant), or a combination<br />
of N–acetylcysteine (antioxidant) and hydrogen peroxide. Telomere length, telomerase<br />
activity, and protein content of telomere-repeat binding factors 1 and 2 (TRF1 and<br />
TRF2; important for telomere protection) were determined.<br />
rEsuLTs: In isolated skeletal muscle fibers of both mouse strains, oxidative stress<br />
resulted in significant telomere shortening. Telomerase enzyme activity was not altered<br />
by oxidative stress but was different between strains, with greater telomerase activity<br />
in long-telomere C57BL/6 mice (p < 0.01). TRF1 protein content was increased in<br />
CAST/Ei fibers that were exposed to the combination of hydrogen peroxide and N–<br />
acetylcysteine. In hydrogen peroxide -treated C57BL/6 fibers TRF2 protein content<br />
was increased compared to control fibers but this was attenuated in the presence of<br />
N–acetylcysteine.<br />
CONCLusIONs: Strain-specific telomere length dictates the response of telomere<br />
protective proteins to oxidative stress, with long-telomere mice responding by<br />
increasing expression of TRF2 and short telomere mice up-regulating expression of<br />
TRF1. These data suggest a mechanism by which increased oxidative stress during<br />
exercise induces shorter skeletal muscle telomere lengths.<br />
FuNdING AG000268 and CA124334 A.T. Ludlow.<br />
1210 Board #155 May 30, 9:00 AM - 10:30 AM<br />
Mechanical Modulation Of The Mtor Pathway Is dependent<br />
upon The Magnitude Of Cyclic Compressive Load<br />
Emily H. Brownell, Sarah Abshire, Esther Dupont-Versteegden,<br />
Timothy A. Butterfield. University of Kentucky, Lexington, KY.<br />
(Sponsor: Thomas M. Best, FACSM)<br />
(No relationships reported)<br />
Massage is a therapeutic tool that has been used clinically to facilitate muscle recovery,<br />
decrease soreness, and reduce muscle edema. The underlying mechanisms for its<br />
beneficial effects are not well known, but one effect of massage that has been noted<br />
sporadically and anecdotally in the literature is a potential to decrease atrophy. If<br />
massage can attenuate the loss of muscle mass and associated muscle function, then<br />
manual therapies may prove to be an effective a means to facilitate an earlier return to<br />
normal function.<br />
PurPOsE: To test the hypothesis that p70s6k phosphorylation will increase<br />
following cyclic compressive loading (CCL, a massage-mimetic), and is dependent<br />
upon the magnitude of applied load.<br />
METhOds: Fifteen male Wistar Rats were divided into three groups, and the right<br />
tibialis anterior muscle was subjected to one bout of 30 minutes massage-mimetic<br />
loading. Group 1 (N=6) received CCL of 1.4 N, Group 2 received CCL of 4.5 N, and<br />
Group 3 served as a pure control. Tissues were harvested six hours post CCL.<br />
rEsuLTs: Following massage-mimetic loading, the mTOR pathway was<br />
significantly upregulated compared to controls (p=0.042). Post-hoc analysis revealed<br />
the upregulation of pp70s6k was significantly increased in the 4.5N load compared to<br />
the control group (5.132au +/- 1.528 au compared to 2.898 au +/- 1.145 au., p=0.017).<br />
There was also a trend for greater upregulation of the mTOR pathway following<br />
massage with the 4.5N load compared to massage with the 1.4N load (5.132au +/-<br />
1.528 au compared to 3.909 au +/- 0.511 au., p=0.088). Applied massage of 1.4N load<br />
did not result in a difference in upregulation of pp70s6k when compared to the control<br />
limbs (3.909 a.u +/- 0.511 a.u., compared to 2.898 +/- 1.145 a.u., p=0.2334), indicating<br />
a load dependent response of the mTOR pathway.<br />
CONCLusION: Applying a massage-mimetic to muscle tissue resulted in an increase<br />
in phosphorylation of p70s6k (pp70s6k), a protein marker that directly induces protein<br />
synthesis. Phosphorylation of p70s6k is notably increased in a load dependent manner,<br />
and is significantly upregulated following CCL of 4.5 N in healthy rat muscle. This<br />
indicates that massage may be an effective intervention to attenuate muscle atrophy<br />
through upregulation of mTOR pathway and its downstream targets. Funded by an<br />
NATA Osternig Research Award.<br />
1211 Board #156 May 30, 9:00 AM - 10:30 AM<br />
mTOr Pathway activation Following resistance Exercise<br />
with Vibration in human subjects<br />
Michael G. Leavitt, J. Brent Feland, David M. Thomson, Gary<br />
W. Mack, FACSM, Daniel S. Nelson, Brenda Benson, Allen C.<br />
Parcell, FACSM. Brigham Young University, Provo, UT.<br />
(No relationships reported)<br />
Functional adaptations in human skeletal muscle following a period of resistance<br />
exercise are the result of regular activation of cellular signaling pathways that elevate<br />
muscle protein synthesis. It has been reported that the addition of whole body vibration<br />
(WBV) to a resistance exercise program enhances performance. Such improvements<br />
in muscle function may be the result of increased activation of cellular signaling<br />
pathways associated with muscle growth.<br />
PurPOsE: We have investigated whether an acute bout of resistance exercise in<br />
combination with WBV results in a greater activation of the mTOR signaling pathway<br />
compared to resistance exercise alone.<br />
METhOds: Eight untrained college-age males (23±2 yrs, 179±1 cm, 75±2.5 kg, and<br />
12.6±1.8% body fat) performed unilateral leg press exercises with (Vbx) and without<br />
(RT) vibration. Muscle samples were obtained from the vastus lateralis muscle pre-<br />
ACSM May 28 - June 1, 2013 Indianapolis, Indiana
Official Journal of the American College of Sports Medicine<br />
exercise (baseline) and one-hour following the bout of resistance exercise. Muscle<br />
tissue samples were analyzed for phosphorylated levels of mTOR, p70S6K, and 4E-<br />
BP1 proteins.<br />
rEsuLTs: One-hour following the resistance exercise bout there were no differences<br />
between phosphorylated levels of mTOR or 4E-BP1 in Vbx or RT (p>0.05). Levels<br />
of phosphorylated p70S6K were increased at the one-hour post-exercise time-point in<br />
both Vbx (22±9 fold increase, p
<strong>Thursday</strong>, May 30, 2013<br />
S232 Vol. 45 No. 5 Supplement<br />
(RR vs. RX/XX) had different methylation pattern following five weeks of training in<br />
both exercise protocols. AE+RE, 8,981 CpG sites (5952 genes), and RE, 3,432 CpG<br />
sites (2550 genes) had different methylation pattern between the 2 genotype groups.<br />
CONCLusION: As hypothesized, ACTN3 R577X genotype has a significant effect<br />
on the methylation profile in skeletal muscle at baseline and following five weeks of<br />
exercise training. Our findings suggest that ACTN3 R577X genotype can influence<br />
epigenetic signature and skeletal muscle response to exercise.<br />
This work was supported in part by the National Space Biology Research Institute<br />
NSBRI, NCC 9-58-70, MA01601 (Adams), UL1TR000153, and by NICHD/NINDS<br />
5R24HD050846-08: NCMRR-DC Core Molecular and Functional Outcome Measures<br />
in Rehabilitation Medicine.<br />
1216 Board #161 May 30, 9:00 AM - 10:30 AM<br />
Exercise Increases Insulin sensitivity related To Obesity By<br />
reducing The Pro-Inflammatory Biomarkers In rat skeletal<br />
Muscle<br />
Leandro P. Moura1 , Luciana S. Pauli2 , Eduardo R. Ropelle2 ,<br />
Dennys E. Cintra2 , Rodolfo Marinho1 , Eliete Luciano1 , Maria<br />
Alice R. Mello1 , José Rodrigo Pauli2 . 1UNESP, São Paulo State<br />
University, Rio Claro, Brazil. 2Campinas University State,<br />
Limeira, Brazil.<br />
(No relationships reported)<br />
INTrOduCTION: Among non-pharmacological therapies for the treatment of<br />
Diabetes Mellitus stands out the regular practice of physical exercises.<br />
PurPOsE: The present study investigated the effects of physical exercise on proinflammatory<br />
proteins and insulin signaling in skeletal muscle of obese rats.<br />
METhOds: In order to analyze the effects of administration of high fat diet, young<br />
Wistar rats (1 month old) were divided into 3 groups: control (C) rats treated with<br />
standard chow and Sedentary (SO) and Trained Obese (TO) were fed with high<br />
fat diet during 8 weeks. The TO group was submitted to two sessions of 1 hour of<br />
swimming exercise with 30 min interval between them. The body weight, epididymal<br />
fat, insulin sensitivity (Kitt), glucose and insulin were measured. In skeletal muscle<br />
(gastrocnemius) the activity of the insulin signaling pathway such as analysis of<br />
insulin receptor (IR), insulin receptor substrate 1 (IRS-1) and protein kinase B (Akt)<br />
were analyzed. It was also analyzed in the gastrocnemius muscle expression of<br />
proinflammatory proteins such as Jun N-terminal kinase (JNK), IKappa kinase beta<br />
(IKKβ) and Toll Like Receptor (TLR-4).<br />
rEsuLTs: The results show that acute exercise did not alter the body weight of<br />
this animals, but was effective in decreasing the inflammatory process in obesity and<br />
improve insulin sensitivity by improving the activity of key proteins of the signaling<br />
cascade via this hormone.<br />
CONCLusION: It is concluded that acute exercise can reduce the inflammation<br />
induced by obesity regardless of body mass reduction.<br />
1217 Board #162 May 30, 9:00 AM - 10:30 AM<br />
acute Normobaric hypoxia Blunts The Blood Glucose Peak<br />
after a high-glycemic Meal In humans<br />
Gommaar D’Hulst, Ruud Van Thienen, Peter Hespel, Louise<br />
Deldicque. KU Leuven, Leuven, Belgium.<br />
(No relationships reported)<br />
In muscle cells glucose transport is regulated by insulin and by stimuli that increase the<br />
demand for glucose such as contraction and hypoxia. Those latter stimuli are known to<br />
induce the translocation of GLUT4 vesicles from the cytoplasm to the cell membrane<br />
via, amongst others, the activation of PKB and/or AMPK. Unlike for insulin and<br />
contraction, much less is known about how hypoxia regulates glucose metabolism and<br />
induces GLUT4 translocation in human skeletal muscle.<br />
PurPOsE: To investigate the molecular mechanisms by which hypoxia regulates<br />
glucose transport in human skeletal muscle.<br />
METhOds: According to a randomized cross-over study, 15 healthy men<br />
participated in 2 experimental sessions separated by a 4-week wash-out period. After<br />
a standardized, high glycemic breakfast (65% carbohydrate, 29% fat and 6% protein,<br />
glycemic load: 56g), subjects were subjected in random order to either 4 hours of<br />
normoxia (NOR) or severe hypoxia (11% O2, HYP). Biopsies were taken at the start<br />
(T0), after 1h (T60) and at the end of the trial (T240). Arterial blood saturation (SpO2)<br />
was measured by pulsoximetry. Phosphorylation status and mRNA level of various<br />
molecular regulators involved in glucose metabolism were measured by Western Blot<br />
and qPCR, respectively.<br />
rEsuLTs: Mean SpO2 dropped from 99.0 ± 0.2% in NOR to 75.0 ± 2.0% in HYP.<br />
Blood glucose peaked ~60min after termination of breakfast in both NOR and HYP,<br />
but the peak was more pronounced in NOR (after 30min: NOR, 113.8 ± 5.4 mg.dl-1<br />
vs. HYP, 102.2 ± 4.7 mg.dl-1, p < 0.10; after 60 min: NOR, 113.8 ± 5.4 vs. HYP, 89.5<br />
± 4.7 mg.dl-1, p < 0.05; after 90 min; NOR, 97.2 ± 3.7 vs. HYP, 85.6 ± 4.8 mg.dl-1,<br />
p < 0.05). There were no differences between conditions in plasma insulin at T0 and<br />
T60. In contrast, at T240, when blood glucose had returned to baseline levels, plasma<br />
insulin was ~2-fold higher in HYP compared to NOR (p < 0.05). Phospho-PKB<br />
(Ser473) followed the insulin pattern almost completely, with no differences between<br />
MEDICINE & SCIENCE IN SPORTS & EXERCISE ®<br />
conditions at T0 and T60, and a ~2-fold higher phosphorylation in HYP at T240 (p <<br />
0.05). Phospho-AMPK (Thr172) and HIF-1α at protein or mRNA level did not differ<br />
between conditions or with time.<br />
CONCLusIONs: Acute systemic hypoxia rapidly blunts the peak in blood glucose<br />
after a high glycemic meal independently of plasma insulin concentrations and PKB<br />
and AMPK phosphorylation.<br />
1218 Board #163 May 30, 9:00 AM - 10:30 AM<br />
autophagy In Muscle Of Mice during Exercise In a Fasted<br />
Or In a Fed state<br />
Marc Francaux, Damien Naslain, Hélène Gilson, Cécile Jamart.<br />
Université catholique de Louvain, Louvain-la-Neuve, Belgium.<br />
(No relationships reported)<br />
PurPOsE: Recent findings suggest that activation of autophagy in skeletal muscle is<br />
essential for inducing beneficial effects of exercise in mice fed with a high fat diet (He<br />
et al. Nature 481 :511-5, 2012). As autophagy is also activated by food deprivation and<br />
as exercising in a fasted state is a common practice in endurance athletes, we designed<br />
a study the purpose of which was investigating various markers of autophagy in<br />
skeletal muscle of mice running in a fasted or fed state.<br />
METhOds: Thirty-six C57BL6/R3 female mice, 12 weeks old, were divided into<br />
4 groups. Eight animals were fed ad-libitum (NE-Fed) and 8 others were kept fasted<br />
(NE-Fasted) for 9h30 before being anesthetized and then sacrificed. The 16 other<br />
mice were submitted to an exercise of 1H30 on a treadmill at a speed of 10m/min,<br />
which corresponds to moderate intensity exercise for those mice. Half of the mice<br />
performed the exercise in a fasted state (Ex-Fasted) and the other half was fed ad<br />
libitum (Ex-Fed). Mice were anesthetized immediately after exercise completion and<br />
the gastrocnemius muscles were removed. Soluble proteins were extracted for Western<br />
blotting analyses. Plasma insulin concentration was assayed by ELISA. An ANOVA<br />
design was used to assess the statistical significance of the differences between the<br />
means. When appropriate, a Bonferroni test was applied as a post-hoc.<br />
rEsuLTs: As expected, fasting and exercise lowered plasma insulin concentration,<br />
which was the lowest in Ex-Fasted. The highest values of LC3b-II, ATG12 and<br />
GABARAP-I and the lowest value of p62 were observed in Ex-Fasted indicating<br />
that autophagy is more activated in this condition than in Ex-Fed and in NE-Fasted.<br />
The phosphorylation state of Ulk-1 (ser757) that controls the initiation of autophagy<br />
was also more decreased in EX-Fasted in comparison with the other conditions.<br />
Ulk-1 is controlled by mTORC1 whose activity was decreased as assessed by the<br />
phosphorylation state of two downstream targets (S6K1 and 4EBP1). mTORC1 is<br />
under the control of both AMPK and PKB. AMPK was unaffected in all conditions<br />
whereas PKB followed the changes observed in plasma insulin concentrations.<br />
CONCLusION: Exercising in a fasted state is an efficient strategy to activate<br />
autophagy in mice. This activation seems related to the decrease in plasma insulin<br />
concentration.<br />
1219 Board #164 May 30, 9:00 AM - 10:30 AM<br />
Cachectic skeletal Muscle response To a Novel Bout Of Low<br />
Frequency stimulation<br />
Melissa Puppa, James Carson, FACSM. University of South<br />
Carolina, Columbia, SC.<br />
(No relationships reported)<br />
Cachexia is a condition of skeletal muscle wasting associated with an underlying<br />
disease. It is commonly associated with a loss in muscle function. While we have<br />
demonstrated exercise training benefits related to cachexia-induced muscle and body<br />
weight loss, the cachectic muscle’s response to an acute bout of exercise is unknown.<br />
PurPOsE: The purpose of this study was to determine if cachectic mice are able to<br />
respond to an acute bout of low frequency muscle stimulation (LoFS).<br />
METhOds: Cachectic ApcMin/+ (Min) and wild type (WT) mice had the left leg<br />
undergo a simulated endurance exercise bout, while the right leg served as the intraanimal<br />
control. The siatic nerve was stimulated for one second at 10Hz every other<br />
second for thirty minutes. Mice were sacrificed 3h after completion of the protocol.<br />
rEsuLTs: Min mice exhibited a 13.8±2.9% decrease in body weight from peak<br />
weight and gastrocnemius muscle mass was significantly reduced compared to WT<br />
mice (p
Official Journal of the American College of Sports Medicine<br />
C-35 Free Communication/Poster - Pain, RPE and<br />
Fatigue<br />
May 30, 2013, 7:30 AM - 12:30 PM<br />
Room: Hall C<br />
1220 Board #165 May 30, 9:00 AM - 10:30 AM<br />
The Effect of submaximal Isometric Exercise to Fatigue on<br />
Pressure Pain Threshold in the Finger<br />
Alexander R. Gonglach, Brandon K. Tynes, Dwight E. Waddell,<br />
Mark Loftin, FACSM, Christopher D. Black. University of<br />
Mississippi, University, MS.<br />
(No relationships reported)<br />
Exercise reduces pressure pain thresholds (PPT) in muscles, especially those<br />
activated during the exercise bout. The effect(s) in non-contracting tissue are less well<br />
characterized and limited due to methodological considerations.<br />
PurPOsE: The purpose of this study was to examine the effects of isometric exercise<br />
to fatigue with the knee extensors on PPT in the finger.<br />
METhOds: Data were collected on 25 males (age: 19-29 yrs). Testing consisted<br />
of participants holding 25% of maximal voluntary contraction (MVC) with the knee<br />
extensor muscles until fatigue. Fatigue was defined as a force declining >10% below<br />
the target force. PPT was assessed before, 2-minutes and 15-minutes following<br />
exercise in the middle finger on the right hand using a pressure algometer. Applied<br />
force was progressively increased until participants indicated the stimulus moved from<br />
being “uncomfortable” to “faintly painful.”<br />
rEsuLTs: Prior to exercise PPT was 5.5±2.6 kg/cm^2. Following exercise, PPT<br />
showed a trend toward an increase (p=0.087) with values increasing to 6.2±2.4 and<br />
5.8±2.5 kg/cm^2 at 2-minutes 15-minutes post-exercise, respectively.<br />
CONCLusIONs: The results of the present study indicated fatiguing isometric<br />
exercise with the knee extensors did not alter pressure pain threshold in the finger 2<br />
minutes and 15 minutes post-exercise. Indicating exercise restricted to a single muscle<br />
group may not significantly alter central pain processing in a manner sufficient to alter<br />
pain sensitivity in a more distant tissue.<br />
1221 Board #166 May 30, 9:00 AM - 10:30 AM<br />
a randomized, Controlled, Crossover study Investigating<br />
the repeated Bout Effect of Eccentric Exercise<br />
Mahdi Hosseinzadeh, Ole K. Andersen, Lars Arendt-Nielsen,<br />
Pascal Madeleine. Aalborg University, Aalborg, Denmark.<br />
(Sponsor: Jonathan Myers, FACSM)<br />
(No relationships reported)<br />
Pain experienced after unaccustomed eccentric exercise induces delayed onset muscle<br />
soreness (DOMS). However, eccentric exercise training (ECC) is suggested to have a<br />
protective effect on subsequent bouts of ECC, known as repeated bout effect (RBE).<br />
PurPOsE: This randomized controlled crossover study tested the protective effect of<br />
repeated bouts of ECC using both subjective and objective pain assessment methods.<br />
METhOds: 16 healthy students (age 25.7 ± 0.6 years, BMI 24.8 ± 1kg.m-2)<br />
participated in the study. Two identical bouts of high intensity eccentric exercises<br />
(ECC1 and ECC2) on tibialis anterior (TA) muscle were performed 7 days apart.<br />
Control sessions were performed 4 weeks apart from the exercise sessions in a<br />
randomized and balanced design. Pressure pain thresholds (PPTs) as a subjective<br />
outcome, and the nociceptive withdrawal reflex threshold (NWRT) as an<br />
electrophysiological outcome, were recorded before, immediately after, and the day<br />
after both exercises.<br />
rEsuLTs: Deep tissue sensitivity measured by PPT decreased significantly at two TA<br />
muscle belly sites by 59% and 66% the day after ECC1 compared to baseline (P
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S234 Vol. 45 No. 5 Supplement<br />
RPE despite contraction mode (ECC or CON). Validation of the relation between<br />
RPE and muscle activation was further supported. Results suggest ECC loads ranging<br />
from 30-70% of 1-RM are altered by time under tension. This preliminary evidence<br />
reveals how time under tension impacts effort during ECC loads for the knee extension<br />
exercise.<br />
1224 Board #169 May 30, 9:00 AM - 10:30 AM<br />
relationship Between student and Observer rPE during<br />
Fitness activities in a Physical Education setting<br />
Kristen M. Lagally, FACSM, Kim Walker-Smith, Deborah A.<br />
Garrahy, Skip M. Williams, Mary L. Henninger. Illinois State<br />
University, Normal, IL.<br />
(No relationships reported)<br />
PurPOsE: The purpose of this investigation was to examine the relationship between<br />
ratings of perceived exertion (RPE) reported by students and RPE estimated by a<br />
trained observer during physical education class.<br />
METhOds: As part of the fitness unit of physical education class, students in grades<br />
six through eight (N=78; Mean age = 12.3+.88 years) performed cardiovascular and<br />
muscular endurance exercises in a circuit format. Each exercise lasted between two<br />
and three minutes. Heart rate from a Polar monitor, and both overall body (RPE-O) and<br />
active muscle RPE (RPE-AM) from mode-specific OMNI-Child scales were recorded<br />
by the students. An observer trained in physical education separately estimated overall<br />
body and active muscle RPE of students using an exertional observation technique. All<br />
measures were recorded at the end of the exercise bout.<br />
rEsuLTs: Relationships were examined using bivariate correlation coefficients.<br />
For the cardiovascular exercise, correlations between observer and student ratings<br />
were r=0.47 (p
Official Journal of the American College of Sports Medicine<br />
However, exercise has been shown to increase pain sensitivity in clinical pain<br />
populations.<br />
PurPOsE: Delayed-onset muscle soreness (DOMS) approximates clinical pain; thus<br />
the purpose of this study was to examine the effects of fatiguing isometric exercise on<br />
PPT in the presence and absence of DOMS.<br />
METhOds: Data were collected on 23 males (age: 19-29yrs). Following<br />
familiarization, baseline testing (no DOMS) was performed. Eccentric exercise was<br />
then performed to induce DOMS, and all tests were repeated 48-hours later when<br />
DOMS was present. Participants held 25% of maximum voluntary contraction (MVC)<br />
until fatigue, defined as force declining >10% below the target force. PPT was assessed<br />
in the left and right rectus femoris at the mid-point between the patella and ASIS prior<br />
to, every 30 seconds during, and 2 and 15-minutes post exercise.<br />
rEsuLTs: No condition x time interactions were found for either the ipsilateral<br />
(p=0.81) or contralateral (p=0.61) thigh nor was a main effect for condition found<br />
(p=0.65). A main effect for time was found with PPT being elevated during (p≤0.001)<br />
and after exercise in the ipsilateal thigh (p≤0.039), but only during exercise in the<br />
contralateral thigh (p≤0.002).<br />
CONCLusIONs: Unlike clinical pain, DOMS had no effect on the PPT response<br />
exercise in either the ipsilateral or contralateral thigh. Increases in PPT during exercise<br />
in both thighs suggests a centralized alteration in pain sensitivity. The restriction of<br />
post-exercise effects to the contracting thigh suggests a localized mechanism due to<br />
contraction may be at play.<br />
1229 Board #174 May 30, 9:00 AM - 10:30 AM<br />
Work distribution Influences session rPE during resistance<br />
Exercise<br />
Justin A. Kraft1 , James M. Green, FACSM2 , Tyler M. Gast1 .<br />
1 2 Missouri Western State University, St. Joseph, MO. University<br />
of North Alabama, Florence, AL.<br />
(No relationships reported)<br />
Previous research has indicated that session ratings of perceived exertion (RPE) are<br />
sensitive to changes in both total work volume and work rate (total work/unit time)<br />
during resistance training.<br />
PurPOsE: This study examined the influence of work distribution (varied load, set,<br />
and repetitions (reps)) on session RPE in two resistance exercise trials matched for<br />
total work volume and work rate.<br />
METhOds: Participants were tested for their one repetition maximum (1RM) on the<br />
bench press, lat pull down, overhead press, upright row, triceps extension, and biceps<br />
curl. Participants then completed a low load/high rep (LLHR) trial (2 sets x 12 reps x<br />
3 min recovery at ~60% 1RM) and a high load/low rep (HLLR) trial (3 sets x 6 reps x<br />
1.5 min recovery at ~80% 1RM) of each exercise that differentiated work distribution<br />
but equated work volume and rate. One warm-up set of 12 reps at ~40% 1RM was<br />
completed prior to the bench press. A standard 2 min recovery separated each exercise<br />
in both trials. Session RPE and recovery heart rate (HR) were recorded 20 min after<br />
exercise. Differences were considered significant at the p ≤ 0.05 level.<br />
rEsuLTs: Pre-set RPE and post-set RPE were significantly lower for LLHR vs.<br />
HLLR (2.1 ± 1.4 vs. 3.0 ± 1.9) and (4.6 ± 0.8 vs. 5.8 ± 1.0) respectively despite<br />
matched total volume and work rate. Pre-set HR (96 ± 11 bpm vs. 105 ± 16 bpm) and<br />
post-set HR (128 ± 12 bpm vs. 137 ± 16 bpm) were significantly higher for HLLR<br />
when compared to LLHR. Session RPE results indicated the LLHR trial was perceived<br />
as significantly easier (4.5 ± 1.3) vs. the HLLR (5.8 ± 1.6) trial. No difference in<br />
recovery HR (20 min post) was observed between trials (86 ± 8 bpm (LLHR) vs. 85 ±<br />
11 bpm (HLLR)).<br />
CONCLusIONs: Session RPE was sensitive to changes in work distribution and<br />
increased with increased load even when total volume and work rate were matched.<br />
Significantly higher pre-set RPE and pre-set HR in HLLR may indicate differences in<br />
recovery between sets. Significantly higher post-set RPE and post-set HR in HLLR<br />
indicated increased difficulty of individual sets in the HLLR trial. Differences in<br />
recovery and individual set difficulty likely contributed to session RPE differences.<br />
Differences in session RPE despite no difference in recovery HR indicate that session<br />
RPE is sensitive to variation in work distribution but is estimated independently of<br />
recovery HR.<br />
1230 Board #175 May 30, 9:00 AM - 10:30 AM<br />
do division III Cross Country runners Experience the<br />
Intended Coach Prescribed Training Impulse (TrIMP)?<br />
Mitchell A. Hagen1 , Colleen E. Bouchard2 , Jacquie M.<br />
Donohue2 , Mary C. Stenson3 , Don V. Fischer3 . 1Saint John’s<br />
University, Collegeville, MN. 2College of Saint Benedict, Saint<br />
Joseph, MN. 3College of Saint Benedict /Saint John’s University,<br />
Saint Joseph and Collegeville, MN.<br />
(No relationships reported)<br />
Cross country coaches create training plans to induce desired adaptations. However,<br />
research suggests athletes do not consistently train as the coach prescribed.<br />
PurPOsE: To examine the relationship between coach intended, athlete-perceived,<br />
and physiological training impulses (TRIMPs) during recovery, slow long distance,<br />
Vol. 45 No. 5 Supplement S235<br />
tempo, and interval training performed by 14 Division III female cross country<br />
runners.<br />
METhOds: A TRIMP weighting scale and an associated rate perceived exertion<br />
(RPE) scale were created for each athlete based on the individual’s blood lactate<br />
curve. Heart rate data were collected using Polar Team System heart rate (HR)<br />
monitors during a two week in-season period; athletes were blinded to the HR data.<br />
Physiological TRIMPs were calculated by multiplying time spent in each HR zone by<br />
the assigned weighting factor. Coach intended TRIMPs for each practice session were<br />
calculated by multiplying the time spent training by the weighting factor associated<br />
with the prescribed session RPE. . The athlete perceived TRIMPs for each practice<br />
session were calculated by multiplying the time spent training by the weighting factor<br />
associated with the athlete-perceived session RPE.<br />
rEsuLTs: One-way ANOVA revealed significant differences between the coach<br />
intended, athlete-perceived, and physiological mean TRIMPs for recovery [(F (2,204)<br />
= 3.359, p < .05], tempo [(F (2, 75) = 19.034; p < .001)], and interval [(F (2, 55) =<br />
4.161, p .05)]. Least Significant Difference post-hoc testing revealed a significant difference<br />
(p < .05) in the mean coach intended (52.52 ± 29.73) and physiological (65.80 ± 32.50)<br />
TRIMPs during recovery training. Post-hoc testing also revealed significant differences<br />
(p < .001) in the mean coach intended and athlete perceived TRIMPS during tempo (C:<br />
109.87 ± 26.54; A: 62.77 ± 30.37) and interval training (C: 72.17 ± 38.16; A: 41.93 ±<br />
26.21).<br />
CONCLusION: During recovery sessions, participants ran at intensities greater than<br />
that prescribed by the coach. During tempo and interval training, athletes ran at the<br />
coach indicated intensity, but perceived themselves to be training at a lower intensity.<br />
Closer monitoring of training intensity may be needed to ensure the appropriate<br />
training stimulus is achieved.<br />
1231 Board #176 May 30, 9:00 AM - 10:30 AM<br />
Effect of the Exercise setting on Body Consciousness, Body<br />
satisfaction and social Physique anxiety in Females<br />
Isaura Castillo-Hernández 1 , Vanessa Smith-Castro 2 , Walter<br />
Salazar-Rojas 1 , José Moncada-Jiménez 3 . 1 University of Costa<br />
Rica, San José, Costa Rica. 2 Psychological Research Institute<br />
(IIP), UCR, San José, Costa Rica. 3 Human Movement Sciences<br />
Laboratory (LACIMOV), UCR, San José, Costa Rica.<br />
(No relationships reported)<br />
The beneficial effects of exercise programs are widely recognized; however, the use of<br />
mirrors in the exercise setting might counteract the positive acute and chronic effects<br />
of resistance training programs.<br />
PurPOsE: To examine the acute and chronic effects of a resistance training program<br />
performed with and without mirrors on the social physique anxiety (SPA), objectified<br />
body consciousness (OBC; body surveillance [BS], body shame [BSH] and appearance<br />
control beliefs [ACB]), body segment satisfaction (BSS), and body image satisfaction<br />
(BIS; actual figure [AF] and desired figure [DF]) of sedentary females.<br />
METhOds: Volunteers were 52 females (Mean age = 22.6 ± 5.15 yrs.) randomly<br />
allocated in four experimental groups: a) 25-min resistance training exercise in front of<br />
a mirror at 70% 1RM; b) 25-min resistance training exercise at 70% 1RM, no mirror;<br />
c) 25-min passive table games in front of a mirror; and d) 25-min passive table games,<br />
no mirror. Participants performed one session per week in their respective experimental<br />
condition for six weeks and filled the Social Physique Anxiety Scale, the Objectified<br />
Body Consciousness Scale, the Multidimensional Body Self Relations Questionnaire<br />
(Body Segment Satisfaction subscale) and the Contour Drawing Rating Scale, at the<br />
beginning (pre-test) and at the end of the program (post-test). BIS was computed as the<br />
difference between the AF minus the DF scores.<br />
rEsuLTs: Three-way analysis of variance revealed a significant main effect (p =<br />
0.027) in the acute AF between females performing exercise (M = 6.15 ± 0.38) and<br />
those performing table games (M = 4.92 ± 0.39). Significant main effects were found<br />
for chronic exercise on BS (Pre-test = 4.54 ± 0.21 vs. Post-test = 4.26 ± 0.19; p =<br />
0.360), experimental paradigm on AF (Exercise = 6.12 ± 0.36 vs. Table games = 4.98<br />
± 0.37; p = 0.032), measurement time on the DF (Pre-test = 4.34 ± 0.16 vs. Post-test =<br />
4.68 ± 0.17; p = 0.36) and measurement time on BIS (Pre-test = 1.15 ± 0.22 vs. Posttest<br />
= 0.93 ± 0.19; p = 0.046). No significant interactions or main effects were obtained<br />
for the acute or chronic effects on SPA, BSH, ACB, BSS, and SPC.<br />
CONCLusIONs: No acute or chronic effect of a resistance training program<br />
performed with or without mirrors was observed on body consciousness, body<br />
satisfaction and social physique anxiety in sedentary females.<br />
1232 Board #177 May 30, 9:00 AM - 10:30 AM<br />
The rating of Fatigue scale (rOF)<br />
Abdulaziz Al Salman 1 , Alan St Clair Gibson 2 , Dominic<br />
Micklewright 1 . 1 University of Essex, Colchester, United<br />
Kingdom. 2 Northumbria University, Newcastle, United Kingdom.<br />
(No relationships reported)<br />
PurPOsE: Perceived exertion scales represent how ‘hard’ an exercise feels but not<br />
how ‘fatigued’ an athlete feels. Measuring perceived fatigue may be advantageous in<br />
<strong>Abstracts</strong> were prepared by the authors and printed as submitted.<br />
<strong>Thursday</strong>, May 30, 2013
<strong>Thursday</strong>, May 30, 2013<br />
S236 Vol. 45 No. 5 Supplement<br />
monitoring overtraining, tiredness in the build up to a race, between bouts of exercise<br />
or during recovery. These studies developed a rating of fatigue scale (ROF)<br />
METhOds: A 0-11 scale, 12 adjectives and 12 pictures were presented independently<br />
to 18 participants at 100 s intervals during a graded cycling test to exhaustion and 30<br />
minutes during recovery. Blood lactate (BLc), oxygen uptake (VO2), heart rate reserve<br />
(HRR) and RPE were also measured. The five adjectives and pictures used to construct<br />
the ROF were the modal ones given by participants at the numeric points of 0, 2/3,<br />
5, 7/8 and 10. ROF scores were correlated with various physiological measurements,<br />
RPE and time to exhaustion to ascertain validity. Various ratings of ROF face validity<br />
were taken from 95 participants, using a scale of 0 (low) to 4 (high).<br />
rEsuLTs: The ROF scale, established through modal responses, is presented in<br />
Figure 1. A strong association was found between ROF and RPE (r-mean= 0.992,<br />
P
Official Journal of the American College of Sports Medicine<br />
1236 Board #181 May 30, 9:00 AM - 10:30 AM<br />
Intensity Thresholds For aerobic Exercise-induced<br />
hypoalgesia To Pressure, Prolonged Thermal, and Temporal<br />
summation Pain responses<br />
Kelly M. Naugle, Keith E. Naugle, Brian Samuels, Joseph L.<br />
Riley, 3rd. University of Florida, Gainesville, FL.<br />
(No relationships reported)<br />
Despite many studies investigating exercise-induced hypoalgesia, there is limited<br />
understanding of the optimal intensity of aerobic exercise in producing these effects<br />
across different types of pain stimuli. Given that not all individuals are willing or<br />
capable of engaging in high intensity aerobic exercise, whether moderate intensity<br />
aerobic exercise is associated with a hypoalgesic response and whether this response<br />
generalizes to multiple pain induction techniques needs to be substantiated.<br />
PurPOsE: To test for differences in the magnitude of pressure and thermal pain<br />
modulation induced by moderate (MAE) and vigorous (VAE) intensity aerobic exercise.<br />
METhOds: Eleven healthy males (age=24±5 yrs) and 11 females (age=20 ±1 yrs)<br />
completed one training session and three testing sessions consisting of 25 minutes<br />
of either 1) stationary cycling at 70% heart rate reserve (HRR), 2) stationary cycling<br />
at 50% HRR (MAE), or 3) quiet rest (control). Pain testing was conducted on both<br />
forearms prior to and immediately following each condition and included the following<br />
tests: pressure pain threshold (PPT) and suprathresholds (PPS), 30 s prolonged heat<br />
stimulus, and temporal summation (TS) of late pain responses to thermal stimuli (i.e.,<br />
increased pain evoked by repetitive stimuli at a constant intensity). Subjects rated<br />
pain using a 0-100 visual analogue scale. A Sex × Forearm × Time ANOVA with<br />
repeated measures on Forearm and Time was conducted on each pain measure for each<br />
condition.<br />
rEsuLTs: No significant results were found for the control condition. PPT’s were<br />
increased following MAE (pre=2.96kg±.98, post=3.17kg ±1.14; p
<strong>Thursday</strong>, May 30, 2013<br />
S238 Vol. 45 No. 5 Supplement<br />
(Compared to Weekday)< 0.05
Official Journal of the American College of Sports Medicine<br />
of 2% when averaged out across the two experimental conditions. The use of music,<br />
regardless of its motivational qualities, resulted in higher self-reported motivation as<br />
well as more dissociative thoughts.<br />
1244 Board #189 May 30, 9:00 AM - 10:30 AM<br />
Treatment of shoulder Impingement syndrome Pain<br />
Richard Radnovich1 , Arnold Gammaitoni2 , Jeremiah Trudeau3 ,<br />
Thomas Marriott4 . 1Injury Care Medical Center, Boise, ID. 2Nuvo Research, West Chester, PA. 3Analgesic Solutions, Natick, MA.<br />
4Nuvo Research, Salt Lake City, UT.<br />
Supported by r. radnovich: Consulting Fee; Nuvo Research. Contracted<br />
Research - Including Principle Investigator; Nuvo Research.<br />
Patients treated twice daily for 14 days with the heated lidocaine/tetracaine patch<br />
(“HLT patch”) for acute musculoskeletal pain associated with shoulder impingement<br />
syndrome (SIS) demonstrated clinically important decreases in pain and functional<br />
improvement in an open-label pilot study.<br />
PurPOsE: To compare the efficacy of the HLT patch with a single corticosteroid<br />
injection in the treatment of SIS pain in a 6-week, open-label study.<br />
METhOds: Patients with SIS of ≥14 days duration with an average pain score of ≥4<br />
(0 to 10 scale) were enrolled in the study and randomized to treatment with a single<br />
HLT patch twice daily for 14 days or to a single subacromial corticosteroid injection.<br />
After 2 weeks, patients in the HLT patch group could continue with treatment on<br />
an as-needed basis for an additional 2 weeks. After 4 weeks no additional treatment<br />
was allowed. At baseline and at 2, 4, and 6 weeks patients rated their pain and pain<br />
interference with specific activities (0 to 10 scale).<br />
rEsuLTs: Sixty patients enrolled in the study (average age=51, range 18 to 75, n=21<br />
female). Patients in the HLT patch group averaged 1 patch/day during the 2 weeks of<br />
as-needed treatment. Average pain scores at baseline were similar in the HLT patch<br />
(6.0, n=29) and injection (5.6, n=31) groups. Twenty-three patients in each group<br />
completed the study. Both per-protocol groups demonstrated a significant (P
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S240 Vol. 45 No. 5 Supplement<br />
in TUG (6%; P=0.01), stride length (3%; P=0.008), single limb support time (1.3%;<br />
P=0.006), balance confidence (5.2%; P
Official Journal of the American College of Sports Medicine<br />
rEsuLTs: Both groups significantly improved between each pre/post trial. The<br />
children improved 0.7007 seconds (p=.00188) and the adults improved .9632 seconds<br />
(p=.00365).<br />
CONCLusIONs: Results show that subjects in this investigation saw positive effects<br />
from physical stimulation on the receptors of the feet. This study suggests that those<br />
experiencing balance deficiencies, such as the elderly population, may benefit from<br />
daily brushings of the feet.<br />
1251 Board #197 May 30, 9:00 AM - 10:30 AM<br />
Concurrent Validity Of Two Postural stability Tests In a<br />
healthy Population<br />
A. Page Glave1 , Jennifer J. Didier1 , Jacqueline Weatherwax1 ,<br />
Casidhe Leonard1 , Sarah Barragan1 , Robert Fiasco1 , Vanessa<br />
Fiaud2 . 1Sam Houston State University, Huntsville, TX. 2West Texas A & M University, Canyon, TX.<br />
(No relationships reported)<br />
The Biodex Balance System Limits of Stability Test (LOS) and Star Excursion Balance<br />
Test (SEBT) are described as measuring dynamic aspects of balance. Practitioners<br />
tend to base test choice on their assessment of face validity in relation to the desired<br />
outcome. This is commonplace with psychomotor testing, but it is important to<br />
establish concurrent validity to ensure the same construct is being assessed.<br />
PurPOsE: To examine concurrent validity of LOS and SEBT.<br />
METhOds: Healthy adult participants (n = 31) were randomly assigned to different<br />
testing orders to randomize the order of tests within the LOS and SEBT tests. LOS<br />
was tested under more stable (12) and less stable (6) conditions using the moderate<br />
setting. SEBT was tested on the right and left legs. Following practice, three trials<br />
were obtained on both tests. LOS scores were averaged using the system protocol,<br />
which does not control for height in dynamic tests. Outliers were eliminated for SEBT<br />
scores and scores were averaged. SEBT directions were offset by 180o to approximate<br />
similar movement patterns to LOS direction. The ipsilateral leg score was used for<br />
the diagonal and frontal directions; bilateral scores were combined for the anterior<br />
and posterior directions on the SEBT. Subjects’ height affects balance, thus partial<br />
correlations were used to examine the relationship between SEBT and LOS while<br />
controlling for height. SAS 9.2 was used to analyze the data.<br />
rEsuLTs: Height was directly related to all directions for SEBT (r = 0.53 – 0.59, p<br />
< .01) and inversely related to some directions for LOS (6: right – r = -0.41, back – r<br />
= -0.41, back left – r = -0.36; 12: front – r = -0.39, back left – r = -0.53; all p ≤ .05).<br />
There were no significant partial correlations between SEBT and LOS scores. Partial<br />
correlations were negative for all directions between SEBT and LOS except for 270o<br />
and right at a platform setting of 12 on the LOS (rSEBT, LOS. H = 0.09, p = .71).<br />
CONCLusIONs: It appears the SEBT and LOS assess different balance constructs,<br />
though both involve dynamic balance. Using these tests could identify different<br />
balance deficiencies and/or potential injury risks. Additional research is needed to<br />
determine and define what specific constructs of balance are being assessed.<br />
1252 Board #198 May 30, 9:00 AM - 10:30 AM<br />
Effect of Water Immersion and Jet resistance on Postural<br />
sway<br />
Matt Baldwin, Talin Louder, Breanna Studenka, Eadric Bressel.<br />
Utah State University, Logan, UT.<br />
(No relationships reported)<br />
Assessment of postural sway or balance is a common practice in athletic rehabilitation<br />
and special populations. Researchers have postulated that water immersion has an<br />
effect on balance due to buoyancy, in part, but the extent of this effect has not been<br />
determined.<br />
PurPOsE: To quantify the effect of water depth and water jet intensity on measures<br />
of postural sway.<br />
METhOds: Ten healthy participants (female = 5, male = 5: Age = 24.1 ± 3.6 years;<br />
weight = 721.5 ± 222.6 N) volunteered for the study. Postural sway measurements<br />
were collected using a waterproof force plate (20 Hz) as participants stood quietly for<br />
90 s, with eyes open, in a double support stance under the following conditions: Land<br />
and water immersion at the level of the greater trochanter (GT) and xiphoid (XI). At<br />
the xiphoid water depth, participants were also perturbed by underwater jets at three<br />
intensities (20%, 40%, and 60%). The area covered by the trajectory of the center of<br />
pressure was computed as a 95% confidence ellipse which served as the dependent<br />
measure in the study. The effect of water depth and jet intensity on the 95% ellipse was<br />
determined using repeated-measures ANOVA with follow-up comparisons.<br />
rEsuLTs: There was a significant main effect (F = 36.68, p = 0.0001) and followup<br />
comparisons revealed that the 95% ellipse area was greater for GT and XI depths<br />
(6.76 ± 4.31 cm2 and 13.4 ± 5.14 cm2, respectfully) when compared to land (3.13 ±<br />
2.48 cm2). Differences were also observed across jet intensities (20% = 14.81 ± 4.98<br />
cm2, 40% = 32.67 ± 10.55 cm2, 60% = 76.65 ± 24.42 cm2, p = 0.003 - 0.026) except<br />
between the 0%/xiphoid condition and the 20%/xiphoid condition (p = 0.530).<br />
CONCLusION: Water immersion and jet intensity have a significant effect on<br />
balance. Based on the results of this study, balance becomes progressively more<br />
challenging with increasing water depth and jet intensity. However, no significant<br />
change was observed when comparing no jet resistance to 20% jet intensity. Therefore,<br />
Vol. 45 No. 5 Supplement S241<br />
in clinical applications where desired functional outcomes include improvement in<br />
postural stability, water immersion to the XI and jet intensities at or above 40% may be<br />
more effective than land therapies in stimulating postural sway.<br />
1253 Board #199 May 30, 9:00 AM - 10:30 AM<br />
Familiarization Trial Needed When Measuring Postural<br />
sway with a Mobile device<br />
Carina A. Staab, Elizabeth J. Epps, Jeremy A. Patterson,<br />
FACSM. Wichita State University, Wichita, KS.<br />
(No relationships reported)<br />
The latest Smartphone’s have built-in motion sensors called a tri-axis accelerometer.<br />
One of the clinical measures that can take advantage of this technology is balance<br />
assessment. Previous studies assessing balance show the need for familiarization.<br />
PurPOsE: The purpose of this study was to determine if a familiarization test was<br />
needed when using Smartphone devices to measure balance.<br />
METhOds: 49 healthy individuals (18 male, 31 female; 23.1±2.6 years) performed a<br />
bilateral, tandem, and single leg balance tests. A barefoot familiarization was recorded<br />
for the 3 stances, and then follow-up testing was done in barefoot, five-toed shoes, and<br />
athletic shoes. All trials consisted of 10-second measures with eyes closed and were<br />
random in order. A commercially available Smartphone was used to determine postural<br />
sway. One trial was completed for each test with an average of 4-minute rest between<br />
trials.<br />
rEsuLTs: Significant differences were demonstrated between familiarization and<br />
each of the assessments that followed (barefoot p=0.007; five-toed shoes p=0.023;<br />
athletic shoe p=0.028). No differences were observed between barefoot and five-toed<br />
shoes (p=0.576), barefoot and athletic shoes (p=0.521), or five-toed shoes and athletic<br />
shoes (p=0.901).<br />
CONCLusION: Outcomes of this study show that balance data measured with a<br />
mobile device requires a familiarization trial. This is in agreement with previous<br />
publications using laboratory based balance assessment equipment and shows that<br />
familiarization is necessary when assessing balance regardless of equipment used.<br />
This may also suggest good consistency with Smartphone technology but should to be<br />
studied further.<br />
1254 Board #200 May 30, 9:00 AM - 10:30 AM<br />
Influence Of age On Balance Initiation<br />
Karen Roemer 1 , Stephanie Hamilton 2 , Louisa Raisbeck 2 .<br />
1 Central Washington University, Ellensburg, WA. 2 Michigan<br />
Technological University, Houghton, MI.<br />
(No relationships reported)<br />
Single Leg Stance (SLS) is often used as a test in clinical settings to assess balance<br />
disorders and risk of falling in various age groups (Berg, 1989; Jonsson et al., 2004).<br />
Establishing the SLS requires controlled transfer of weight from one base of support<br />
to another, which has been shown to deteriorate with age for various activities such as<br />
gait, unrestricted stance, or sit-to-stand movements (Jonsson et al., 2007; Prado et al.,<br />
2011). Little is known about the age related effects on the early phase of establishing<br />
a SLS.<br />
PurPOsE: This study aims to investigate the effect of age on the early phase of<br />
balance initiation during a SLS.<br />
METhOds: Twenty-three subjects (Y: n=15, Mean + SD; Age= 22.5 + 3.4; Wt= 63.2<br />
+ 10.5 kg; Ht = 168.9 + 9.3 cm; O: Y: n=8, Mean + SD; Age= 67.6 + 4.1; Wt= 63.2 +<br />
13.9 kg; Ht = 162.6 + 10.4 cm) who were considered healthy with no previous injuries<br />
or history of falls performed a SLS on a force plate. Subjects were instructed to stand<br />
behind the force plate and to perform a step onto the force plate to establish SLS<br />
and maintain it for 15 seconds. The first second of SLS (initiation) and the next two<br />
seconds (maintenance) were analyzed. Dependent variables: maximum and average<br />
sway velocity, sway area, semi-major and semi-minor axes of the sway area. Variables<br />
were analyzed for the dominant leg. Leg dominance was determined using the balance<br />
recovery test. One-way ANOVA was used to identify differences between Y and O.<br />
rEsuLTs: O compared to Y showed significantly increased values for average sway<br />
velocity (O: 18.9±7.2cm/s, Y: 13.1 ±3.2cm/s, p=0.015) in the initial phase and in the<br />
maintenance phase for average sway velocity (O: 12.5±4.8cm/s , Y: 6.1 ±2.1cm/s,<br />
p
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S242 Vol. 45 No. 5 Supplement<br />
1255 Board #201 May 30, 9:00 AM - 10:30 AM<br />
Postural Control Variation in the single Leg anterior reach<br />
Maria Talarico, Dustin Grooms, Meghan Miller, Paul Gubanich,<br />
Jennifer Novak, James Borchers, FACSM, James Onate. The<br />
Ohio State University, Columbus, OH.<br />
(No relationships reported)<br />
The single leg anterior reach (SLAR) of the star excursion balance test is often used<br />
to assess dynamic postural control. However, the SLAR has yet to undergo a balance<br />
plate assessment of postural control that may yield information on the movement<br />
coordination strategy utilized during the SLAR.<br />
PurPOsE:To examine the effect of different postural control strategies utilized to<br />
complete SLAR and how variability affects injury risk from future injury data..<br />
METhOds:Prior to the start of the season 31 male professional lacrosse athletes<br />
(26.7±2.87 years, 1.82±0.07 m, and 89.7±11.1 kg) and 15 NCAA Division 1 female<br />
volleyball athletes (19.4±1.15 years, 1.82±0.08 m, and 75.6±7.6 kg) performed balance<br />
plate instrumented SLAR measurements. While maintaining a single-leg stance,<br />
participants maximally reached with the contralateral limb in the anterior direction,<br />
touched the tape measure with the distal part of the foot, and returned to starting<br />
position. The reach distance, normalized to leg length, was measured (cm) from the<br />
starting point to the farthest point on the measurement line the participant was able<br />
to touch. SLAR center of pressure (CoP) excursion was collected during each trial<br />
by a balance plate and was dichotomized into high CoP excursion (greater movement<br />
variability) and low excursion (lower movement variability). Between group t-tests<br />
were performed between high vs. low CoP groups to assess normalized reach distance<br />
between movement strategy with an alpha level set at .05.<br />
rEsuLTs:Reach distance was significantly higher in those with higher CoP<br />
excursion in the lateral plane (Left: 63.2±4.01 cm high excursion (HE), 60±3.35 cm<br />
low excursion (LE), Right: 62.4±5.56 cm HE, 59.40±3.82 cm LE) and no difference<br />
in reach distance for CoP excursion in the sagittal plane (Left: 62.82±4.77 cm HE,<br />
60.96±4.07 cm LE, Right: 61.07±5.55 cm HE, 60.72±4.39 cm LE).<br />
CONCLusIONs:Increased frontal plane movement variability during a sagittal reach<br />
SLAR task resulted in greater reach performance. These findings may have clinical<br />
implications for individuals demonstrating a lack of movement variability in the frontal<br />
plane resulting in lower sagittal plane reach distances. Improvements to frontal plane<br />
movement variability strategies may result in increased dynamic postural control.<br />
1256 Board #202 May 30, 9:00 AM - 10:30 AM<br />
Comparison Of Balance Outcomes Between aquatic<br />
and Land-based Exercises In Older adults With Knee<br />
Osteoarthritis<br />
Gioella Chaparro, Cameron Lievense, Leora Gabay,<br />
Konstantinos Vrongistinos, Shane Stecyk, Taeyou Jung. Cal-<br />
State University Northridge, Northridge, CA.<br />
(No relationships reported)<br />
Balance improvement has been well documented in healthy older adults after<br />
participating in aquatic or land-based exercise programs. Aquatic exercise is frequently<br />
recommended for people with arthritis. While various effects of aquatic exercise have<br />
been studied, limited research has investigated its effects on balance among people<br />
with osteoarthritis (OA).<br />
PurPOsE: To compare balance outcomes between aquatic and land-based exercise<br />
programs in older adults with knee OA.<br />
METhOds: A total of 20 participants (Mean age 74.1 ± 14.2, 17 females, and<br />
3 males) with knee OA were randomly assigned to an aquatic exercise group or a<br />
land exercise group. The aquatic group participants completed a 45-minute Arthritis<br />
Foundation Aquatic Program (AFAP) 3 times a week for 12 weeks while the land<br />
exercise group performed the Arthritis Foundation Land Program (AFLP). Balance<br />
outcomes were measured by using a computerized posturographic balance assessment<br />
equipment (Neurocom Balance Master, NeuroCom International, Clackamas, OR,<br />
2010) and a psychometric balance test, the activities-specific balance confidence<br />
(ABC) scale. The posturographic balance tests were performed pre and postintervention<br />
including the sensory organization test (SOT), motor control test (MCT),<br />
adaptation test (AT), and the limits of stability test (LOS).<br />
rEsuLTs: MANOVA showed no group-interaction in all balance measures except<br />
in the ABC scale in which the land exercise group revealed greater improvement (p<br />
< .05). Within group analyses demonstrated that both groups increased MCT and AT<br />
scores after 12-week intervention (all ps < .05) while no significant changes were<br />
noted in SOT score.<br />
CONCLusION: The findings indicate that both aquatic and land exercise programs<br />
can help older adults with knee OA improve their balance. Our results also suggest that<br />
land-based intervention may be more effective in increasing balance confidence than<br />
aquatic environment in this particular population.<br />
MEDICINE & SCIENCE IN SPORTS & EXERCISE ®<br />
1257 Board #203 May 30, 9:00 AM - 10:30 AM<br />
reliability study of a Wireless accelerometer for the<br />
assessment of Postural Control in Older adults<br />
Nathan W. Saunders 1 , Panagiotis Koutakis 2 , Deborah A.<br />
Kegelmeyer 1 , Anne D. Kloos 1 , Jessica D. Dicke 1 , Richard<br />
A. LaFountain 1 , Steven T. Devor, FACSM 1 . 1 The Ohio State<br />
University, Columbus, OH. 2 University of Nebraska Medical<br />
Center, Omaha, NE.<br />
(No relationships reported)<br />
Studies have shown that a single accelerometer placed on the lower back at L3<br />
(the estimated center of mass) is capable of discriminating between both distinct<br />
populations and clinical conditions. We evaluated the reliability of a new wireless<br />
tri-axial accelerometer that is smaller, less expensive, and more sensitive than those<br />
previously utilized in postural control studies.<br />
PurPOsE: Our specific aim was to assess the test-retest reliability of this<br />
accelerometer for quantifying postural control in healthy older adults. To achieve our<br />
aim, we tested the hypothesis that the trial-to-trial variability would be relatively small<br />
indicated by high intraclass correlation coefficients (ICC), low coefficients of variation<br />
(CV), and absolutely small indicated by small within-subject standard deviations (Sw).<br />
METhOds: Four common testing conditions (eyes 1. open or 2. closed, while on<br />
a 3. firm or 4. compliant surface) were utilized to progressively challenge the static<br />
balance of 20 healthy male (n=8) and female (n=12) older adults (age: 81±4.3 yr).<br />
Subjects completed three 30-second trials per condition with a brief rest between<br />
trials and conditions. The accelerometer was applied to L3 with surgical tape and<br />
positioned to acquire mediolateral (ML) and anterior-posterior (AP) accelerations. The<br />
raw acceleration signal was transformed to correct for pelvic tilt and adjust for low<br />
frequency body sway using custom made Matlab programs, and the root mean square<br />
(RMS) subsequently calculated. Finally, ICC, CV, and Sw were calculated for each<br />
condition and horizontal axis.<br />
rEsuLTs: ICCs were good to high with values ranging from 0.74 for AP RMS for<br />
the mat eyes closed condition to 0.97 for ML RMS for the floor eyes closed condition.<br />
Unlike the ICCs, we observed a broad range of CVs values (15.3 for ML RMS for the<br />
floor eyes closed condition to 54.4 for AP RMS for the mat eyes closed). Finally, Sw<br />
values were consistently very low with values ranging from 0.0017 for ML RMS for<br />
the floor eyes open condition to 0.0134 for AP RMS for the mat eyes closed condition.<br />
CONCLusIONs: Our hypothesis of high relative test-retest reliability was not<br />
consistently supported. However, similar to a previous study of accelerometer<br />
reliability, our accelerometer demonstrated very low absolute variability.<br />
1258 Board #204 May 30, 9:00 AM - 10:30 AM<br />
Limb segment Vibration Modulates Neural Control<br />
strategies during a Postural Task<br />
Colleen L. McHenry, Elizabeth Easker, Kelsey Hake, Katrina J.<br />
Risma, Richard K. Shields. The University of Iowa, Iowa City,<br />
IA.<br />
(No relationships reported)<br />
Mechanical oscillation training reduces postural control disruptions resulting from<br />
age or extended bed rest. However, these whole body vibration interventions activate<br />
vestibular, muscular, and neural systems simultaneously. Accordingly, the local effect<br />
of limb segment vibration on balance control strategies has not been examined. Recent<br />
fMRI studies support that localized metatarsal vibration modulates brain activity that is<br />
associated with postural control.<br />
PurPOsE: We determined the effect of isolated limb segment vibration on center of<br />
pressure (CoP), joint kinematics (KIN), and muscle activity (EMG) during single leg<br />
stance.<br />
METhOds: Thirty-five motion capture markers were placed on 21 subjects to<br />
collect kinematic data of the ankle, knee, and hip during single leg stance with eyes<br />
closed. Postural sway (AP/ML) and soleus/tibialis anterior EMG were measured while<br />
standing on a force plate. Each subject had the non-dominant lower leg assessed before<br />
and after limb segment vibration (0.6g, 30 Hz) for 15 minutes. We used paired t-tests<br />
to determine significant changes in kinematics, EMG, and postural sway (ML/AP).<br />
rEsuLTs: Soleus and tibialis anterior muscle activity increased by 7.9%MVC and<br />
30.1%MVC, respectively (p
Official Journal of the American College of Sports Medicine<br />
1259 Board #205 May 30, 9:00 AM - 10:30 AM<br />
underlying Motor Control of the romberg and Wii Balance<br />
assessments in Concussed athletes<br />
Nicholas G. Murray 1 , Anthony P. Salvatore 1 , Joe Tomaka 1 ,<br />
Arthur Islas 2 , Rebecca J. Reed-Jones 1 . 1 The University of Texas<br />
at El Paso, El Paso, TX. 2 Texas Tech University Health Sciences<br />
Center, El Paso, TX.<br />
(No relationships reported)<br />
Approximately 300,000 sports-related concussion injuries occur yearly in the United<br />
States. Balance disturbances, which occur in approximately 30% of these injuries, are<br />
typically assessed via the Romberg Test. Recently, the NCAA has recommended the<br />
WiiFit as an alternative measure of balance post-concussion However, the reliability<br />
and validity of the Wii, and its relationship to the Romberg test, are unknown.<br />
PurPOsE: This study examined relationships among the WiiFit Balance Test,<br />
the Romberg Test, and composite scores on the ImPACT test in a sample of postconcussed<br />
athletes. Composite scores were included as indicators of the motor<br />
processes underlying the balance tests.<br />
METhOd: 55 post-concussed athletes (40 male) completed the Romberg Test<br />
(-/+), the WiiFit balance test, and ImPACT test. WiiFit balance performance was<br />
operationalized as the number of successfully completed trials (of 5 trials of increasing<br />
difficulty) within 30 seconds. Pearson’s correlations examined univariate associations<br />
among the variables. ROC curves evaluated the sensitivity and specificity of each<br />
balance test against performance on the ImPACT. Lastly, a multiple regression analysis<br />
examined whether the Romberg and Wii tests shared redundant or unique variance<br />
with ImPACT composite score.<br />
rEsuLTs: The Romberg test and Wii balance test were not significantly related (r<br />
= -.029, p = .832). The Romberg correlated positively with ImPACT scores (r = .26,<br />
p = .041), whereas Wii trials did not (r = -.20, p = .155). Romberg scores positively<br />
correlated with ImPACT Visual Processing Speed Score (r = .27, p = .036) and<br />
Reaction Time score (r = .34, p =0.006). In contrast, Wii trials correlated negatively<br />
with the ImPACT Visual Memory Score (r = -.41, p = .003). The Romberg test resulted<br />
in sensitivity = 0.55 and specificity = 0.77, while the Wii had specificity and sensitivity<br />
values of 0.76 and 0.57 respectively. Lastly, a multiple regression analysis suggested<br />
that Wii balance scores accounted for variance in overall ImPACT scores (b= -.37, p <<br />
.05) independently of variance accounted for by Romberg scores.<br />
CONCLusION: The Wii Fit balance game and Romberg assess unique aspects of<br />
balance and motor control. The Romberg test relates directly to single sensory motor<br />
processing, while the Wii balance game related to multi-sensory motor processing.<br />
1260 Board #206 May 30, 9:00 AM - 10:30 AM<br />
Balance and sensibility Impairments In adults diagnosed<br />
With hiv: Effectiveness Of an Exercise Program<br />
Maryvi Gonzalez-sola 1 , Martin Rosario 1 , Angel Rosado 2 , Alexis<br />
Ortiz 3 . 1 University of Puerto Rico, Medical Sciences Campus,<br />
San Juan, Puerto Rico. 2 Polytechnic University of Puerto Rico,<br />
San Juan, Puerto Rico. 3 Texas Woman’s University, School of<br />
Physical Therapy, Texas, TX.<br />
(No relationships reported)<br />
Balance and sensibility impairments are common in adults diagnosed with HIV as a<br />
consequence of infection and from secondary effects of medications.<br />
PurPOsE aNd hyPOThEsIs: To assess the effectiveness of a three-month<br />
exercise program on to balance and sensibility in adults diagnosed with HIV. We<br />
hypothesized participation in a three-month exercise program will improve balance and<br />
foot sensation in individulas diagnosed with HIV.<br />
METhOds: Participants (n = 16) were assessed previous to participating in a<br />
community-based physical fitness exercise program and three months after program<br />
initiation. Balance was measured with a MatScan as the displacement of the<br />
center of pressure in cube centimeters in two conditions; eyes open and eyes closed.<br />
Sensibility was evaluated by Semmes-Weinstein monofilaments. Paired t-tests were<br />
used to compare pre and post balance and sensibility values for both conditions.<br />
rEsuLTs: Balance values with the eyes open improved significantly (p = 0.04) from<br />
baseline (3.78 ± 1.4 cm 2 ) to three months (0.84 ± 0.14 cm 2 ) post exercise participation.<br />
Although, balance with eyes closed improved over time (2.26 ± 0.56 cm 2 to 1.42 ±<br />
0.37 cm 2 ), such improvement was not statistically significant (p = 0.15). Sensibility<br />
values did not change after the intervention.<br />
CONCLusIONs: Participation in a fitness program appears to improve balance<br />
with opened eyes suggesting improvement throughout the visual, vestibular, and<br />
proprioceptive systems without improvements in sensibility scoress.<br />
Vol. 45 No. 5 Supplement S243<br />
1261 Board #207 May 30, 9:00 AM - 10:30 AM<br />
Influence of Cognitive Function on Clinical Balance<br />
assessments in Community-dwelling Elderly<br />
Stephanie A. Bomberger, Bonita L. Marks, FACSM, Abbie E.<br />
Smith-Ryan, Tiffany E. Shubert. University of North Carolina at<br />
Chapel Hill, Chapel Hill, NC.<br />
(No relationships reported)<br />
Deficits to balance, mobility, muscle strength, and cognition are risk factors for<br />
falling. In the clinical setting, performance assessments are commonly used to identify<br />
physical deficits; however cognition is rarely screened or assessed. Identifying balance,<br />
mobility or strength tests associated with cognitive performance may enable clinicians<br />
to better assess the risk factors associated with falling and develop appropriate<br />
interventions.<br />
PurPOsE: To investigate relationships between cognitive function, balance, mobility,<br />
and muscular strength in higher functioning community-dwelling elderly volunteers.<br />
METhOds: This was a cross-sectional study. Age-adjusted multiple regression<br />
models were used to assess relationships between cognitive function (Symbol Digit<br />
Modalities Test, SDMT) and performance assessments of balance (Single-Leg Stance<br />
Test, SLS; Tandem Stance Test, TS; Four Square Step Test, FSST); mobility (gait<br />
velocity per 10-Meter Walk,10MW); and muscular strength (Timed Chair Rise, TCR).<br />
rEsuLTs: Data from 107 older adults (75% female), aged 65-93 years (mean 78.1<br />
± 7.2) were analyzed. All completed 12+ years of school; 82% completed postsecondary<br />
education. Age was a significant in all models, uniquely responsible for<br />
29-30% of the variability in SDMT score (p < 0.01). The FSST (β = -0.289, p < 0.01)<br />
and gait velocity (β = 0.256, p < 0.01) were the only significant predictors for SDMT<br />
performance.<br />
CONCLusIONs: Faster gait velocity (10MW) and faster FSST (dynamic balance)<br />
performance may be predictive of better cognitive function. In a clinical setting, the<br />
FSST and 10MW are reliable and valid assessments of fall risk. These two assessments<br />
may also provide additional insight about cognitive and physical risk factors, without<br />
having to do a formal cognitive assessment. This may aid clinicians in prescribing<br />
balance intervention protocols tailored to cognitive ability that will be efficacious for<br />
reducing fall risk.<br />
1262 Board #208 May 30, 9:00 AM - 10:30 AM<br />
Best Predictors of Impending Loss of Balance in single Leg<br />
stance<br />
KyungMo Han 1 , Mark D. Ricard 2 , KiHong Kim 3 . 1 San Jose State<br />
University, San Jose, CA. 2 The University of Texas at Arlington,<br />
Arlington, TX. 3 Dankook University, Cheonan, Republic of<br />
Korea.<br />
(No relationships reported)<br />
The typical measures of balance from center of pressure variables include radial area, x<br />
& y: amplitude, area, velocity and mean frequency. Single leg stance trials in which the<br />
subjects loose balance are typically discarded. We theorized that the data just prior to<br />
the loss of balance contain valuable information on impending loss of balance.<br />
PurPOsE: To determine which center of pressure variables are significantly different<br />
between stable and unstable (impending loss of balance) in single leg stance.<br />
METhOds: Sixteen (8 females, 8 males) healthy college age subjects (age =<br />
20.8±2.4 yrs, height = 157.5±6.3 cm, mass = 63.3±7.9 kg) were participated in the<br />
study. Each subject completed 8 trials of single leg balance on a force platform.<br />
The force data were sampled for 15 seconds at 60 Hz and low pass filtered with a<br />
10 Hz cutoff. The first trial where the subject lost balance was retained for analysis.<br />
Impending loss of balance was identified by visual inspection of vertical, anteriorposterior,<br />
and medial-lateral force signals. The center of pressure data were separated<br />
into stable and unstable epochs within each loss of balance trial. Total travel distance,<br />
radial area, x & y: amplitude, area, velocity and mean frequency for stable and<br />
unstable phases in single leg stance were compared using dependent t-tests.<br />
rEsuLTs: There were no differences between stable and unstable phases for:<br />
Vx (0.15±0.73 cm/s, −0.14±1.29 cm/s), Vy(−0.03±0.38 cm/s, −1.34±3.00 cm/s), x<br />
Amplitude (0.08±0.02 cm, 0.08±0.07 cm), x Range (4.02±0.09 cm, 3.65±3.00 cm),<br />
and XY area (22.21±11.87 cm2, 42.78±42.87 cm2), respectively p>0.05. There were<br />
significant differences between stable and unstable phases for: Total travel distance<br />
(0.13±0.04 cm, 0.26±0.11 cm), y Amplitude (0.08±0.03 cm, 0.23±0.10 cm), y Range<br />
(5.31±2.37 cm, 10.48±4.52 cm), radial area(1.50±0.47 cm2, 2.39±1.29 cm2), x mean<br />
frequency (3.67±1.23 Hz, 5.56±1.25 Hz), and y mean frequency (2.17±0.98 Hz,<br />
5.49±1.54 Hz), respectively, p
<strong>Thursday</strong>, May 30, 2013<br />
S244 Vol. 45 No. 5 Supplement<br />
C-37 Free Communication/Poster - Respiratory<br />
System and Exercise<br />
May 30, 2013, 7:30 AM - 12:30 PM<br />
Room: Hall C<br />
1263 Board #209 May 30, 8:00 AM - 9:30 AM<br />
day To day repeatability and Circadian Variation Of Lung<br />
Volume Measurements<br />
Arne Instebø, Vegard Helgheim, Gottfried Greve, Thomas<br />
Halvorsen. Haukeland University Hospital, Bergen, Norway.<br />
(No relationships reported)<br />
Knowledge on circadian rhythms in human pulmonary function is controversial, and<br />
predominantly related to patients with asthma exhibiting early morning obstruction<br />
with corresponding decreases in forced expiratory volume in first second (FEV1).<br />
PurPOsE: To study day to day repeatability and circadian variation during daytime<br />
hours for forced vital capacity (FVC), FEV1 and residual volume (RV) in healthy<br />
individuals.<br />
METhOds: Ten healthy non-smoking men (age: 26.1± 3.6 years) performed<br />
spirometry and body plethysmography according to guidelines once on day one and<br />
day two (08.00 am) and three times on day three (08.00 am, 12.00 am and 16.00<br />
pm) after having abstained from coffee and alcohol at least twelve hours. All tests<br />
were done in the same laboratory at similar room temperatures and barometric<br />
pressures using Vmax 22 spirometer and Autobox 6200 whole body plethysmograph<br />
(SensorMedics, Anaheim, USA). Calibration was performed in accordance with<br />
automated procedures and instructions given by the manufacturer. Coefficients<br />
of repeatability (COR) were calculated as two standard deviations (SD) for the<br />
differences between replicate measurements and given as percentages of their mean<br />
values.<br />
rEsuLTs: Lung volumes (litre) (first vs. second day): FVC (SD) 5.9 (0.7) vs. 5.8<br />
(0.7), COR 4.3; FEV1 (SD) 4.9 (0.6) vs. 4.8 (0.5), COR 3.6; RV (SD) 1.6 (0.5) vs.<br />
1.4 (0.5), COR 23.3. Lung volumes (litre) measured the third day (08.00 am/12.00<br />
am/16.00 pm): FVC (SD) 5.8 (0.7) vs. 5.8 (0.7) vs. 5.8 (0.7); FEV1 (SD) 4.8 (0.5)<br />
vs. 4.8 (0.5) vs. 4.9 (0.5); RV (SD) 1.6 (0.5) vs. 1.4 (0.5) vs. 1.5 (0.4). Measurements<br />
obtained 08.00 am day one vs. day two and day two vs. day three did not differ<br />
significantly (paired samples t-tests).<br />
CONCLusION: Excellent day to day repeatability was observed for FEV1 and FVC,<br />
and these were better than for RV. No circadian variations were observed for any of the<br />
lung volumes measured.<br />
1264 Board #210 May 30, 8:00 AM - 9:30 AM<br />
The Ergogenic Effect of Chronic high dose salbutamol<br />
John Molphy1 , John Dickinson2 , Neil Chester1 , Mike<br />
Loosemoore3 , Gregory Whyte, FACSM1 . 1Liverpool John<br />
Moores University, Liverpool, United Kingdom. 2University of<br />
Kent, Chatham Maritime, United Kingdom. 3English Institute of<br />
Sport, Sheffield, United Kingdom.<br />
(No relationships reported)<br />
There is limited evidence to suggest the acute inhalation of short acting β2-agonist have<br />
an ergogenic effect. To date, no study has examined the ergogenic impact following the<br />
chronic use of inhaled Salbutamol at the WADA upper daily limit (1600 µg).<br />
PurPOsE: To determine the effect of the WADA upper limit of 1600 μg per<br />
day Salbutamol every day for six weeks, on endurance, strength, power and body<br />
composition.<br />
METhOds: Sixteen trained male athletes provided written consent and agreed to take<br />
part in the study (mean + SD: age 20.1 ± 1.6 years; height 179.9 ± 8.2 cm; weight 74.6<br />
± 9.1 kg). Participants entered into a 6-week, 4 times per week training study having<br />
been assigned to one of two groups in a double blind design. Group 1 (n=8) inhaled<br />
4 x100 μg of placebo, via pocket chamber, 4 times per day for 6 weeks (PLA). Group<br />
2 (n=8) inhaled 4 x100 μg of Salbutamol, via pocket chamber, 4 times per day for 6<br />
weeks (SAL). Pre- and post-training endurance, body composition, power and strength<br />
was assessed.<br />
rEsuLTs: In both groups there was an overall improvement in (Pre- Post-) VO2peak<br />
(51.7 ± 4.7 - 56.8 ± 7.1 ml.min.kg-1; 53.1 ± 6.1 -55.0 ± 6.7 ml.min.kg-1); 3 km<br />
running time-trial performance (988.6 ± 194.6 - 947.5 ± 155.5 s; 1040.4 ± 187.4<br />
-1004.2 ± 199.4 s); 1RM bench press (65.7 ± 15.4 - 70.3 ± 13.8 kg; 64.3 ± 14.0 - 72.5<br />
± 15.3 kg) and leg press (250.0 ± 76.4 - 282.5 ± 63.6 kg; 217.9 ± 54.0 - 282.8 ± 51.9<br />
kg) between SAL and PLA, respectively. Peak extension and flexion torque, and body<br />
composition remained unchanged across the study period. Of note, no difference in any<br />
endurance; strength and power; or body composition measures were noted between<br />
SAL and PLA groups pre-, during, or post-intervention.<br />
CONCLusION: There was no significant improvement in endurance, or strength<br />
and power performance following the inhalation of 1600 µg Salbutamol per day<br />
for six weeks in non-asthmatic males, compared to placebo. The current WADA<br />
MEDICINE & SCIENCE IN SPORTS & EXERCISE ®<br />
recommendations, of up to 1600 µg inhaled Salbutamol per day, appear sufficient to<br />
avoid an ergogenic impact on endurance, strength and power performance. Data from<br />
this study will assist WADA in the implementation of regulations on the use of inhaled<br />
short acting β2-agonist and in the resolution of contested doping violations.<br />
1265 Board #211 May 30, 8:00 AM - 9:30 AM<br />
Oxygen Cost of Breathing does Not differ Between Obese<br />
Women With vs. Without dyspnea on Exertion<br />
Vipa Bernhardt, Santiago Lorenzo, Raksa B. Moran, J. Todd<br />
Bassett, Sarah F. Haller, Jessica N. Pineda, Tony G. Babb,<br />
FACSM. Institute for Exercise and Environmental Medicine,<br />
Texas Health Presbyterian Hospital Dallas and University of<br />
Texas Southwestern Medical Center, Dallas, TX.<br />
(No relationships reported)<br />
PurPOsE: During constant load cycling exercise, some otherwise healthy obese<br />
women experience dyspnea on exertion (+DOE), while others do not (-DOE). In<br />
previous studies, we observed the oxygen cost of breathing to be increased in +DOE.<br />
We wondered if this would remain true in a larger sample of obese women. To<br />
investigate, we recruited 80 obese women who were divided into groups based on their<br />
Ratings of Perceived Breathlessness (RPB, Borg 0-10 scale) at the end of 6 minutes of<br />
constant load cycling at 60 W as in the previous studies.<br />
METhOds: 34 women were classified as +DOE (RPB ≥ 4, 34 ± 7 yr, 36 ± 5 kg/m 2<br />
BMI, 46 ± 4% body fat; mean ± SD) and 24 women as -DOE (RPB ≤ 2, 33 ± 8 yr, 37 ±<br />
4 kg/m 2 BMI, 45 ± 5% body fat; p > 0.05 from +DOE). 22 women with RPB = 3 were<br />
excluded to better delineate the +DOE and -DOE groups. The oxygen cost of breathing<br />
was obtained from the slope of the oxygen uptake (ml/min) vs. ventilation (L/min)<br />
relationship during eucapnic voluntary hyperpnea (EVH) at 40 and 60 L/min. Data<br />
were analyzed between groups by independent t-test.<br />
rEsuLTs: Breathlessness ratings during each level of EVH was significantly greater<br />
in the +DOE than the -DOE women (p < 0.0001). However, there was no significant<br />
difference in the oxygen cost of breathing between +DOE (2.24 ± 0.88 ml/L; n = 33)<br />
and -DOE (2.22 ± 0.85 ml/L; n = 22). The only other difference between groups during<br />
EVH was a relatively larger minute ventilation (as a percentage of maximal voluntary<br />
ventilation) (p < 0.05), which, however, was not associated with the oxygen cost of<br />
breathing.<br />
CONCLusIONs: Many obese women experience significant increases in the<br />
intensity of breathlessness during submaximal exercise and EVH; but in contrast<br />
to previous studies, the oxygen cost of breathing was not uniformly larger in obese<br />
women +DOE compared with -DOE.<br />
Supported by NIH Grant R01 HL096782 and King Charitable Foundation Trust.<br />
1266 Board #212 May 30, 8:00 AM - 9:30 AM<br />
The Effect of Combining Fish Oil and Vitamin C on<br />
hyperpnea-Induced Bronchoconstriction in asthmatic<br />
adults<br />
Sally K. Head 1 , Joseph W. Duke 2 , Timothy D. Mickleborough,<br />
FACSM 2 . 1 Indiana University School of Medicine, Indianapolis,<br />
IN. 2 Indiana University, Bloomington, IN.<br />
(No relationships reported)<br />
Asthma is a multi-faceted disease that often includes exercise-induced<br />
bronchoconstriction (EIB). Previous research has demonstrated that individual<br />
nutritional supplements, such as fish oil and vitamin C, alleviate EIB. Hyperpneainduced<br />
bronchoconstriction (HIB) has been shown to reliably detect EIB.<br />
PurPOsE: To determine whether the combination of fish oil and vitamin C<br />
supplementation offers increased protection against HIB over either one alone.<br />
METhOds: Fourteen subjects (18-29 yrs; 8 M, 6 F) with asthma and HIB<br />
participated in a randomized, double-blind, parallel group trial consisting of two<br />
treatment periods in which subjects first received either active fish oil (Fish Oil Group,<br />
n = 7) or vitamin C supplements (Vitamin C Group, n = 7) every day for 3 weeks.<br />
After a 2-week washout period, all subjects received both active fish oil and vitamin<br />
C for 3 weeks. Subjects visited the laboratory following an initial 2-week run-in phase<br />
and after each supplementation phase for a total of three visits. Bronchoprovocation<br />
was elicited with eucapnic voluntary hyperventilation (EVH), a surrogate exercise<br />
challenge involving rapid breathing. Pulmonary function and fraction of exhaled nitric<br />
oxide (FENO) were measured pre- and post-EVH.<br />
rEsuLTs: Fourteen subjects completed the trial. One subject, whose post-EVH<br />
forced expiratory volume in one second (FEV1) progressively worsened during the<br />
study, was deemed a “non-responder” and was excluded from further data analysis.<br />
The two groups of subjects were analyzed separately. For the primary outcome of<br />
maximum percent change in post-EVH FEV1, the Fish Oil Group (n = 6) significantly<br />
improved (p < 0.016) with fish oil (9.94 ± 1.90%), but not with the combination<br />
treatment (10.19 ± 3.35%), as compared to pre-supplementation (17.29 ± 1.98%). The<br />
Vitamin C Group (n = 7) did not show a significant change (p > 0.016) with either<br />
vitamin C (18.03 ± 7.05%) or combination treatment (8.64 ± 2.14%) as compared to<br />
pre-supplementation (23.48 ± 4.50%).<br />
CONCLusIONs: Previous research has shown that either fish oil or vitamin C<br />
ACSM May 28 - June 1, 2013 Indianapolis, Indiana
Official Journal of the American College of Sports Medicine<br />
can reduce bronchoconstriction and airway inflammation on their own. The variable<br />
responses obtained in this study suggest that for subjects not reaping the full benefits<br />
from either supplement alone, a combination of fish oil and vitamin C may be more<br />
effective.<br />
1267 Board #213 May 30, 8:00 AM - 9:30 AM<br />
decrements In Pulmonary diffusing Capacity With duration<br />
Of disease In Type-1 diabetes<br />
Michelle J. Lee1 , J Christopher Baldi, FACSM2 , J Richard,<br />
Coast, FACSM1 . 1Northern Arizona University, Flagstaff, AZ.<br />
2University of Otago, Dunedin, New Zealand.<br />
(No relationships reported)<br />
Diabetes is known to affect peripheral tissues by damaging capillaries and basement<br />
membranes, however, its effects on the lung are less known. Lung diffusing capacity<br />
(DLCO) is influenced by alveolar-capillary membrane conductance (DM) and<br />
pulmonary capillary blood volume (VC), both of which have shown impairments in<br />
adults with type-1 diabetes (T1D).<br />
PurPOsE: We sought to determine the effect of T1D, age, and diabetes duration on<br />
DLCO, DM, VC, and cardiac output (Q).<br />
METhOd: We recruited 48 subjects, 24 people with T1D (ages 10.7 – 52.8 years old)<br />
and 24 non-diabetic controls matched for age, gender, and fitness level and measured<br />
DLCO, DM, VC, and Q at rest and three exercise workloads (40% VO2max, 70%<br />
VO2max, and 90% VO2max).<br />
rEsuLTs: When stratified into two groups based on age (young < 20.6 years old),<br />
there were no significant differences in DLCO, DM, VC, or Q (all of which were<br />
normalized to body surface area [BSA]) in the young group, or in the old group. When<br />
stratified into two groups based on diabetes duration (short duration range 0.33 – 8.9<br />
years, long duration range 9.6 – 28 years), the T1D in the long duration group had<br />
significantly lower DLCO/BSA and DM/BSA compared to the matched controls (16.5<br />
± 0.6 and 19.0 ± 0.6 mL/min/mmHg/BSA, p= 0.014 and 22.5 ± 0.9 and 25.6 ± 0.9 mL/<br />
min/mmHg/BSA, p= 0.033, respectively) with no differences in VC/BSA and Q/BSA.<br />
There were no differences in any of the variables in the short duration group.<br />
CONCLusION: While we initially hypothesized that age would be a factor in the<br />
decrements in lung function, this study has shown that independent of age, duration<br />
of diabetes is a factor more associated with decrements in diffusing capacity and its<br />
components. Supported by NIH Grant R15 HL097335-01A1.<br />
1268 Board #214 May 30, 8:00 AM - 9:30 AM<br />
Carbon Monoxide reduces O 2 Extraction but not Peripheral<br />
Tissue diffusing Capacity at VO 2 max<br />
George H. Crocker, James H. Jones. University of California,<br />
Davis, CA.<br />
(No relationships reported)<br />
PurPOsE: We hypothesized that breathing hypoxic gas and/or carbon monoxide<br />
(CO) would similarly affect peripheral tissue (skeletal muscle) O2 extraction (EO2,<br />
fraction of O2 delivered that is consumed) and diffusing capacity for O2 (DTO2),<br />
despite altering aerobic capacity by different mechanisms – decreased blood O2<br />
saturation (hypoxia) vs. decreased circulatory capacitance (CO).<br />
METhOds: We ran six goats on a treadmill at speeds eliciting maximal aerobic<br />
capacity while breathing inspired O2 fraction (FIO2) of 0.21 or 0.12 and maintaining<br />
carboxyhemoglobin fraction (FHbCO) of 0.02 or 0.30. We measured O2 consumption<br />
(VO2) and sampled arterial and mixed-venous blood to calculate cardiac output (Q) via<br />
Fick Principle and total cardiopulmonary O2 delivery (TO2, product of Q and arterial<br />
[O2]). We calculated for each gas EO2 as VO2/TO2 and DTO2 as VO2/mixed-venous<br />
O2 tension (PvO2).<br />
rEsuLTs: Compared to room air (EO2 0.90 ± 0.03), EO2 decreased with FHbCO<br />
0.30 when breathing either FIO2 0.21 or 0.12 (EO2 0.79 ± 0.04 and 0.81 ± 0.03) and<br />
increased with hypoxia alone (EO2 0.92 ± 0.02). The VO2 and PvO2 were highly<br />
correlated and the slopes of the regressions were significant for five of six goats<br />
(0.951 < R2 < 0.994, P < 0.001 for each). The DTO2 did not differ between the four<br />
FIO2/FHbCO combinations (P = 0.867). We analyzed data from previous studies that<br />
calculated DTO2 as the slope of VO2 vs. PvO2 for various inspired gases. Compared<br />
to the means of individual points, DTO2 estimates based on slope are biased high when<br />
the VO2 vs. PvO2 intercept is negative and low when the VO2 vs. PvO2 intercept is<br />
positive.<br />
CONCLusIONs: The EO2 differed for hypoxia and elevated FHbCO, indicating<br />
goats had to deliver more O2 with elevated FHbCO than with hypoxia to reach<br />
similar VO2, suggesting CO impairs (and hypoxia improves) the ability to extract<br />
and consume O2 compared to normoxia. However, DTO2 was unchanged by FIO2<br />
or FHbCO. Oxyhemoglobin affinity effects on diffusion pressure head explain the<br />
EO2 differences observed. Because non-zero intercepts of VO2 vs. PvO2 bias DTO2<br />
estimates, future studies should calculate DTO2 both as the average of individual gas<br />
mixtures as well as the slope of VO2 vs. PvO2 for all gases. Supported by the U.S.<br />
Army Medical Research and Materiel Command (Contract No. W81XWH-11-D-0011)<br />
through L-3/Jaycor.<br />
Vol. 45 No. 5 Supplement S245<br />
1269 Board #215 May 30, 8:00 AM - 9:30 AM<br />
Breathing Pattern and strategy during Exercise In young<br />
swimmers and Non-swim Trained Children<br />
Joel M. Stager, FACSM, Kosuke Kojima, Masataka Ishimatsu,<br />
Daniel P. Wilhite, Brian V. Wright. Indiana University,<br />
Bloomington, IN.<br />
(No relationships reported)<br />
Swim training has been suggested to promote proportionate lung growth though the<br />
training effects on pulmonary function remain controversial (Courteix et al., 1997;<br />
Silvestri et al., 2012). Specifically, breathing patterns and strategies during incremental<br />
exercise in young swimmers as compared with non-swim trained children have not<br />
been documented.<br />
PurPOsE: To characterize the breathing patterns and strategies of young swimmers<br />
during incremental exercise to volitional exhaustion and compare those measures to<br />
age- and size-matched non-swim trained children.<br />
METhOds: Twenty four healthy non-asthmatic, young, competitive swimmers (12<br />
girls and 12 boys; 10.5 yrs, 144.5 cm, 38.0 kg) and 11 non-swim trained children (4<br />
girls and 7 boys; 10.2 yrs, 141.1 cm, 33.3 kg) performed resting pulmonary function<br />
and incremental exercise tests to volitional exhaustion (VO 2peak ) on a cycle ergometer.<br />
Pulmonary function was collected during a set of maximal inspiratory and expiratory<br />
maneuvers for the determination of the maximal flow-volume loop. Metabolic<br />
and ventilatory data were recorded at each minute during the VO 2peak test. Exercise<br />
inspiratory and expiratory tidal volume (V Tinsp and V Texp ) and peak flow (PF Tinsp and<br />
PF Texp ) were measured during the last 30 sec of each minute, and inspiratory and<br />
expiratory reserve volumes (IRV and ERV) were determined using inspiratory capacity<br />
maneuvers.<br />
rEsuLTs: At rest, swimmers showed significantly greater forced vital capacity (2.37<br />
± 0.40 vs. 1.84 ± 0.56 L) and maximal mid expiratory flow (2.90 ± 0.71 vs. 2.34 ± 0.65<br />
Lsec-1). The groups were similar in relative VO2 (47.3 ± 7.95 vs. 43.7 ± 9.09 mlmin-<br />
1kg-1 at peak), breathing frequency, and IRV at 60, 70, 80, 90 and 100% of VO2peak.<br />
Greater minute ventilation (70.6 ± 19.3 vs. 53.6 ± 11.2 L at VO2peak), tidal volume<br />
(1.29 ± 0.32 vs. 0.99 ± 0.19 L at VO2peak), ERV, VTinsp, VTexp, PFTinsp, and<br />
PFTexp were observed in swimmers throughout the exercise bout (p < 0.05).<br />
CONCLusION: With no difference in breathing frequency, the higher tidal flow in<br />
young swimmers permitted a higher tidal volume, thus allowing for greater minute<br />
ventilation during incremental exercise. Young swimmers seem to exploit a higher<br />
available expiratory airflow by breathing at higher lung volumes possibly as a means<br />
of avoiding mechanical constraints to ventilation.<br />
1270 Board #216 May 30, 8:00 AM - 9:30 AM<br />
Effects Of heliox On respiratory Mechanics and Cycling<br />
Performance In Endurance-trained Men and Women<br />
Sabrina S. Wilkie, Paolo B. Dominelli, Benjamin C. Sporer,<br />
Michael S. Koehle, A. William Sheel. University of British<br />
Columbia, Vancouver, BC, Canada.<br />
(No relationships reported)<br />
Mechanical ventilatory constraints develop in some endurance-trained (ET) men<br />
during strenuous exercise. Both ET and untrained women have been shown to develop<br />
expiratory flow limitation (EFL) during maximal and sub-maximal exercise. Women’s<br />
increased susceptibility to EFL can be attributed to structural and functional sex-based<br />
differences with respect to the pulmonary system. Consequently women’s endurance<br />
performance may be limited to a larger extent than men’s through increases in the work<br />
of breathing (WOB) and higher sensations of leg and breathing discomfort.<br />
PurPOsE: To determine the effects of partially unloading the respiratory system<br />
using a heliox (He-O2; 79% He, 21% O2) inspirate on EFL, the WOB, operational<br />
lung volumes, sensory responses (leg and breathing discomfort) and cycling<br />
performance between men and women.<br />
METhOds: Competitive cyclists (n = 11 men; n = 11 women) completed two 5-km<br />
time trials (TT), breathing either room air (RA) or He-O2. The maximum expiratory<br />
flow-volume (MEFV) curve method was used to determine EFL. The WOB was<br />
measured with an esophageal balloon catheter.<br />
rEsuLTs: During both the RA and He-O2 TTs EFL developed in men (RA: n =<br />
36%; He-O2: n = 45%) and women (RA: n = 60%; He-O2: n = 40%). The magnitude<br />
of EFL was variable throughout both TTs for all subjects due to alterations in endexpired<br />
lung volume and expiratory flow rates. At 5-km women’s minute ventilation<br />
was significantly lower than men’s (RA-women: 94.417.8; men: 134.412.7; p
<strong>Thursday</strong>, May 30, 2013<br />
S246 Vol. 45 No. 5 Supplement<br />
1271 Board #217 May 30, 8:00 AM - 9:30 AM<br />
Marine Lipid Fraction PCsO-524 (Lyprinol®/Omega<br />
XL®) attenuates airway Inflammation and hyperpnea-<br />
Induced Bronchoconstriction in asthmatic Individuals<br />
Timothy D. Mickleborough, FACSM, Cherissa L. Vaughn, Ren-<br />
Jay Shei, Eliza M. Davis, Jacob A. Sinex, David Platt, Daniel P.<br />
Wilhite. Indiana University, Bloomington, IN.<br />
(No relationships reported)<br />
It has previously been shown that fish oil supplementation, rich in the omega-3<br />
fatty acids (Ω3FAs) eicosapentaenoic acid (EPA) and docosahexaenoic acid<br />
(DHA) can attenuate airway inflammation and exercise and hyperpnea-induced<br />
bronchoconstriction (EIB and HIB respectively) in elite athletes and asthmatics.<br />
PCSO-524 (Lyprinol®/Omega XL®) is a supplement extracted from the New<br />
Zealand green-lipped mussel (Perna Canaliculus) comprising 14 + 7% EPA and 11<br />
+ 7% DHA, and containing up to 22 times more fatty acids than regular fish oil. It<br />
has been shown that PCSO-524 can moderate airway inflammation in humans with<br />
asthma, and in a murine-model of allergic airway disease.<br />
PurPOsE: Evaluate the effect of PCSO-524 on airway inflammation and the<br />
bronchoconstrictor response to eucapnic voluntary hyperpnea (EVH) in asthmatics.<br />
METhOds: In this model of EIB twenty asthmatic subjects, with HIB, participated in<br />
a placebo controlled double-blind randomized crossover trial. Subjects entered the study<br />
on their usual diet and were then placed on 3 weeks of PCSO-524 (~56 mg EPA/day;<br />
~44 mg DHA/day) or placebo supplementation (olive oil), followed by a 2 week washout<br />
period, before crossing over to the alternative diet. Pre- and post-EVH pulmonary<br />
function, fraction of exhaled nitric oxide (F E NO), asthma symptom scores, medication<br />
use, exhaled breath condensate (EBC) pH, cysteinyl leukotrienes (cyst-LT), 8-isoprostane<br />
and urinary 9α, 11β-prostaglandin (PG)F 2 and Clara (CC16) protein concentrations were<br />
assessed at the beginning of the trial and at the end of each treatment period.<br />
rEsuLTs: The PCSO-524 diet significantly reduced (p
Official Journal of the American College of Sports Medicine<br />
1275 Board #221 May 30, 8:00 AM - 9:30 AM<br />
a Multivariable Index for Grading Exercise Gas Exchange<br />
severity in Patients with Pulmonary arterial hypertension<br />
and heart Failure<br />
Chul-Ho Kim, Steve Anderson, Dean McMacarter, Bruce D.<br />
Johnson. Mayo Clinic, Rochester, MN.<br />
(No relationships reported)<br />
Patients with pulmonary arterial hypertension (PAH) and heart failure (HF) display<br />
a number of abnormalities in respiratory gas exchange with exercise. These<br />
abnormalities track disease severity and are associated with prognosis. However, there<br />
are limitations due to the large number of variables and difficulty in interpretation.<br />
PurPOsE. To develop a multivariable gas exchange index (MVI) that integrates key<br />
variables obtained during submaximal exercise and to demonstrate its utility clinical<br />
populations.<br />
METhOds. 1) Normal values and ranges of 6 gas exchange variables (Rest PetCO2,<br />
Delta PetCO2, SaO2, OUES, VE/VCO2 and PCAP) that are associated with a higher<br />
risk in PAH and HF were obtained from previous literature and used to develop a<br />
score. 2) To test the MVI score, the gas exchange data from 3 populations (42-PAH,<br />
47-HF, 25-controls) were gathered. Each variable was scored based on severity<br />
(=4=very severe) in HF or PAH and was calculated into a weighted cumulative<br />
individual variable index score which was then divided by total number of variables<br />
to get the MVI. Relationships between individual gas exchange measures, calculated<br />
MVI, cardiac Index (CI), New York Heart Association (NYHA), Right Ventricular<br />
Systolic Pressure (RVSP) and WHO classification were examined.<br />
rEsuLTs. We developed a model to integrate gas exchange variables using a<br />
weighted classification system that categorized disease severity based on the final MVI<br />
outcome. A MVI value of
<strong>Thursday</strong>, May 30, 2013<br />
S248 Vol. 45 No. 5 Supplement<br />
1279 Board #225 May 30, 8:00 AM - 9:30 AM<br />
Comparison Of Oxygen utilization during Magnetic Muscle<br />
stimulation With That during handgrip Exercise<br />
Tadashi Saitoh, Kyuichi Niizeki. Yamagata University,<br />
Yonezawa, Japan.<br />
(No relationships reported)<br />
PurPOsE: This study aimed to investigate the dynamics of oxygen utilization during<br />
intermittent muscle contraction induced by magnetic stimulation compared with that<br />
during handgrip exercise.<br />
METhOds: This study included 7 healthy volunteers (means ± SD: age, 24.4 ±<br />
5.6 yr; height, 167.9 ± 3.8 cm; body mass, 63.3 ± 6.4 kg). After a 2-minute rest,<br />
the volunteers received magnetic stimuli with a magnitude of 0.4 kV in the flexor<br />
digitorum superficialis muscle or performed handgrip exercise for 2 min at 1 Hz,<br />
followed by a 2-minute rest. The intensity of the handgrip exercise was controlled so<br />
that its amplitude, as measured by mechanomyography, matched that of the magnetic<br />
stimulation. Pulmonary gas exchange rates, ventilation level, and heart rate were<br />
measured breath by breath. Hemoglobin concentrations were measured at 1 Hz using<br />
near-infrared spectroscopy.<br />
rEsuLTs: During the handgrip exercise, oxygen uptake and heart rate immediately<br />
increased to 407.6 ± 117.7 ml/min (baseline, 196.6 ± 47.3 ml/min) and 76.6 ± 8.6<br />
beats/min (baseline, 66.2 ± 7.0 beats/min), respectively. Moreover, deoxyhemoglobin<br />
levels exponentially increased at an amplitude of 15.4 μM. On the other hand, during<br />
the magnetic stimulation, oxygen uptake, heart rate, and the levels of oxyhemoglobin,<br />
deoxyhemoglobin, and total hemoglobin remained constant.<br />
CONCLusIONs: This experiment showed that oxygen utilization did not<br />
increase during the intermittent muscle contraction induced by magnetic<br />
stimulation. The data also suggest that the aTP-PCr system served as the primary<br />
energy supply system for contraction during magnetic stimulation, or that muscle<br />
contraction during magnetic stimulation did not require aTP.<br />
1280 Board #226 May 30, 8:00 AM - 9:30 AM<br />
Effects of stretch shortening Cycle Warm-up on Cycling<br />
Performance in Females<br />
Jessica W. Chow1 , David Heikkinen2 , Elaina Mertens3 , Tracey<br />
D. Matthews3 , Vincent J. Paolone, FACSM3 . 1Brooklyn College,<br />
Brooklyn, NY. 2Fitchburg State University, Fitchburg, MA.<br />
3Springfield College, Springfield, MA.<br />
(No relationships reported)<br />
Respiratory muscle fatigue has been recognized to be a contributing factor to the<br />
termination of high intensity exercise performance due to a sympathetically mediated<br />
vasoconstriction response in the peripheral muscles. Inspiratory muscle specific warmup<br />
(2 x 30 repetitions) has been reported to improve performance in several high<br />
intensity activities.<br />
PurPOsE: To determine the effects of performing 2 x 30 stretch shortening cycling<br />
(SSC) respiratory muscle warm-up on cycling performance.<br />
METhOds:Fifteen highly fit female subjects (VO2peak: 51.70 ± 6.67 ml·kg-1·min-1)<br />
participated in the study. The control trial involved a 5 min whole body warm-up<br />
cycling at 40% of peak power output. The experimental trial consisted of 2 x 30<br />
breathing exercises following the 5 min whole body warm-up. Maximum expiratory<br />
volume (MEV) and maximum inspiratory volume (MIV) were assessed after the<br />
warm-up routines and post exercise. Subjects exercised at 85% of peak power output<br />
until volitional fatigue. During the exercise test minute ventilation (VE), relative<br />
volume of oxygen consumption (VO2/kg), tidal volume (VT), breathing frequency<br />
(F), rating of perceived breathlessness (RPE-B), respiratory exchange ratio (RER),<br />
and breathing economy (VE/VO2) were measured every minute. Time to exhaustion<br />
(TEX) was also measured to assess performance. Multiple statistical analyses were<br />
used including one paired sample t-test, three analysis of variance (ANOVA), and one<br />
multivariate analysis of variance (MANOVA) to assess for statistical differences.<br />
rEsuLTs: No significant differences were observed between the treatment and<br />
MEDICINE & SCIENCE IN SPORTS & EXERCISE ®<br />
control for MIV, MEV, VE, VO2/kg, VT, F, RPE-B, RER, and VE/VO2 (p > .05).<br />
Expected exercise physiological responses were observed over time for VE, VO2/<br />
kg, VT, F, RPE-B, RER and VE/VO2. No significant differences were observed for<br />
MIV (2.425 L ±.104 vs. 2.358 L ±.084, p > .05). MEV was significantly reduced post<br />
exercise (3.168 L ± 0.151 vs. 2.994 L ± 0.127, p < .05).<br />
CONCLusIONs:Performing the 2 x 30 repetition of SSC warm-up breathing<br />
exercises with whole body warm-up appeared to have an ergolytic effect on cycling<br />
performance by exasperating respiratory muscle fatigue,inducing the sympathetically<br />
mediated vasoconstriction response in the peripheral muscles.<br />
1281 Board #227 May 30, 8:00 AM - 9:30 AM<br />
Effects of acute Oleic acid-induced Lung Injury on aerobic<br />
Capacity<br />
James H. Jones, George H. Crocker. University of California,<br />
Davis, CA.<br />
(No relationships reported)<br />
Soldiers in combat, rescue workers and miners may receive blast injuries that reduce<br />
pulmonary diffusing capacity for O2 (DLO2) and aerobic capacity (VO2max),<br />
jeopardizing their ability to escape to safety.<br />
PurPOsE: We tested the hypothesis that we could simulate acute lung injury that<br />
reduces DLO2 with oleic acid (OA) infusion and that it would decrease VO2max.<br />
METhOds: We infused OA (0.05 ml/kg) coupled with high-velocity saline through a<br />
dual-lumen catheter into the right atria of five goats to evenly distribute OA throughout<br />
their lungs. At 2-h and 24-h post-OA infusion or without OA infusion (control), goats<br />
ran on a treadmill at speeds eliciting VO2max while we measured O2 consumption,<br />
heart rate (fH) and sampled arterial and mixed-venous blood. We measured pulmonary<br />
diffusing capacity for CO (DLCO) using a rebreathing method both pre-infusion and<br />
pre-exercise.<br />
rEsuLTs: The DLCO returned to control values within ~3 days post-OA. Compared<br />
to control, VO2max decreased by 33% at 2-h and 24% at 24-h post-OA (P = 0.007),<br />
although VO2max did not differ between times (P = 0.319). The fH decreased by 29%,<br />
stroke volume (VS) did not change and cardiac output (Q) tended to decrease post-OA<br />
(fH, P = 0.009; VS, P = 0.155; Q, P = 0.073). However, OA also reduced arterio-mixed<br />
venous [O2] difference by 17% (P < 0.001) because arterial [O2] (CaO2) decreased<br />
by 17% (P < 0.001) with only a tendency for mixed-venous [O2] to do so (P = 0.080).<br />
Decreased CaO2 resulted from O2 saturation decreasing by 21% (P < 0.001) due to<br />
hypoxemia from impaired gas exchange (alveolar-arterial O2 partial pressure (PO2)<br />
difference increased by 32 Torr (P < 0.001)), not hypoventilation (P = 0.899). We<br />
tested whether fH decreased due to direct OA effect or due to hypoxemia by running<br />
the goats on the treadmill post-OA while breathing hyperoxic gas (30% O2) to defend<br />
arterial PO2. The fH remained lower in hyperoxia, not different from breathing<br />
normoxic gas (P = 0.803), suggesting OA directly affects fH.<br />
CONCLusIONs: The OA decreased pulmonary diffusing capacity, fH, CaO2 and<br />
VO2max, supporting our hypothesis. Infusion of OA may provide a reproducible and<br />
repeatable model of acute lung injury for animals in exercise studies. Supported by<br />
the U.S. Army Medical Research and Materiel Command (Contract No. W81XWH-<br />
11-D-0011) through L-3/Jaycor.<br />
C-38 Free Communication/Poster - Upper<br />
Extremity Mechanics<br />
May 30, 2013, 7:30 AM - 12:30 PM<br />
Room: Hall C<br />
1282 Board #228 May 30, 9:00 AM - 10:30 AM<br />
Vibration Exercise With Or Without Xco-trainer In<br />
Epicondylitis (VIBEs) - a randomized study<br />
Karsten Knobloch, Berit Schiffke. Sports Private Practice Prof.<br />
Karsten Knobloch, FACS, Hannover, Germany.<br />
(No relationships reported)<br />
PurPOsE: To study the effect of vibration training with or without a dynamic mass<br />
training (XCO-Trainer) on lateral epicondylitis.<br />
Hypothesis: A proprioceptive training with a dynamic mass device (XCO-Trainer)<br />
intervention is beneficial in terms of pain reduction and improvement of function in<br />
lateral epicondylitis.<br />
METhOds: We performed a randomized study and included a total number of 72<br />
patients with unilateral lateral elbow tendinopathy and randomized in a 1:1 allocation<br />
to two groups:<br />
•Group A (n=40, final analysis n=29): Flexi-Bar only: vibration training only over 12<br />
weeks with three distinct exercises and 10min training twice daily<br />
•Group B (n=32, final analysis n=28): Flexi-Bar+XCO Trainer: Combination<br />
intervention using vibration device Flexi-Bar and XCO-Trainer (oscillating mass<br />
within a tube moved during running 40-60min/week with reactive impact technology)<br />
The primary outcome parameter wa pain on visual analogue scale (VAS 0=no pain,<br />
ACSM May 28 - June 1, 2013 Indianapolis, Indiana
Official Journal of the American College of Sports Medicine<br />
10=worst pain), secondary outcome parameters were<br />
oDASH score [0=no impairment, 100=severe impairment]<br />
oGrip strength (JAMAR) [kg] in 0° and 90° elbow flexion<br />
oVibration using 128 Hz tuning fork<br />
ClinicalTrials.gov NCT01269879.<br />
rEsuLTs: •Pain was reduced in the vibration training only group (A) from 3.6±2.0<br />
to 2.4±2.0 (p=0.019) and in the combination group (Flexi-Bar + XCO-Trainer) from<br />
3.6±2.3 to 2.1±1.8 (p=0.002)<br />
oThere was no intergroup difference in terms of pain reduction superiority (figure 1)<br />
•DASH: Improvement in both groups (A: 30±13 to 14±12, p=0.001; B: 26±13 to<br />
12±11, p=0.001, no intergroup differences)<br />
•Grip strength: significant improvement in 0° elbow flexion in both groups<br />
•128 Hz tuning fork: Improvement in both groups (A: 6.1 to 6.3, B: 6.1±0.8 to 6.4±0.6,<br />
both p
<strong>Thursday</strong>, May 30, 2013<br />
S250 Vol. 45 No. 5 Supplement<br />
1286 Board #232 May 30, 9:00 AM - 10:30 AM<br />
heterogeneous Mechanomyographic activity of Wrist<br />
Extensors in response to Eccentric Exercise<br />
Afshin Samani1 , Ernst A. Hansen1 , Adam Kawczynski2 , Pascal<br />
Madeleine1 . 1Aalborg University, Aalborg, Denmark. 2University School of Physical Education, Wroclaw, Poland.<br />
(No relationships reported)<br />
The mechanomyography (MMG) signal furnishes information on the intrinsic muscle<br />
mechanical activity. Heterogeneous MMG activity has been reported for erector spinae<br />
and trapezius muscle during sustained contraction but no studies have investigated the<br />
effects of high intensity eccentric exercise on the spatio-temporal MMG activity.<br />
PurPOsE: To investigate spatio-temporal MMG activity of wrist extensor muscles<br />
before and after eccentric exercise in healthy subjects.<br />
METhOds: Twelve volunteers performed one bout of repeated eccentric exercise at<br />
high intensity involving wrist extensors of the dominant arm. MMG signals from wrist<br />
extensors were detected by means of accelerometers placed over 12 points forming a<br />
3×4 grid. MMG recordings were made during standardized wrist isometric, concentric<br />
and eccentric contractions performed before, immediately after and 24 hours after<br />
eccentric exercise. Root mean square (RMS) and percentage of determinism (%DET)<br />
of the MMG signals were computed to estimate the level muscular activation and the<br />
amount of regularity of the MMG signals. RMS and %DET were used as markers of<br />
neuromuscular changes due to fatigue and delayed onset muscle soreness.<br />
rEsuLTs: Muscle strength decreased by 14% and soreness intensity was 4.1 ± 0.8<br />
cm (mean ± SEM) 24 hours after eccentric exercise. There was a significant increase<br />
in RMS immediately after and 24 hours after compared with before eccentric exercise,<br />
respectively 23.8 and 15.5 vs. 13.3 ± 0.3 mm/s-2 (P < 0.05). The %DET was higher<br />
at 24 hours after compared with before and immediately after eccentric exercise,<br />
respectively 96.7 vs. 95.8 and 96.0 ± 0.1 % (P < 0.05). The RMS and %DET depended<br />
on the accelerometer locations (P < 0.001) with higher RMS values (25 %) and lower<br />
%DET (1.4 %) on extensor digitorum communis compared with extensor carpi radialis<br />
ulnaris.<br />
CONCLusIONs: These present study depicted neuromuscular changes exemplified<br />
by increase MMG activity and regularity in MMG signals in presence of delayed onset<br />
muscle soreness. Inhomogeneous MMG activity in wrist extensors muscles was also<br />
found confirming the importance of using multiple recording sites when assessing<br />
muscle MMG activity.<br />
Supported by GigtForeningen R77-A1202 and Danish Ministry of Culture Committee<br />
on Sports Research grants.<br />
1287 Board #233 May 30, 9:00 AM - 10:30 AM<br />
Comparison of Electromyographic activity of Muscles<br />
associated with Elbow Flexion using different resistance<br />
devices<br />
Melissa Humphres, Cole Sillaman, Craig Parker, Christine<br />
Rettig, Peter Jordan, Patrick Sells. Belmont University,<br />
Nashville, TN.<br />
(No relationships reported)<br />
BaCKGrOuNd: Research has demonstrated that forces exerted on muscles when<br />
using different resistance devices significantly affect how the muscles respond and<br />
develop. Moreover, exercise performed in stable environments will isolate and<br />
recruit individual muscles to achieve a desired motion, while exercise in unstable<br />
environments will globally recruit groups of muscles to achieve the same motion.<br />
Researchers of this study were looking to combine these two notions to determine if a<br />
potentially stable device would elicit more muscle activity within an individual muscle,<br />
and if a potentially unstable device would require recruitment of additional muscles.<br />
The newly designed HaloBell is designed to distribute its weight evenly in all planes<br />
providing a potentially stable device, and the dumbbell distributes its weight to the<br />
poles of the device in a single plane providing a potentially more unstable device.<br />
PurPOsE: The purpose of this study is to determine if different resistance devices,<br />
the traditional dumbbell and the HaloBell, yield different levels of muscle activity in<br />
the elbow flexors during a standard biceps curl.<br />
METhOds: EMG activity was collected from 33 healthy participants that completed<br />
a MVIC in three positions. After randomizing the trials, subjects underwent four sets<br />
of three repetitions of elbow flexion in order to use each device in midposition and<br />
supination. Data was analyzed using a 3x2x2 ANOVA.<br />
rEsuLTs: A significant difference (p < 0.05) was found between devices with the<br />
forearm in midposition (p = 0.033) for the biceps brachii; the HaloBell was found to<br />
elicit less EMG activity (48% of MVIC) than the traditional dumbbell (50% of MVIC).<br />
The data did not produce any significant differences between devices with any other<br />
combinations examined.<br />
CONCLusION: The overall findings were not pronounced, and inferences that can<br />
be made from the data are limited. It cannot be concluded that the HaloBell is able to<br />
definitively elicit a greater EMG activity in target muscles compared to the traditional<br />
dumbbell. However, EMG activity was similar between the two devices suggesting<br />
similar efficacy.<br />
MEDICINE & SCIENCE IN SPORTS & EXERCISE ®<br />
1288 Board #234 May 30, 9:00 AM - 10:30 AM<br />
shoulder Joint reaction Forces during Wheelchair<br />
Propulsion With arms and arm-legs By The Elderly<br />
Xiang Ke 1 , Yaping Zhong 2 , Peng Liu 2 , Yong Tai Wang, FACSM 3 .<br />
1 Georgia State University, Atlanta, GA. 2 Shandong Sport<br />
University, Jinan, China. 3 Shandong Sport University and<br />
Georgia State University, Atlanta, GA.<br />
(No relationships reported)<br />
PurPOsE: This study was to investigate the difference of SJRFs between wheelchair<br />
propulsion with arms (AP) and with combination of arms and legs (ALP) in the elderly.<br />
METhOds: Fourteen subjects aged 65 to 90 years old were recruited from local<br />
assisted living facilities, with five in AP group and nine in ALP group. Each subject<br />
performed two wheelchair locomotive activities (moving straight or along a curved<br />
line) at self-comfortable speed, using three different types of wheelchairs (drive-axis<br />
positioned in the front, middle, or rear). A Qualisys motion analysis system was<br />
employed to record and analyzed 3-D kinematical data from the land-markers of the<br />
right shoulder, elbow, wrist, hip, knee and ankle, and 5 th metacarpal joints. A JR3<br />
force measurement system built in the drive-axis was used to record 3-D right hand<br />
contact reaction forces from the pushrim. Peak SJRFs were predicted by an inverse<br />
dynamic model. The differences of SJFRs between two groups across two locomotive<br />
activities and three wheelchair types were determined by a three-way ANOVA, and the<br />
differences between two groups, in straight or curved locomotive activities with the<br />
same wheelchair type were compared by an Independent T test.<br />
rEsuLTs: SJFRs between AP group and ALP group across wheelchair activities<br />
and types were 78.5±7.9 N and 74.9±5.9 N (p=.716) and no differences were<br />
identified between the two groups across wheelchair activities and types, except for<br />
the interaction of three factors (group, wheelchair activity and type) together. In the<br />
straight wheelchair activity, there were no significant differences between AP and ALP<br />
groups with neither middle nor rear drive-axis wheelchairs (82.9±49.6 vs 48.3±11.6N,<br />
p=.195; 66.4±20.2 vs 50.0±14.1N, p=.098, respectively), but a significant difference<br />
was founded when propelling with front drive-axis wheelchair (55.2±14.7 vs<br />
126.9±63.1 N, p=.009). No significant differences were found between the two groups<br />
in the curved activity with respect to the front, or middle, or rear drive-axis wheelchair<br />
(67.2±27.3 vs 55.2±14.1N, p=.291; 75.9±37.5 vs 81.1±45.3N, p=.833; 123.6±97.6 vs<br />
88.2±53.3N, p=.484, correspondingly).<br />
CONCLusIONs: The involvement of legs with arms may not effectively facilitate<br />
reduction of SJFR for the elderly during wheelchair propulsion.<br />
1289 Board #235 May 30, 9:00 AM - 10:30 AM<br />
does Mode of Wheelchair Propulsion Influence Interlimb<br />
Wrist Coordination?<br />
Mark D. Tillman, FACSM, Patty Hovis, Lisa A. Zukowski,<br />
Jaimie A. Roper, Dana M. Otzel, Orit Shechtman, Ryan<br />
Roemmich. Univ. of Florida, Gainesville, FL.<br />
(No relationships reported)<br />
Individuals who use manual wheelchairs for mobility have increased risk of upper<br />
extremity pain that can lead to loss of mobility and decreased quality of life. In fact,<br />
49 to 63% of conventional manual wheelchair (CMW) users suffer from carpal tunnel<br />
syndrome (CTS). Our recent work has revealed that use of an ergonomic hand drive<br />
(EHD) mechanism for propulsion improves utilizes more neutral wrist orientation. In<br />
addition, other researchers have indicated that interlimb coordination is constrained<br />
(and potentially harmful) in CMW users with shoulder pain. Similar effects may occur<br />
at the wrist when using different propulsion techniques and have not been investigated.<br />
PurPOsE: To evaluate interlimb coordination of the wrist via cross-correlation<br />
coefficients (CCC) in relation to angular movements while using an EHD mechanism<br />
and a CMW.<br />
METhOds: Fourteen full-time CMW users (41.4±15.9 yrs, 73.4±16.7 kg, and<br />
172.3±12.9 cm) participated in the study. Motion data were captured by 11 cameras<br />
as participants propelled across a length of 8m completing 5 trials in a CMW and 5<br />
trials in the same CMW fitted with the EHD. Angular kinematics and CCC of the wrist<br />
(flexion/extension, radial/ulnar deviation) were calculated with the understanding that<br />
lower values would indicate reduced symmetry and constraint. At least one push phase<br />
was analyzed per trial and all trials were combined to calculate an average push per<br />
participant. CCC from the two propulsion styles were compared using paired samples<br />
t-tests (α=0.05).<br />
rEsuLTs: Use of the EHDM resulted in reduced flexion/extension CCC compared<br />
to CMW (0.509 and 0.908, respectively; p=0.012). Radial/ulnar deviation CCC did not<br />
vary between propulsion techniques (p>0.05).<br />
CONCLusION: EHD use resulted in reduced interlimb coordination regarding<br />
wrist flexion/extension. These results indicate that EHD employment may ease<br />
constraints on wrist flexion and extension during wheeling. The observed differences<br />
in coordination/symmetry may have clinical implications regarding overuse injuries<br />
of the wrist including CTS. This work supported by the Clinical and Translational<br />
Science Institute Pilot & Collaborative Research Projects (NIH: UL1 RR02980). The<br />
EHD is the intellectual property of Shands Healthcare.<br />
ACSM May 28 - June 1, 2013 Indianapolis, Indiana
Official Journal of the American College of Sports Medicine<br />
1290 Board #236 May 30, 9:00 AM - 10:30 AM<br />
Efficacy of shoulder rehabilitation with the Infinity Method<br />
Treatment<br />
Michaela Tomanova1 , Lee Cabell2 . 1Rehabilitation Clinic,<br />
Brandys nad Orlici, Czech Republic. 2Seton Hall University,<br />
South Orange, NJ.<br />
(No relationships reported)<br />
INTrOduCTION: The Infinity method represents a kinesitherapy approach based<br />
on anatomy, neurophysiology, and biomechanics of musculoskeletal dysfunction. In<br />
the early post-operative phases, static sub-maximal isometric contraction with exercise<br />
is utilized. In subsequent phases, 3-dimensional (3-D) movements in figure eight,<br />
circular, and spiral dynamic stabilization exercises are used in shoulder rehabilitation<br />
patients with functional and structural joint instabilities.<br />
PurPOsE: To test the efficacy of rehabilitation on shoulder joint stabilization utilizing<br />
the Infinity method from four to six weeks for 30 min daily in patients treated with<br />
conservative conventional method treatment (CMT) and post-surgical treatment (PST).<br />
METhOds: Quasi-experimental, non-randomized study in a rehabilitation hospital<br />
with 81 participants divided into CMT (n=34, 61.6±10.9 years) and PST (n=47,<br />
61.3±16.2 years) groups. The dependent variables, the visual analog scale (VAS) of<br />
shoulder subjective pain scores (from 1 for “no pain” to 10 for “very severe pain”),<br />
and the 3-D shoulder range of motion (ROM), were analyzed with the Wilcoxon and<br />
paired t tests.<br />
rEsuLTs: After the Infinity treatment was applied, the CMT group showed a<br />
decrease in VAS pain score of 5.72 vs. 3.33 (p
<strong>Thursday</strong>, May 30, 2013<br />
S252 Vol. 45 No. 5 Supplement<br />
D-12 Thematic Poster - Cardiovascular<br />
Responses to Resistance Exercise<br />
May 30, 2013, 1:00 PM - 3:00 PM<br />
Room: 206<br />
1336 Chair: Randal P. Claytor. Miami University and CCHMC,<br />
Oxford, OH.<br />
(No relationships reported)<br />
1337 Board #1 May 30, 1:00 PM - 3:00 PM<br />
Cardiovascular responses to Eight Weeks of high-Intensity<br />
resistance Training<br />
Lindy M. Rossow, Christopher A. Fahs, Robert S. Thiebaud,<br />
Jeremy P. Loenneke, Daeyeol Kim, Grant Mouser, Erin A.<br />
Shore, Emily A. Siegrist, Michael G. Bemben, FACSM.<br />
University of Oklahoma, Norman, OK.<br />
(No relationships reported)<br />
Resistance exercise training is beneficial for the musculoskeletal health of a wide range<br />
of people. Previous studies have suggested resistance training may benefit, harm, or<br />
have no effect on cardiovascular function. Further examinations of cardiovascular<br />
responses to this type of training in women, particularly older women, are needed.<br />
PurPOsE: The purpose of this study was to determine cardiovascular responses to<br />
high-intensity resistance training in young (aged 18-25; n = 10) and older (aged 50-64;<br />
n = 8) women.<br />
METhOds: Brachial systolic (SBP) and diastolic (DBP) blood pressures, heart rate<br />
(HR), central (carotid to femoral) and peripheral (femoral to posterior tibial) arterial<br />
pulse wave velocity (PWV), resting forearm blood flow (fBF), and forearm reactive<br />
hyperemia (fRH) were assessed approximately two weeks prior to exercise training<br />
(Pre1), immediately prior to exercise training (Pre2), and immediately following<br />
exercise training (Post). Exercise training consisted of 8 weeks of 3 sets (10 reps, 10<br />
reps, reps to failure) of 6 (3 upper, 3 lower) different exercises performed on standard<br />
weight-machines 3 days per week. Paired-samples t-tests compared Pre1 to Pre2. As no<br />
t-tests were statistically significant, Pre1 and Pre2 values were then averaged and 2 x 2<br />
(group x time) repeated measures ANOVA was performed. Data are reported as mean ±<br />
standard error. Statistical significance was set at p
Official Journal of the American College of Sports Medicine<br />
untrained participants over time.<br />
rEsuLTs: Participants were similar for age (22 ± 2 yrs), height (1.72 ± 0.10m) and<br />
weight (73.0 ± 16.7 kg) but there were significant differences (p
<strong>Thursday</strong>, May 30, 2013<br />
S254 Vol. 45 No. 5 Supplement<br />
and MuRF-1 (51%). A significant relationship was found between IL-6 and MuRF-1<br />
expression after incubation with PGE2 (r=0.77, P
Official Journal of the American College of Sports Medicine<br />
1350 Board #7 May 30, 1:00 PM - 3:00 PM<br />
aMPK Play a role In The substrate Energy selection<br />
during Post Exercise recovery<br />
Andreas Mæchel Fritzen, 1987, Mette Landau Brabæk<br />
Christiansen, Jacob Jeppesen, Bente Kiens. Copenhagen<br />
University, Copenhagen, Denmark.<br />
(No relationships reported)<br />
Several studies have shown a substantial fractional fatty acid (FA) oxidation during<br />
the post exercise period. It appears that after exercise muscle glycogen resynthesis has<br />
such a high metabolic priority that a higher utilization of lipids to cover the energy<br />
expenditure in the muscle cell is observed. Interestingly, the mechanisms responsible<br />
for the selection of energy substrate in muscle post-exercise are virtually unknown,<br />
and the mechanism(s) regulating post exercise increased FA oxidation has not been<br />
fully explained. AMP-activated kinase (AMPK) has been found to be involved in FA<br />
oxidation at rest and could potentially play a role in fuel selection post exercise.<br />
PurPOsE: To investigate the possible role of AMPK for the energy substrate<br />
selection in post exercise recovery.<br />
METhOds: Homozygote AMPKα2 knock-out (KO) and wildtype (WT) littermates<br />
were allocated into 3 groups: a resting control group, an exercise group and a postexercise<br />
group. Treadmill exercise was performed for 2 hours at 50% of maximal<br />
running capacity for each group. Post-exercise recovery group was studied 6 hours post<br />
exercise. Oxygen uptake and respiratory exchange ratio were measured in metabolic<br />
chambers during both resting, exercise and in post-exercise recovery conditions.<br />
rEsuLTs: In both genotypes RER was lower (p
<strong>Thursday</strong>, May 30, 2013<br />
S256 Vol. 45 No. 5 Supplement<br />
performed with a validated and reliable software tool (Optidiet, Linden, Germany).<br />
The reference value for vitamin C used in our study (100mg/d; which is 40 mg/d above<br />
the recommendations of the US Food and Drug Administration (FDA)) was based<br />
on the recommendations of the European and German societies of nutrition. Blood<br />
samples were collected 1-week pre-race (V2), and immediately (V3), 24-h (V4), and<br />
72-h (V5) post-race, and were analyzed for inflammatory parameters (IL-6, highsensitivity<br />
CRP, and blood leukocyte counts).<br />
URTI rates were assessed by the Wisconsin Upper Respiratory Symptom Survey<br />
(WURSS-21), with symptoms recorded by the participants for two weeks following the<br />
race. The association between URTI incidence, inflammatory parameters, and vitamin<br />
C intake was investigated.<br />
rEsuLTs Incidence of URTI during the 2-week post-marathon period was inversely<br />
related to pre-race vitamin C intake (mean vitamin C-intake and URTI incidence: <<br />
50mg/d, 20%; 50-75mg/d, 18%; 75-100mg/d, 10%; 100-125mg/d, 8%; >125mg/d, 4%;<br />
p for trend = 0.04). This was observed independent from other potential confounders<br />
such as intake of polyphenols or total energy intake. Low vitamin C intake (
Official Journal of the American College of Sports Medicine<br />
1358 Board #6 May 30, 1:00 PM - 3:00 PM<br />
Effects Of a Freeze-dried Fruit-vegetable Juice Powder On<br />
Exercise-induced Metabolic Outcomes: a Metabolomics<br />
approach<br />
Amy M. Knab 1 , David C. Nieman, FACSM 1 , Nicholas D.<br />
Gillitt 2 , R. Andrew Shanely 1 , Lynn Cialdella-Kam 1 , Dru A.<br />
Henson 3 , Wei Sha 4 , Mary Pat Meaney 1 . 1 Appalachian State<br />
University, Human Performance Laboratory, North Carolina<br />
Research Campus, Kannapolis, NC. 2 Dole Nutrition Research<br />
Laboratory, North Carolina Research Campus, Kannapolis,<br />
NC. 3 Appalachian State University, Boone, NC. 4 Bioinformatics<br />
Services Division, University of North Carolina at Charlotte,<br />
North Carolina Research Campus, Kannapolis, NC.<br />
Supported by a.M. Knab: Contracted Research - Including Principle<br />
Investigator; Dole Foods Inc..<br />
PurPOsE: To investigate a freeze-dried fruit-vegetable juice powder (JUICE) in<br />
decreasing exercise-induced inflammation, oxidative stress, and immune perturbations.<br />
METhOds: Thirty-four endurance cyclists (25 male, 9 female) were randomized to<br />
control (non-JUICE) or JUICE for 17 days. JUICE provided 230 mg of flavonoids/<br />
day, doubling the typical adult daily intake. On days 15-17, subjects cycled at 70-75%<br />
VO2max for 2.25-h, followed by a 15 min time trial. Blood samples were collected<br />
pre-suppl, post-suppl (pre-exercise), and immediately post-exercise and 14-h postexercise<br />
on the third day. Samples were analyzed for inflammation [interleukin (IL)-<br />
6, IL-8, tumor necrosis factor alpha (TNFα), monocyte chemoattractant protein 1<br />
(MCP-1)], oxidative stress (ORAC, FRAP, reduced and oxidized glutathione, protein<br />
carbonyls), and immune function [granulocyte (G-PHAG) and monocyte (M-PHAG)<br />
phagocytosis and oxidative burst activity] biomarkers, with metabolomics conducted<br />
using gas and liquid chromatographic mass spectrometry (GC-MS; LC-MS).<br />
rEsuLTs: A 2 (group) x 4 (time points) repeated measures ANOVA revealed<br />
significant time effects due to 3 days of exercise for IL-6 (396% increase), IL-8 (78%<br />
increase), TNFα (12% increase), MCP-1 (30% increase), G-PHAG (38% increase),<br />
M-PHAG (36% increase), FRAP (12.6% increase), ORAC (11% decrease at 14-h<br />
post-exercise), and protein carbonyls (82% increase at 14-h post-exercise) (p < 0.01).<br />
No significant interaction effects were found for all of the inflammation, oxidative<br />
stress, and immune function measures. Repeated measures ANOVA revealed a >2-fold<br />
shift in 103 metabolites due to exercise in the non-JUICE condition (FDR p-values<br />
all 20% DV) of five<br />
nutrients (22% vitamin A, 245% vitamin C, 20.5% vitamin B6, 23.6% potassium, and<br />
33.7% folate). Funded by Dole Foods Inc.<br />
D-15 Thematic Poster - Immunology<br />
May 30, 2013, 1:00 PM - 3:00 PM<br />
Room: 209<br />
1359 Chair: Jeffrey A. Woods, FACSM. University of Illinois,<br />
Urbana, IL.<br />
(No relationships reported)<br />
1360 Board #1 May 30, 1:00 PM - 3:00 PM<br />
Microarray analysis revealed Gene Expression Profiling<br />
In Lps- stimulated Whole Blood Following Prolonged<br />
Exhaustive Exercise<br />
Asghar Abbasi1 , Melanie Hauth1 , Michael Walter2 , Jens<br />
Hudemann3 , Veit Wank4 , Andreas M. Niess3 , Hinnak Northoff1 .<br />
1Clinical and Experimental Transfusion Medicine, Tübingen,<br />
Germany. 2Medical Genetics, Tübingen, Germany. 3Institute of Sports Medicine, Tübingen, Germany. 4Institute of Sports<br />
Science, Tübingen, Germany.<br />
(No relationships reported)<br />
An acute bout of prolonged exhaustive exercise can cause adverse effects on the<br />
immunity reflected by transient immunosuppression following the event.<br />
PurPOsE: To gain more insight into these mechanisms, the capacity of whole blood<br />
cultures in profiling gene expression in response to endotoxin (LPS) was studied in<br />
athletes before, 30min after, 3h after and 24h after a half-marathon run.<br />
METhOds: Eight well trained men and 8 well trained women were participated<br />
Vol. 45 No. 5 Supplement S257<br />
and gene expression patterns were assessed in LPS-stimulated (1h) and un-stimulated<br />
whole blood using Affymetrix GeneChip microarrays.<br />
rEsuLTs: Results showed that prolonged exhaustive exercise altered several genes<br />
in LPS-stimulated cultures relative to un-stimulated cultures. These included genes<br />
related to inflammatory response (30min and 3h post-exercise/both sexes), activation<br />
of AMPK activity, response to hypoxia (3h post exercise/men), angiogenesis (3h post<br />
exercise/women), prostaglandin biosynthetic process (30min and 3h post-exercise/<br />
both sexes), myeloid cell differentiation (24h post exercise/women) Functional<br />
categorization (KEGG pathway analysis) showed that genes associated with TLRs<br />
signalling were the most significantly over presented in both sexes.<br />
CONCLusION: The results of the present study indicate that prolonged exhaustive<br />
exercise resulted in a rich variety of changes in expression of inflammatory and antiinflammatory<br />
genes in short-time LPS stimulated whole blood cultures. This may<br />
provides novel insights into the molecular processes involved in the immune response<br />
following exhaustive exercise.<br />
This work was supported by a grant from the Bundesinstitut für Sportwissenschaften<br />
(Bonn, Germany, KZIIA1-070108/08-09).<br />
1361 Board #2 May 30, 1:00 PM - 3:00 PM<br />
The Impact of Ironman Triathlon on Innate Immune Cell<br />
Numbers and Function<br />
Shlomit Radom-Aizik 1 , Carl M. Maresh, FACSM 2 , Fadia<br />
Haddad 1 , Dan M. Cooper 1 , Cherryl Nugas 1 , Douglas J.<br />
Casa, FACSM 2 , Jenna M. Apicella 2 , Elaine C. Lee 2 , Julie K.<br />
DeMartini 2 , Colleen X. Munoz 2 , Frank Zaldivar 1 . 1 Pediatric<br />
Exercise Research Center, UC Irvine, Irvine, CA. 2 Korey Stringer<br />
Institute, University of Connecticut, Storrs, CT. (Sponsor: Carl<br />
M. Maresh, FACSM)<br />
(No relationships reported)<br />
Prolonged, high-intensity endurance exercise activities such as the Ironman Triathlon<br />
(typically lasting 10-12 hours) profoundly perturb homeostasis in a variety of<br />
physiological systems, and would likely impact key cellular components of innate<br />
immunity (e.g., natural killer cells and monocytes), a “first responder” to stress and<br />
infection. The effect of such exercise on numbers and functional indexes of circulating<br />
innate immune cells is poorly understood.<br />
PurPOsE: To study the impact of the Ironman Triathlon on innate immune cell<br />
number and function. We hypothesized that there would be immediate effects on<br />
measures of number of cells and cellular activation in NK cells (KIR, killer cell<br />
immunoglobulin-like receptors) and in monocytes (toll-like receptors, TLR) which<br />
would continue throughout the recovery period.<br />
METhOds: 10 elite male triathletes, 32-64 y/o volunteered. Blood was drawn<br />
between 2-3 days before the triathlon (baseline), and during recovery at 1-, 24-,<br />
and 48-h after completion. CBC and standard flow cytometry methods were used<br />
to determine monocyte and NK cell (CD3 - CD56+) count, NK dim and bright<br />
subpopulation (CD56 dim and CD56 bright ), and cell function (NK, KIR2DL2; and<br />
monocyte, TLR4). Repeated Measure ANOVA was applied (p
<strong>Thursday</strong>, May 30, 2013<br />
S258 Vol. 45 No. 5 Supplement<br />
rEsuLTs: Elite marathon runners tend to have lower concentrations of salivary<br />
antimicrobial peptides (HBD-2 and LL-37) than sedentary subjects(P
Official Journal of the American College of Sports Medicine<br />
pain, and pain/effusion) with a week between each condition. A single injection of 5%<br />
sodium chloride (1 mL) to the right infrapatellar fat pad and 0.9% sodium chloride (50<br />
mL) to the suprapatellar pouch were administered to induce knee pain and effusion,<br />
respectively. To induce pain/effusion, both injections were employed. No injection<br />
was performed for the control. High-speed videography was used to measure lowerextremity<br />
joint kinematics during walking. For each condition, subjects walked at three<br />
time intervals: precondition (prior to injections), condition (3 minutes post injections),<br />
and postcondition (30 min post injections). Functional linear models were utilized<br />
to detect differences between groups. This analysis used all of the data during stance<br />
phase, rather than discrete values.<br />
rEsuLTs: The biggest changes were observed under the pain/effusion condition.<br />
Compared to the precondition, subjects walked with more dorsiflexion (initial contact,<br />
35-60% of stance phase, and toe off), more knee flexion (at initial contact and 30-90%<br />
of stance phase), and less hip extension (37-82% of stance phase) in the involved side.<br />
In the uninvolved side, subjects walked with more dorsiflexion (10-35% of stance<br />
phase), knee flexion (3-20% and 50-70% of stance phase), and less hip abduction at toe<br />
off. Subjects walked with more knee flexion (50-70% of stance phase) under isolated<br />
knee pain condition while they walked with more knee flexion (45-80% of stance<br />
phase) and more dorsiflexion at initial contact under isolated knee effusion condition.<br />
CONCLusIONs: When a knee stimulus is combined with knee joint effusion it<br />
appears to produce a summative effect on joint kinematics. Since knee joint effusion<br />
is typically accompanied by pain, both variables should be aggressively managed in<br />
acute and chronic stages of knee joint injury and rehabilitation in order to avoid plastic<br />
changes to movement strategies.<br />
1368 Board #2 May 30, 1:00 PM - 3:00 PM<br />
Gait and speech are Interdependent in young healthy<br />
adults<br />
Tiphanie Raffegeau, Shirley Rietdyk, Jeffery M. Haddad, Jessica<br />
Huber. Purdue University, West Lafayette, IN.<br />
(No relationships reported)<br />
Recent studies have demonstrated that gait involves executive function (EF). In healthy<br />
adults, performing a concurrent task typically resulted in decreased performance of<br />
the secondary task and reduced gait speed. Arbitrary tasks, typical to dual-task gait<br />
research, such as counting backwards, may result in stronger associations between gait<br />
and EF due to the novelty of the task and may not reflect typical behavior. Therefore,<br />
it is important to extend the observations to common well-practiced tasks to fully<br />
examine the relationship between gait and EF. Conversational speech relies on EF, and<br />
people often talk while walking with a friend, providing an ideal concurrent task.<br />
PurPOsE: To investigate the interdependence of gait and speech in young healthy<br />
adults.<br />
METhOds: 16 adults (9 males, 22±1.4 yrs) walked under two speech conditions,<br />
talking and not talking. A topic was selected from a list and subjects spoke<br />
extemporaneously for one minute. Gait and speech measures were recorded. Paired<br />
t-tests were used to compare across conditions. Speech measures are currently being<br />
analyzed, only gait measures are reported here<br />
rEsuLTs: When speaking, gait speed decreased (1.44 ± .56 m/s to 1.36 ± .56 m/s,<br />
(p
<strong>Thursday</strong>, May 30, 2013<br />
S260 Vol. 45 No. 5 Supplement<br />
PurPOsE: Examine the dose-response relationship between load carried and sagittal<br />
plane knee mechanics during walking.<br />
METhOds: 25 active duty male volunteers (20.9 ± 3.3 yrs; 178.1 ± 8.3 cm; 86.3<br />
± 14.6 kg) carried 5 vest borne loads while walking on a force sensing treadmill at<br />
1.34m/s for 10 minutes. Soldiers first walked with body weight only, which served as<br />
a baseline condition. The 5 loads (15, 25, 35, 45 and 55 kg) were presented randomly<br />
with at least 3 min rest between loads. Kinematic and kinetic data were collected. Knee<br />
extensor moments (Mkne) and range of motion (ROM) from footstrike to mid-stance<br />
were compared across all 5 loads using repeated measures ANOVAs (p < .05).<br />
rEsuLTs: Post hocs revealed (Table 1) significant differences between each<br />
increasing load for Mkne (p < .025) but no differences for ROM (p ≥ .175). The Mkne<br />
increase from 45 to 55 kg was 1.9 times greater than any other increase in Mkne.<br />
CONCLusIONs: At a constant velocity and with no change in ROM across trials,<br />
the elevated Mkne was likely a mechanism by which the body responded to increasing<br />
loads. If these elevated Mkne are not sustainable, then Soldiers may be exposed to a<br />
greater risk of injury. Therefore, the disproportionate changes to Mkne at heavier loads<br />
suggest a threshold exists above which injury risk may be magnified.<br />
1372 Board #6 May 30, 1:00 PM - 3:00 PM<br />
Greater step Widths reduce Knee abduction Moments in<br />
Knee Osteoarthritis Patients during stair ascent<br />
Max R. Paquette 1 , Songning Zhang, FACSM 2 , Gary Klipple 3 .<br />
1 University of Memphis, Memphis, TN. 2 University of Tennessee,<br />
Knoxville, TN. 3 University of Tennessee Medical Center,<br />
Knoxville, TN.<br />
(No relationships reported)<br />
Research shows that increased step width (SW) during stair descent reduces first<br />
and second peak internal knee abduction moments in healthy adults but not in knee<br />
osteoarthritis (OA) patients.<br />
PurPOsE: To study the effects of increased SW on knee abduction moment and knee<br />
pain in<br />
healthy and knee OA adults during stair ascent.<br />
METhOds: 13 healthy<br />
adults (58.9±8.3 yrs) and 13 medial compartment knee OA patients (62.5±9.0 yrs)<br />
were recruited. A 9-camera motion analysis system, two force platforms and an<br />
instrumented staircase were used to obtain the 3D stance phase kinematic and GRF<br />
data. Participants performed 5 stair ascent trials at a self-selected speed using preferred<br />
SW, wide SW, and wider SW. The wide and wider SW conditions were normalized<br />
to 26 and 39% of leg length, respectively. A two-way (Group x SW) mixed design<br />
ANOVA was used to detect any differences between groups and SWs.<br />
rEsuLTs: The average self-selected stair ascent walking speed was slower (p=0.044)<br />
in knee OA patients (0.52±0.09 m/s) compared to healthy adults (0.60±0.06 m/s).<br />
In both groups 1st (KAM1) and 2nd (KAM2) peak internal abduction moments and<br />
abduction moment impulse (MI) were all<br />
reduced in wide and wider SW compared to preferred SW and in wider compared to<br />
wide SW (Table 1). Healthy adults rated no pain. Pain scores of knee OA patients were<br />
13.5±15.0mm for preferred,12.9±16.9mm for wide and 10.7±11.6mm for wider SW<br />
but were not significantly different (p>0.05).<br />
CONCLusION: Our results indicate that increased SW reduces peak knee abduction<br />
moments in both healthy and knee OA patients during stair ascent and could have<br />
implications on lowering medial knee joint loads during stair ascent. However,<br />
increased SW did not reduce knee pain in knee OA patients.<br />
MEDICINE & SCIENCE IN SPORTS & EXERCISE ®<br />
1373 Board #7 May 30, 1:00 PM - 3:00 PM<br />
Frontal Plane Walking Mechanics and hip strength<br />
In College-aged Individuals Who are Post-medial<br />
Meniscectomy<br />
Richard W. Willy, Brian C. Clark, FACSM, Megan A. Ossim,<br />
James S. Thomas. Ohio University, Athens, OH.<br />
(No relationships reported)<br />
More than 50% of those who undergo partial medial meniscectomy (PMM) have knee<br />
osteoarthritis (OA) 12 years post-procedure. PMM individuals have previously been<br />
reported to walk with an excessive knee external adduction moment (KEAM) 1-3<br />
months after surgery, likely increasing medial knee joint loads. However, it is unknown<br />
if these gait patterns persist long term. In addition, excessive frontal plane hip and<br />
trunk mechanics, perhaps due to hip abductor weakness, may contribute to high levels<br />
of KEAM in PMM individuals.<br />
PurPOsE:To compare gait mechanics and hip strength in college-aged individuals,<br />
post-PMM due to a traumatic meniscal tear, with healthy controls. Besides deficits<br />
in hip abductor strength (HABDS), PMM subjects were hypothesized to walk with<br />
greater peak knee adduction (KAD), KEAM, internal hip abduction moment (HAM),<br />
and greater trunk sidebending at peak KEAM (TLKEAM).<br />
METhOds:To date, 11 PMM subjects (9 males, post-PMM 40 months ±18.4) and 7<br />
healthy controls (6 males) have been collected. Isometric HABDS and the Knee Injury<br />
and Osteoarthritis Outcome Score (KOOS) were collected. Using standard motion<br />
capture procedures, walking mechanics were sampled as subjects traversed a 10-m<br />
runway at 1.3 m/s (+/-5%). Effect sizes were calculated in this incomplete cohort.<br />
rEsuLTs: To date, PMM subjects walked with greater peak KEAM, even when<br />
normalized to body mass. Interestingly, HAM and TLKEAM were greater while<br />
HABDS was less in PMM subjects.<br />
CONCLusIONs:These preliminary data suggest that young individuals who are<br />
post-PMM walk with excessive KEAM, possibly contributing to their high risk of knee<br />
OA. Potential therapies to reduce KEAM may include movement retraining of the hip<br />
and trunk or strengthening of the hip abductors.<br />
Variables of interest (±sd) and effect size calculations<br />
PMM Control Effect size (d)<br />
Age (Years) 23.1 (6.4) 23.3 (2.8) 0.05<br />
BMI (kg/m2) 26.5(3.2) 24.03(2.3) 0.88<br />
Tegner (x/10) 7.1(1.4) 7.1(0.7) 0.01<br />
KOOS (x/100) 86.3 (9.8) 99.2 (1.2) 2.33<br />
Peak KAD (deg) -3.4(3.9) -2.8 (2.8) 0.44<br />
Peak KEAM (N*m/kg*m) 0.415 (0.147) 0.291(0.111) 0.95<br />
Peak HAM(N*m/kg*m) -0.745(0.243) -0.581(0.121) 0.90<br />
TLKEAM (deg) 2.9 (2.1) 1.3 (0.6) 1.12<br />
HABDS (%BW*m) 12.6 (3.6) 16.6 (4.4) 0.93<br />
1374 Board #8 May 30, 1:00 PM - 3:00 PM<br />
Overground Gait aftereffects Produced By split-belt<br />
Treadmill Walking and unilateral stepping<br />
Kristin V. Huynh, Carolina H. Sarmento, Ryan T. Roemmich,<br />
Chris J. Hass, FACSM. University of Florida, Gainesville, FL.<br />
(No relationships reported)<br />
PurPOsE: To compare the transfer of unilateral stepping and split-belt treadmill<br />
walking aftereffects to overground gait. Rehabilitation to target gait asymmetry in<br />
various movement disorders is needed. Although both split-belt and unilateral step<br />
training have been reported to reduce these asymmetries, these methods have not been<br />
directly compared.<br />
METhOds: Thirteen healthy young adults (21 ± 2 y) participated in this study.<br />
Kinematic data were collected using a 10-camera motion capture system (120Hz). The<br />
participants first performed ten baseline gait trials across a 12-m walkway. Participants<br />
then selected a “fast” walking speed on the treadmill (1.48 ± 0.11 m/s); the “slow”<br />
speed was 50% of the fast speed. All participants completed three treadmill conditions<br />
in a randomized order for 10 minutes each: (1) during slow unilateral, the left leg<br />
walked at the slow speed while the right leg was stationary, (2) during fast unilateral,<br />
the left leg walked at the fast speed while the right leg was stationary, and (3) during<br />
split-belt, the left leg walked at the fast speed and the right leg walked at the slow<br />
speed. Following each condition, the participants performed ten overground gait trials.<br />
Step length asymmetry (SLA) was calculated for each stride by subtracting right step<br />
length from left step length. Linear regressions were fit to model the initial aftereffect<br />
(intercept, β0) and decay (slope, β1) of SLA along the number of steps during the gait<br />
trials following each treadmill condition and during baseline.<br />
rEsuLTs: We observed significantly larger aftereffect in SLA (β0) after split-belt<br />
compared to slow unilateral (β0=.056 vs. .022, p=.003). β0 was also significantly<br />
higher after fast versus slow unilateral (β0= .044 vs. .022, p= .005).<br />
The aftereffect decay (β1) was significantly higher after split-belt and fast unilateral<br />
compared to baseline (β1=-.0024 and -.0018 vs. -.0001, p=.005 and .048, respectively).<br />
β1 was also significantly higher after split-belt compared to slow unilateral (β1=-.0024<br />
vs. -.0009, p= .005).<br />
ACSM May 28 - June 1, 2013 Indianapolis, Indiana
Official Journal of the American College of Sports Medicine<br />
CONCLusION: Our results indicate that transfer of adapted gait parameters to<br />
overground gait following split-belt walking are greater than unilateral stepping,<br />
however some populations with gait asymmetry may benefit from unilateral stepping if<br />
they lack access to a split-belt treadmill.<br />
D-17 Free Communication/Slide - Advancing<br />
Physical Activity Assessment Methods<br />
May 30, 2013, 1:00 PM - 3:00 PM<br />
Room: 125<br />
1375 Chair: Scott Crouter, FACSM. University of Massachusetts<br />
Boston, Boston, MA.<br />
(No relationships reported)<br />
1376 May 30, 1:00 PM - 1:15 PM<br />
Expressing Energy Expenditure in youth: allometric scaling<br />
and Corrected METs<br />
Brian C. Rider, David R. Bassett, Jr., FACSM, Dawn P. Coe.<br />
University Of Tennessee, Knoxville, TN.<br />
(No relationships reported)<br />
Many physiological variables show associations with body size. It has been shown<br />
that scaling submaximal VO2 values helps to normalize the data across individuals<br />
of different size/age/gender. This reduces the likelihood that differences in VO2 will<br />
appear to exist, when in fact, they are due primarily to differences in body size. This<br />
could possibly be achieved by using allometric scaling or corrected METS (i.e. activity<br />
EE/estimated RMR).<br />
PurPOsE: To explore the use of allometric scaling and corrected METs to achieve<br />
better estimates of children’s energy expenditure (EE) based on speed of locomotion,<br />
during treadmill walking and running.<br />
METhOds: Mean data were taken from 13 studies that contained childhood (8-<br />
14y) VO2 data, obtained during submaximal treadmill tests. Due to the fact that each<br />
study had different numbers of participants, studies with a greater number numbers<br />
of subjects were assigned more weight. Linear regression was used to determine the<br />
relationship between VO2 and treadmill speed. For the allometric scaling method,<br />
body mass was expressed in ml.kg-0.75 min-1. Corrected METs were computed using<br />
the Schofield equation to estimate RMR, using both weight (w) and height and weight<br />
(h&w).<br />
rEsuLTs: Both allometric scaling and corrected METs improved the ability to<br />
estimate EE based on speed of locomotion. There was a tighter relationship between<br />
speed and VO2 scaled to body weight raised to the 0.75 power, than there was between<br />
speed and standard METs (i.e. activity EE/3.5) [Walking: r2= 0.6482, vs. 0.2859.<br />
Running: r2= 0.8247 vs. 0.6281]. Corrected METs also showed tighter relationships<br />
with speed than did standard METs [Walking: r2= 0.8722 (h&w) and 0.7942(w) vs<br />
0.2859; Running: r2= 0.4773 (h&w) and 0.6421 (w) vs 0.6281].<br />
CONCLusION: Both allometric scaling and corrected METs yielded stronger<br />
associations with speed of locomotion, than standard METs. Corrected METs also<br />
showed a stronger correlation with submaximal running speeds, but only when using<br />
the Schofield equation based on weight. Further research is needed to determine the<br />
best method available for normalizing energy costs of treadmill walking and running<br />
for youth of different sizes/genders/ages.<br />
1377 May 30, 1:15 PM - 1:30 PM<br />
using receiver Operating Characteristic Curves and<br />
accelerometry To Establish step-count Guidelines For<br />
Twelve-year-old Children<br />
Timothy Fulton, Fabio Fontana, Kent Ingvalson, Kimberly<br />
Decker, Ripley Marston, Kevin Finn. University of Northern<br />
Iowa, Cedar Falls, IA.<br />
(No relationships reported)<br />
Current physical activity guidelines are based on frequency, duration, and intensity<br />
of physical activity. Recollection of physical activity duration and understanding of<br />
physical activity intensity are difficult tasks. Restructuring current guidelines to stepcounts<br />
may facilitate the identification of children not reaching adequate physical<br />
activity levels.<br />
PurPOsE: To measure the ability of step-counts to discriminate between adequate<br />
and inadequate physical activity levels, and establish gender-specific step-count<br />
guidelines for twelve-year-old children.<br />
METhOds: This study employed a fully cross-sectional design. A total of 106<br />
children participated in the study (N girls = 62; N boys = 44). Participants wore a pedometer<br />
and an accelerometer for one full day, and recorded the number of steps on an<br />
activity log. The Freedson equation was used to compute duration and intensity of<br />
exercise. Receiver Operating Characteristic curves were used to determine the ability<br />
of step-counts to discriminate between adequate and inadequate physical activity<br />
Vol. 45 No. 5 Supplement S261<br />
levels. Optimal cutoff points were based on sensitive scores larger than .80 due to the<br />
importance of identifying children and adolescents with inadequate levels of physical<br />
activity, and the maximum sum of sensitive and specificity scores.<br />
rEsuLTs: The area under the curve for each of the sub-groups (AUCgirls = .85,<br />
95% CI = .76 - .95, p > .01; AUCboys = .85, 95% CI = .72 - .97, p > .01) was high,<br />
indicating good ability of step-counts to discriminate among children with adequate<br />
and inadequate levels of physical activity. To achieve minimum daily physical activity,<br />
we suggest 12,007 and 12,605 steps/day for 12-year-old girls and boys respectively.<br />
CONCLusION: Pedometer step-counts discriminate well among children with<br />
adequate and inadequate levels of physical activity. To our knowledge, this is the<br />
first attempt to develop gender- and age-specific guidelines. With the current levels<br />
of obesity on the rise, the use of the suggested step-count guidelines may be a useful<br />
initial epidemiological step in the identification of children with low levels of physical<br />
activity.<br />
1378 May 30, 1:30 PM - 1:45 PM<br />
Comparisons Of Prediction Equations For Estimating<br />
Energy Expenditure In youth<br />
Youngwon Kim 1 , Scott E. Crouter, FACSM 2 , Jung-Min Lee 1 ,<br />
Yang Bai 1 , Glenn A. Gaesser, FACSM 3 , Gregory J. Welk,<br />
FACSM 1 . 1 Iowa State University, Ames, IA. 2 University of<br />
Massachusetts Boston, Boston, MA. 3 Arizona State University,<br />
Tempe, AZ.<br />
(No relationships reported)<br />
Various sets of prediction equations for the Actigraph have been developed to estimate<br />
energy expenditure (EE) in youth, but there is no consensus about the best approach. A<br />
set of two 2-regression models (2RM) have been proposed as alternative to traditional<br />
single regression models (1RM), but they have not been directly compared.<br />
PurPOsE: The purpose of this study was to compare the VM (VM2RM) and VA<br />
(VA2RM) and 1RM models from Freedson/Trost (FT), Trost (TR), Puyau (PU) and<br />
Treuth (TH) to indirect calorimetry for estimating EE in youth.<br />
METhOds: Fifty nine participants (7- 13 yrs; male: 41) performed 12 different<br />
activities (randomly assigned from a set of 24) that would mimic “free-living”<br />
activities in youth. While performing these activities, the participants were<br />
concurrently measured with a metabolic gas analyzer (Oxycon Mobile; OM) and an<br />
Actigraph accelerometer. Each activity was performed for 5-min, with a 1-min rest<br />
between activities. Estimates of METs were obtained from the ActiGraph prediction<br />
methods and were compared to OM measured METs (measured VO2/predicted<br />
RMR). Comparisons were first made using the aggregated data from the whole trial<br />
(i.e. between-subject comparisons; n = 59) and then for each individual activity (i.e.<br />
activity-by-activity comparisons; n=24). Agreement with OM values was evaluated<br />
using repeated measures of ANOVA (with Tukey-Kramer pairwise comparisons), and<br />
absolute percent errors (APE).<br />
rEsuLTs: For the whole trial comparisons, estimated EE from each of the ActiGraph<br />
prediction methods significantly underestimated measured OM EE (P
<strong>Thursday</strong>, May 30, 2013<br />
S262 Vol. 45 No. 5 Supplement<br />
METhOds: Activity data were collected during a longitudinal bone growth study,<br />
contrasting gymnasts (GYM: non-seasonal OPA) vs. non-gymnasts (NON: seasonal<br />
OPA). Activity-specific OPA for each calendar month was recorded using semi-annual<br />
questionnaires. Total OPA monthly means (MOPA) and annual means (AOPA) were<br />
calculated. For individual subjects, MOPA and AOPA means, standard deviations (sd)<br />
and coefficients of variation (CV, sd/mean) were calculated; similar group statistics<br />
were calculated for GYM, NON and ALL (GYM + NON).<br />
rEsuLTs: OPA data were analyzed for 59 girls (27 GYM, 32 NON), aged 8-17 yrs.<br />
AOPA group means were as follows: ALL 8.5 h/wk (sd 5.3); GYM 12.6 h/wk (sd 4.3);<br />
NON 5.1 h/wk (sd 3.4). For MOPA, mean intra-subject CVs (INTRACV) were: ALL<br />
52%, GYM 35% and NON 66%. For AOPA, mean inter-subject CVs (INTERCV)<br />
were: ALL 63%, GYM 34%, NON 66%. Thus, monthly intra-individual variability<br />
(MOPA INTRACV) was high and similar to annual inter-individual variability (AOPA<br />
INTERCV).<br />
suMMary: For females in late childhood and adolescence, MOPA differs widely<br />
from month-to-month and may not reflect annual VPA exposure. Thus, use of<br />
“snapshot” activity sampling may weaken associations with biological properties of<br />
interest, as intra-individual variation across time rivals inter-individual differences. For<br />
growing females, use of general AOPA records may be more appropriate for studies of<br />
skeletal adaptation and maintenance than extrapolation from more specific “snapshot”<br />
sampling.<br />
1380 May 30, 2:00 PM - 2:15 PM<br />
assessment of Light-Intensity activities and sedentary<br />
Behaviors using Multiple Measurement devices<br />
Nathanael Meckes, Laura R. Brittain, Barbara E. Ainsworth,<br />
FACSM. Arizona State University, Phoenix, AZ.<br />
(No relationships reported)<br />
PurPOsE: To examine the accuracy of three measurement devices (ActiGraph<br />
GT3x+, ActivPAL, and Sensewear Armband) in assessing sedentary behavior and<br />
light-intensity physical activity (PA) against a referent measure of oxygen uptake<br />
(Oxycon Mobile).<br />
METhOds: 16 adults (8 males, 8 females) wore the four measurement devices<br />
while performing 7 activities (walking at 1.0 mph, 1.5 mph, 2.0 mph, cleaning a<br />
kitchen, standing and reading, typing at a computer, and playing board games)<br />
classified in the 2011 Compendium of Physical Activities between 1.2 and 1.8 METs<br />
or were unmeasured activities that were light-intensity in nature. Activities were<br />
classified as either sedentary or light-intensity according to the oxygen uptake, and<br />
the other measurement devices were compared against oxygen uptake for accuracy<br />
in measurement. Mean absolute percent error (MAPE) was used to calculate<br />
measurement accuracy.<br />
rEsuLTs: The Sensewear Armband measured treadmill walking accurately (0%<br />
MAPE), but activities requiring arm movement were less accurate (typing - 50.00%<br />
MAPE). The ActivPAL also measured treadmill walking accurately (1.88% MAPE)<br />
but misclassified standing activities (reading - 86.88% MAPE). The ActiGraph GT3X+<br />
misclassified activities with slow (
Official Journal of the American College of Sports Medicine<br />
activity protocol (median=11.5%, range=6.3%-27.4%) compared to the lifestyle<br />
activity protocol (median=77.2%, range=60.6%-98.3%). Patterns of prevalence<br />
for both activity protocols were similar for sex, race/ethnicity, education, and BMI<br />
subgroups. Prevalence decreased with age for the walking/running activity protocol<br />
whereas prevalence increased for 25-44 year olds before decreasing with age for the<br />
lifestyle activity protocol.<br />
CONCLusION: Prevalence estimates for meeting Guidelines in U.S. adults varied<br />
widely, indicating the choice of cut point impacts the prevalence estimates. Whether<br />
accuracy of the prevalence for meeting Guidelines for U.S. adults may be further<br />
improved if cut points (1) captured lifestyle activities in which many U.S. adults<br />
participate and (2) were generated from samples with characteristics similar to that of<br />
the U.S. adult population should be evaluated.<br />
D-18 Clinical Case Slide - Low Back Issues<br />
May 30, 2013, 1:00 PM - 2:40 PM<br />
Room: 103<br />
1384 Chair: Stanley A. Herring, FACSM. University of Washington<br />
Medical Center, Seattle, WA.<br />
(No relationships reported)<br />
1385 discussant: Gary P. Chimes. Northwestern University, Chicago, IL.<br />
(No relationships reported)<br />
1386 discussant: Lisa Colvin, FACSM. ULM, Monroe, LA.<br />
(No relationships reported)<br />
1387 May 30, 1:00 PM - 1:20 PM<br />
spine Injury _ Gymnast<br />
Bryan Murtaugh, Ellen Casey. Northwestern McGaw Medical<br />
Center, Chicago, IL. (Sponsor: Joel Press, FACSM)<br />
(No relationships reported)<br />
hIsTOry: 16-year-old gymnast and cheerleader presenting for second opinion<br />
for 6 month history of low back pain. During the onset of pain, she was returning<br />
to gymnastics after several months of limited participation while recovering from<br />
a right knee injury. She was initially seen by another physician, and had x-rays and<br />
MRI, which were interpreted as a stress fracture of the superior endplate of S1. Initial<br />
treatment included a lumbar corset, NSAIDs, PT, and modified gymnastics. Pain<br />
persisted, so she received a different soft orthosis, and stopped all gymnastics and<br />
cheerleading 2 months prior to presentation.<br />
PhysICaL EXaMINaTION: Increased thoracic kyphosis, decreased lumbar<br />
lordosis, and pelvic obliquity. Tenderness at L5 and S1 spinous processes and bilateral<br />
sacral sulcus. Significantly restricted lumbar extension. Strength 5-/5 for right great toe<br />
extension and eversion. Seated slump and straight leg raise causes bilateral posterior<br />
thigh pain that improves with cervical extension.<br />
PhysICaL EXaMINaTION: 1.Spondylolysis 2.Persistent S1 ring apophysis<br />
fracture 3.Sacral stress fracture 4.Lumbosacral radiculopathy<br />
TEsT aNd rEsuLTs:<br />
1.Lumbosacral xrays: No DDD, spondylosis, or spondylolisthesis. 2.Lumbosacral MRI<br />
11/2011: L5-S1 with a linear low signal endplate irregularity in the superior margin of<br />
the superior S1 endplate, right disc bulge with encroachment upon S1. 3.Lumbosacral<br />
MRI 4/2012: L5-S1 focal depression of the posterior portion of the superior S1<br />
endplate to the right of the midline, disc bulge L5-S1.<br />
FINaL WOrKING dIaGNOsIs: Right L5-S1 radiculopathy<br />
TrEaTMENT aNd OuTCOMEs: 1. Further imaging with a focused CT of<br />
L5-S1 obtained to determine if she truly has a persistent ring apophysis fracture.<br />
CT demonstrated that the presumed S1 endplate fracture was actually a congenital<br />
anomaly rather than an acute injury. 2. Treatment plan for R L5-S1 radiculopathy,<br />
including extension-biased mechanical diagnosis and treatment. Trial of Gabapentin<br />
200 mg PO HS. 3. Activity modification - No gymnastics until strength normalized,<br />
and pain decreased with daily activities, then progressed to stretching and conditioning<br />
with team. 4. She had 80% improvement with the treatment, and gradually returned to<br />
cheerleading and gymnastics without limitation from pain.<br />
1388 May 30, 1:20 PM - 1:40 PM<br />
Back Pain - Football<br />
Jesse Sally, Gary Chimes, Tanya Hagen. UPMC, Pittsburgh, PA.<br />
(No relationships reported)<br />
hIsTOry: A 22 year-old college football player presents with low back pain after<br />
being hit from behind, striking his back on the top of the opposing player’s helmet.<br />
He had acute pain in the left low back at the time of the injury, which persisted during<br />
practice the following week. He describes dull, aching pain in the left low back and<br />
paraspinal region that is worsened by prolonged standing and walking. He also reports<br />
pain with sitting upright for extended periods and bending forward to put on shoes.<br />
PhysICaL EXaMINaTION: Pain with lumbar range of motion was most<br />
Vol. 45 No. 5 Supplement S263<br />
significant between 30-70 degrees of lumbar flexion. There was tenderness to palpation<br />
of left lower lumbar paraspinals. With the knee flexed, the patient could flex, internally<br />
rotate, and externally rotate the hip without limitation. Sensation is intact to light<br />
touch throughout his L2-S2 dermatomes bilaterally. Manual muscle testing revealed<br />
5/5 strength throughout his L2-S2 myotomes. Muscle stretch reflexes were 2+/4 at<br />
the knee, medial hamstring, and ankle bilaterally. Stork maneuver with reproduction<br />
of low back pain bilaterally. Slump-sit test with reproduction of concordant back pain<br />
bilaterally, more intensely on the left and better with cervical extension on the left.<br />
PhysICaL EXaMINaTION:<br />
Pars interarticularis fracture<br />
Lumbar facet syndrome<br />
Sacroiliac joint inflammation<br />
Lumbar disc herniation<br />
Lumbar annular tear<br />
Lumbar radiculitis<br />
TEsT aNd rEsuLTs:<br />
Lumbar spine x-ray imaging without acute fracture or spondylolisthesis.<br />
MRI of the lumbar spine with left paracentral disc protrusion at L4-5. Bilateral facet<br />
hypertrophy also at the same level with minimal foraminal encroachment.<br />
Standing extension-based exercises performed in the clinic helped to centralize pain<br />
from the left low back into the axial spine. This confirmed the diagnosis and helped<br />
guide treatment.<br />
FINaL WOrKING dIaGNOsIs:<br />
L4-5 left paracentral disc protrusion with L5 radiculitis<br />
TrEaTMENT aNd OuTCOMEs:<br />
Left L5 transforaminal epidural steroid injection.<br />
Immediate improvement in symptoms post-injection.<br />
Prescribed physical therapy with focus on centralization (if symptoms were to recur),<br />
core stabilization, and lumbar strengthening for high level functionality.<br />
Full return to competition and practice without symptoms when evaluated for clinical<br />
follow-up.<br />
1389 May 30, 1:40 PM - 2:00 PM<br />
Lumbar spine-professional Ladies Professional Golf<br />
association Golfer<br />
Michael W. Perry, Elizabeth M. Hudak, Michael Weiss. Laser<br />
Spine Institute, Tampa, FL.<br />
(No relationships reported)<br />
hIsTOry: In 2010, a 27-year old LPGA golfer presented with a 7-year history<br />
of intermittent shooting sharp pain in her left lower back and left hip flexors. She<br />
also noticed a sensation of weakness in her left hip. Pain severity increased with<br />
posture and rotation, spine loading, sitting, and playing golf. There were no radicular<br />
symptoms, numbing, tingling, or changes in gait. Failed attempts to alleviate pain<br />
included acupuncture, spinal decompression using the DRX-9000, chiropractic care,<br />
hydro-therapy, and yoga. In 2008, short-term pain relief was achieved through a caudal<br />
epidural and facet injections.<br />
PhysICaL EXaMINaTION: The patient had a negative straight leg raise.<br />
Dorsiflexion and plantar flexion strength was 5/5 bilaterally. There was no alteration<br />
to sensation distally. Bilateral paraventrebal tenderness was noted at the left lumbar<br />
region. Pain was noted in the lumbar-thoracic spine with flexion, hyperextension, left<br />
lateral flexion and left rotation. Motor strength was satisfactory with a score of 5/5 in<br />
all muscle groups. No pathologic deep tendon reflexes were elicited.<br />
PhysICaL EXaMINaTION:<br />
1.lumbar disc disruption<br />
2.lumbar facet disease<br />
3.lumbar paraspinal muscle strain<br />
TEsT aNd rEsuLTs:<br />
MRI of the lumbar spine:<br />
•degenerative disc disease and bulge at L3-S1<br />
•annular tear at L3/4<br />
•degenerative facet disease at L4/5<br />
•mild forminal narrowing at L4/5 and L5/S1<br />
•mild spinal stenosis at L3-5<br />
X-Ray of the lumbar spine:<br />
•no instability or acute osseus abnormalities<br />
•disc spaces relatively maintained<br />
•mild facet changes of the lower lumbar facets at L4/5 and L5/S1<br />
X-Ray of the pelvis:<br />
•concentric hips without degenerative changes<br />
•pseudoarthrosis is not well visualized<br />
FINaL/WOrKING dIaGNOsIs:<br />
1.facet degeneration<br />
2.lumbar arthritis/osteoarthritis without myelopathy<br />
3.bulging disc<br />
TrEaTMENT aNd OuTCOMEs:<br />
1.minimally invasive endoscopic spinal surgery<br />
•destruction by thermal ablation of the paravertebral facet joint nerves at bilateral L3/4,<br />
bilateral L4/5, and bilateral L5/S1 facet joints<br />
2.post-operative care<br />
<strong>Abstracts</strong> were prepared by the authors and printed as submitted.<br />
<strong>Thursday</strong>, May 30, 2013
<strong>Thursday</strong>, May 30, 2013<br />
S264 Vol. 45 No. 5 Supplement<br />
•lumbar bracing<br />
•follow-up evaluations<br />
•physical therapy<br />
3.surgical outcomes<br />
•back pain 6-months post-surgery: a short course of NSAIDs resolved all symptoms<br />
•patient is free from back pain, uses no pain medications, and playing in the LPGA tour<br />
1390 May 30, 2:00 PM - 2:20 PM<br />
Tingling and Weakness - Gymnastics<br />
Nailah Coleman, FACSM. Children’s National Medical Center,<br />
Washington, DC.<br />
(No relationships reported)<br />
hIsTOry: 16 y/o gymnast presented with sharp right patellar tendon pain and midlower<br />
back pain after two separate vault injuries within the prior two weeks. Her pain<br />
was exacerbated by movement and use of her knee and back. She denied sedentary<br />
pain, sleep disturbance, or bowel-bladder insufficiency. She noted atraumatic “pins and<br />
needles” on her right dorsal hand over the past five days but denied neck, elbow, or jaw<br />
pain or injury.<br />
Her past medical and surgical histories were unremarkable.<br />
Her only medicine was Aleve. She had no known allergies.<br />
Exam: she was WDWN in NAD. She had symmetric appearance of her extremities<br />
and a minimal curvature of her spine. She had a normal gait and was able to heel, toe,<br />
and duck walk. She was nontender to palpation. She had full motion of her trunk and<br />
extremities but pain with lumbar extension. Strength, sensation, and neurovascular<br />
status were intact and symmetric, except for 4+/5 strength in the right upper extremity.<br />
She had right hand cramping with elevated arm stress test and right shoulder pain with<br />
empty can, O’Brien’s test, and Speed’s test.<br />
PhysICaL EXaMINaTION:<br />
•Spinal cord lesion<br />
•Nerve root compression<br />
•Peripheral nerve disease<br />
•Patellar tendinitis<br />
•Spondylolysis<br />
•Back strain<br />
TEsTs aNd rEsuLTs<br />
X-rays<br />
•Cervical spine with oblique views: increased transverse processes<br />
•Scoliosis views: minimal curvature<br />
•Lumbar spine with oblique views: normal<br />
•Shoulder: normal<br />
•Knee: normal<br />
MRI<br />
•Spine: a lesion at C4-C5 measuring 5 mm (width) x 15 mm (cranial-caudal) with mild<br />
enhancement, which could signal a demyelinating process, tumor, or trauma.<br />
•Brain: findings suggestive of volume loss without evidence of gliosis or<br />
demyelination process.<br />
Final Working Diagnosis: transverse myelitis<br />
TrEaTMENT aNd OuTCOMEs<br />
•Urgently seen by Neurology and admitted from clinic with a progressively<br />
symptomatic exam, including hyperreflexia and clonus.<br />
•CSF and serum studies for infectious and rheumatologic diseases were normal, except<br />
for an elevated ANA. A definitive etiology has not been found.<br />
•She was given a three-day course of methylprednisolone and responded well.<br />
•She was discharged home with plans for Neuro-Ophthalmology, PM&R, and repeat<br />
imaging.<br />
•New studies are pending.<br />
1391 May 30, 2:20 PM - 2:40 PM<br />
acute Back Pain-Football<br />
Tom W. Bartsokas, FACSM. Summa Orthopaedics & Sports<br />
Medicine, Streetsboro, OH.<br />
(No relationships reported)<br />
hIsTOry: 13-yo male sustained direct blow to right lumbar area from helmet.<br />
Pain progressed over next 2 days, was constant, rated 9/10 at worst and 6/10 at least,<br />
radiated from right LB to right knee, and was associated with severe loss of spinal<br />
motion. Denied changes in bowel/bladder control, hematuria, weakness, previous<br />
episodes of LBP.<br />
PhysICaL EXaMINaTION: Standing exam revealed neutral spinal alignment.<br />
AROM: moderate restriction to flexion; severe restriction to extension (caused<br />
severe right LBP); severe restriction to right sidebending; moderate restriction to left<br />
sidebending; moderate restrictions to rotation bilateral. Gait was slightly antalgic<br />
secondary to back pain. 4+ TTP over right lumbar paraspinals, which had moderately<br />
increased tonus. No TTP at midline, SI joints, sciatic notches bilateral. DTR’s 2/4.<br />
PhysICaL EXaMINaTION: Lumbar contusion, Spondylolysis, Facet syndrome,<br />
Fracture (spinous process, transverse process, pedicle, vertebral body), Lumbar disc<br />
displacement<br />
TEsT aNd rEsuLTs: X-rays of lumbar spine: 5 lumbar vertebrae in normal<br />
MEDICINE & SCIENCE IN SPORTS & EXERCISE ®<br />
alignment. Slerotic line at right L5 pars interarticularis. No other suggestive evidence<br />
for fractures. Lumbar MRI scan: nondisplaced right L2 transverse process fracture,<br />
bone marrow edema at right L3 & L4 transverse processes.<br />
FINaL WOrKING dIaGNOsIs: Right L2 transverse process fracture<br />
TrEaTMENT aNd OuTCOMEs: First visit: TLSO brace 23 hours/day and<br />
withheld from sports/PE. Second visit: Feeling better, walking normally, throwing<br />
football without pain; continue brace use when up and rest for another 3 weeks. Third<br />
visit: Released to full activity 4.5 weeks after injury.<br />
D-19 Clinical Case Slide - Football I<br />
May 30, 2013, 1:00 PM - 2:40 PM<br />
Room: 117<br />
1392 Chair: Jeffrey M. Anderson, FACSM. Univ. of Connecticut,<br />
Storrs, CT.<br />
(No relationships reported)<br />
1393 discussant: Bryan Wiley. Rancho Cucamonga, CA.<br />
(No relationships reported)<br />
1394 discussant: Aaron Rubin, FACSM. Kaiser Permanente Sports<br />
Medicine Program, Fontana, CA.<br />
(No relationships reported)<br />
1395 May 30, 1:00 PM - 1:20 PM<br />
recurrent deep Vein Thrombosis - Football<br />
Dale C. Gold. University of Colorado, Littleton, CO. (Sponsor:<br />
Tod Sweeney, FACSM)<br />
(No relationships reported)<br />
hIsTOry: 18 year old high school football player presented with right upper<br />
extremity pain and swelling. He reported no injury to the area other than normal hits<br />
playing football. He reported recent heavy weight lifting. Ultrasound showed a right<br />
axillary DVT. Hypercoagulable workup was negative. He was treated with 6 months<br />
of warfarin therapy then cleared for athletic participation. In May 2010 the patient<br />
resumed weight lifting after a four month break and presented with pain and swelling<br />
of the right arm. Ultrasound showed a right subclavian DVT. He was restarted on<br />
warfarin and evaluated by vascular surgery in February 2011. A venogram performed<br />
April 2011 showed no acute clots. He was determined a non-surgical candidate due to<br />
the chronic nature of the occlusion. In June 2011, Warfarin was discontinued and low<br />
dose aspirin was started. In October 2011, patient presented with right arm swelling<br />
and pain after 2 weeks of lifting. Ultrasound showed an axillary vein DVT. Patient<br />
restarted on warfarin. Between acute episodes the patient had stable mild edema of the<br />
right arm after lifting, occasional bluish discoloration of the right upper extremity, and<br />
occasional pain in his right shoulder and neck.<br />
PysICaL EXaMINaTION: Examination when presenting with acute complaints<br />
reveal:<br />
5/10: Right arm notably swollen compared to left, 2+ radial pulses bilaterally<br />
10/11: subtle swelling of the right dorsal hand<br />
PhysICaL EXaMINaTION:<br />
1. Paget-Schroetter Syndrome:<br />
- Increased muscle mass/impingement of vein by musculature of dominant arm<br />
- Cervical rib<br />
2. Hypercoagulable state<br />
3. Cervical Radiculopathy<br />
TEsT aNd rEsuLTs:<br />
Hypercoagulable workup:<br />
- Negative Factor V, Factor II DNA mutation, anticardiolipin antibodies, homocysteine<br />
level, protein C & S<br />
IMaGING:<br />
4/08: US: thrombus right axillary vein<br />
8/08: CTPE negative<br />
11/08: US: no thrombus<br />
5/10: US: thrombus right subclavian vein<br />
2/11: US: no thrombus<br />
4/11: Venogram: chronic occlusion of right subclavian vein at level of thoracic inlet<br />
with mature appearing collaterals.<br />
10/11: US: thrombus right axillary vein<br />
FINaL/WOrKING dIaGNOsIs:<br />
Paget-Schroetter Syndrome due to venous impingement by musculature of dominant<br />
arm.<br />
TrEaTMENT aNd rECCOMEdaTIONs:<br />
1. Chronic Warfarin therapy<br />
2. Modified activity while on warfarin<br />
3. Repeat Surgical Evaluation<br />
ACSM May 28 - June 1, 2013 Indianapolis, Indiana
Official Journal of the American College of Sports Medicine<br />
1396 May 30, 1:20 PM - 1:40 PM<br />
Wrist Injury _ Football<br />
Patrick Moreno1 , Steven Collina1 , David Webner1 , Andrew<br />
Reisman2 . 1Crozer Keystone, Springfield, PA. 2University of<br />
Delaware, Newark, DE. (Sponsor: Daniel Miles, FACSM)<br />
(No relationships reported)<br />
hIsTOry: 21 y/o male college football cornerback presented with right wrist pain<br />
after forced wrist flexion during a ball stripping drill at practice. He reported pain<br />
localized to the dorsoradial aspect of the wrist that was worse with flexion. Although<br />
he did not recall a previous injury to the wrist, he mentioned having intermittent wrist<br />
pain for 1 year in the same location. He did not experience paresthesias or weakness.<br />
PhysICaL EXaMINaTION: Passive range of motion with wrist flexion to 65<br />
degrees, extension to 50 degrees, radial deviation to 18 degrees, ulnar deviation to 30<br />
degrees. There was no tenderness over the anatomic snuffbox. There was tenderness<br />
over the scapholunate junction. Watson’s test was positive.<br />
PhysICaL EXaMINaTION:<br />
1. Scaphoid fracture<br />
2. Scapholunate ligament dissociation<br />
3. DISI (Dorsal Intercalated Segmental Instability)<br />
4. SLAC (Scapho-Lunate Advance Collapse)<br />
5. CMC joint arthritis<br />
TEsT aNd rEsuLTs:<br />
Wrist A/P, lateral, and scaphoid radiographs:<br />
-widening of the scapholunate joint to 4.8mm with avulsion of the scaphoid<br />
Wrist Magnetic Resonance Imaging:<br />
-4mm scapholunate diastasis. Scapholunate angle increased to 80 degrees<br />
FINaL WOrKING dIaGNOsIs:<br />
DISI with scapholunate ligament tear<br />
TrEaTMENT aNd OuTCOMEs:<br />
1. Initially treated with wrist splint and evaluation by hand specialist.<br />
2. As an academic senior with 2 years of eligibility and redshirted as a freshman he<br />
elected to have custom wrist splint and continue playing the rest of the season.<br />
3. Reconstruction of the scapholunate ligament is planned for after the season.<br />
1397 May 30, 1:40 PM - 2:00 PM<br />
Knee Injury - Football<br />
Karen Gustafson, Aaron Provance. University of Colorado,<br />
Denver, CO. (Sponsor: John Hill, FACSM)<br />
(No relationships reported)<br />
hIsTOry: 10 year-old football player with left knee pain after sustaining two patellar<br />
contusions two weeks prior to presentation. He describes pain along the medial border<br />
of the patella that then causes his quad to spasm, along with general stiffness. He<br />
denied having any pain in his left knee prior to contusions, nor any locking or catching<br />
episodes. No right knee pain. His father states he has been grasping the banister while<br />
walking up and down the stairs for months.<br />
PhysICaL EXaMINaTION:<br />
Left Knee<br />
No swelling, deformity or ecchymosis. Tenderness to palpation over the medial border<br />
of the patella. ROM with full extension/flexion. Neurovascular exam intact with brisk<br />
pulses, 2 second capillary refill and a normal motor and sensory nerve examination in<br />
the affected limb. No laxity with valgus, varus stress testing at 0 and 30 deg. Negative<br />
anterior/posterior drawer, lachman’s, McMurray’s tests.<br />
PhysICaL EXaMINaTION:<br />
1.Patella Contusion<br />
2.Patella Fracture<br />
3.Patella Osteochondral Injury<br />
TEsT aNd rEsuLTs:<br />
Left Knee 4 view-xray<br />
-bony defect is noted in the posterior patella, likely residing at the level of the middle<br />
patella facet, which measures 1 cm in the craniocaudal dimension<br />
-findings compatible with osteochondral injury of the patella.<br />
MRI Left Knee<br />
-Regional marrow edema involving three quarters of the patella.<br />
-Defect arising from the subchondral bone of the middle patella facet with dimensions<br />
of 3.5 CC x 10 AP x 1.6 cm ML mm.<br />
-Overlying hyaline cartilage remains intact.<br />
FINaL/WOrKING dIaGNOsIs:<br />
Osteochondritis Dissecans of the patella.<br />
TrEaTMENT aNd OuTCOMEs:<br />
1.Immobilization in hinge-knee brace with limited flexion, 0 to 30 degrees, for 6<br />
weeks.<br />
2.No running, jumping activities.<br />
3.Return to clinic in 6 weeks for repeat physical examination and xrays.<br />
Vol. 45 No. 5 Supplement S265<br />
1398 May 30, 2:00 PM - 2:20 PM<br />
Leg Injury- Football<br />
David C. Waterson. Western Michigan University, Kalamazoo,<br />
MI. (Sponsor: Dilip Patel, FACSM)<br />
(No relationships reported)<br />
hIsTOry: A 17 year-old high school football offensive lineman sustained a right leg<br />
injury while blocking down field. Late in the game, he describes a hypertextension<br />
injury to the right knee. A defender missed the ball carrier and ran into his knee forcing<br />
it into hyperextension. He was unable to continue play or bear weight. There was knee<br />
swelling immediately following the injury.<br />
PhysICaL EXaMINaTION: Examination at an injury clinic the following morning<br />
revealed a large right knee effusion, slight flexion contracture, minimal active flexion<br />
secondary to pain, gapping of the medial joint line when testing near zero degrees,<br />
limited Lachman’s test due to effusion and limited range of motion, and medial joint<br />
line tenderness. The right lower extremity was neurovascularly intact.<br />
PhysICaL EXaMINaTION: 1. MCL sprain<br />
2. Torn PCL<br />
3. Torn ACL<br />
4. Tibia fracture<br />
5. Femur fracture<br />
TEST AND<br />
rEsuLTs: Right knee- anterior-posterior, lateral, and sunrise radiographs ( initial<br />
films).<br />
-effusion<br />
-fracture of the medial femoral condyle with a 2 mm step off at the trochlea<br />
-a couple of lucent areas running horizontally at the distal medial femur<br />
Right knee-anterior-posterior, lateral, and sunrise radiographs (repeated two days after<br />
initial films):<br />
-as above with increased step off at the trochlea<br />
CT scan of the right knee- sagittal and coronal images:<br />
-large hemarthrosis<br />
-horizontally oriented fracture through the medial aspect of the distal femoral physis<br />
extending in a sagittaly oriented fashion into both the intercondylar notch and the<br />
patellofemoral joint<br />
Right knee-anterior-posterior, lateral, and sunrise radiographs ( taken postoperatively):<br />
-evidence of two screws in the distal femur<br />
-anatomic reduction of the fracture in the AP and lateral views with step off of 1mm or<br />
less in the sunrise view<br />
FINaL WOrKING dIaGNOsIs: Medial femoral condyle fracture<br />
TrEaTMENT aNd OuTCOMEs:<br />
1. Open reduction and internal fixation of the fracture.<br />
2. Placed in a knee immobilizer and made non-weightbearing for at least two months.<br />
3. Start with formal physical therapy one month out from the surgical intervention.<br />
This will include gentle range of motion.<br />
4. Doing well eleven days postoperatively. The pain is decreasing and he is compliant<br />
with non-weightbearing.<br />
1399 May 30, 2:20 PM - 2:40 PM<br />
Knee Injury - Football<br />
Lauren M. Salas, Jeffrey A. Bonacci. University of Arkansas,<br />
Fayetteville, AR. (Sponsor: Barry S Brown, FACSM)<br />
(No relationships reported)<br />
hIsTOry: A 21-year-old junior male NCAA division I football wide receiver entered<br />
the athletic training room with complaints of posterior joint line left knee pain. The<br />
athlete complained of pain with both flexion and extension. Athlete also complained<br />
of pain with running, cutting, and abrupt stopping. There was no known mechanism of<br />
injury. Athlete had history of a left knee injury which included one meniscal repair and<br />
two menisectomies of the medial meniscus. The surgeries occurred two years prior to<br />
the diagnosis, five months prior to the diagnosis, and a month prior to diagnosis.<br />
PhysICaL EXaMINaTION:Tenderness over the medial and posterior joint line<br />
of the left knee and pain on the posterior side of the knee. Passive and active range of<br />
motion was only slightly decreased and created minor pain for the athlete. Positive<br />
McMurray’s test was found for a meniscus tear. Athlete performed functional tests<br />
including running, cutting, and jumping which also created some pain, Athlete was still<br />
able to perform wide receiver duties during practice and games.<br />
PhysICaL EXaMINaTION:<br />
1.Meniscus tear<br />
2.Distal strain of the hamstrings (biceps femoris, semitendinosus, or<br />
semimembranosus)<br />
3.Baker’s cyst<br />
TEsT aNd rEsuLTs:<br />
McMurray’s Test<br />
•positive for posterior medial joint line pain<br />
Manual Muscle Test<br />
•increased pain in distal hamstring tendons without weakness<br />
Magnetic resonance imaging (MRI)<br />
•normal findings for ligaments and muscles<br />
<strong>Abstracts</strong> were prepared by the authors and printed as submitted.<br />
<strong>Thursday</strong>, May 30, 2013
<strong>Thursday</strong>, May 30, 2013<br />
S266 Vol. 45 No. 5 Supplement<br />
•cyst found in posterior compartment of the knee<br />
•cyst was not found on previous knee arthroscopy to repair meniscus<br />
FINaL WOrKING dIaGNOsIs:<br />
Symptomatic Baker’s cyst in the left knee<br />
TrEaTMENT aNd OuTCOMEs:<br />
1.Removal of cyst through constant draining<br />
2.Anti-inflammatory medication was used on continuous basis to control swelling<br />
3.Increase range of motion by stretching to regain any lost flexibility<br />
4.Strengthening of surrounding musculature including hamstrings and quadriceps<br />
5.Kept playing during season and drained cyst four times after initial draining<br />
throughout season and since the completion of that season<br />
6.Wore knee compression sleeve or brace to take tension off knee joint and provided<br />
support.<br />
7.Athlete continued participation with cyst and treated systematically<br />
D-20 Clinical Case Slide - Upper Extremity II<br />
May 30, 2013, 1:00 PM - 3:00 PM<br />
Room: 123<br />
1400 Chair: Mary Lloyd Ireland, FACSM. Kentucky Sports Medicine<br />
Clinic, Lexington, KY.<br />
(No relationships reported)<br />
1401 discussant: Jimmy D. Bowen. Advanced Orthopedic Specialists,<br />
Cape Girardeau, MO.<br />
(No relationships reported)<br />
1402 discussant: David L. Weldy, FACSM. University of Toledo,<br />
Toledo, OH.<br />
(No relationships reported)<br />
1403 May 30, 1:00 PM - 1:20 PM<br />
Forearm Pain in a high school softball athlete<br />
Charles F. Ware, III1 , Thomas L. Pommering2 . 1Mount Carmel<br />
West Hospital, Columbus, OH. 2Nationwide Children’s Hospital,<br />
Columbus, OH.<br />
(No relationships reported)<br />
hIsTOry: A 14 y/o F softball pitcher with insidious onset L forearm pain. She is<br />
a L hand dominant, two sport athlete, who participates in both basketball and year<br />
round softball. She presented with L medial forearm pain for the past 2 weeks. There<br />
is no specific injury noted, but was first apparent during softball practice. She was<br />
first seen at urgent care, where XR of the forearm yielded normal results, and was<br />
placed in a sling. The aching pain starts below the elbow, radiates to the wrist, and has<br />
been increasing over the past 2 weeks. There is a throbbing pain over the ulna while<br />
throwing which worsens to a 10/10 as she continues to throw. She has a new complaint<br />
of intermittent numbness and tingling with activity and is located over the radial side<br />
of the forearm, and radiates to her ring finger.<br />
PhysICaL EXaMINaTION: Upon palpation of her LUE reveals tenderness at the<br />
olecranon, and wrist extensor. She has full ROM and 5/5 strength throughout, though<br />
notes pain with extension and supination of her LUE. There is no atrophy, motor<br />
weakness, and the elbow remains stable. Neurovascular exam reveals normal pulses,<br />
decreased sensation over the ulna distribution of the forearm and digits.<br />
PhysICaL EXaMINaTION:<br />
1. Ulnar stress fracture<br />
2. Extensor train / Tear<br />
3. Tendinitis / Tenosynovitis<br />
4. Entrapment neuropathy<br />
Tests & Results<br />
X-Rays: Initial & 2 weeks Later both normal<br />
MRI: Abnormal signal within L intramedullary space and periosteum of<br />
ulnar diaphysis indicating a stress injury<br />
EMG: Mild L ulnar neuropathy at the elbow<br />
Final Working Diagnosis<br />
Ulnar midshaft stress fracture in a softball pitcher, associated with left ulnar<br />
neuropathy<br />
TrEaTMENT aNd OuTCOME: Following the urgent care visit she was provided<br />
a tennis elbow strap brace to wear as needed for pain relief. She was recommended<br />
to abstain from participation until MRI. Once her MRI indicated a stress injury she<br />
was instructed to stop her current summer softball season. Her LUE paresthesias were<br />
now more localized to an ulnar nerve distribution, so an EMG was ordered. After a<br />
period of rest and symptom resolution, she completed a course of PT emphasizing<br />
functional progression back to sports. Her symptoms continued to improve and she<br />
was essentially pain-free at follow-up. She will enter her winter basketball season and<br />
subsequent softball season without restrictions.<br />
MEDICINE & SCIENCE IN SPORTS & EXERCISE ®<br />
1404 May 30, 1:20 PM - 1:40 PM<br />
Elbow Injury In Female softball Player<br />
Ryan P. Cole. Rush University Medical Center, Chicago, IL.<br />
(No relationships reported)<br />
hIsTOry: Patient is a 21 year old right hand dominant softball pitcher who presents<br />
for evaluation of her right elbow. Several months prior she suffered a fall on the field<br />
and has progressive soreness over the medial aspect of her elbow. Pain is worse with<br />
overhead throwing motions and with pitching. She has attempted physical therapy, ice<br />
and heat modalities with little improvement.<br />
PhysICaL EXaMINaTION: Patient has full range of motion about the right elbow<br />
although complains of discomfort of medial aspect, she is tender to palpation medially,<br />
mild to moderate laxity with valgus stress, neurologic testing normal<br />
PhysICaL EXaMINaTION:<br />
1. Ulnar Collateral ligament (UCL) injury<br />
2. Flexor/Pronator tendinopathy<br />
3. Ulnar Neuritis<br />
TEsT aNd rEsuLTs:<br />
MRI shows partial thickness tear of the UCL<br />
FINaL WOrKING dIaGNOsIs:<br />
Partial thickness tear of the right UCL<br />
TrEaTMENT aNd OuTCOMEs:<br />
Received 3 PRP injections. Repeat MRI shows improvement in UCL tear. She was<br />
pain free upon follow up exam and was able to return to play pain free.<br />
1405 May 30, 1:40 PM - 2:00 PM<br />
acute arm swelling-Tennis<br />
Fred Reifsteck, III. University of Georgia, Athens, GA. (Sponsor:<br />
Andrew Gregory, FACSM)<br />
(No relationships reported)<br />
hIsTOry: 18 yo D I RHD female tennis player who presented with acute swelling<br />
of the right upper extremity and hand. The swelling occured during a tennis practice.<br />
Four days earlier had an IV placed for rehydration after a match for cramping in the<br />
contralateral arm. The swelling subsided and almost totally resolved a few minutes<br />
after resting. Patient relates no previous episodes or injuries.<br />
PhysICaL EXaMINaTION: Muscular hypertrophy of the right upper extremity,<br />
approriate for sport. Swelling from elbow distally. Pulses equal and strong bilaterally.<br />
Patient had full range of motion and strength was normal. Pulse did not diminish with<br />
Adson test<br />
PhysICaL EXaMINaTION: 1) Non-occlusive venous disease-Thoracic Outlet<br />
Syndrome<br />
2) Occlusive venous disease-Padgett Schroetter<br />
3) Lymphedema<br />
4) Acute muscle injury, tear vs. strain<br />
TEsT aNd rEsuLTs: AP cervial radiograh- no cervical rib<br />
Venous Doppler exam right upper extremity- negative<br />
Contrast venography- presence of occlusion in the subclavian vein near the jugular/<br />
subclavian junction<br />
FINaL WOrKING dIaGNOsIs: Transient venous occlusion of the suclavian vein<br />
TrEaTMENT aNd OuTCOMEs:1) rest-resolution of symptoms<br />
2) Clopidogrel 75 mg daily, after a 300 mg loading dose<br />
3) Return to play after 4 to 6 weeks of rest, finished season<br />
4) Repeat, 2 months after initial study, contrast venography RESOLUTION of the<br />
venous clot<br />
5) Hydration during play<br />
6) Discontinuation of estrogen containing OCP<br />
ACSM May 28 - June 1, 2013 Indianapolis, Indiana
Official Journal of the American College of Sports Medicine<br />
1406 May 30, 2:00 PM - 2:20 PM<br />
Medial Elbow Pain - softball athlete<br />
Mary Lloyd Ireland, FACSM, D. Jeff Covell. University of<br />
Kentucky Healthcare, Lexington, KY.<br />
(No relationships reported)<br />
hIsTOry: 17YO female, right hand dominant softball athlete fell on outstretched<br />
right arm when she dived back to base to avoid being thrown out. She had immediate<br />
pain in the medial aspect of her right elbow. No previous injuries. She went to an urgent<br />
treatment center and radiographs showed a medial epicondyle avulsion fracture, joint<br />
was reduced. Neurocirculatory status was intact and she was seen the following day.<br />
PhysICaL EXaMINaTION: Right elbow: Active range of motion was 45-110.<br />
Ecchymosis medially. Tenderness over the medial epicondyle. 2+ opening on valgus<br />
stress testing at maximal extension of 45°. No tenderness over the radial head.<br />
Negative Tinel’s over the ulnar nerve. Pulses present. No firmness of the forearm<br />
compartments. Normal wrist and shoulder exam.<br />
PhysICaL EXaMINaTION:<br />
1. Elbow dislocation, reduced.<br />
2. Medial epicondyle fracture.<br />
3. Ulnar collateral ligament partial vs complete tear.<br />
4. Radial head fracture, distal humeral fracture, coronoid fracture.<br />
TEsT aNd rEsuLTs:<br />
RADIOGRAPHS: AP lateral, oblique views showed medial epicondyle fracture in<br />
two pieces which measure 8 mm and 3 mm. Stress views showed opening medially.<br />
Epiphyseal plates closed.<br />
MRI scan showed disruption of ulnar collateral ligament proximally, comminuted<br />
medial epicondyle fracture, bone edema of the posterior aspect of the radial head<br />
consistent with valgus axial loading mechanism.<br />
FINaL WOrKING dIaGNOsIs:<br />
1. Medial humeral epicondyle comminuted fracture.<br />
2. Proximal ulnar collateral ligament proximal tear.<br />
TrEaTMENT aNd OuTCOMEs:<br />
The patient was placed in a hinged elbow brace. She began active and passive ROM.<br />
Two weeks after her injury, her ROM was 30-120°. Patient underwent right elbow<br />
internal fixation of the medial humeral epicondyle fracture with repair proximally of<br />
the ulnar collateral ligament. Ulnar nerve was inspected but was left in its anatomic<br />
position. Postoperatively she was immobilized for a couple of weeks to allow for<br />
healing of the incision and then range of motion emphasizing extension more than<br />
flexion was done. At 6 months followup, range of motion was 2-140°. Her elbow was<br />
stable. She returned to full activity.<br />
The interesting message about this case is that surgery is indicated to manage medial<br />
epicondyle fracture/UCL sprain from an elbow dislocation on the dominant arm of a<br />
throwing athlete.<br />
1407 May 30, 2:20 PM - 2:40 PM<br />
Wrist Injury In Collegiate Basketball Player<br />
Abigail K. DeBusk, Robert G. Hosey, FACSM, Wade M.<br />
Rankin, Scott D. Mair. University of Kentucky, Lexington, KY.<br />
(No relationships reported)<br />
hIsTOry: 23-year-old collegiate women’s basketball player complaining of left wrist<br />
pain presented to clinic with a three week history of intermittent pain after falling on<br />
an outstretched hand during off season workouts. She described pain with dorsiflexion<br />
of the wrist and especially with weight-bearing activity. She denied radiation of pain<br />
into her hand or elbow. She had been taping the wrist and continuing to play with some<br />
pain. She also had taken an anti-inflammatory in the past which helped as well. Initial<br />
xrays were interpreted as negative.<br />
PhysICaL EXaM: She had full range of motion in dorsiflexsion, pronation, and<br />
supination of the wrist. She had pain with active and resisted dorsiflexion over dorsum<br />
of her wrist. Radial pulses 2+ bilaterally. She was neurologically intact. Negative<br />
Watson’s test. No TFCC tenderness. No pain over carpal bones.<br />
8-10 weeks later patient presented and still had recurrent and worsening symptoms<br />
with weight lifting and playing basketball. Physical exam at this time showed<br />
decreased dorsiflexion of approximately ten degrees with continued pain. Xrays now<br />
showed widening of scapholunate ligament and flattening of lunate with mild sclerosis.<br />
PhysICaL EXaMINaTION:<br />
1. Carpal fracture<br />
2. Extensor Carpi Ulnaris tendinitis<br />
3. Osteochondrosis of the lunate (Kienbock’s Disease)<br />
4. Carpal Tunnel Syndrome<br />
5. Ganglion Cyst<br />
6. Scapholunate ligament disruption<br />
TEsT aNd rEsuLTs:<br />
L wrist xrays:<br />
-July:No acute bony injury or significant degenerative changes<br />
-December: Widening of scapholunate ligament and flattening of lunate with mild<br />
sclerosis<br />
MR Arthrogram Left Wrist with corticosteroid injection:<br />
-Disruption of scapholunate ligament<br />
Vol. 45 No. 5 Supplement S267<br />
-AVN with fragmentation of the lunate<br />
-Joint effusion and synovitis<br />
-Volar ganglion on the radioscaphoid articulation<br />
FINaL/WOrKING dIaGNOsIs:<br />
Kienbock’s Disease (avascular necrosis of the lunate)<br />
TrEaTMENT/OuTCOME:<br />
1. Initial treatmenta.<br />
She had good relief of symptoms with the injection at the time of MR arthrogram.<br />
b. She continued to play basketball.<br />
c. Repeat corticosteroid injection in February, again with good results of symptom relief<br />
2. Surgery May 2012<br />
a. Radial shortening with plate fixation<br />
b. Graduated and was lost to follow up<br />
c. Currently playing basketball in European leagues<br />
1408 May 30, 2:40 PM - 3:00 PM<br />
shoulder Injury in soccer player<br />
Zarinah Hud. LECOM Medical Fitness & Wellness Center, Erie,<br />
PA. (Sponsor: Patrick Leary and Gregory Coppola, FACSM)<br />
(No relationships reported)<br />
hIsTOry: A right hand dominant, 19 year old male college soccer player is seen 21<br />
days post right shoulder injury in the clinic. He reported that he fell directly onto right<br />
side of his neck and abducted shoulder. He denied numbness, weakness or pain at the<br />
time of impact, but did report immediate dysesthesia in right shoulder that worsened<br />
throughout the game. He was evaluated after the game by an ATC. The athlete<br />
denied headache, cervical, elbow and wrist pain. No prior history of upper extremity<br />
injuries. Review of systems, social history, and past medical history was otherwise<br />
unremarkable.<br />
PhysIaL EXaMINaTION: Athlete in no acute distress. Right upper limb<br />
inspection revealed atrophy in the deltoid, rhomboid, upper/middle trapezius,<br />
supraspinatus and infraspinatus; elevated shoulder and upward, internally rotated<br />
scapula at rest. There was generalized tenderness over the superior and anterolateral<br />
right shoulder. The cervical spine exam revealed full AROM/PROM without restriction<br />
in all planes and no tenderness over midline or paraspinal musculature. Spurling’s test<br />
was negative bilateral. The manual muscle test revealed maximum resistance against<br />
AROM (5/5) throughout the upper extremity on the left and right except for: shoulder<br />
abduction, flexion, and external rotation on the right, which exhibited incomplete range<br />
of motion against gravity (3-/5). DTR’s: +1/4 over bicep, brachioradialis and triceps<br />
tendons bilateral. Sensation was intact to light touch and pinprick C5-T1 bilateral.<br />
PhysICaL EXaMINaTION:<br />
1.Mononeuropathy vs plexopathy<br />
2. Adhesive Capsulitis<br />
3. Rotator cuff Tear<br />
4. Parsonage-Turner Syndrome<br />
5. Occult fracture<br />
TEsT aNd rEsuLTs:<br />
I. Shoulder X-ray Findings (AP/Lateral)<br />
- Non displaced greater tuberosity fracture<br />
II.MRI Shoulder w/o Contrast<br />
-Fracture of greater tuberosity of humerus and bony contusion; tendinosis of<br />
supraspinatus and infraspinatus tendons without tear<br />
III. EMG Evaluation<br />
-No evidence for a right upper extremity radiculopathy, plexopathy or mononeuropathy<br />
FINaL WOrKING dIaGNOsIs:<br />
Neer’s II Classification Humeral head fracture<br />
TrEaTMENT aNd OuTCOMEs:<br />
1. Greater Tuberosity ORIF<br />
2. Shoulder Immobilization<br />
3. Repeat X-rays<br />
4. Rehabilitation: Throwers Ten, Scapulo-thoracic strengthening exercises<br />
5. Will RTP once he has full painless ROM and normal strength<br />
<strong>Abstracts</strong> were prepared by the authors and printed as submitted.<br />
<strong>Thursday</strong>, May 30, 2013
<strong>Thursday</strong>, May 30, 2013<br />
S268 Vol. 45 No. 5 Supplement<br />
D-21 Free Communication/Poster - Assessment of<br />
Physical Activity and Energy Expenditure<br />
May 30, 2013, 1:00 PM - 6:00 PM<br />
Room: Hall C<br />
1409 Board #1 May 30, 2:00 PM - 3:30 PM<br />
Estimating Food Energy requirements and average daily<br />
Metabolic rate For The us Population: 2005-2006<br />
Edward Archer, Greg A. Hand, FACSM, James R. Hebert, Erica<br />
Lau, Xuewen Wang, Robin Shook, Raja Fayad, Steven N. Blair,<br />
FACSM. Univeristy of South Carolina, Columbia, SC.<br />
(No relationships reported)<br />
PurPOsE:To estimate population-level food energy requirements (FER), total daily<br />
energy expenditure (TDEE), and average daily metabolic rate (ADMR) in a nationally<br />
representative sample of US adults.<br />
METhOds:FER, TDEE, and ADMR were estimated via a factorial equation in<br />
a nationally representative, cross-sectional, stratified sample of 2597 adults, aged<br />
20 to 74 years (US National Health and Nutrition Examination Survey; NHANES<br />
2005-2006). TDEE was calculated using estimated resting energy expenditure (REE),<br />
ADMR, and thermic effect of food (TEF). REE was derived from validated equations<br />
using demographic (i.e., age and sex) and anthropometric (i.e., height and weight) data.<br />
ADMR was calculated from objectively measured PA via accelerometry-based activity<br />
monitors and self-reported sleep duration. TEF was assigned a value of 7.5% of TDEE<br />
based on previous calorimetric research.<br />
rEsuLTs:The 2005-2006 estimated FER for the US population were 2940 kcal/day<br />
for men and 2275 kcal/day for women. FER ranged from 3230 kcal/day in obese (i.e.,<br />
BMI ≥30kg/m2) men to 2026 kcal/day in normal weight (BMI < 25kg/m2) women.<br />
There were significant inverse relationships between ADMR and obesity and age. For<br />
men and women, the ADMR values were 1.53 and 1.52, respectively. Obese men and<br />
women had lower ADMR values than normal weight (p
Official Journal of the American College of Sports Medicine<br />
1413 Board #5 May 30, 2:00 PM - 3:30 PM<br />
Effect Of seasonality and Temperature On Free-living<br />
Physical activity: PaMs Project<br />
Jung-Min Lee, Youngwon Kim, Sarah M. Nusser, Alicia L.<br />
Carriquiry, Gregory J. Welk, FACSM. Iowa Sate University,<br />
Ames, IA.<br />
(No relationships reported)<br />
Considerable work has been done to understand aspects of the built environment<br />
but few studies have systematically studied the effect of weather temperature on PA<br />
behavior. Cold weather and lack of daylight are commonly cited as barriers to PA but<br />
the impact has not been systematically studied.<br />
PurPOsE: The present study fills this gap by examining the weather temperature<br />
variability in PA in a free-living population. The study capitalizes on a unique dataset<br />
collected through the Physical Activity Measurement Study (PAMS), a large fieldbased<br />
study of PA behavior conducted in Iowa.<br />
METhOd: A representative sample of 1405 adults (ages 21-70) wore a SenseWear<br />
Mini Armband (SWA) for a randomly assigned day and then completed a 24PAR<br />
survey administered by a trained interviewer using a computerized telephone system.<br />
Estimates of minutes of moderate and vigorous physical activity (MVPA) were<br />
obtained from both instruments. The data were collected over a two year time span<br />
with an average of 19.7 ± 5.5 days per month so means reflect seasonal variation in this<br />
representative sample. Koppen’s weather climate classification was used to specifically<br />
classify the temperature: cold (-13 to 32ºF), cool (32 to 50 ºF), mild (50 to 64ºF),<br />
warm (64 to 73 ºF), and hot (73 to 95 ºF). A three-way ANOVA (gender x age group x<br />
temperature) was used to examine the impact of weather temperature variability on the<br />
objectively and subjectively monitored physical activity.<br />
rEsuLT: The overall F-test for the evaluation of temperature differences was<br />
significant (SWA: F = 8.05, p < .001, 24PAR: F=2.54, p < .001). There was significant<br />
main effect for gender in SWA and 24PAR, and a significant main effect for age for<br />
the SWA. Interestingly, the main effect of temperature was not significant for either<br />
measure. The minutes of MVPA (mean ± SD) were consistent across the 5 temperature<br />
codes for both the SWA (117.4 ± 4.9) as well as the 24PAR (139.1 ± 10.2). Similar<br />
patterns of consistent PA levels were observed when examined across the 12 months.<br />
CONCLusION: The present study revealed the expected patterns for age group<br />
and gender but rather subtle differences in MVPA minutes with both objective and<br />
subjective methods across temperature conditions. The results discount the widely<br />
assumed notion that physical activity levels are lower in winter when weather is colder.<br />
1414 Board #6 May 30, 2:00 PM - 3:30 PM<br />
Validation of the senseWear armband in Estimating Energy<br />
Expenditure in Professional Female soccer Players<br />
Bei Wang, Chen Wang, Fenglei Qian, Defeng Zhao, Haiyan<br />
Zhao. Shanghai Research Institute of Sports Science, Shanghai,<br />
China.<br />
(No relationships reported)<br />
Maintaining energy balance is important for optimal body composition and exercise<br />
performance in athletes. However, the total daily energy expenditure in athletes is not<br />
easily measured. A portable device, the SenseWear armband (SWA), was shown to be<br />
valid in estimating energy expenditure in free-living individuals at rest and during lowto-moderate<br />
intensity activities. However, whether the SWA is reliable in estimating<br />
energy expenditure during exercise in professional athletes is not known.<br />
PurPOsE: To assess the validity and reliability of the SWA in professional female<br />
soccer players at various exercise intensities.<br />
METhOds: After 2-hour fasting, nine professional female soccer players (19.2±1.4<br />
yrs) rested at sitting position for 10 minutes and then performed four 10-min treadmill<br />
runs at 50, 65, 75, and 85% of their VO 2max each. Energy expenditure was assessed<br />
with SWA and a portable indirect calorimetry (IC).They were asked to rest between<br />
each trial to allow their heart rate recovery below 100 bpm before start of the next trial.<br />
Heart rate was monitored during the whole process.<br />
rEsuLTs: The intra-individual minute-by-minute correlations between<br />
energy expenditure assessed by the SWA and IC were significant for all nine subjects<br />
(r=0.879-0.987, mean=0.95±0.01). However, energy expenditure calculated by<br />
the SWA and IC was significantly different at all trials except when running at<br />
65%VO2max (p
<strong>Thursday</strong>, May 30, 2013<br />
S270 Vol. 45 No. 5 Supplement<br />
1417 Board #9 May 30, 2:00 PM - 3:30 PM<br />
Estimation Of steps recorded By The sensewear armband<br />
during Treadmill Walking and Free-living<br />
Jeff C. Mathis, Laura A. Wheatley, Joey A. Lee, Dale D. Brown,<br />
Dr, FACSM, Kelly R. Laurson, Dr. Illinois State University,<br />
Normal, IL.<br />
(No relationships reported)<br />
The Sensewear Armband (SWA) is relatively accurate when used to assess daily<br />
energy expenditure and is increasingly being used by clinicians and researchers during<br />
physical activity interventions. However, the layperson may have difficulty interpreting<br />
SWA physical activity metrics such as minutes of moderate activity or kilocalories<br />
expended in regard to goal-setting. Steps per day is a more interpretable metric that<br />
could be used instead, if measured accurately by the SWA.<br />
PurPOsE: To compare estimations of steps taken by the SWA during treadmill<br />
walking and free-living.<br />
METhOds: Healthy adult participants (n = 41, mean age = 21.9 ± 2.0 years) wore<br />
the SWA during five 3-minute stages of treadmill walking at 54, 67, 80, 94, and 107<br />
meters per minute while steps were also counted using a manual counter (serving as<br />
the treadmill criterion). Additionally, during three days of free-living, the subjects<br />
also wore the SWA and a pedometer that has been previously validated for research<br />
purposes (Yamax Digiwalker SW-701 pedometer [DIGI], serving as the free-living<br />
criterion). SWA performance was evaluated using Pearson’s correlation coefficients<br />
and paired-samples t-tests against the respective criterion method.<br />
rEsuLTs: During treadmill walking, steps recorded by the SWA were significantly<br />
correlated with manually counted steps. The strength of the association tended to<br />
increase as walking speed increased (r = 0.37, 0.47, 0.69, 0.77, and 0.78 at 54, 67,<br />
80, 94, and 107 meters per minute, respectively). However, the results of the t-tests<br />
indicated that the SWA significantly underestimated steps taken at each speed (mean<br />
percent difference from criterion ranged from 16.0% to 5.6%, all p < 0.05). In contrast,<br />
during free-living, the SWA significantly overestimated steps taken in comparison to<br />
the DIGI by an average of 1,023 steps per day (11.3% difference, p < 0.001). Although<br />
the correlation between mean steps taken per day between the SWA and DIGI was<br />
strong (r = 0.96, p < 0.001).<br />
CONCLusIONs: Under controlled conditions the SWA significantly underestimated<br />
steps. During free-living conditions the SWA appears to significantly overestimate<br />
steps, perhaps over-counting during non-ambulatory activity. Clinicians and<br />
researchers should use caution in setting stepping goals with the SWA during activity<br />
interventions.<br />
1418 Board #10 May 30, 2:00 PM - 3:30 PM<br />
Inter-instrument reliability Of Gt3x accelerometers In a<br />
Free-living Condition<br />
Emily E. Davis, Wonwoo Byun, Cemal Ozemek, Leonard A.<br />
Kaminsky, FACSM. Ball State University, Muncie, IN.<br />
(No relationships reported)<br />
Accelerometers have the advantage of providing objective measures of both<br />
physical activity performed at various intensities and of sedentary time. Actigraph<br />
accelerometers are widely used, however with technological advancements new<br />
models are periodically released. The GT3X is the most recent model. Although<br />
research has shown previous Actigraph models to be reliable, little information is<br />
available on the inter-instrument reliability of GT3X accelerometers.<br />
PurPOsE: To determine inter-instrument reliability of GT3X accelerometers<br />
measures of physical activity and inactivity in a free-living condition.<br />
METhOds: Sixteen women and 11 men (age 24.6 ± 9.9 yr, BMI 24.1 ± 3.6 kg/m2)<br />
wore two accelerometers simultaneously, one on the left and one on the right hip,<br />
for >4 consecutive days. Accelerometers were initialized to collect step counts and<br />
activity counts/minute (cpm), simultaneously. Activity counts (60 sec epochs) were<br />
categorized into time spent in sedentary (
Official Journal of the American College of Sports Medicine<br />
1421 Board #13 May 30, 2:00 PM - 3:30 PM<br />
development and Validation of sedentary Behavior record<br />
(sBr) Instrument<br />
Rose M. D. Carter, Saori Ishikawa, James L. Farnsworth,<br />
Vaughn W. Barry. Middle Tennessee State University,<br />
Murfreesboro, TN. (Sponsor: Dr. Minsoo Kang, FACSM)<br />
(No relationships reported)<br />
Prior measures of sedentary behavior have not systematically measured sedentary<br />
activities in multiple domains and over various routinely performed daily sedentary<br />
activities with a user-friendly device. The Sedentary Behavior Record (SBR) was<br />
designed to fill the gap in the literature in measuring sedentary behavior. The SBR is<br />
an adaptation of the 3-day Physical Activity Record for the purpose of quantifying<br />
sedentary behavior time (SBT) over a 24-hour day. The SBR includes 3 domains<br />
(work, non-work sitting and lying down or reclining) and a choice of 3 activities under<br />
each domain (transportation, screen time, and other) to quantify SBT by 15-minute<br />
blocks of time for 24-hours.<br />
PurPOsE: Develop and validate the SBR instrument.<br />
METhOds: A total of 46 adults, aged 37 ± 12 years old, wore an Actigraph<br />
accelerometer and recorded subjective SBT by SBR for 7 consecutive days. Outcome<br />
measurements included SBT for 24-hour day with with sleep (SBT-S) and SBT without<br />
sleep time (SBT-NS), beginning when accelerometer is reported as off the body for<br />
sleep, measured by Actigraph (activity counts per minute < 100) and by SBR. Pearson<br />
correlations and paired sample t tests were examined to establish concurrent validity<br />
evidence. The alpha level was set at .025, adjusted by the Bonferroni technique.<br />
Intraclass correlation coefficients (ICC) were also computed for reliability.<br />
rEsuLTs: SBT-NS as measured by Actigraph (M = 574.48; SD = 83.33) and SBR<br />
(M = 524.54; SD = 180.49) had a moderate-to-strong relationship (r = .59, p < .001),<br />
and SBT-S as measured by Actigraph (M = 1041.04; SD = 148.31) and SBR (M =<br />
987.87; SD = 196.74) had a low-to-moderate relationship (r = .31, p<br />
CONCLusIONs:Overall, the results support the potential use of SBT-NS and SBT-S<br />
from the SBR instrument. Further studies are warranted to validate the SBR instrument<br />
in other populations.<br />
1422 Board #14 May 30, 2:00 PM - 3:30 PM<br />
Validity and reliability of Two self-report Measures to<br />
assess sedentary Behavior in Older adults<br />
Keith P. Gennuso 1 , Charles E. Matthews, FACSM 2 , Dale A.<br />
Schoeller 1 , Lisa H. Colbert, FACSM 1 . 1 University of Wisconsin<br />
- Madison, Madison, WI. 2 National Cancer Institute, National<br />
Institutes of Health, Bethesda, MD.<br />
(No relationships reported)<br />
PurPOsE: To examine the test-retest reliability and criterion-related validity of<br />
the Yale Physical Activity Survey for Older Adults (YPAS) and Community Health<br />
Activities Model Program for Seniors (CHAMPS) survey to assess sedentary behavior<br />
(SB) in older adults.<br />
METhOds: Adults aged 65 years and older were recruited to participate in a<br />
larger study comparing the validity of various objective and self-report measures of<br />
physical activity. Participants completed the YPAS and CHAMPS before and after<br />
a 10 day period during which they wore an Actigraph accelerometer (ACC). ACCderived<br />
average daily SB time (defined as
<strong>Thursday</strong>, May 30, 2013<br />
S272 Vol. 45 No. 5 Supplement<br />
1425 Board #17 May 30, 2:00 PM - 3:30 PM<br />
Pedometer-determined Physical activity Patterns in adults<br />
with Mild Intellectual disabilities<br />
Sharon Hsu1 , Bo Fernhall, FACSM2 , Stanley Hui, FACSM3 ,<br />
James Halle4 . 1California State University, Northridge,<br />
Northridge, CA. 2University of Illinois, Chicago, Chicago,<br />
IL. 3Chinese University of Hong Kong, Shatin, Hong Kong.<br />
4University of Illinois, Urbana-Champaign, Urbana, IL.<br />
(No relationships reported)<br />
The increasing prevalence of overweight and obesity is a worldwide problem. Regular<br />
physical activity participation is a determinant to reverse the obesity epidemic and a<br />
key element in health promotion.<br />
PurPOsE: The purpose of this study was to investigate pedometer-determined<br />
physical activity patterns in adults with mild intellectual disabilities (MID).<br />
METhOds: A sample of 120 adults with MID (Age: M = 26.6 ±8.8) in Taiwan<br />
participated in this study. Among those participants, 52.5% were males, 31.7% lived in<br />
cities, 77.5% lived with their families, 64.2% were employed; 65% had a high school<br />
diploma, and 56.7% were overweight or obese (OW/OB; BMI, M = 23.95±4.28). Step<br />
count data were gathered using Yamax DigiWalker SW-200 pedometers from each<br />
participant for 7 consecutive days.<br />
rEsuLTs: Participants walked an average of 8868 steps per day (±4830). They had<br />
significantly higher step counts (t119 = 5.195, p
Official Journal of the American College of Sports Medicine<br />
METhOds: Fifty-three women wore the SenseWear® Mini armband for 7-days at<br />
week 18 and 35 of pregnancy. All MVPA completed in at least 10-, 20-, or 30-minute<br />
bouts were summed. Total MET-minutes for the week were summed to reflect total PA<br />
including sedentary and light activity. GWG was calculated as the difference of prepregnancy<br />
weight from measured weight at week 35. A one-way ANOVA evaluated the<br />
differences in GWG for women meeting prenatal PA recommendations (sufficient PA;<br />
>150 min MVPA per week), those with insufficient PA (1-149 min), and none (0 min)<br />
for all 3 bout lengths. Total MET-minutes per week were compared with independent<br />
t-tests for women gaining within or in excess of the IOM guidelines.<br />
rEsuLTs: Twenty-six (49%) women gained in excess of IOM guidelines. A trend<br />
for MVPA completed in ≥ 10 min bouts was identified: sufficient PA (11.3 ± 4.3<br />
kg), insufficient PA (13.3 ± 5.1 kg), and none (18.9 ± 4.2 kg) (P = 0.056). GWG<br />
was not significantly different when PA was analyzed in at least 20 or 30 min bouts.<br />
Participants who gained within IOM guidelines had significantly higher MET-minutes<br />
at week 18 than women who gained in excess (11,068 vs. 10,414, respectively;<br />
P=0.032). PA at week 35 was not significantly related to weight gain.<br />
CONCLusION: Longer sustained activity (> 20 or 30 min bouts) did not significantly<br />
affect GWG, whereas moderate PA completed in ≥10-minute bouts may be a beneficial<br />
strategy to promote healthy GWG. Total activity (e.g. total MET-minutes per week)<br />
had a significant favorable relationship with GWG. Future work should address<br />
reducing sedentary time and increasing PA in at least 10-minute bouts.<br />
1429 Board #21 May 30, 2:00 PM - 3:30 PM<br />
Objectively Measured Total accelerometer Counts and<br />
MVPa: Contrasting relationships with Biomarkers using<br />
2003 - 2006 NhaNEs<br />
Dana L. Wolff1 , Eugene C. Fitzhugh1 , David R. Bassett,<br />
FACSM1 , James R. Churilla, FACSM2 . 1University of Tennessee,<br />
Knoxville, TN. 2University of North Florida, Jacksonville, FL.<br />
(No relationships reported)<br />
PurPOsE: To contrast the associations of objectively measured moderate-tovigorous<br />
physical activity (MVPA) and total accelerometer counts with biomarkers in<br />
a representative sample of U.S. adults.<br />
METhOds: Data from the 2003 – 2006 NHANES were used for this analysis. The<br />
sample included adults ≥ 20 y, not pregnant or lactating, who had self-reported PA and<br />
≥ 4 d of accelerometer data with ≥ 10 h wear time (N = 5668). MVPA was defined<br />
as the mean minutes with counts ≥ 2020 using a 10-min bout criterion on valid days.<br />
Total accelerometer counts represented the mean total counts acquired on valid days.<br />
Biomarkers included: blood pressure, body mass index (BMI), waist circumference,<br />
triceps and subscapular skinfolds, cholesterol, triglyceride, glycohemoglobin, plasma<br />
glucose, C-peptide, insulin, C-reactive protein, and homocysteine. Simultaneous<br />
regressions were conducted in which each biomarker was regressed on MVPA and total<br />
accelerometer counts per day independently while adjusting for relevant covariates.<br />
rEsuLTs: When compared to MVPA, total accelerometer counts per day displayed<br />
stronger associations with the following biomarkers: BMI, waist circumference, triceps<br />
skinfolds, subscapular skinfolds, HDL, triglycerides, plasma glucose, C-peptide,<br />
insulin, C-reactive protein, and homocysteine (adj. Wald F = 9.04 – 97.41, P <<br />
0.05 – 0.0001). Only one biomarker, glycohemoglobin, had stronger associations<br />
with MVPA (F = 6.67, P ≤ 0.05) than total accelerometer counts (F= 0.87, P > 0.05).<br />
After adjusting for BMI and other relevant covariates, total accelerometer counts<br />
remained more strongly associated with cardiometabolic biomarkers than MVPA, with<br />
glycohemoglobin found to have no relationship with either PA variable.<br />
CONCLusIONs: Total accelerometer counts per day were more robustly associated<br />
with various cardiobiomarkers than MVPA. Thus, using total accelerometer counts per<br />
day may provide a better estimate of the strength of the relationship between PA and<br />
biomarkers.<br />
1430 Board #22 May 30, 2:00 PM - 3:30 PM<br />
reliability of Peak stepping Cadences using Generalizability<br />
Theory<br />
Minsoo Kang, FACSM1 , Youngdeok Kim1 , David A. Rowe,<br />
FACSM2 . 1Middle Tennessee State University, Murfreesboro, TN.<br />
2University of Strathclyde, Glasgow, United Kingdom.<br />
(No relationships reported)<br />
Recent studies have introduced the concept of using peak stepping cadences to<br />
quantify the intensity of ambulatory physical activity using step-count data. Although<br />
this is a novel approach and has demonstrated evidence of validity (Tudor-Locke<br />
et al., 2011), the reliability of peak stepping cadences associated with measurement<br />
conditions (e.g., a number of monitoring days) has not been addressed.<br />
PurPOsE: The purpose of this study was to establish the minimum number of days<br />
required for reliably estimating peak stepping cadence among adults.<br />
METhOds: Data from the 2005-2006 National Health and Nutrition Examination<br />
Survey were analyzed. A total of 1,300 adults (> 17 yr) with valid accelerometer<br />
step-count data (defined as 7 days with ≥ 10 hr wear time) were included. One-min,<br />
30-min, and 60-min peak cadences were obtained across 7 days. Generalizability (G)<br />
theory with unbalanced two-facet nested design [i.e., person x (days: type of days)]<br />
was applied for each peak stepping cadence, with days nested within weekend or week<br />
Vol. 45 No. 5 Supplement S273<br />
days. G-studies were performed to quantify the percentage of variance associated<br />
with each facet and interaction in the model. Follow-up D-studies were performed to<br />
determine the optimal combinations of number of days for weekend and week days to<br />
achieve a desirable reliability coefficient (G ≥ .80).<br />
rEsuLTs: The G-study showed that the relative magnitudes of variances attributed<br />
to differences between weekend and week days were relatively low (i.e., < 10%) for<br />
all peak stepping cadence measures; however, the D-study indicated that at least 1<br />
weekend day should be included in the monitoring period in addition to 4 week days<br />
for 1-min peak cadence. For 30-min and 60-min peak cadences, at least 5 week days,<br />
or the combinations of 1 weekend day and 3 week days, or 2 weekend days and 2 week<br />
days would be necessary for reliable measures of peak stepping cadences.<br />
CONCLusIONs: This study provides empirical evidence of the number of required<br />
monitoring days to obtain reliable measures of peak stepping cadences based on a<br />
large, nationally-representative sample of US adults. The guidelines suggested in<br />
this study could be applied in future research as a reference for monitoring periods to<br />
obtain a reliable measure of peak stepping cadences.<br />
1431 Board #23 May 30, 2:00 PM - 3:30 PM<br />
Physical activity and Energy Expenditure Measurements<br />
using sensewear armband, actiheart and actigraph in<br />
adults<br />
Dharini M. Bhammar, Brandon J. Sawyer, Wesley J. Tucker,<br />
Julian C. Baez, Glenn A. Gaesser, FACSM. Arizona State<br />
University, Phoenix, AZ.<br />
(No relationships reported)<br />
PurPOsE: Our aim was to estimate validity and reliability of the Sensewear<br />
Armband (SWA), Actiheart (AH) and Actigraph GT3X+ (AG) monitors for assessing<br />
physical activity (PA) levels and energy expenditure (EE) in adults.<br />
METhOds: Twenty-four adults (ages 29 ± 9 years; BMI: 23.9 ± 3.7 kg/m 2 )<br />
underwent two identical 96-min exercise sessions, at least 24 h apart, including<br />
walking, cycling, arm cranking, and simulated activities of daily living. Each activity<br />
lasted 8 min with a 4-min seated rest period between activities. EE and PA levels were<br />
measured by indirect calorimetry using the Oxycon Mobile TM (OM) and estimated by<br />
four activity monitors: SWA (version 7.0), AH software versions 2.0 (AH 2.0) and 4.0<br />
(AH 4.0) and AG. Linear mixed models and intraclass correlation coefficients (ICC)<br />
were used for statistical analysis.<br />
rEsuLTs: Total EE for 96-min was not significantly different between SWA and OM<br />
(P = 0.084). Total EE for AH 4.0, AH 2.0 and AG was significantly lower than OM<br />
by 62 ± 63 kcal (P = 0.015), 110 ± 47 kcal (P < 0.001) and 129 ± 60 kcal (P < 0.001)<br />
respectively. During steady-state periods (min 4 to 7 of each activity), only AH 4.0<br />
accurately predicted walking EE (P = 1.000) and only AH 2.0 accurately predicted<br />
jogging EE (P = 0.704). AH 2.0 and AH 4.0 accurately estimated time spent in light<br />
and moderate PA, while only AH 2.0 accurately tracked time spent in vigorous PA.<br />
ICC analysis for OM and the four activity monitors showed high test-retest reliability<br />
for total EE (0.847 to 0.911) and for time spent in moderate to vigorous PA (MVPA;<br />
0.888 to 0.999). ICC analysis for individual activities showed high test-retest reliability<br />
for walking at 3 mph (0.824 to 0.943), moderate-to-high reliability for walking at 4<br />
mph, jogging at 5 mph, sweeping, and loading and unloading boxes (0.506 to 0.989),<br />
and low to moderate reliability for cycling, arm cranking and seated rest (0.005 to<br />
0.738).<br />
CONCLusIONs: The SWA provides valid estimates for total EE, while the AH<br />
provides valid estimates for walking and jogging EE. All devices were unreliable<br />
for estimating EE for activities with minimal or variable accelerometer input such<br />
as cycling, arm cranking and activities of daily living. Additionally, only AH 2.0<br />
accurately tracked time spent in MVPA suggesting that it may be the best device for<br />
tracking PA levels.<br />
supported by NIh grant r01 hL091006<br />
1432 Board #24 May 30, 2:00 PM - 3:30 PM<br />
The Context of Physical activity in a representative sample<br />
of adults: Physical activity Measurement survey<br />
Bradley P. Peters, Youngwon Kim, Gregory J. Welk, FACSM,<br />
Sarah M. Nusser, Alicia L. Carriquiry, Miguel A. Calabro,<br />
Jungmin Lee. Iowa State University, Ames, IA.<br />
(No relationships reported)<br />
Numerous studies have sought to assess and evaluate levels of participation in physical<br />
activity (PA) in the population but few studies have provided contextual information<br />
about PA behaviors. This information is needed to better understand and promote PA<br />
in the population. PURPOSE: The purpose of this study was to provide insights on the<br />
purpose and location of accumulating PA in a representative sample of adults ages 21<br />
to 70.<br />
METhOds: Data were obtained from the Physical Activity Measurement Survey<br />
(PAMS), a large field-based study of PA behavior conducted in Iowa. As part of the<br />
study, a representative sample of 1459 Iowa adults from four counties completed a<br />
telephone-administered 24hour PA recall (PAR). Participants were asked to report<br />
participation in different types of PA and to categorize each activity by both purpose<br />
(work, home/family, leisure, sports, education/volunteering) and location (work, home/<br />
<strong>Abstracts</strong> were prepared by the authors and printed as submitted.<br />
<strong>Thursday</strong>, May 30, 2013
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S274 Vol. 45 No. 5 Supplement<br />
indoor, home/outdoor, transportation, and community). The proportion of time spent<br />
in moderate PA (MPA) and vigorous PA (VPA) was segmented by both purpose and<br />
location to understand the context of PA behavior.<br />
rEsuLTs: Approximately 83% of participants reported participating in some MPA<br />
(3-6 METS) on the previous day (mean = 156.4 +/- 32.6 min) while 21% reported<br />
participating in some VPA (> 6 METS) on the previous day (mean = 67.1 +/- 9.1<br />
min). Participants reported that they performed 42% of their MPA while working,<br />
37% for home needs, 14% for leisure, 5% for sports, and about 2% for volunteer<br />
/ education tasks. Corresponding allocations for VPA were 33%, 27%, 14%, 25%,<br />
and 1%, respectively. The majority of MPA was performed at work (41%) followed<br />
by home indoor (26%), community settings (18%), home outdoor (13%), and in<br />
transportation (2%). The majority of VPA was also performed at work (33%),<br />
followed by community settings (32%), home indoor (21%), home outdoor (13%) and<br />
transportation (1%). Differences in allocations for purpose and location were noted<br />
when the sample was stratified by gender, age, and education<br />
CONCLusION: The results demonstrate the diverse nature of PA behavior and reveal<br />
that the majority of MPA and VPA is accumulated as part of daily living rather than for<br />
leisure or recreation. These results provide new insights about the settings and context<br />
of PA behavior in adults.<br />
1433 Board #25 May 30, 2:00 PM - 3:30 PM<br />
Pedometer accuracy in Lower-Limb amputees<br />
John D. Smith 1 , Gary Guerra 2 . 1 Texas A&M University-San<br />
Antonio, San Antonio, TX. 2 Loma Linda University, Loma Linda,<br />
CA.<br />
(No relationships reported)<br />
The accuracy of the pedometer on lower limb amputees has yet to be explored.<br />
PurPOsE: To assess the accuracy of pedometers in lower limb amputees.<br />
METhOds: Thirty-nine participants (age = 48.0±14.1 yrs, ht = 172.7±9.3 cm, wt<br />
= 76.2±14.8 kg) had their height and weight measured and were then fitted with a<br />
pedometer belt around the waistline at the hip. They were fitted with three pedometers:<br />
a SW-701 spring-levered pedometer on the anterior mid-line of the right hip, an NL-800<br />
pedometer just laterally to the SW-701, and an Omron HJ-112 on the outside of the NL-<br />
800. They then engaged in one over-ground level walk for 200m at a self-selected pace at<br />
an indoor facility. At the end of each trial pedometer counts and actual step counts from<br />
a hand tally (AC) were recorded. A repeated measures ANOVA was used to determine<br />
significant differences between the counts. Single measure intraclass correlation (ICC)<br />
from a two-way random effects ANOVA was used to assess the agreement between<br />
AC and pedometer counts. Bland-Altman plots of AC vs. pedometer counts were also<br />
used to provide an indication of agreement between the measures. Pedometer error was<br />
calculated as [(pedometer steps-actual steps)/actual steps] * 100.<br />
rEsuLTs: Counts from the SW were significantly lower than AC (255.6±12.6 and<br />
314.7±6.0 steps, p = .001) and counts from the NL and Omron were not significantly<br />
different from AC (p > .05). Agreement according to ICC was very low (0.26) for the<br />
SW, low for the NL (0.71) and high for the Omron (.98). Bland-Altman plots indicated<br />
agreement was strongest with the Omron and weakest with the SW. Percent error was<br />
greatest with SW at 18.0%, 2.1% for the NL, and least in the Omron (0.7%).<br />
CONCLusION: The results indicate that of the three pedometers tested, the Omron<br />
HJ-112 is the best pedometer for a person with a lower limb amputation wearing a<br />
prosthesis.<br />
1434 Board #26 May 30, 2:00 PM - 3:30 PM<br />
association Between Cardiorespiratory Fitness and<br />
Metabolic risk Factors: an application of Quantile<br />
regression<br />
Wonwoo Byun1 , Jonathan A. Mitchell2 , Mitchell H.<br />
Whaley, FACSM1 , Leonard A. Kaminsky, FACSM1 . 1Ball State University, Muncie, IN. 2University of Pennsylvania,<br />
Philadelphia, PA.<br />
(No relationships reported)<br />
Higher cardiorespiratory fitness (CRF) has been associated with improved metabolic<br />
risk factors (MRFs). However, the evidence that exists largely assessed the mean<br />
values of MRFs and it is not known if the association between CRF and MRFs is<br />
uniform across the distributions of individual MRFs.<br />
PurPOsE: To determine the association between CRF and MRFs, using quantile<br />
regression, in a cross-sectional sample of men and women.<br />
METhOds: Participants were 429 adults (Female: 51%, Age: 49 ± 13 yrs), who<br />
enrolled in Adult Physical Fitness Program at Ball State University. CRF was assessed<br />
via maximal exercise testing with measured VO max (ml/kg/min). Participants were<br />
2<br />
also screened for fasting glucose (GLU), triglycerides (TG), high-density lipoprotein<br />
cholesterol (HDL-C), mean arterial blood pressure (MAP), and waist circumference<br />
(WC). Quantile regression was used to examine the associations between CRF<br />
and MRFs at the 10th , 25th , 50th , 75th , and 90th percentiles of each MRF. The models<br />
were adjusted for age, gender, education level, smoking status, and medications for<br />
hypertension, diabetes, and dyslipidemia.<br />
rEsuLTs: CRF was inversely associated with GLU at the 50th (β= -0.34, 95% CI:<br />
MEDICINE & SCIENCE IN SPORTS & EXERCISE ®<br />
-0.52, -0.17), 75th (β= -0.53, 95% CI: -0.74, -0.32), and 90th (β= -0.70, 95% CI: -0.99,<br />
-0.40) percentiles; and inversely associated with MAP at the 50th (β= -0.21, 95% CI:<br />
-0.35, -0.07), 75th (β= -0.25, 95% CI: -0.44, -0.06), and 90th (β= -0.29, 95% CI: -0.49,<br />
-0.09) percentiles. Significant inverse associations between CRF and TG and WC were<br />
found at the 10th, 25th, 50th, 75th, and 90th percentiles; the magnitude of associations<br />
were gradually stronger at upper tails of TG distribution (from 10th percentile β=<br />
-1.14, 95% CI: -1.62, -0.66 to 90th percentile β= -3.74, 95% CI: -6.75, -0.72) and WC<br />
distribution (from 10th percentile β= -0.72, 95% CI: -1.10, -0.33 to 90th percentile β=<br />
-1.25, 95% CI: -1.48, -1.02). CRF was positively associated with HDL-C at 25th (β=<br />
0.33, 95% CI: 0.21, 0.45), 50th (β= 0.28, 95% CI: 0.11, 0.45), 75th (β= 0.39, 95% CI:<br />
0.07, 0.71), and 90th (β= 0.43, 95% CI: 0.09, 0.85) percentiles.<br />
CONCLusION: CRF was significantly associated with better MRFs profiles.<br />
The associations were stronger at upper tails of MRFs distributions indicating that<br />
improving CRF is especially important for those with poor MRF profiles.<br />
1435 Board #27 May 30, 2:00 PM - 3:30 PM<br />
Type I and Type II Errors in Correlation analyses of Various<br />
sample sizes<br />
Duane Knudson, FACSM1 , Crawford Lindsey2 . 1Texas State<br />
University, San Marcos, TX. 2Tennis Warehouse, San Louis<br />
Obispo, CA.<br />
(No relationships reported)<br />
Studies are designed to balance pragmatic and theoretical issues. A common problem<br />
in sport and exercise science research is small sample sizes, which was recently noted<br />
in ACSM abstracts (Pyne & Hopkins, 2012).<br />
PurPOsE: This study documented the likely rates of type I and type II errors in<br />
correlation analyses in sample sizes common in sport and exercise science.<br />
METhOds: Data from mechanical testing of most all polyester tennis strings<br />
commercially available in 2012 using the protocol by Cross et al. (2000) were analyzed<br />
in this study. Variables measured were gauge, impact duration, string deflection, peak<br />
force, string stiffness, and energy return for 198 different strings tested at 276 N of<br />
tension. Three additional sample sizes were created by randomly down sampling to 99,<br />
50, and 25. Correlations and partial correlations were calculated and compared to those<br />
observed for the complete sample (N=198).<br />
rEsuLTs: For the whole sample, 14 of 15 zero-order correlations were significant<br />
(p
Official Journal of the American College of Sports Medicine<br />
There were no significant differences between actual steps taken and Yamax<br />
and Omron recorded steps (p>0.05). In addition, there were no significant<br />
differences between actual distance traveled and Yamax and Omron recorded<br />
distance (p>0.05). However, the BCF pedometer significantly underestimated<br />
step count (p
<strong>Thursday</strong>, May 30, 2013<br />
S276 Vol. 45 No. 5 Supplement<br />
group. However, given the line equation between HR and PR in subjects with SPAH<br />
is significantly different compared to NPAH and MPAH, using PR in predicting<br />
HR may be inaccurate and misleading. This puts into question the utility of PR in<br />
predicting actual HR. To monitor intensity of exercise, HR should be measured by<br />
electrocardiography during the 6 minute walk test.<br />
1441 Board #33 May 30, 3:30 PM - 5:00 PM<br />
Characterization of the Ventilatory drive in Patients with<br />
Pulmonary hypertension and Interstitial Lung disease<br />
Lisa M. K. Chin1 , Randall E. Keyser, FACSM2 , Joshua G.<br />
Woolstenhulme1 , Bart Drinkard1 , Gerilynn Connors3 , Steven<br />
D. Nathan3 , Leighton Chan1 . 1National Institutes of Health,<br />
Bethesda, MD. 2George Mason University, Fairfax, VA. 3Inova Fairfax Hospital, Falls Church, VA.<br />
(No relationships reported)<br />
Pulmonary hypertension (PH) and interstitial lung disease (ILD) are conditions that<br />
may develop without a known cause (idiopathic) or in association with other etiologies<br />
such as connective tissue disease. Both conditions result in exercise intolerance, yet the<br />
pathomechanisms by which these conditions limit cardiorespiratory function are likely<br />
different.<br />
PurPOsE: To characterize differences in pulmonary respiration and/or ventilatory<br />
function that may limit cardiorespiratory capacity among patients with PH and ILD.<br />
METhOds: Six patients with idiopathic PH (iPH), 20 patients with associative PH<br />
(aPH), 16 patients with ILD, and 14 healthy controls (HC) completed a symptomlimited<br />
treadmill cardiopulmonary exercise test (CPET) as part of the NIH Exercise<br />
Therapy for Advanced Lung Disease Trial. Patients with right or left heart failure or<br />
PH that was co-morbid with ILD were not included. Pulmonary gas exchange was<br />
measured breath-by-breath. Variables of interest included peak oxygen consumption<br />
(VO ), expired carbon dioxide volume (VCO ), expired ventilatory volume (Ve), tidal<br />
2 2<br />
volume (Vt), breathing frequency (f), ventilatory equivalent ratio for carbon dioxide<br />
(Ve/VCO ) and end tidal partial pressure of CO (PETCO ).<br />
2 2 2<br />
rEsuLTs:Age and BMI (52 ± 11 yrs; 30.7 ± 6.8 kg/m2 ) were similar across all<br />
groups. Diminished (P < 0.05) peak VO , VCO , Ve and Vt were observed in patients<br />
2 2<br />
with iPH, aPH and ILD compared to HC. Peak f was higher (P
Official Journal of the American College of Sports Medicine<br />
METhOds: Fourteen older (67.9 ± 1.2 yr) obese adults (BMI: 34.2 ± 1.1kg/m2) with<br />
metabolic syndrome underwent 12-weeks of supervised exercise training (60 minutes/d<br />
for 5 d/week at ~85% HRmax). Peripheral insulin sensitivity was determined by<br />
the euglycemic-hyperinsulinic clamp (40 mU·m2·min-1), hepatic insulin action was<br />
estimated by HOMA-IR, and 2-hr glucose levels were determined after a 75 gram oral<br />
glucose tolerance test. Visceral fat was determined by computerized tomography. Basal<br />
fat oxidation and aerobic fitness was measured by indirect calorimetry. Plasma DPP-4<br />
was analyzed using an enzyme-linked immunosorbent assay.<br />
rEsuLTs: Exercise decreased body weight and visceral fat and increased aerobic<br />
fitness (p
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S278 Vol. 45 No. 5 Supplement<br />
was obtained and serum cortisol was measured. Additionally, a 60 min intravenous<br />
glucose tolerance test was completed. The product of glucose and insulin area under<br />
curve (AUC) was used to estimate IS. Linear mixed models were used to assess sex<br />
differences, and correlations determined associations of cortisol and AUC.<br />
rEsuLTs: Cortisol was significantly lower in males compared to females in both<br />
conditions (p
Official Journal of the American College of Sports Medicine<br />
of HMG-CoA reductase, LDL-R, SR-BI and StAR protein in Leydig’s cells were<br />
examined by the real-time PCR with the Taq-man probe technique.<br />
rEsuLTs: The results showed that the serum T of TA group decreased significantly<br />
(1.44±0.42 vs. 8.83±4.57ng/ml, p
<strong>Thursday</strong>, May 30, 2013<br />
S280 Vol. 45 No. 5 Supplement<br />
PurPOsE: To assess the impact of sex/gender on the associations of MQ, estimated<br />
using laboratory (MQ-L) or field (MQ-F) methods, to functional performance tasks<br />
varying in muscle mass recruitment.<br />
METhOds: Age- and BMI-matched, community-dwelling older men (n = 40, 76.2<br />
± 6.2 years, BMI = 27.3 ± 3.8 kg/m2) and women (n = 40, 75.8 ± 5.5 years, BMI =<br />
27.0 ± 3.8 kg/m2) were assessed for grip strength via Jamar dynamometer, leg power<br />
via Nottingham Power Rig, and body composition via DXA. Physical function was<br />
assessed with the 30-sec chair rise (CHR) and the Physical Performance Test (PPT;<br />
score range = 0 to 36). MQ-L was calculated as total leg power divided by lower body<br />
lean mass. MQ-F was calculated as total grip strength divided by BMI.<br />
rEsuLTs: MQ methods were correlated (r=0.52, p
Official Journal of the American College of Sports Medicine<br />
or compared to the normal-weight women during both conditions. There were no<br />
significant group*condition interactions or main effects for total activity or sedentary,<br />
moderate, or vigorous activity time (P>0.05).<br />
CONCLusION: Acute sleep deprivation and obesity may influence dietary intake at<br />
certain times of the day but does not appear to acutely influence physical activity or<br />
physical activity intensity. Additional work examining the relationship between sleep<br />
deprivation and energy balance pathways is needed.<br />
1461 Board #53 May 30, 3:30 PM - 5:00 PM<br />
The relationship between Objectively Measured sleep and<br />
diet Quality in College Women<br />
Timothy W. Hope, Wyatt W. Sessions, James LeCheminant,<br />
FACSM, Bruce W. Bailey. Brigham Young University, Provo, UT.<br />
(No relationships reported)<br />
OBJECTIVE: The purpose of this study was to examine the relationship between<br />
sleep (duration and quality) and diet quality among young adult women. Subjects:<br />
Three-hundred seventy-five women (18-24 years) were recruited to participate in the<br />
study. Measurements: Each participant wore an actigraph for 7 consecutive nights to<br />
measure sleep. Sleep logs were used to verify bedtime and wake time for each night.<br />
Actigraph data was then evaluated to determine sleep latency, efficiency, and number<br />
of awakenings. Diet was evaluated using automated self-administered 24-hour recall<br />
over three nonconsecutive days. Diet quality was evaluated using the 2005 Healthy<br />
Eating Index (HEI 2005), consumption of fruits and vegetables and consumption of<br />
non-nutrient dense foods (NNDF).<br />
rEsuLTs: On average women in the study consumed 1980 ± 540 calories per day,<br />
1.2 ± 0.7 servings of fruits and vegetables per 1000 calories and 27.4 ± 11.9% of their<br />
calories from junk foods. The average Healthy Eating Index score was 59.3 ± 12.5,<br />
which is classified as “needs improvement.” The HEI 2005 was negatively related to<br />
bedtime (F = 7.89, p = 0.0053) and the coefficient of variation in wake time (F = 5.13,<br />
p = 0.0242). Fruit and vegetable consumption was negatively related to wake time (F<br />
= 9.85, p = 0.0019)and the coefficient of variation in wake time (F = 6.34, p = 0.0123).<br />
NNDF was positively related to bedtime (F = 4.82, p = 0.0289).<br />
CONCLusIONs: Result for this study suggest that young adult women who go to<br />
sleep earlier, wake up earlier and have more consistent sleep patterns eat less NNDF,<br />
more fruits and vegetables and better meet dietary recommendations than women who<br />
go to sleep later, wake up later and have less consistent sleep patterns.<br />
1462 Board #54 May 30, 3:30 PM - 5:00 PM<br />
Modification Of students adiposity according To Nutritional<br />
status: an analysis Of 30 years<br />
Gerson Luis de Moraes Ferrari1 , Sandra Matsudo2 , Timoteo<br />
L. Araujo2 , Luis Carlos Oliveira2 , Victor Rodrigues Matsudo2 .<br />
1 2 CELAFISCS - UNIFESP, Itu, Brazil. CELAFISCS, São<br />
Caetano do Sul, Brazil.<br />
(No relationships reported)<br />
OBJECTIVE: To analyze the adiposity changes over 30 year-period, according to the<br />
nutritional status in students.<br />
METhOds: Sample is part of the Ilhabela Mixed-Longitudinal Project on Growth<br />
and Physical Fitness*, which is held since 1978. From a data base of 16.000 students of<br />
both sexes, 1144 students, 635 males and 509 females, from 10 to 11 years-old met the<br />
following inclusion criteria: to be in the prepubertal stage of sexual maturation; to be<br />
apparently healthy; and do not have physical impairments.The selected data were part<br />
of a database from 1978/1980 (Initial), 1988/1990 (10 years), 1998/2000 (20 years) and<br />
2008/2010 (30 years). The variables analyzed were: body mass, body height and fatness:<br />
average of seven skinfolds. Children were categorized according to the nutritional status<br />
through the WHO body mass index curves for age and sex in normal, overweight and<br />
obese. Used was ANOVA one-way, followed by post-hoc Scheffé was p
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S282 Vol. 45 No. 5 Supplement<br />
ID genotypes whereas insulin (from 3.84 to 2.69) and HOMA-IR (from 1.57 to 1.08)<br />
in DD genotype were significantly decreased after exercise program (p 0.05).<br />
Aspartate transaminase remained unchanged from pre- to post-testing (Control 3.50 +/-<br />
7.23, PL -2.01 +/- 5.83, EX -1.70 +/- 12.95IU/L, p > 0.05). No significant interactions<br />
were observed between groups for the aforementioned blood values (interaction p ><br />
0.095).<br />
CONCLusIONs: The nutritional supplements used in the current investigation<br />
enhanced total body fat loss when added to a reduced calorie diet. Both the diet alone<br />
and the diet with supplements did not alter hepatic or renal functions negatively.<br />
ACSM May 28 - June 1, 2013 Indianapolis, Indiana
Official Journal of the American College of Sports Medicine<br />
1469 Board #61 May 30, 3:30 PM - 5:00 PM<br />
Paleolithic diet and Exercise suppress hunger during Inter-<br />
Meal Interval By different Mechanisms<br />
Po-Ju Lin, Katarina Borer. University of Michigan, Ann Arbor, MI.<br />
(No relationships reported)<br />
Both exercise and higher fat and protein diet have been shown to reduce hunger ratings<br />
compared to high carbohydrate diet or sedentary condition. To find out whether this<br />
effect has a common mechanism, we examined how Paleolithic (P) versus Western diet<br />
(W), and exercise (X) versus sedentary (S) condition affected hunger ratings. Gastric<br />
inhibitory polypeptide (GIP) secretion and acetaminophen (APAP) absorption as a<br />
marker of gastric emptying (GE) served as a measure of gastrointestinal food transit<br />
(GFT). Although GIP has not been implicated in the control of hunger, GIP could<br />
affect hunger ratings indirectly by changing GE.<br />
PurPOsE: Examine the effect of P and W meal on hunger ratings and plasma GIP<br />
and APAP concentrations during X or S condition.<br />
METhOds: Twenty-four healthy postmenopausal women participated in 1 of 4<br />
conditions: S or 2 h of X (14 to 16 h) with P or W meal (PS, PX, WS, WX; n=8 each).<br />
The P meal contained 30% carbohydrate (CHO), 25% protein (PRO), and 45% FAT<br />
while W meal contained 60% CHO, 15% PRO, and 25% FAT. The meal was provided<br />
at 10 h. Participants were provided 20ml of liquid acetaminophen (160mg/5ml),<br />
30 minutes after the start of the meal. Plasma GIP and APAP concentrations were<br />
measured, and hunger ratings assessed with a visual analog scale, at hourly intervals<br />
during 3 h after the start of exercise. Changes in hunger ratings, GIP and APAP<br />
concentrations were analyzed with repeated measures mixed model ANOVA.<br />
rEsuLTs: Hunger ratings were overall significantly higher after W than after P meal<br />
(F=10.3, p
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Moreover, it affects the synthesis of inflammatory proteins, promoting a picture of lowintensity<br />
inflammation. Despite this evidence, little attention is given for investigation<br />
of strategies that may attenuate this situation. Therefore, the aim of this study was to<br />
analyze the effect of caloric restriction on the fat depots and inflammatory proteins in<br />
detrained rats.<br />
METhOds: Twelve (12) male adult Sprague-Dawley rats were divided into 3 groups<br />
(n = 4) after 8 weeks of training on a treadmill. One group (TRAIN) consisted of<br />
animals that continued training for 6 more weeks with access to food ad libitum. The<br />
other two groups discontinued training and had either access to food ad libitum (DT)<br />
or 30% caloric restriction (DTRC) for the next 6 weeks. The animals were euthanized<br />
and blood was collected for adipocytokine measurements (leptin, adiponectin, PAI-1<br />
and MCP-1). Retroperitoneal (RET), epididymal (EPI) and subcutaneous (SUB) fat<br />
pads were excised and weighed on an analytical scale. Adipocytokines were measured<br />
using Lincoplex 200. For statistical analysis, one-way ANOVA was used followed by<br />
Scheffe post-hoc test, considering P
Official Journal of the American College of Sports Medicine<br />
practice and may provide an opportunity for trainees to achieve the required physical<br />
activity to maintain cardiovascular health through routine activity.<br />
PurPOsE: The purpose of this study is to determine the level of activity of PM&R<br />
residents as measured by the number of steps taken during both a typical workday from<br />
7:30am to 4:30pm and during a 24 hour call period. We quantified physical activity in<br />
order to make recommendations specific to PM&R residents as to whether additional<br />
exercise is needed to maintain cardiovascular health.<br />
METhOds: The resident-on-call (ROC) at the Rehabilitation Institute of Chicago<br />
wore a FitBit accelerometer in order to record how many steps were tracked every<br />
minute of every day. The accelerometer was attached to the ROC’s keys, which are<br />
with him/her at all times. Subjects were blinded to the number of steps they took.<br />
rEsuLTs: On average, residents walked 6673 ± 2040 steps per 24h period; only 1 of<br />
the 30 days (3.3%) consisted of greater than 10,000 steps. During the typical workday,<br />
residents walked 3129 ± 1244 steps with no workdays reaching the required 10,000<br />
steps.<br />
CONCLusIONs: During the typical workday and when on 24-hour in-house call,<br />
residents training in PM&R do not achieve the level of daily activity required to<br />
maintain cardiovascular health. Consequently, PM&R residents would be required<br />
to achieve activity comparable to approximately 7,000 daily steps outside of work to<br />
achieve recommended guidelines.<br />
1477 Board #69 May 30, 2:00 PM - 3:30 PM<br />
Feasibility and acceptance of Breaks in Office-Based<br />
Occupational sedentary Time<br />
Eszter Füzéki, Lutz Vogt, Katharina Schmidt, Markus Stross,<br />
Winfried Banzer. Goethe University Frankfurt, Frankfurt am<br />
Main, Germany.<br />
(No relationships reported)<br />
Recent evidence suggests that prolonged sitting might be detrimental to health,<br />
independent of leisure time physical activity or exercise, and that breaks in sedentary<br />
time can counteract these effects. However there is only limited evidence how<br />
acceptable and feasible breaks are in office jobs.<br />
PurPOsE: To investigate the feasibility and acceptance of breaks at different time<br />
intervals in office-based occupational sitting.<br />
METhOds: Using a standardized diary subjects (n=18; age 37.2 years; BMI 25.4 kg/<br />
m2) documented the number of regular breaks in occupational sitting at baseline (T0).<br />
After having received written information on health risks of prolonged sitting subjects<br />
were randomized into 3 groups (breaks at every 30, 60, 120 min.). All subjects were<br />
encouraged to follow their respective break interval during their workday (≥8 hrs).<br />
Number, time, duration and cause of breaks were reported by subjects on 5 consecutive<br />
working days. The general practicability (10=very difficult) and subjective experience<br />
(10=very disturbing) were reported on a visual analogue scale at the end of every day.<br />
Compliance with break intervals was based on the calculation of the average difference<br />
per week between the target and the actual number of breaks per subject.<br />
rEsuLTs: No between-groups difference was observed in the number (range 2-17) of<br />
breaks taken at baseline. Subjects worked on average 8:51 h/d. The duration per break<br />
ranged from 1:40 - 15:00 min. More than 40% of all breaks were work-related. The<br />
average number (mean±SE) of actual breaks for group 1 to 3 per week was 9.5±1.0<br />
vs. 6.4±1.2 vs. 6.9±1.2, corresponding to average differences from the target number<br />
of breaks of 2.8±2.2 vs. -1.4±1.4 vs. 3.3±1.2. No significant differences in the number<br />
of actual breaks between groups or consecutive days of self-report were detected.<br />
Subjective ratings for practicability and experience were 4.1±0.6 and 1.8±0.3.<br />
CONCLusIONs: The present findings demonstrate that subjects feel comfortable<br />
with breaks at different intervals. Although statistics failed significance data suggest<br />
that breaks at every 60 min. in office-based occupational sedentary time seem<br />
most feasible. Since breaks were to a large extent work-related behavioural and<br />
environmental support in the office setting might enhance readiness to take breaks<br />
more often.<br />
1478 Board #70 May 30, 2:00 PM - 3:30 PM<br />
hamsters Without Wheels: The Built Classroom<br />
Environment Makes undergraduates Inactive and<br />
unhealthy<br />
Matthew Kuennen1 , Jorge Granados1 , Trevor Gillum2 . 1West Texas A&M University, Canyon, TX. 2California Baptist<br />
University, Riverside, CA.<br />
(No relationships reported)<br />
Sedentarism is a learned behavior that increases the incidence of hypertension (30%),<br />
Alzheimer’s disease (40%), coronary artery disease (45%), type II diabetes (50%),<br />
stroke (60%), and costs U.S. taxpayers >2.4 billion dollars annually. College students<br />
spend >75% of each school day engaged in sedentary pursuits.<br />
PurPOsE: Our purposes were threefold: 1) Determine the contribution of the seated<br />
classroom environment to sedentarism in college students; 2) Define the relationship<br />
between sedentarism and physiological and psychological health; and 3) Discern<br />
whether sedentarism influences student outcomes on academic coursework.<br />
METhOds: 12 male and 12 female undergraduates tracked the number of steps they<br />
took before, during, and after school each day for 1 week; these data were used to<br />
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stratify students into groups (high, moderate, or low physical activity). Risk factors<br />
for atherosclerotic cardiovascular disease (age, family history, cigarette smoking,<br />
sedentary lifestyle, hypertension, dyslipidemia, prediabetes); psychological health<br />
(Beck Depression Inventory); and academic outcomes (student’s final course grades)<br />
were assessed. A Pearson correlation was used to determine the relationship between<br />
student’s physical activity levels and their risk for atherosclerotic cardiovascular<br />
disease. A one-way ANOVA was used to determine if psychological health and<br />
academic outcomes differed between physical activity groups.<br />
rEsuLTs: Time spent in the seated classroom environment was the single largest<br />
contributor to physical inactivity during the school day in this undergraduate student<br />
cohort. 14 of 24 (58%) students did not achieve recommended physical activity levels<br />
(10,000 steps/d). An inverse relationship (r = 0.71; p
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were included.<br />
rEsuLTs: The literature reviewed draws attention to the global health crisis<br />
that is being caused by physical inactivity. Inactive children have a higher risk of<br />
developing chronic diseases such as obesity, type 2 diabetes, high blood cholesterol<br />
and hypertension. Other undesirable consequences include orthopaedic problems,<br />
cardiovascular disease and various psychological complications. Both aerobic and<br />
resistance training should be incorporated into paediatric exercise programs. The<br />
recommended guidelines for childhood activity are 60 minutes of moderate intensity<br />
exercise every day of the week.<br />
CONCLusION: This abstract highlights the importance of formalised paediatric<br />
exercise programs in disease prevention and health promotion. A healthy and happy<br />
adolescent population ultimately contributes to a low risk adult population. The<br />
combined effect of healthy children and adults will in the long-term decrease the<br />
burden on the national health sector. Therefore both children and parents should be<br />
encouraged to participate in regular activity.<br />
1481 Board #73 May 30, 2:00 PM - 3:30 PM<br />
awareness Of aCsM Physical activity recommendations<br />
for health Promotion among Portuguese and Polish College<br />
students<br />
Jolanta Zuzda1 , Dulce Esteves2 , Paulo Pinheiro3 , Kelly O’Hara2 ,<br />
Rui Brás4 , Robert Latosiewicz5 . 1University Bialystok of<br />
Technology, Bialystock, Poland. 2University of Beira Interior,<br />
CIDESD, Covilhã, Portugal. 3University of Beira Interior,<br />
NECE, Covilhã, Portugal. 4University of Beira Interior,<br />
CIDESD, Covilhã, Portugal. 5Medical University of Lublin,<br />
Lublin, Poland.<br />
(No relationships reported)<br />
Embracing an active lifestyle has an important role in preventing chronic disease and<br />
improving mental health, perceived health status, and quality of life. Many health<br />
behaviors, such physical activity (PA) level are established during early adulthood,<br />
when many attend college, so the decline in PA during college is a disturbing trend.<br />
Little investigation has focus on students’ awareness on adequate PA characteristics for<br />
health improvement, and if that awareness presents differences for students of different<br />
contexts.<br />
PurPOsE: This study aims to examine the extent to which knowledge of the ACSM<br />
PA recommendations has diffused through portuguese and polish college students.<br />
METhOds: The study included a stratified randomly recruited sample of 300<br />
Portuguese students (23.7% M; 76.3% F), 19.58±1.61 y and 358 Polish students<br />
(39.1% M; 60.9% F), 21.06±1.39 y. The awareness of ACSM Physical Activity<br />
Recommendations for Health Promotion was assessed as indicated by Bennett et al.<br />
(2009).<br />
rEsuLTs: 43.0% of Portuguese and 31.9% of Polish students were accurately<br />
knowledgeable of the ACSM physical activity recommendations. Recommendations<br />
knowledge was slightly higher among male students (45.1% for Portuguese and 32.9%<br />
for Polish) than females (42.1% for Portuguese and 31.2% for Polish).<br />
CONCLusIONs: Despite efforts to promote PA and widespread knowledge on<br />
ACSM recommendations, more than an half of college students can not accurately<br />
identify adequate PA characteristics for health improvement. This lack of awareness<br />
is common in students from different universities and from different countries. These<br />
findings highlight the need for more effective campaigns to widespread ACSM<br />
recommendations for health promotion among universities.<br />
References: Bennett, G., Wolin, K. et al. (2009) Awareness of National Physical<br />
Activity Recommendations for Health Promotion among US Adults. Med Sci Sports<br />
Exerc. 41(10), pp. 1849-1855<br />
1482 Board #74 May 30, 2:00 PM - 3:30 PM<br />
Physical activity habits and related Counseling Practices<br />
among health Care Providers: a Literature review<br />
Isabel Garcia de Quevedo 1 , John Duperly 2 , Felipe Lobelo 1 .<br />
1 Centers for Disease Control and Prevention, Atlanta, GA.<br />
2 Universidad de los Andes, Bogota, Colombia.<br />
(No relationships reported)<br />
Health care providers (HCPs) play a key role counseling their patients to adopt healthy<br />
physical activity (PA) levels, (Healthy People 2020 objective). It has been reported<br />
that active HCPs that are more likely to counsel and give better, more credible and<br />
motivating PA counseling to their patients.<br />
PurPOsE. Summarize the evidence on HCPs personal PA habits and related<br />
counseling practices.<br />
METhOds. A snow-ball literature search methodology based on relevant articles<br />
and key search terms (“attitudes”, “habits”, “health personnel”, “physical activity”,<br />
“exercise” and “role model”) was used to select applicable articles in PubMed between<br />
1979 and 2012.<br />
rEsuLTs. Out of 196 articles screened, 26 were finally included in this review, 23<br />
observational studies and three interventions to modify HCP, PA habits, counseling<br />
or both. Most studies were from the US (n=16) and included MD’s samples (n=18).<br />
MEDICINE & SCIENCE IN SPORTS & EXERCISE ®<br />
Synthesis from the findings suggests that, compared to general population, MD’s<br />
report higher compliance with current PA recommendations, ranging from 45 to 90%.<br />
Among other HCP (nurses and dietitians) compliance with PA recommendations<br />
ranged from 39 to 70%. MD PA advice found to be influenced by: older age, being<br />
female, being physically active, and patients’ higher level of education. Specialty<br />
was also an important factor being GPs and internists the ones that counsel more. PA<br />
counseling among other HCP (nurses, social workers and dietitians) ranged from 88 to<br />
95%. In general knowledge of current PA recommendations was low and ranged from<br />
12-27% among MD’s and from 9 to7% among other HCP. The most common barriers<br />
reported for not counseling on PA were similar among physicians and non-physicians<br />
and included lack of time, low self-efficacy, lack of PA counseling materials and lack<br />
of knowledge. Some interventions successfully improved MD’s PA/fitness, access to<br />
training and materials, and increased PA prescription knowledge, but no significant<br />
increase in PA counseling was observed.<br />
CONCLusION. Personal PA habits are associated with HCP’s PA-related counseling.<br />
More research is needed on effective interventions to improve HCPs PA habits and<br />
address other PA counseling barriers in particular among non-physician population and<br />
in low-to-middle income countries where the burden of inactivity is greatest.<br />
1483 Board #75 May 30, 2:00 PM - 3:30 PM<br />
Long Term Effects Of a Community Group Versus<br />
Physiotherapist-led home-based Physical activity Program<br />
Nicole Freene, Gordon Waddington, Wendy Chesworth, Rachel<br />
Davey, Tom Cochrane. University of Canberra, Bruce, Australia.<br />
(No relationships reported)<br />
Few studies have compared the long term effects of physical activity programs with<br />
varying program methods, program deliverers and participant preferences.<br />
PurPOsE: To compare a physiotherapist-led home-based physical activity program<br />
to a standard community group exercise program to determine the long term physical<br />
activity adherence and health benefits.<br />
METhOds: A pragmatic quasi-experimental design was used to compare a nonrandomized<br />
group and home-based intervention over 18 months. Sedentary community<br />
dwelling 50-65 year olds were recruited using the Australian Federal Electoral Roll<br />
(n=2105). Initially participants were invited to a community group exercise program<br />
(G, n=93). Those not interested in the group exercise program were invited to take<br />
part in a physiotherapist-led home-based physical activity program (HB, n=65). Both<br />
interventions were for 6 months over the same time period. The primary outcome<br />
was physical activity adherence derived from exercise diaries. Secondary outcomes<br />
included the Active Australia Survey, accelerometry, aerobic capacity (step test),<br />
quality of life (SF-12v2), blood pressure, waist circumference, waist-to-hip ratio<br />
(WHR) and body mass index. Comparisons between interventions were made using a<br />
repeated measures ANCOVA.<br />
rEsuLTs: Home-based participants were more likely to be younger, working full<br />
time and not be in a relationship (p
Official Journal of the American College of Sports Medicine<br />
rEsuLTs: Based on Repeated Measures ANOVAs, there were significant program<br />
main effects for sedentary [F(2, 74)=31.38, p
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S288 Vol. 45 No. 5 Supplement<br />
participants were asked to maintain normal diet, and record daily fluid intake while the<br />
E group participants were asked to maintain normal diet, consume an additional 710<br />
ml of water daily, and record daily fluid intake.<br />
rEsuLTs: During Pre, hydration status was not significantly different between the<br />
groups and both groups appeared to be hypohydrated (p>0.05, C: 1.025 ± 0.005; E:<br />
1.025 ± 0.004). During the week leading to the Post, the average fluid intake was<br />
significantly greater in the E group compared to C group (p = 0.03, C = 2160 ± 1080<br />
ml; E: 3033 ± 934 ml), yet, hydration status was not significantly different during Post<br />
(p>0.05, C: 1.025 ± 0.007; E: 1.020 ± 0.006).<br />
CONCLusION: The results of the study demonstrated that, similar to other reports,<br />
Division III collegiate athletes were hypohydrated prior to practice. In addition,<br />
although the hydration regimen resulted in a greater fluid consumption, hydration<br />
status between the groups was not different.<br />
1489 Board #81 May 30, 3:30 PM - 5:00 PM<br />
Influence of hydration status on Ironman Triathletes using<br />
heart rate Based Pace Feedback<br />
Rebecca L. Stearns, Douglas J. Casa, FACSM, Julie K.<br />
DeMartini, Tracy L. Hicks, Robert A. Huggins, Lesley W.<br />
Vandermark, Evan C. Johnson, Colleen X. Muñoz. University of<br />
Connecticut, Storrs, CT.<br />
(No relationships reported)<br />
Endurance athletes commonly use heart rate (HR) to pace themselves. However,<br />
dehydration elevates HR, potentially impacting pacing during an endurance event.<br />
PurPOsE: Evaluate the influence of hydration status on triathletes utilizing heart rate<br />
(HR) to pace themselves during the bike and run sections of an Ironman triathlon.<br />
METhOds: Sixteen athletes (3 women, 13 men) in the 2012 Lake Placid<br />
Ironman traiathlon participated (Mean±SD: age=40±5yrs, height=173±12cm, body<br />
fat=16.1±6.5%). Average HR (HRavg), global positioning system (GPS) data,<br />
percent body mass loss (%BML), urine color (UC) and urine specific gravity (USG)<br />
were collected. HRavg and pace (min*km-1) for the two identical bike (B1, B2) and<br />
run (R1, R2) course loops were collected. Based on post race USG, subjects were<br />
divided into two groups: hydrated (HY, USG
Official Journal of the American College of Sports Medicine<br />
Mean Local Sweat Rate (mg/min/cm2) ± SD<br />
Drink 15 min 30 min 50 min 60 min 75 min<br />
1.5ºC 0.20 ± 0.09 0.40 ± 0.11 0.53 ± 0.12 0.58 ± 0.14 0.69 ± 0.15<br />
37ºC 0.23 ± 0.11 0.50 ± 0.17 0.61 ± 0.22 0.66 ± 0.24 0.72 ± 0.27<br />
50ºC 0.29 ± 0.15 0.61 ± 0.18 0.74 ± 0.21 0.79 ± 0.22 0.78 ± 0.23<br />
NG 50ºC 0.39 ± 0.23 0.65 ± 0.23 0.70 ± 0.23 0.71 ± 0.23 0.69 ± 0.24<br />
NG 1.5ºC 0.27 ± 0.11 0.43 ± 0.15 0.49 ± 0.16 0.51 ± 0.15 0.57 ± 0.16<br />
SW 50ºC 0.29 ± 0.17 0.50 ± 0.20 0.57 ± 0.24 0.60 ± 0.21 0.61 ± 0.21<br />
SW 1.5ºC 0.36 ± 0.29 0.51 ± 0.24 0.62 ± 0.22 0.60 ± 0.24 0.60 ± 0.24<br />
1493 Board #85 May 30, 3:30 PM - 5:00 PM<br />
sweat sodium Content: Concurrent Validity Of The horiba<br />
C-122 Tm and Wescor sweat Chek Tm analysers<br />
Eric DB Goulet, Tommy Dion, Audrey Asselin, Félix A. Savoie.<br />
University of Sherbrooke, Sherbrooke, QC, Canada.<br />
(No relationships reported)<br />
Currently, there exists two instruments that coaches and scientists can use to measure<br />
sweat sodium content under field conditions: the Horiba C-122TM and Wescor Sweat<br />
ChekTM. The former device (ion selective electrode technology) is low weight (~<br />
40g), low cost (~250 US$), pocket-sized and battery operated, whereas the latter (ion<br />
conductance technology) is semi portable (~1 kg), medium-priced (~2000 US$) and<br />
electrically operated. No studies have yet concurrently compared the validity of both<br />
instruments. This is an important issue, given the discrepant cost and physical and<br />
technical characteristics of the two devices.<br />
PurPOsE: To simultaneously determine the validity of the Horiba C-122TM and<br />
Wescor Sweat ChekTM against sweat sodium concentration values obtained with<br />
the flame photometry technique, which is the accepted reference method for the<br />
measurement of bodily sodium contents.<br />
METhOds: Sweat sodium samples (N=74) (patch collection technique, 5 x 7 cm<br />
non-adherent pads covered with highly-adhesive transparent dressings) were obtained<br />
from 26 exercising, heat-acclimatized soccer players, runners and triathletes, who<br />
each provided between 1 to 4 sweat samples from 1 to 4 different anatomical sites<br />
(forefront, thigh, upper back or forearm).<br />
rEsuLTs: Data were normally distributed (kolmogorov-smirnov test) and showed<br />
no sign of heteroscedasticity (standardized residuals vs. dependent variables). Sweat<br />
sodium concentration values obtained with the Horiba C-122TM and Wescor Sweat<br />
ChekTM correlated highly with those determined by flame photometry (Pearson<br />
product-moment correlation coefficient: r=0.98 vs. r=0.99; single measures (two-way<br />
random/absolute agreement) intra-class correlation coefficient: r=0.97 vs. r=0.98). In<br />
comparison to flame photometry, the Horiba C-122TM and Wescor Sweat ChekTM<br />
demonstrated similar biases (-3 mmol/L vs. 1 mmol/L), pure error of measurements (6<br />
mmol/L vs. 5 mmol/L), standard error of the estimates (5.51 mmol/L vs. 3.53 mmol/L)<br />
and 95% Bland and Altman level of agreement confidence intervals (-3 ± 12 mmol/L<br />
vs. 1 ± 10 mmol/L).<br />
CONCLusION: These results indicate that both the Horiba C-122TM and Wescor<br />
Sweat ChekTM portable sodium analysers demonstrate a moderate level of agreement<br />
with the flame photometry technique.<br />
1494 Board #86 May 30, 3:30 PM - 5:00 PM<br />
sweat Electrolyte Content and Fluid Loss in Elite Triathletes<br />
Riana R. Pryor, Amy B. Mausser, Douglas J. Casa, FACSM,<br />
J Luke Pryor, Lawrence E. Armstrong, FACSM, Evan C.<br />
Johnson, Brittanie M. Volk, Amy L. McKenzie, Luke N. Belval.<br />
University of Connecticut, Storrs, CT.<br />
(No relationships reported)<br />
Knowledge of 24-hour sodium and water turnover in trained triathletes during<br />
training in a warm environment is important for personalized nutrition, hydration and<br />
performance.<br />
PurPOsE: This study investigated triathlete urine and sodium 24-hour turnover<br />
during a period that included endurance exercise in a warm environment to determine<br />
if increases or decreases in consumption are necessary.<br />
METhOds: Thirty-three sponsored triathletes (19 men, 14 women; age: 37 ± 11 y,<br />
32 ± 6 y; height: 181 ± 6 cm, 170 ± 4 cm; weight: 75.7 ± 7.6 kg, 60.1 ± 5.9 kg; best<br />
half Ironman time 4:16 ± 0:24 hr:min, 4:42 ± 0:20 hr:min, respectively) completed a<br />
43.4 ± 3.8 minute treadmill run or friction resisted cycle ergometer ride (28.0 ± 0.5 ºC;<br />
27.2 ± 4.9 % RH) at a self-selected intensity which was estimated to be similar to half<br />
Ironman triathlon race pace for the chosen modality. Whole body wash-down (WBW)<br />
determined sweat electrolyte content. Twenty-four hour urine and dietary records were<br />
collected to calculate sodium and water intake and losses.<br />
rEsuLTs: Both 24-hour water and sodium balance were similar between men and<br />
women.<br />
Vol. 45 No. 5 Supplement S289<br />
Water (L·d-1 ) Sodium (mg)<br />
Male Female Male Female<br />
Total Intake 4.1 ± 1.9 3.0 ± 1.2 5081 ± 2277 3589 ± 1005*<br />
Exercise Intake 0.4 ± 0.4 0.3 ± 0.2 --- ---<br />
Sweat Output 1.4 ± 0.3 1.0 ± 0.3* 1423 ± 438 941 ± 476*<br />
Urine Output 2.8 ± 0.8 2.4 ± 0.7 4687 ± 1419 2791 ± 1162*<br />
Net Balance -0.2 ± 1.9 -0.5 ± 1.4 -1048 ± 2229 -161 ± 1435<br />
Note. *Difference between sexes, p ≤ 0.05. Total water intake includes exercise<br />
intake.<br />
CONCLusION: Twenty-four hour sodium and water turnover were similar<br />
between trained male and female triathletes. When exercising in warm conditions,<br />
trained triathletes may need to slightly increase water replacement (5-17%) and<br />
moderately increase sodium supplementation (4-21%) to remain homeostatic.<br />
Supported by Timex, Inc., Middlebury, CT.<br />
1495 Board #87 May 30, 3:30 PM - 5:00 PM<br />
Physiological Effects of Compression Garments during<br />
uncompensable heat stress<br />
Joshua T. Bautz, David Hostler, FACSM, Priya Khorana, Joe<br />
Suyama. Emergency Responder Human Performance Lab,<br />
University of Pittsburgh, Pittsburgh, PA.<br />
(No relationships reported)<br />
Thermal protective clothing (TPC) worn by firefighters protect users from flames but<br />
prevent evaporative cooling. Volume lost from sweating combined with heat stress<br />
and physical exertion places considerable strain on the cardiovascular system. Lower<br />
extremity compression garments (LECGs) have gained popularity with endurance<br />
athletes and are purported to improve performance by augmenting venous return. We<br />
hypothesized that the use of LECGs would therefore preserve intravascular volume<br />
leading to a lower heart rate (HR) while working in a hot environment.<br />
PurPOsE. Examine the effect of wearing LECGs under TPC on HR, core<br />
temperature (Tc), and markers of hydration during treadmill exercise.<br />
METhOds. Ten male subjects (mean age 27± 6 years, height 1.78± 0.092 m, mass<br />
74.75± 6.974 kg, body fat 10.6± 4.22%, VO2 max 57.8± 9.29 mL/kg/min) completed<br />
the control (no LECG) and LECG experimental conditions in randomly assigned<br />
order. Protocols were separated by a minimum of three days. Subjects exercised for<br />
90 minutes on a treadmill while wearing wilderness firefighter TPC and helmet in a<br />
heated room. Venous blood was drawn pre and post exercise to measure hemoglobin<br />
(Hgb), hematocrit (Hct), serum OSM (OSM), and serum CPK (CPK). Vital signs and<br />
perceptual measures of comfort and exertion were recorded every five minutes during<br />
the protocol. Paired samples t-tests were performed to compare the change in metrics<br />
between the two conditions.<br />
rEsuLTs. In comparing the LECG condition with the control condition, there were<br />
no differences in the change in HR (84±27 vs. 85±14 bpm, p=0.9), Hgb (0.49±0.66<br />
vs. 0.33±1.11 g/dL, p=0.7), Hct (1.22±1.92 vs. 1.11±3.62%, p=0.9), or body mass<br />
(1.72±0.78 vs. 1.77±0.58 kg, p=0.7). There were no differences in distance walked<br />
(3.9±0.5 vs. 4.0±0.5 miles, p=0.2), exercise interval (88.6±3.5 vs. 88.4±3.6 minutes,<br />
p= 0.8), or perceptual measures of comfort or exertion. Additionally, there were<br />
no differences in Tc rise (1.8±0.6 vs. 1.9±0.5°C, p=0.394), OSM (1.67±6.34 vs.<br />
6.22±11.39 mOsm/kg, p = 0.3), or CPK (22.2±30.2 vs. 29.8±19.4 IU/L, p = 0.5).<br />
Conclusions. LECG worn beneath TPC did not acutely alter the physiologic response<br />
to exertion in TPC. These data neither encourage nor discourage LECG use during<br />
uncompensable heat stress.<br />
1496 Board #88 May 30, 3:30 PM - 5:00 PM<br />
Effects of different Types of Clothing on Thermoregulation<br />
and Microenvironments during simulated american<br />
Football<br />
Eric J. Jones, Nathan Frischmann, Mark D. Faries, Wesley<br />
Kephart. Stephen F. Austin State University, Nacogdoches, TX.<br />
(Sponsor: Thomas J. Pujol, FACSM)<br />
(No relationships reported)<br />
PurPOsE: This study assessed the effects of two different types of clothing on core<br />
temperature (Tc), skin temperature (Ts), and the microenvironments (ME) of collegeaged<br />
males during a simulated football game within hot environments.<br />
METhOds: Trained college-aged males (n = 10) participated in a series of 5-second<br />
ergometer sprints in a climate-controlled chamber (35°C, 55%RH). The sprint protocol<br />
was based on the average number and length of plays within NCCA Division I<br />
football games. Subjects performed two separate trials, each consisting of 85 minutes,<br />
separated by a 48-hour washout period. During trials, either cotton or channeled fabric<br />
clothing (CFC) was donned under protective football gear. Tc, Ts, and ME temperature<br />
and humidity was monitored throughout trials.<br />
rEsuLTs: Paired samples t-test revealed significant differences (p
<strong>Thursday</strong>, May 30, 2013<br />
S290 Vol. 45 No. 5 Supplement<br />
CFC was 2.6±0.8 and 2.2±1.1 respectively (p=0.04). ME chest temperature changes<br />
for cotton and CFC were 3.7±1.05 and 3.0±0.91, respectively (p
Official Journal of the American College of Sports Medicine<br />
when compared to the smaller (1A-2A) schools.<br />
CONCLusIONs: These results suggest the larger schools (3A-4A) have greater<br />
access to an increased level of Sports Medicine coverage and as such appear to have<br />
an increased level of care for their high school student-athletes. Based on these results,<br />
there is a clear trend towards the smaller schools being at a disadvantage when it come<br />
is having an acceptable standard of “Sports Medicine coverage” at their schools.<br />
1501 Board #93 May 30, 2:00 PM - 3:30 PM<br />
assessing the Impact of youth Climate differences in Elite<br />
Major League Baseball Pitchers<br />
Gregory Paul Kolovich, Lorena Floccari, Mark Schickedantz,<br />
David C. Flanigan, Grant L. Jones, Michael Griesser. Wexner<br />
Medical Center at The Ohio State University, Columbus, OH.<br />
(No relationships reported)<br />
PurPOsE: Recent studies demonstrate the detrimental effects on the glenohumeral<br />
joint by repetitive throwing at an early age in organized youth baseball. Pitchers born<br />
in warmer climates are more likely to throw year round, as opposed to pitchers born<br />
in colder climates, where young pitchers are likely to take a break from throwing<br />
during the winter. The purpose of this study was to investigate whether youth climate<br />
differences affect longevity of elite MLB pitchers.<br />
METhOds: Data were collected from all 710 Major League Baseball (MLB) pitchers<br />
who compiled a minimum of 1500 career innings. Forty pitchers were excluded from<br />
the study as they were currently active on a MLB roster in 2011 bringing the total to<br />
670 MLB pitchers. Six outcome variables were investigated: career innings, career<br />
wins, career losses, career complete games, career games started, and career years<br />
pitched.<br />
rEsuLTs: We found that MLB pitchers born in regions with colder average<br />
temperatures (Canada, Europe, Midwest US, and Northeast US) compiled an average<br />
of 187 more career innings (2497 v. 2310 p < 0.0049), had 13 more career wins (153<br />
v. 140 p < 0.005), and had 49 more career complete games (153 v 104 p < 0.000) than<br />
pitchers born in regions with warmer average temperatures (Southeast US, Southwest<br />
US, West US, Latin America, and Asia).<br />
CONCLusIONs: MLB pitchers born in regions with colder average temperatures<br />
are more likely to break from throwing during the winter season. These colder weather<br />
youth pitchers compiled greater career innings, career wins and career complete games<br />
suggesting that pitching year round at an early age may be detrimental to the longevity<br />
of Major League pitchers. These findings support the need for continued pitch count<br />
regulation in youth baseball as well suggest a need for monitored rest from throwing<br />
during the offseason.<br />
1502 Board #94 May 30, 2:00 PM - 3:30 PM<br />
Preparticipation Physical Evaluation Forms and<br />
Implementation Policies differ across united states high<br />
school athletic associations<br />
Mary C. Chabolla, Amanda M. Caswell, Jatin P. Ambegaonkar,<br />
Nelson Cortes, Shane V. Caswell. George Mason University,<br />
Manassas, VA.<br />
(No relationships reported)<br />
The American Academy of Pediatrics’ (AAP) Preparticipation Physical Evaluation 4 th<br />
edition (PPE) monograph contains guidelines for screening and determining eligibility<br />
for United States (US) high school athletes. However, evidence of how PPEs are being<br />
implemented and AAP whether guidelines are being followed is lacking.<br />
PurPOsE: To investigate current PPE policies and practices in US high school<br />
athletic associations (HSAA).<br />
METhOds: We accessed publicly available PPE forms, policies, and procedures<br />
documents from all 50 states’ and the District of Columbia’s HSAA. We analyzed<br />
the content of PPE documents from each state using an electronic coding form<br />
for: A) policy existence, B) update frequency and C) format of PPE and examined<br />
requirements of the frequency of administration, and D) providers approved to perform<br />
PPEs. The PPE content was analyzed to determine whether a heart health history<br />
(HHR) component was included. Analyses were calculated for all PPE content items.<br />
rEsuLTs: Forty-nine states (96%) require that PPEs be completed for HS sport<br />
participation eligibility, while in 2 states (4%) it is recommended. Seventeen (33%) states<br />
either recommended (13.7%) or required (19.6%) use of the AAP 4th edition PPE form.<br />
Fifteen (30%) states revised PPE forms in 2012, while 5 (
<strong>Thursday</strong>, May 30, 2013<br />
S292 Vol. 45 No. 5 Supplement<br />
CONCLusION: A positive significant correlation between the Single hop and Triple<br />
hop tests suggests that assessment of patients’ physical function by either test might<br />
provide relatively comparable data. There was also a significant correlation between<br />
knee passive laxity (anterior tibial translation) measured by application of 150N<br />
force and maximal manual force using an arthrometer, suggesting that these measures<br />
can be used interchangeably. Questionnaire results were not correlated with any of<br />
the objective measures. Further investigation on a larger population is underway.<br />
Investigation of correlations between the results of functional tests and KT arthrometer<br />
measurements may help inform clinical decision-making.<br />
1505 Board #97 May 30, 2:00 PM - 3:30 PM<br />
Quadriceps strength, Not activation, Improves in the<br />
unexercised Limb Following a single-Legged Eccentric<br />
Exercise Program<br />
Lindsey Lepley, Riann Palmieri-Smith. University of Michigan,<br />
Ann Arbor, MI.<br />
(No relationships reported)<br />
Following injury, eccentric exercise of the injured limb is often contraindicated. Crosseducation<br />
training, whereby the uninvolved limb is exercised, is an alternative that may<br />
improve quadriceps strength and activation in the unexercised limb. Understanding<br />
the benefits of eccentric cross-education training can help determine if this exercise<br />
regimen can be used in individuals post-injury.<br />
PurPOsE: Determine if eccentric exercise is capable of producing quadriceps<br />
strength and activation gains in the unexercised limbs of healthy participants.<br />
METhOds: Eccentric exercise group (EX; 4f/5m; age 23.3±2.4 yrs; height 1.7±0.1<br />
m; mass 70.6±14.3 kg) and control group (CNTRL; 6f/3m; age 22.6±3.6 yrs; height<br />
1.7±0.1 m; mass 66.7±10.1 kg) had quadriceps strength and activation measures<br />
collected at pre-, mid- and post-intervention time points. EX participants exercised<br />
their dominant limb with an isokinetic dynamometer in eccentric mode at 60°/sec,<br />
three times per week for eight weeks. Quadriceps strength was quantified at 30 and<br />
60°/sec in concentric and eccentric modes. Quadriceps activation was assessed using<br />
the burst superimposition technique and quantified via the central activation ratio. 2x3<br />
Repeated Measures ANOVA was used to detect the effects of group and testing session<br />
on quadriceps strength and activation. Where appropriate, post hoc Bonferroni multiple<br />
comparison procedures were used.<br />
rEsuLTs: Greater eccentric quadriceps strength was found in the unexercised limbs<br />
of EX participants between the pre-to-mid and pre-to-post intervention time points<br />
(30°/sec (Nm/kg): Pre=2.2±0.2, Mid=3.4±0.4, Post=3.5±0.4, Pre-to-Mid P=0.05,<br />
Pre-to-Post P=0.02; 60°/sec: Pre=2.1±0.2, Post=3.9±0.5, P=0.02). No differences<br />
were noted between the mid-to-post time point (30°/sec P=0.06; 60°/sec P=0.18)<br />
or in concentric strength (P>0.05). No gains in quadriceps activation were detected<br />
(P=0.06). CNTRL participants strength did not change (P>0.05).<br />
CONCLusION: Exercising with eccentric contractions resulted in mode specific<br />
gains in quadriceps strength in the unexercised limbs of healthy participants at four<br />
weeks. No gains in quadriceps muscle activation were detected. Rehabilitation<br />
programs can utilize this type of eccentric exercise to safely improve quadriceps<br />
strength in the injured knee.<br />
1506 Board #98 May 30, 2:00 PM - 3:30 PM<br />
Platelet rich Plasma: Improvement in Pain by anatomical<br />
site and Number of Injections<br />
Bronson Elizabeth Delasobera1 , Neal Shelley1 , Scott Robinson2 ,<br />
Garry Ho, FACSM3 , Thomas Howard, FACSM3 . 1Georgetown University, Washington, DC. 2United States Army, Lacey, WA.<br />
3Virginia Commonwealth University, Fairfax, VA.<br />
(No relationships reported)<br />
INTrOduCTION: Platelet rich plasma (PRP) treatment has been used for years in<br />
the sports medicine community, but there are very few studies evaluating its efficacy.<br />
We measured pain scores following PRP injections in a variety of anatomic sites,<br />
receiving either single or multiple injections. Our null hypotheses were that, among<br />
patients treated with PRP: 1) there are no significant differences in mean pain by<br />
anatomic region and 2) there is no significant difference in mean pain scores between<br />
patients receiving either single or multiple injections.<br />
METhOds: Study type: a retrospective, survey-based, cohort study. Setting: an<br />
academic sports medicine clinic where PRP injections are frequently performed.<br />
Subjects who received PRP injections completed surveys to quantify their pain and<br />
percent improvement. Each subject filled out the survey approximately one month<br />
post-injection and reported three pain scores: within 72 hours post-injection (PS1),<br />
one week following injection (PS2), and approximately one month following injection<br />
(PS3). Descriptive statistics and hypothesis testing (using a one way analysis of<br />
variance or Student’s t test where appropriate) were performed. Alpha was set at 0.05<br />
for all comparisons.<br />
rEsuLTs: One hundred thirty five patients, who received two hundred PRP<br />
injections, were included for study. Overall, patients reported a 49.2% (95% CI: 45.2-<br />
54%) mean improvement in pain scores (for combined single and multiple injection<br />
subjects). The mean percent improvements in pain scores by anatomic sites were<br />
not significantly different (p=0.58; see Table and Figure below). The mean percent<br />
MEDICINE & SCIENCE IN SPORTS & EXERCISE ®<br />
improvement (regardless of anatomical site) for patients who received multiple<br />
injections (mean 58.9%; 95% CI: 50.9-66.9%), compared to those who received a<br />
single injection (mean 54.3% (95% CI: 47.8-60.8%) was not significantly different<br />
(p=0.4).<br />
CONCLusIONs: PRP injections (combined single and multiple) are associated with<br />
a significant improvement in reported pain one-month post injection. PRP injections<br />
are most effective for thigh injuries, and least effective for hip injuries. We identified<br />
no significant difference in pain scores for patients receiving single vs. multiple<br />
injections.<br />
1507 Board #99 May 30, 2:00 PM - 3:30 PM<br />
Gold Medal sports Medicine: Integrative Model of Medical<br />
Care during International Competition<br />
John P. Vardiman1 , Jake Siedlik1 , Michael Cooper1 , Russell<br />
Emmons1 , William Moreau2 , Dustin Nabhan3 , Jenna Street3 ,<br />
Philip M. Gallagher1 . 1University of Kansas, Lawrence, KS.<br />
2United States Olympic Committee, Colorado Spring, CO.<br />
3United States Olympic Committee, Colorado Springs, CO.<br />
(Sponsor: Joseph Weir, FACSM)<br />
(No relationships reported)<br />
Many manual therapy techniques and therapeutic modalities are utilized to return<br />
patients to functional activities or activities of daily living. Assessing the change in a<br />
patients perception of their functional ability after receiving Instrument Assisted Soft<br />
Tissue Mobilization (IASTM) treatment has yet to be determined.<br />
PurPOsE: The purpose of this project was to assess the efficacy of the Instrument<br />
Assisted Soft Tissue Mobilization (IASTM) technique at changing a patient’s<br />
functional ability as well as their perception of functional ability of the functional squat<br />
test.<br />
METhOds: Twenty-four college-aged students (20.96±1.27 years, 62.11±13.11 kg,<br />
168.52±9.08cm) participated in this study. Eleven subjects (8 female, 2 male) were<br />
randomly selected to receive the IASTM treatment (TG) and 13 subjects (11 female, 3<br />
male) were randomly selected for the control group (CG). All subjects completed the<br />
Perception of Functional Ability Questionnaire (PFAQ) and then performed a baseline<br />
functional squat test using a 3-D Marker-less Motion Capture System (Dynamic<br />
Athletics, Overland Park, KS). The TG received a bilateral IASTM treatment to the<br />
posterior lower leg and the CG rested in a prone position for 10 minutes and did not<br />
receive the treatment. After the IASTM or 10 minute rest period all subjects performed<br />
a follow-up functional squat test in the motion capture system and completed a followup<br />
PFAQ. All pre-test post-test data was analyzed using a 2x2 repeated measures<br />
ANOVA (p
Official Journal of the American College of Sports Medicine<br />
CONCLusIONs: Diagnosis of Achilles tendinopathy in adolescent athletes is<br />
rare and less frequent than in adult athletes. Clinical findings were observed more<br />
frequent in males than in females, which is comparable to data in older athletes.<br />
Neovascularizations are present in both painful and asymptomatic tendons.<br />
Nevertheless, in spite of a low prevalence of 2.3% Achilles tendinopathy has to be<br />
considered in differential diagnosis of heel pain.<br />
1509 Board #101 May 30, 2:00 PM - 3:30 PM<br />
The Iontophoresis delivery of dexamethasone Measured via<br />
Microdialysis<br />
Justin H. Rigby, Chase D. Frampton, David O. Draper, Gary W.<br />
Mack, FACSM. Brigham Young University, Provo, UT.<br />
(No relationships reported)<br />
Dexamethasone sodium phosphate (DEX-P), the prodrug of the biologically active<br />
dexamethasone (DEX), is a corticosteroid used during transdermal drug delivery via<br />
iontophoresis. The ability of iontophoresis to increase tissue DEX concentrations has<br />
been difficult to assess in vivo in human subjects.<br />
PurPOsE: To determine the subcutaneous tissue concentration of DEX during<br />
iontophoretic delivery of DEX-P.<br />
METhOds: Hollow fiber (18 KD MWCO) microdialysis probes perfused at 1 µl/min<br />
with saline were used to assess [DEX] in dialysate from probes placed at 1.5±0.3 and<br />
4.0±0.5 mm below the calf skin surface during iontophoresis (4 mA x 10 min) of 4 mg/<br />
ml DEX-P in 10 healthy subjects. Following a 60 min recovery period following probe<br />
insertion, DEX-P was delivered to the treatment area via a 12.6 cm2 delivery pad. Three<br />
dialysates were collected per probe at 50 minute intervals starting at the initiation of the<br />
iontophoresis treatment. [DEX] in dialysates was analyzed by RP-HPLC.<br />
rEsuLTs: Microdialysis probe integrity was evaluated by two bench-top trials. First,<br />
retrograde dialysis in air showed a 104 ± 16% recovery of DEX. Second, recovery<br />
of DEX from a well-mixed bath containing 2 µg/ml DEX in a 2% BSA solution was<br />
determined to be 63 ± 6%. During iontophoresis of DEX-P on human skin, only three<br />
out of 10 subjects showed any measurable levels of DEX in probes placed 1 mm<br />
below the skin surface. The average concentration of DEX in these three subjects was<br />
54.04±17.62 ng/mL. None of the dialysate samples from probes at 4 mm depth showed<br />
any sign of DEX.<br />
CONCLusION: The microdialysis probes used in this study did not retain any DEX<br />
on its components based upon the 104% recovery of DEX during retrograde dialysate.<br />
In addition, an in vitro experiment demonstrated significant DEX recovery (63%)<br />
from a bath containing DEX in an artificial skin interstitial fluid solution. Finally,<br />
transdermal delivery of 4 µg/ml DEX-P using a 40mA*min iontophoretic dose was<br />
only able to deliver DEX 1 mm deep into the skin and this was only 30% effective.<br />
The concentration of DEX detected in the three samples was high enough to produce<br />
biological effects, however, the 40mA*min iontophoretic dose is ineffective in<br />
delivering DEX to deeper subcutaneous tissues.<br />
1510 Board #102 May 30, 2:00 PM - 3:30 PM<br />
Injury Incidence and Injury Patterns in high school<br />
Volleyball student-athletes - a retrospective study<br />
Lobo H. Louie. Hong Kong Baptist University, Hong Kong,<br />
Hong Kong. (Sponsor: Stephen Wong, FACSM)<br />
(No relationships reported)<br />
Volleyball was originated in the United States in 1895 as a blend of basketball,<br />
baseball, tennis, and handball. Today, volleyball has spread to more than 200 countries<br />
around the world, and is recognized as an international, widely played, popular sport<br />
in schools. Previous studies indicated that ankle sprains are the most common injuries<br />
in volleyball, accounting for about half of all injuries and with an incidence of about<br />
one per 1000 player hours. Apart from the ankle, knee, shoulder, fingers and the back<br />
are the common injury sites. However, most injuries were classified as being of minor<br />
severity and about half of the injuries occurred during spiking and blocking.<br />
PurPOsE: To describe the incidence and patterns of volleyball injuries among the<br />
high school student-athletes in Hong Kong.<br />
METhOds: Questionnaires were administered to 206 high school volleyball<br />
student-athletes who participated in the inter-school volleyball competitions during<br />
the academic season of 2011 to 2012 in Hong Kong. Data recorded including the<br />
anatomical site, nature, cause, severity of injury, playing time, level, and treatment.<br />
rEsuLTs: A total of 148 injury cases were reported during 37,770 hours of exposure,<br />
giving an injury incidence of 3.9 injuries/1000 player-hours. 64.1% of the respondents<br />
have suffered from at least one injury during the past season. The most frequently<br />
injured sites were ankle (35.2%), fingers (24.3%), knee (16.2%), and shoulder<br />
(10.8%). Regarding the playing positions, ace spikers had the highest injury rate (4.8<br />
injuries/1000h), followed by quick spikers (3.9 injuries/1000h), and assistant setters<br />
(3.7 injuries/1000h). No significant (p>0.05) differences in the injury rates between<br />
male and female players as well as various age groups were found. 65.1% of the<br />
injured athletes reported to have recurrent injury and only 4.5% of all injuries required<br />
hospitalization.<br />
CONCLusIONs: The injury incidence rate of high school volleyball student-athletes<br />
in Hong Kong was found to be 3.9 injuries/1000 player-hours. The majority of the<br />
injuries occurred in the ankle, fingers, knee and shoulder.<br />
Vol. 45 No. 5 Supplement S293<br />
1511 Board #103 May 30, 2:00 PM - 3:30 PM<br />
arthroscopic double Bundle anterior Cruciate Ligament<br />
reconstruction : Prospective Clinical and MrI Evaluation<br />
study in athletes<br />
Ashish Devgan. Pt BD Sharma Post Graduate Institute of<br />
Medical Sciences, Rohtak, Haryana, India.<br />
(No relationships reported)<br />
PurPOsE: Single-bundle (SB) anterior cruciate ligament (ACL) reconstruction has<br />
been the current standard for treating of ACL deficiency. However, a significant subset<br />
of patients continues to report residual symptoms of instability with a poor pivot<br />
control especially during sports, after such reconstructions. Cadaveric biomechanical<br />
studies have shown that double-bundle (DB) ACL reconstructions better restore knee<br />
kinematics but clinical trials are few and in between.<br />
METhOds: We report current clinical outcomes of 30 consecutive patients who<br />
underwent anatomic DB ACL reconstruction with an average follow-up of 12-24<br />
months. All patients were prospectively evaluated by arthrometer, functional knee<br />
scores (IKDC & Lysholm) and post operative MRI imaging of both knees for<br />
comparing the orientation and size of graft with that of normal ACL in contraleteral<br />
knee.<br />
rEsuLTs: Mean postoperative Lysholm score was 93.13 ± 3.31(p < 0.0001).<br />
22 (73.3%) had excellent results, 8 (26.6%) cases had good result. Post operative<br />
objective IKDC score showed 26 patients (86.6%) in group A while four (13.3%) in<br />
group B with none in group C or D. The mean differential anterior tibial translation<br />
by GNRB arthrometer was 1.07 ± 0.8 mm (range 0.1 - 2.3mm). At one year follow<br />
up, all showed a negative pivot shift test. None reported instability during activities<br />
of daily living or during sports. MRI of operated and contralateral knee showed mean<br />
sagital ACL-tibial angle of 56.1 + 5.06 in operated knee, which was comparable to<br />
the values of ACL in the contralateral normal knee - 58.8 + 4.9 (p >0.05). The mean<br />
coronal ACL-tibial angle of 74.86 + 5.69 too was comparable to the values of ACL in<br />
contralateral normal knee - 69.6+5.6 (p value >0.05). The size of the tibial footprint<br />
of the graft in sagital section was 12.65 + 1.93 mm which was in accordance with the<br />
values of contralateral normal knee - 12.38+0.64. (p >0.05)<br />
CONCLusIONs: The study objectively demonstrates that DB ACL reconstruction<br />
truly restores ACL anatomically in terms of footprint size and angle of orientation of<br />
graft; as well as excellent restoration of antero-posterior & rotatory stability. Subjective<br />
scores too depict excellent patient-reported outcomes when evaluated two years after<br />
surgery.<br />
1512 Board #104 May 30, 2:00 PM - 3:30 PM<br />
diclofenac sodium Topical Gel (dsG) 1% For acute soft<br />
Tissue Injuries/contusions Of The Limbs<br />
Helmut Pabst 1 , Bruno Giannetti 2 , Ian Burnett 3 , Joelle Monnet 3 .<br />
1 Independent Physician, Gilching, Germany. 2 CRM Clinical<br />
Trials GmbH, Rheinbach, Germany. 3 Novartis Consumer Health,<br />
Nyon, Switzerland.<br />
Supported by h. Pabst: Contracted Research - Including Principle<br />
Investigator; Novartis Consumer Health.<br />
Contusions are among the most common sports-related injuries and are often are<br />
self-treated. Many over-the-counter oral medications, known to reduce pain and<br />
inflammation, may be associated with an increased risk for gastrointestinal adverse<br />
events, while topically applied rubefacients, while popular, are seldom effective. DSG<br />
1% is clinically proven to effectively relieve pain due to osteoarthritis, and it could<br />
represent a new option for the treatment of acute blunt trauma.<br />
PurPOsE: This study evaluated the efficacy and safety of DSG 1% in subjects with<br />
acute blunt, soft tissue injuries/contusions of the limbs compared with placebo.<br />
METhOds: In this double-blind, multicenter study, 204 patients with acute blunt,<br />
soft tissue injuries/contusions of the limbs were randomized in a 1:1 ratio to DSG 1%<br />
(n=104) or placebo (n=100) applied q.i.d. for ≥48 hours and up to 7 days. Follow-up<br />
visits were made at 4, 12, 24, 36, and 48 hours, and 7 days after treatment initiation.<br />
The primary efficacy outcome was pain-on-movement (POM) at 24 hours. Secondary<br />
outcomes included POM at all other time points, spontaneous pain intensity (SPI)<br />
and spontaneous pain relief (SPR), assessed at regular intervals on Day 1 and over<br />
the 7 day treatment period. All adverse events were recorded and blood samples were<br />
collected for laboratory safety analysis.<br />
rEsuLTs: Patients treated with DSG 1% experienced significantly greater reduction<br />
in POM at 24 hours with a mean decrease in VAS score of 47 mm compared with<br />
13 mm in the placebo group (p
<strong>Thursday</strong>, May 30, 2013<br />
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treatment for the symptoms of blunt soft tissue injuries/contusions of the limbs, with a<br />
perceptible onset of effect after the first application.<br />
1513 Board #105 May 30, 2:00 PM - 3:30 PM<br />
Perception of Cold Intensity of Topical Vapocoolant sprays<br />
in human subjects<br />
Kimberly M. Martin, Mark A. Merrick. The Ohio State<br />
University, Columbus, OH.<br />
(No relationships reported)<br />
Ethyl chloride (EC) is a topical vapocoolant whose flammability limits potential<br />
clinical usage. Another topical vapocoolant (AV) spray has been offered as an<br />
alternative with similar cooling properties.<br />
PurPOsE: The purpose of this study was to compare subjects’ ratings of the cold<br />
intensities they experience of the forearm during a typical application of vapocoolant.<br />
METhOds: A 2x2x2 factorial design produced eight testing conditions for each<br />
vapocoolant product from three independent variables; nozzle (mist & stream),<br />
distance (near & far), and duration (short & long). Treatment order was determined<br />
using a balanced Latin square. 20 healthy college-age subjects without a history of<br />
cold sensitivity, prior forearm injury or any other exclusionary criteria consented to<br />
participate in this study. In the first arm of the study AV was applied to the forearm<br />
of each subject according to the parameters of each of the eight testing conditions. In<br />
the second arm of the study, EC was applied in the same manner. Subjects rated their<br />
perception of the cold sensation using a 100mm VAS labeled “Not Cold” on one end to<br />
“Coldest Thing Ever” on the other. Dependent measure was cold perception score out<br />
of ten. Data were analyzed using a repeated measures MANOVA with α=0.05.<br />
rEsuLTs: Subjects did not perceive a difference between the two products across<br />
conditions (p=0.214). Subjects perceived the mist nozzle (5.067±0.31) to feel colder<br />
than the stream nozzle (4.120±0.36; p=0.015), close distance spray (4.961±0.30) to<br />
feel colder than far distance spray (4.226±0.35; p=0.036) and longer duration spray<br />
(5.603±0.31) to feel colder than shorter duration (3.584±0.30; p
Official Journal of the American College of Sports Medicine<br />
1517 Board #109 May 30, 2:00 PM - 3:30 PM<br />
a Phase 3 study of diclofenac sodium Topical Gel (dsG) 1%<br />
for acute ankle sprains<br />
Hans-Georg Predel 1 , Bruno Giannetti 2 , Ian Burnett 3 , Morris<br />
Gold 4 . 1 German Sports University, Cologne, Germany. 2 CRM<br />
Clinical Trials GmbH, Rheinbach, Germany. 3 Novartis<br />
Consumer Health, Nyon, Switzerland. 4 Novartis Consumer<br />
Health, Parsippany, NJ.<br />
Supported by h. Predel: Contracted Research - Including Principle<br />
Investigator; Novartis Consumer Health.<br />
Ankle sprains are one of the most common sports injuries and are frequently selftreated.<br />
Over-the-counter treatment options mainly include oral non-steroidal antiinflammatory<br />
drugs (NSAIDs), which, however, may cause an increased rate of<br />
systemic side effects (e.g. gastrointestinal), and topical rubefacients, which, while<br />
popular, are frequently ineffective. DSG 1%, which has been proven to be effective<br />
and well tolerated for the treatment of osteoarthritis, could be a good alternative for the<br />
treatment of acute conditions such as ankle sprains.<br />
PurPOsE: This study evaluated the efficacy and safety of DSG 1% in subjects with<br />
acute ankle sprain.<br />
METhOds: In a double-blind, multicenter study, 205 patients with acute sprain of<br />
the lateral ankle (Grade l-ll) were randomized in a 1:1 ratio to DSG 1% (n=102) or<br />
placebo (n=103) applied q.i.d for 7 days. Follow-up visits were made at 12, 24, and 72<br />
hours and 7 days after treatment initiation. The primary efficacy outcome was pain-onmovement<br />
(POM) at 72 hours. Secondary outcomes included POM at all other time<br />
points, spontaneous pain intensity (SPI) and spontaneous pain relief (SPR), assessed at<br />
regular intervals on Day 1 and over the 7 day treatment period. All adverse events were<br />
recorded and blood samples were collected for laboratory safety analysis.<br />
rEsuLTs: DSG 1% treatment resulted in significantly greater reduction of POM at<br />
72 hours with a mean decrease in VAS score of 57 mm compared with 21 mm in the<br />
placebo group (p
<strong>Thursday</strong>, May 30, 2013<br />
S296 Vol. 45 No. 5 Supplement<br />
CONCLusION: Four hours of accumulated acupuncture treatment significantly<br />
improved limb flexibility, which may, in part, be attributed to change in tension within<br />
the muscle, allowing for relaxation and elongation.<br />
1521 Board #113 May 30, 2:00 PM - 3:30 PM<br />
Influence of Time since aCL Injury and rehabilitation<br />
Frequency on Patient-Based Outcome Measures<br />
Jessica C. Martinez, Thomas Trojian, Michael Joseph, Timothy<br />
Rubino, Max Soontararak, Lindsay J. DiStefano. University of<br />
Connecticut, Storrs, CT. (Sponsor: Dr. Douglas Casa, FACSM)<br />
(No relationships reported)<br />
Previous research has shown that patients who have sustained an ACL injury are at an<br />
increased risk for early onset of osteoarthritis and knee re-injury, which can result in<br />
increased pain, decreased function and decreased quality of life.<br />
PurPOsE: To determine if time since sustaining an ACL injury or the number of<br />
rehabilitation visits have an effect on function and willingness to be active in daily<br />
living as measured by the International Knee Documentation Committee (IKDC)<br />
Subjective Knee Form and the Lysholm Knee Score.<br />
METhOds: 20 healthy, active subjects (10 males, 10 females, Age=22+4 yrs,<br />
Height=173.0+7.3 cm, Mass=75.6+9.9 kg) with a history of an ACL reconstruction<br />
(57.0 +39.9 months since surgery) completed a questionnaire about their rehabilitation,<br />
a Lysholm Knee Score, and an IKDC questionnaire. Both scales have been found to be<br />
valid and reliable in measuring health-related quality of life and function. A high score<br />
on both scales indicates high levels of function and activity. A linear regression model<br />
was used to examine the relationship between each outcome scale and time since ACL<br />
injury, as well as the number of rehabilitation visits (α≤.05). A correlation was utilized<br />
to determine the relationship between Lysholm score and IKDC score.<br />
rEsuLTs: There were no significant relationships between time since ACL injury<br />
(R2=0.001, P=0.90) or number of rehabilitation visits (R2=0.02, P=0.59) and the<br />
Lysholm Knee Score. Similarly, time since ACL injury (R2=0.007, P=0.72) and the<br />
number of rehabilitation visits (R2=0.03, P=0.54) were not significantly related to the<br />
IKDC score. A high score on the Lysholm Knee Score was significantly correlated with<br />
a high IKDC score (r=0.68, p=0.001).<br />
CONCLusION: Clinicians should not use number of rehabilitation visits or time<br />
since injury as the principle methods to predict positive outcomes in a patient with an<br />
ACL reconstruction. Other factors such as injury history or concomitant injury may be<br />
more predictive when determining a patients’ level of function.<br />
1522 Board #114 May 30, 2:00 PM - 3:30 PM<br />
rehabilitation attendance Following Knee surgery is not<br />
Influenced by driving distance<br />
Jenny L. Toonstra, Carl G. Mattacola, Christian Lattermann,<br />
Jennifer S. Howard. University of Kentucky, Lexington, KY.<br />
(No relationships reported)<br />
Travel distances beyond 10 miles have been shown to adversely affect the utilization<br />
of health care services. To achieve optimum outcome following knee surgery, frequent<br />
access to rehabilitation services is required. Therefore, limited access to rehabilitation<br />
services in close proximity to one’s home may ultimately influence post-operative<br />
rehabilitation participation.<br />
PurPOsE: To examine rehabilitation attendance in postoperative patients to<br />
determine if travel distance influences the frequency of rehabilitation visits. We<br />
hypothesized that patients traveling greater than 10 miles for rehabilitation would<br />
average fewer visits/week than patients traveling less than 10 miles.<br />
METhOds: Data on patients undergoing autologous chondrocyte implantation<br />
(ACI) for articular cartilage defects of the knee were collected retrospectively. Home<br />
addresses of patients and locations of their respective rehabilitation centers were<br />
entered into MapQuest to estimate driving distance. The total number of rehabilitation<br />
sessions and duration of therapy were assessed from rehabilitation records. The<br />
number of attended rehabilitation sessions/week was compared between patients living<br />
less than or greater than 10 miles from their rehabilitation. An independent t-test was<br />
used to compare number of visits/week between groups.<br />
rEsuLTs: Seven patients (4 male, 3 female, age 33.9±7.6) traveled > 10 miles for<br />
rehabilitation (mean=27.3 miles) while nine patients (3 male, 6 female, age 36.3±7.6)<br />
traveled 10 miles<br />
for rehabilitation attended a significantly greater number of rehabilitation sessions/<br />
week than patients traveling
Official Journal of the American College of Sports Medicine<br />
both motor and non-motor symptoms of PD was detected: UPDRS-III 21.1 ± 3.5 vs.<br />
14.1 ± 3.5, p
<strong>Thursday</strong>, May 30, 2013<br />
S298 Vol. 45 No. 5 Supplement<br />
1529 Board #121 May 30, 2:00 PM - 3:30 PM<br />
Examination of sustained Gait speed in Individuals with<br />
Chronic stroke<br />
Tracy A. Dierks1 , Peter A. Altenburger1 , Kristine K. Miller2 ,<br />
Rebecca L. Phipps3 , Arlene A. Schmid2 . 1Indiana University,<br />
Indianapolis, IN. 2Roudebush VA Medical Center, Indianapolis,<br />
IN. 3Indiana University Health, Indianapolis, IN. (Sponsor:<br />
Stuart J. Warden, FACSM)<br />
(No relationships reported)<br />
While improvements in gait speed are commonly achieved following therapy for<br />
individuals with stroke, many in the chronic stages still experience gait deficits,<br />
causing declines in community ambulation. This may be associated with an inability to<br />
sustain gait speed for an extended period of walking, yet little is known regarding gait<br />
speed sustainability.<br />
PurPOsE: To determine if individuals with chronic stroke have the ability to sustain<br />
gait speed for 6 minutes of walking.<br />
METhOds: Forty-five individuals with chronic stroke completed a 10 meter walk<br />
test (10MWT) and 6 minute walk test (6MWT) over a gait mat. For the 10MWT,<br />
subjects walked at the fastest pace possible that felt safe. For the 6MWT, subjects<br />
walked at a comfortable pace for 6 minutes while traversing a 30-meter walkway,<br />
allowing for multiple passes over the gait mat. Gait speed sustainability was measured<br />
as the difference between the peak speed during the 6MWT and the speed at the end.<br />
rEsuLTs: The 6MWT peak speed (0.89 m/s ±0.38) was significantly slower than the<br />
10MWT speed (1.06 m/s ±0.51), suggesting subjects were capable of selecting a fast<br />
pace versus one for extended walking. Yet, there was a significant gait speed reduction<br />
of 0.07 m/s (±0.09) from peak to end (0.82 m/s ±0.36) during the 6MWT, indicating an<br />
inability to sustain speed. These findings were most evident in Unlimited Community<br />
Ambulators (CA) (10MWT 1.38 m/s; 6MWT peak 1.15, end 1.07), followed by<br />
Limited CA (10MWT 0.71 m/s; 6MWT peak 0.61, end 0.55), while Household<br />
Ambulators showed no differences (10MWT 0.34 m/s; 6MWT peak 0.30, end 0.28).<br />
The total distance walked during the 6MWT (277.7 m ±135.5) was significantly less<br />
than the estimated distance (320.9 m ±138.2) based on peak speed. Subjects also<br />
displayed a significant increase in Rating of Perceived Exertion at the end (8 ±3 to 12<br />
±4) of the 6MWT. These indicate that the declining gait speed occurred with increased<br />
exertion and a reduction in total distance walked.<br />
CONCLusION: Individuals with chronic stroke could not sustain their gait speed<br />
for extended walking, which was associated with increased exertion and a reduction<br />
in estimated total distance walked. As these differences were primarily observed in<br />
Unlimited and Limited CA subgroups, community ambulation potential might be<br />
incomplete without assessing gait speed sustainability.<br />
1530 Board #122 May 30, 2:00 PM - 3:30 PM<br />
Investigating The Walking ability Of Patients With<br />
Parkinson’s disease Via Non-motorized Treadmills<br />
Han-Wen Chang1 , Wen-Hsu Sung1 , Tien-Yow Chuang2 .<br />
1 2 National Yang-Ming University, Taipei, Taiwan. Taipei Veterans<br />
General Hospital, Taipei, Taiwan.<br />
(No relationships reported)<br />
Decreased walking ability of patients with Parkinson’s disease (PD) may result in the<br />
limitations of activity of daily living. Non-motorized treadmills (NMTs) can provide<br />
active walking training. Subjects need to exert force from lower limbs to drive the belt<br />
forward to walk on it. Currently there are still few studies on the application of NMTs,<br />
especially on patients with PD.<br />
PurPOsE: The purpose of this study is to investigate the walking ability of patients<br />
with PD and to compare the walking ability between healthy adults and the patients<br />
with PD via NMTs.<br />
METhOd: Six healthy adults (group A) and six patients with PD (group B) were<br />
recruited. Group B was assessed during on-period (in 2 hours after taking medicine).<br />
Subjects were asked to walk on the NMT at self-paced speed and at as fast as possible<br />
speed for 1 minute respectively. We acquired the data of walking velocity, cadence,<br />
step length, and ground reaction force (GRF, which was normalized to body weight<br />
and conveyed to %BW). Independent sample t-test was used to analyze the data.<br />
Statistical significance was set at level of 0.05.<br />
rEsuLT: The mean age (y/o) (70.83±3.60 vs. 72.08±5.55; p=.654), height (cm)<br />
(161.33±11.27 vs. 161.83±8.86; p=.934), and weight (kgw) (61.67 ±11.48 vs.<br />
68.67±11.22; p=.311) between two groups were shown no significant difference.<br />
At self-paced speed, parameters of group A & group B: walking velocity (m/sec) is<br />
0.58±0.13 vs. 0.47±0.25 (p=.395); cadence (step/min) is 98.00±18.85 vs.100.50±18.76<br />
(p=.823); step length (m) is 0.36±0.10 vs. 0.28±0.10 (p=.185); GRF (%BW) is<br />
1.16±0.36 vs. 1.02±0.03 (p=.381). At fast speed, parameters of the two groups:<br />
walking velocity (m/sec) is 0.86±0.12 vs. 0.60±0.31 (p=.101); cadence (step/min) is<br />
122.00±17.66 vs. 124.50±20.50 (p=.826); step length (m) is 0.43±0.11 vs. 0.29±0.12<br />
(p=.054); GRF (%BW) is 1.16±0.34 vs. 1.03±0.02 (p=.401). There was no significant<br />
difference in these parameters between two groups.<br />
CONCLusION: The parameters revealed no significant difference between groups.<br />
However, the walking velocity of group B was slower than group A (self-paced<br />
MEDICINE & SCIENCE IN SPORTS & EXERCISE ®<br />
speed & as fast as possible speed: 82.32% & 69.50% respectively); step length was<br />
decreased (76.85% & 65.77% resp.); GRF is decreased (87.94% & 88.91% resp.).<br />
Our preliminary results may be a reference for the further NMT training on patients<br />
with PD.<br />
1531 Board #123 May 30, 2:00 PM - 3:30 PM<br />
Validity of handgrip Exercise to study Vascular Function in<br />
Parkinson’s disease<br />
Kylene Peroutky, Brandon Pollock, Keith Burns, John<br />
McDaniel, Angela Ridgel. Kent State University, Kent, OH.<br />
(Sponsor: Ellen L Glickman, FACSM)<br />
(No relationships reported)<br />
BaCKGrOuNd: Parkinson’s disease (PD) is a degenerative disorder of the central<br />
nervous system characterized by symptoms of motor dysfunction including tremors,<br />
impaired gait, and rigidity. Although autonomic dysfunction impairs the regulation<br />
of the cardiovascular system and oxidative stress may be associated with peripheral<br />
vascular dysfunction in this population, blood flow limitations during exercise and the<br />
extent of vascular dysfunction has yet to be established. Although handgrip exercise is<br />
a common modality used to evaluate blood flow and vascular function during exercise,<br />
the impaired motor control of this population may prevent from being a valid testing<br />
modality. PUPROSE: This study was used to validate whether the PD group was<br />
capable of performing consistent handgrip contractions over a prolonged duration and<br />
across various intensities.<br />
METhOds: Ten volunteers, 5 with PD and 5 controls matched for age performed a<br />
four stage handgrip protocol. Each participant was instructed to squeeze a handgrip<br />
dynamometer once per second for 3 minutes at 4 different intensities (30, 60, 90, and<br />
120 N). The subjects had real-time visual feedback of the force tracings during the<br />
entire protocol as well as a horizontal guideline which represented the target force.<br />
rEsuLTs: Statistical analysis indicated that across the entire protocol there was<br />
no difference in the percentage of contractions between the control (63.3±7.8%) and<br />
PD (69.7±9.9%) groups that were within 10% of the target force. There was also no<br />
statistical significance in the absolute error between the control (3.6±1.4 N, 5.6±0.84<br />
N, 7.7±0.90 N, 10.8±3.4 N) and PD (2.9±0.79 N, 5.3±1.03 N, 7.2±1.5 N, 8.2±1.3<br />
N) groups for the 4 levels of increasing intensity, respectively. In addition, although<br />
the duration of the contraction increased from Stage 1 to Stage 4 for both groups<br />
(approximately 298 ms to 534 ms) there was no statistical difference between the<br />
healthy controls and PD.<br />
CONCLusION: The results of this study indicate that the PD patients are capable<br />
of performing the handgrip exercise to the same aptitude as the control group. This<br />
suggests that the handgrip protocol is a valid method that can be used to evaluate<br />
vascular health and blood flow in PD patients compared to controls.<br />
1532 Board #124 May 30, 2:00 PM - 3:30 PM<br />
Loading asymmetry during the sit to stand in People with<br />
Multiples sclerosis<br />
Bradley J. Bowser 1 , Cathleen N. Brown 2 , Lesley J. White,<br />
FACSM 2 , Simpson J. Simpson, FACSM 2 . 1 South Dakota State<br />
University, Brookings, SD. 2 University of Georgia, Athens, GA.<br />
(No relationships reported)<br />
Mediolateral (ML) postural instability for people with multiple sclerosis (MS) is<br />
largely influenced by interlimb loading asymmetries. During quiet standing, people<br />
with MS favor their stronger limb by shifting their center of pressure towards the<br />
stronger leg side and simultaneously increasing the vertical ground reaction forces<br />
(GRF) to that leg. While ML postural stability and loading asymmetries have been<br />
examined during quiet standing, no research has examined these two variables during a<br />
sit to stand (STS) movement.<br />
PurPOsE: To compare ML stability and loading asymmetry between MS and non-<br />
MS persons during a STS movement.<br />
METhOds: Participants were divided into three groups: an MS group with leg<br />
weakness, less than 1.4 BW on 1RM leg press (MS-LW; n = 10; 49 ± 10 yr), an MS<br />
group with comparable strength to controls, greater than 1.4 BW on 1RM leg press<br />
(MS-CS; n = 11; 40 ± 12 yr), and a non-MS control group (CON; n = 12; 43 ± 12 yr).<br />
GRFs were captured bilaterally during five STS trials. ANOVAs followed by post-hoc<br />
testing (α = 0.05) were used to determine group differences for the variables of interest<br />
displayed in Table 1.<br />
rEsuLTs: Significant group differences for 1RM leg press, RLA, and ML stability<br />
were revealed (Table 1). Post-hoc comparisons indicate lower 1RM leg press and<br />
increased ML instability for MS-LW compared to both CON and MS-CS (Table 1).<br />
RLA was also higher in MS-LW compared to CON (Table 1).<br />
CONCLusION: During the STS, persons with MS who have leg weakness display<br />
greater ML instability that is likely due to greater vertical loading occurring on the<br />
dominant/stronger limb. MS training protocols that emphasize both strength and<br />
symmetry training may be needed in order to improve ML stability during dynamic<br />
movements such as the STS.<br />
ACSM May 28 - June 1, 2013 Indianapolis, Indiana
Official Journal of the American College of Sports Medicine<br />
1533 Board #125 May 30, 2:00 PM - 3:30 PM<br />
Effectiveness of Cognitive Movement Training Machine for<br />
hemiplegic Patients<br />
Kimiyasu Hayakawa1 , Makoto Maruya1 , Takaaki Sekiya1 ,<br />
Mayumi Takahashi1 , Kazuyuki Koike1 , Hisao Fujii1 , Minoru<br />
Hashimoto1 , Kando Kobayashi2 . 1Sendai University, Shibata,<br />
Miyagi, Japan. 2The University of Tokyo, Chiba, Japan.<br />
(No relationships reported)<br />
Functional recovery through rehabilitation is essential for patients with post-stroke<br />
hemiplegia. Various training methods based on approaches such as physical therapy<br />
and occupational therapy have been conducted for patients at medical and other<br />
facilities, and have been effective to some extent.<br />
PurPOsE: The objective of the present study was to elucidate the effectiveness of a<br />
“cognitive movement training machine” in hemiplegic patients.<br />
METhOds: Training using the cognitive movement training machine was conducted<br />
for Mr. A, a hemiplegic patient (age, 62 years; height, 172.0 cm; body weight, 70.2 kg;<br />
body fat percentage, 21.1%). The cognitive movement training machine is designed<br />
as a walking training device, and training using this device consists of both automatic<br />
(passive) exercise with electric control and active exercise involving conscious<br />
movement. The training aims to increase the stride during walking and to enable<br />
the legs to rotate more greatly and smoothly around the trunk. The present training<br />
machine was developed at the University of Tokyo (inventor: Kando Kobayashi). The<br />
subject engaged in training using this machine for approximately 45 min per week,<br />
and 50-m walking ability was measured for 1 year using a three-dimensional analysis<br />
device.<br />
rEsuLTs: Marked improvements were seen when compared to general medical<br />
findings. Specifically, the patient, who initially had difficulty maintaining balance<br />
while walking, even with the use of a walking stick, became able to walk without<br />
requiring a walking stick. The 50-m walking time improved from 85.6 s during the<br />
initial stages of training to 59.1 s (using a stick) after 5 months and 52.4 s after 10<br />
months, while stride increased from 41.5 cm during the initial stage of training to 64.4<br />
cm (using a stick) after 5 months and 58.5 cm after 10 months, indicating marked<br />
improvements in quality of motion (QOM).<br />
CONCLusION: The present training machine was developed with the objective<br />
of improving QOM in walking, an essential activity in daily life. Performance of<br />
the innovative balance exercise described above, which involves active and passive<br />
exercises, enhanced the effectiveness of rehabilitation for hemiplegic patients.<br />
D-30 Free Communication/Poster - Neuromuscular<br />
Mechanics<br />
May 30, 2013, 1:00 PM - 6:00 PM<br />
Room: Hall C<br />
1534 Board #126 May 30, 2:00 PM - 3:30 PM<br />
Length and activation dependent Variations In Muscle<br />
shear Wave speed<br />
Laura Chernak, Ryan DeWall, Ken Lee, Darryl Thelen.<br />
University of Wisconsin-Madison, Madison, WI.<br />
(No relationships reported)<br />
Muscle mechanical properties, such as stiffness, are closely linked with neuromuscular<br />
health. Current clinical methods for quantifying these properties, however, have<br />
significant limitations including cost. We were interested in evaluating the capability of<br />
a novel quantitative ultrasound technique to characterize muscle stiffness.<br />
PurPOsE: To investigate the capability of ultrasound shear wave elastography<br />
(SWE) to measure load-dependent changes in muscle shear wave speed during both<br />
active and passive loading.<br />
METhOds: Ten healthy young adults (25 5.5 yrs) were recruited, and shear<br />
Vol. 45 No. 5 Supplement S299<br />
wave speeds were evaluated by positioning an ultrasound transducer (Aixplorer<br />
Clinical Scanner, Supersonic Imagine, Aix-en-Provence, France) over the medial<br />
gastrocnemius. Data were collected from the relaxed muscle at ankle angles throughout<br />
the range of motion, and also during voluntary contractions of the plantarflexor<br />
muscles at a neutral ankle angle.<br />
rEsuLTs: Shear wave speed increased significantly with passive dorsiflexion from<br />
2.62 m/s to 5.61 m/s when the knee was in an extended position, with little effect on<br />
shear wave speed noted during dorsiflexion when the gastrocnemius was shortened in<br />
a flexed knee posture. Active contractions in the extended knee posture also caused<br />
an increase in shear wave speed to 8.28 m/s when maximally contracted. A linear<br />
correlation between shear wave speed and normalized load was noted for both the<br />
active and passive conditions, with a steeper slope of shear wave speed to normalized<br />
load for the data collected during the passive trials.<br />
CONCLusION: SWE shows promise as a method for quantitatively measuring in<br />
vivo muscle loading, however, our results suggest that loading conditions are relevant<br />
to consider when using SWE to characterize in vivo muscle mechanical properties.<br />
Supported by NIH AR056201.<br />
1535 Board #127 May 30, 2:00 PM - 3:30 PM<br />
Bilateral Tremor responses are Induced With Maximal<br />
Effort Contractions Of a single Limb<br />
Justin Kavanagh 1 , Andrew Cresswell 2 , Robert Stolz 1 , Surendran<br />
Sabapathy 1 , Timothy Carroll 2 . 1 Griffith University, Gold Coast,<br />
Australia. 2 University of Queensland, Brisbane, Australia.<br />
(Sponsor: A/Prof Belinda Beck, FACSM)<br />
(No relationships reported)<br />
Although within-limb physiological tremor has been extensively studied, betweenlimb<br />
tremor relationships are not well understood. Early investigations proposed that<br />
tremor in each limb was driven by parallel CNS oscillators. However, recent evidence<br />
suggests that bilateral tremor relationships emerge under perturbed conditions such as<br />
maximal effort muscle contractions and neuromuscular fatigue.<br />
PurPOsE: To examine bilateral tremor responses to maximal effort intermittent<br />
contractions of a single limb.<br />
METhOds: Nine healthy subjects (age: 26 ± 5 yr) adopted a seated posture<br />
where each humerus was held vertical and the elbows were flexed to 90 degrees.<br />
Lightweight accelerometers were attached over the head of radius so that tremor about<br />
the elbow joint could be measured. Surface EMG was measured for biceps brachii<br />
and brachioradialis. An intermittent protocol was performed which consisted of<br />
maximal effort isometric elbow flexions of the preferred limb, with 1 s of rest between<br />
contractions. The protocol continued until the maximum torque that the subject could<br />
generate about the elbow joint declined by 50%. Subjects were continually encouraged<br />
to relax their non-exercising limb during testing.<br />
rEsuLTs: In the initial stages of the protocol, maximal effort contractions of a single<br />
limb resulted in increased tremor and muscle activity in both the active and non-active<br />
limbs. When the unilateral contractions were repeated until elbow joint torque declined<br />
by 50%, tremor and brachioradialis EMG were decreased in the fatigued limb but<br />
increased in the contralateral non-fatigued limb.<br />
CONCLusION: Maximal effort unilateral contractions induced tremor and muscle<br />
responses in the non-active contralateral limb. Bilateral responses were most likely<br />
mediated by increased cortical drive to the target and non-target motor neuron pool,<br />
and changes to the gain of the stretch reflex which plays a major role in tremor<br />
generation.<br />
1536 Board #128 May 30, 2:00 PM - 3:30 PM<br />
Neuromechanical analysis of Overload Eccentric<br />
Contractions of Elbow Flexors<br />
Frederico Leal. University of Saskatchewan, Saskatoon, SK,<br />
Canada.<br />
(No relationships reported)<br />
Eccentric (ECC) overload in training settings utilizes loads higher than concentric<br />
(CON) one repetition maximum (1RM). There is no clear definition of ECC “failure”<br />
or 1RM using conventional weights; ECC 1RM is defined between 145-190% CON<br />
1RM. The highest intensity used for ECC overload is typically 120% despite little<br />
research using conventional weights with higher ECC intensities.<br />
PurPOsE: To conduct an exploratory neuromechanical analysis of different<br />
intensities of elbow flexors ECC overload using free weights by examining angular<br />
kinematics during contraction.<br />
METhOds: Twenty male participants with weight training experience had unilateral<br />
concentration curl isometric (ISO) peak torque (dynamometer) and CON 1RM<br />
(dumbbells) assessed with biceps brachii electromyography (EMG) and elbow joint<br />
angle (electrogoniometer) recordings. Elbow joint torques were estimated using<br />
inverse dynamics. Participants were randomly assigned in counter balanced order<br />
to perform ECC actions at 120%, 140%, 150%, 160% and 170% CON 1RM with 4<br />
minutes rest between. Variables included peak torque (PT), angular velocity at PT<br />
(AVp), impulse (IM), power (PW), mean EMG, and EMG normalized to peak ISO<br />
(EMG%). Data were analyzed using repeated measures ANOVA or a Friedman test.<br />
rEsuLTs: AVp was significantly lower for 120% (65.3 ± 40.8°/s) compared to all<br />
<strong>Abstracts</strong> were prepared by the authors and printed as submitted.<br />
<strong>Thursday</strong>, May 30, 2013
<strong>Thursday</strong>, May 30, 2013<br />
S300 Vol. 45 No. 5 Supplement<br />
other conditions (range: 65.3 ± 40.8 to 162.1 ± 75.2°/s; p
Official Journal of the American College of Sports Medicine<br />
and-restart in the re-go trials with a PI of 150 ms while they execute two processes<br />
for stop and restart separately in the re-go trials with a PI of 250 ms. Moreover, this<br />
second EEG phase-locking weakened in slow re-go response trials compared with fast<br />
re-go response trials, indicating that stop-and-restart difficulty with a PI of 250 ms<br />
might be associated with an insufficient re-go-signal perception.<br />
CONCLusIONs: These results suggest that difficulty to restart 250 ms after stopping<br />
a movement is related to the presence of the second processes for re-go-signal<br />
perception.<br />
1541 Board #133 May 30, 2:00 PM - 3:30 PM<br />
The acute Effects of static stretching on the Passive Muscle<br />
Properties of the Leg Extensors<br />
Jake A. Deckert, Trent J. Herda, Phil Vardiman, Phil M.<br />
Gallagher, Michael A. Cooper. The University of Kansas,<br />
Lawrence, KS. (Sponsor: Joseph P. Weir, FACSM)<br />
(No relationships reported)<br />
PurPOsE: The purpose of this study was to examine the effects of static stretching<br />
on the passive range of motion (PROM) and musculotendinous stiffness (MTS) of the<br />
leg extensors.<br />
METhOds: Six individuals (mean ± SD; age = 24.5 ± 6.6 yr, height = 143.7 ±<br />
29.8 cm, weight = 66.3 ± 7.3 kg) performed a PROM assessment with the isokinetic<br />
dynamometer (Biodex Medical Systems, Inc., Shirley, New York) programed in<br />
passive mode, which extended the right leg at an angular velocity of 5°s-1. The hip<br />
was hyperextended at an angle of 148° to 152° during all range of motion assessments.<br />
The maximal ROM was determined as the point of discomfort but not pain, as<br />
acknowledged by the subject. MTS of the leg extensors was quantified using a fourthorder<br />
polynomial regression model that was fitted to the passive angle-torque curves<br />
for each subject. MTS (Nm°-1) was calculated for each degree increment in the passive<br />
angle-torque relationship. For analysis, MTS was determined at the second to last joint<br />
angle for the pre-stretching assessment and the same common joint angle selected<br />
during the post-stretching assessment. MTS was calculated offline using a customwritten<br />
software (LabVIEW 8.5, National Instruments, Austin, TX), which included<br />
a gravity correction of the limb. Surface electromyography (EMG) (Ag-AgCL,<br />
Quinton Quik Prep, Quinton Instruments Co., Bothell, WA) was monitored to ensure<br />
the movement was passive. If EMG activity was above baseline during the PROM<br />
assessment, the trial was removed from further analysis. For the stretching of the right<br />
leg extensors, subjects completed four repetitions of four stretches lasting 30 seconds<br />
with 10 seconds rest between stretches, which included three assisted stretches and one<br />
unassisted stretch. Paired samples t-tests were used to examine possible differences<br />
pre- to post-stretching for PROM and MTS.<br />
rEsuLTs: There were no significant differences for PROM (P = 0.099) or MTS (P =<br />
0.470) between pre- and post-stretching.<br />
CONCLusION: In contrast to previous studies testing other muscle groups, there<br />
were no differences between pre- and post-stretching for PROM and MTS. The<br />
subject position in the isokinetic dynamometer may have not allowed for an accurate<br />
assessment of PROM or MTS. Future studies may want to further hyperextend the hip<br />
past the range used in the present study (148° – 152°).<br />
1542 Board #134 May 30, 2:00 PM - 3:30 PM<br />
Contributions of Neural Excitability and Voluntary<br />
activation to Quadriceps Muscle strength<br />
Adam S. Lepley, Nael O. Bahhur, Amanda M. Murray, Brian G.<br />
Pietrosimone. University of Toledo, Toledo, OH.<br />
(No relationships reported)<br />
Previous investigations have suggested that both morphological and neural adaptations<br />
are responsible for modifying muscle strength. New rehabilitative strategies targeting<br />
neural excitability and voluntary activation have been proposed to improve muscle<br />
strength. Understanding how neural excitability and voluntary activation contribute to<br />
muscle strength is critical in developing new therapeutic techniques.<br />
PurPOsE: Determine if spinal-reflexive excitability, corticospinal excitability, and<br />
voluntary activation predict quadriceps strength.<br />
METhOds: Twenty healthy participants (12 Male, 8 Female; 22.1±2.4yrs;<br />
173.4±7.5cm, 71.6±8.2kg) were included. Quadriceps strength was assessed via<br />
maximal voluntary isometric contractions (MVIC) performed at 90° of knee flexion.<br />
Spinal-reflexive excitability was assessed using Hoffmann reflexes normalized to<br />
maximal muscle responses (H:M ratio). Corticospinal excitability was evaluated with<br />
active motor thresholds (AMT), which were elicited by stimulating specific areas<br />
on the motor cortex using Transcranial Magnetic Stimulation during a standardized<br />
contraction at 5% of MVIC. Voluntary activation was measured via a superimposed<br />
burst technique and the central activation ratio (CAR). A hierarchal multiple Linear<br />
Regression model was used to determine the ability of H:M, AMT and CAR to predict<br />
MVIC. The change in R2 to the model from the addition of each predictor variable was<br />
also analyzed.<br />
rEsuLTs: The overall multiple regression model significantly predicted 45% of the<br />
variance in MVIC (R2 = 0.45, P=0.01; MVIC = 2.3H:M -.03AMT + 3.3CAR + 1.2).<br />
Initial imputation of H:M into the model accounted for 24% (R2=0.24, P=0.02) of<br />
the variance in MVIC. The subsequent addition of AMT accounted for a significant<br />
Vol. 45 No. 5 Supplement S301<br />
increase of 16% (Δ R2 = 0.16, P=0.04) in the prediction capability of the model.<br />
Lastly, CAR contributed an insignificant increase of 5%(Δ R2 = 0.05, P=0.23) to the<br />
prediction capability of the model, and was therefore removed.<br />
CONCLusION: Neural excitability predicted nearly half of the variance in<br />
quadriceps strength. This may be interpreted as evidence that neural pathways are<br />
essential in maintaining and increasing quadriceps strength. Interventions targeting<br />
neural pathways may be beneficial to gain and restore optimal quadriceps strength.<br />
1543 Board #135 May 30, 2:00 PM - 3:30 PM<br />
The Effect of Massed versus distributed Practice on the<br />
Variability of Muscle activity and Force<br />
Jessica McGuire 1 , Lara Green 1 , Kristina M. Calder 2 , Jae<br />
Patterson 1 , David A. Gabriel, FACSM 1 . 1 Brock University, St.<br />
Catharines, ON, Canada. 2 McMaster University, Hamilton, ON,<br />
Canada.<br />
(No relationships reported)<br />
PurPOsE: The purpose of this study was to determine if the initial phase of learning<br />
a resistive exercise task is affected by the structure of the practice (i.e., contraction)<br />
schedule.<br />
METhOds: Twenty-six female university students were recruited. Participants were<br />
randomly assigned to one of two experimental groups: massed, which performed 15<br />
isometric elbow flexion contractions on one day, or distributed, which performed the<br />
15 contractions across three days (5 per day). All participants performed two retention<br />
tests, each consisting of 5 contractions, which occurred two weeks and three months<br />
after the final test session. Each contraction was 5-sec in length with a 3-minute intertrial<br />
period. Surface electromyographic (sEMG) activity and force were recorded<br />
concurrently. Mean amplitude values (MAV) and variance ratios (VR) were calculated<br />
for the biceps and triceps sEMG data and force.<br />
rEsuLTs: There was a significant increase in force (∆27.7 N, or 26%) and biceps<br />
brachii sEMG (∆77 µV, or 29.6%) in both groups (p’s0.05). In contrast, the pattern of<br />
change in force variability was different between the two practice schedules (p=0.05).<br />
Force variability for the massed group decreased but plateaued after the first block<br />
of trials, whereas the distributed group exhibited a more gradual reduction of similar<br />
magnitude. Both groups maintained a nearly 60% decrease in force variability across<br />
the two retention tests. The variability in biceps and triceps sEMG mirrored the<br />
variability in force but the F-ratios were non-significant (p’s>0.05).<br />
CONCLusION: The magnitude of force and sEMG revealed no difference between<br />
practice schedules, but the force variability data followed the classic findings for<br />
massed versus distributed practice. The initial phase of learning a resistive exercise<br />
task was, therefore, affected by the type of practice schedule. This work was supported<br />
by the Natural Sciences and Engineering Research Council of Canada.<br />
1544 Board #136 May 30, 2:00 PM - 3:30 PM<br />
h-index Measurement Is Important In Persons With<br />
Peripheral Neuropathy<br />
Matthew Homles 1 , Shuqi Zhang 2 , Duckchan Jang 3 , Li Li,<br />
FACSM 1 . 1 Georgia Southern University, Statesboro, GA.<br />
2 Louisiana State University, Baton Rouge, LA. 3 Keimyung<br />
University, Daegu, Republic of Korea.<br />
(No relationships reported)<br />
Peripheral neuropathy (PN) is a neurodegenerative disease that damages the peripheral<br />
nervous system. The presentation of PN is usually symmetrical sensory nerve damage<br />
to distal extremities but progresses proximally. Strength, sensitivity, and endurance<br />
measures are useful tools in understanding effectiveness of interventions. However,<br />
nerve function measures should be considered for this population. H-index is<br />
measure used in many neurological studies and can provide new insight to peripheral<br />
neuropathy.<br />
PurPOsE: To better understand nerve function, as measured by H-index, and its<br />
relation to functional motor output in people with PN.<br />
METhOds: H-index, standing balance, Timed up-and-go (TUG), 6-min walk test,<br />
peak knee flexion/extension torque were measured from 12 participants with PN.<br />
H-index was determined by eliciting electrical stimulation at the posterior tibial nerve<br />
and recording latency of M- and H-waves by EMG on the lateral gastrocnemius.<br />
H-index was calculated as (Height (cm) / (latency (ms))^2* 2. Participants were<br />
seated and asked to walk as quickly and safely as possible around a cone placed 3 m<br />
away then return to their seat, TUG was the average time of three trials. For the 6 min<br />
walk test, participants were encouraged to walk as far as possible in 6 min. Peak knee<br />
flexion/extension was performed on a Biodex. Pearson correlation was performed<br />
between H-index and other measures of interest.<br />
rEsuLTs: 12 participants (8 women, 4 men) age (72.5 ± 9.2), height (163.0 ± 11.9),<br />
body mass (171.8 ± 46.2) diagnosed with PN were tested. Causes of PN included<br />
diabetes (n=2), trauma (n=1), and idiopathic (n=9). Duration of PN was 10.0 ± 1.7<br />
(Mean ± SD) years. Mean and standard error of mean for our measures of interest<br />
were as follows: H-index (61.21 ± 4.52); TUG (9.22±0.41); 6 min walk (429.58 ±<br />
<strong>Abstracts</strong> were prepared by the authors and printed as submitted.<br />
<strong>Thursday</strong>, May 30, 2013
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S302 Vol. 45 No. 5 Supplement<br />
26.37); 95% area (0.82 ± 0.13); peak flexion (37.15 ± 6.43); and peak extension (64.73<br />
± 6.52). H-index was correlated with 95% area (R²=.26), TUG (R²=.51), 6 min walk<br />
(R²=.27), but not peak flexion (R²=.04) or peak extension (R²=.002).<br />
CONCLusIONs: H-index as a measure of nerve function in people with PN is<br />
related to functional outcomes but not strength measures. H-index could be useful<br />
in understanding functional impairments in gait and standing balance among people<br />
with PN.<br />
1545 Board #137 May 30, 2:00 PM - 3:30 PM<br />
h-index Is Independent From Other sensory Measures<br />
among People With Peripheral Neuropathy<br />
Shuqi Zhang1 , Matthew Homles2 , Duckchan Jang3 , Li Li,<br />
FACSM4 . 1Louisiana State University, Baton Rouge, LA.<br />
2 3 Georgia Southern University, Statesboro, GA. Keimyung<br />
University, Daegu, Republic of Korea. 4Goergia Southern<br />
University, Statesboro, GA.<br />
(No relationships reported)<br />
The balance problem in people with peripheral neuropathy (PN) is believed to be<br />
from deteriorated function of afferent information collection and transition. Nerve<br />
transmission speed in peripheral and central nervous system is critical for movement<br />
control. H-index, as a representative measure of transmit speed in nervous system, is a<br />
potential measure to explain neurological impairments among people with PN.<br />
PurPOsE: This study was to examine if H-index is an independent measure from<br />
other common sensory measures of people with PN.<br />
METhOds: 12 participants (8 women, 4 men) age (72.5 ± 9.2), height (163.0<br />
± 11.9), body mass (171.8 ± 46.2) diagnosed with PN were tested. Causes of PN<br />
included diabetes (n=2), trauma (n=1), and idiopathic (n=9). Duration of PN was<br />
10.0 ± 1.7 (Mean ± SD) years. The foot sole sensitivity was tested at big toe (BT),<br />
1st and 5th metatarsal (M1 and M5), midfoot (MF) and medial heel (MH) with a 5.07<br />
monofilament. The overall score of one foot is the number of its sensitive sites, ranged<br />
from 0 to 5. H-index is based on the linear relationship between participant height and<br />
the latency between H- and M-wave. H- and M-waves were elicited by stimulating<br />
tibial nerve at back of right knee joint and signals were picked up at calf muscle in all<br />
participations. H-index is calculated by [(Height (cm))/(latency(ms)) ]^2*2. Active<br />
ankle proprioception, measured from maximal inversion to the target positions at<br />
inversion of -15°, 0° and eversion of 10°. Proprioception was represented by the errors<br />
between the stop positions and target positions. Pearson correlation analysis examined<br />
the relationship between H-index and plantar sensitivity as well as proprioception of<br />
ankle at three target positions separately.<br />
rEsuLTs: H-index is not correlated with ankle proprioception at 0°, inversion of<br />
-15°, and eversion of 10°, nor with foot sole sensation (R-square = 0.0253, =7E-05,<br />
=0.1914, =0.1233, and =0.0189, respectively).<br />
CONCLusIONs: These results indicate H-index is a neurological parameter can be<br />
measured in nervous system, independently from plantar tactile sensation and ankle<br />
joint proprioception, among this population. In further study, H-index should be<br />
employed to explain how PN affects the nerve system in addition to the deterioration<br />
of proprioception and tactile sensation.<br />
1546 Board #138 May 30, 2:00 PM - 3:30 PM<br />
Corticospinal and spinal Variability during Lengthening<br />
and shortening Contractions Performed by Trained and<br />
untrained Males<br />
Glyn Howatson, FACSM1 , Jamie Tallent1 , Stuart Goodall1 , Alan<br />
St Clair Gibson1 , Tibor Hortobagyi, FACSM2 . 1Northumbria University, Newcastle-upon-Tyne, United Kingdom. 2University of Groningen, Groningen, Netherlands.<br />
(No relationships reported)<br />
There is a controversy concerning the mechanism and pathways involved in the neural<br />
adaptations to resistance training. Here we examined the hypothesis that corticospinal<br />
and spinal excitability differs between previously strength trained (ST) and untrained<br />
(UT) males.<br />
PurPOsE: To compare corticospinal and spinal excitability measured during<br />
dynamic muscle contractions in ST and UT males and to determine the impact of<br />
training status on the variability in motor evoked potentials (MEPs).<br />
METhOds: Nine UT and 10 ST male volunteers reported to the laboratory on<br />
two occasions separated by 24 h. On each visit, MEPs and the cortical silent period<br />
were evoked by transcranial magnetic brain stimulation applied to the left primary<br />
motor cortex and recorded from the tibialis anterior at the instant when the dominant,<br />
right ankle was at 90° during shortening and lengthening contractions. The H-reflex<br />
and V-waves were also evoked during contractions by peripheral nerve stimulation.<br />
Differences in MEP variability were investigated between groups on day 1 and changes<br />
within groups from days 1 to 2.<br />
rEsuLTs: Although the ST vs. UT group was 24% stronger (P = 0.02), there were no<br />
differences in corticospinal or spinal excitability between the groups. MEP variability<br />
was similar in the two groups on day 1 (39.1 and 40.9%, respectively) but variability<br />
of the resting MEPs was significantly lower on day 2 in ST (25%, P < 0.005).<br />
MEDICINE & SCIENCE IN SPORTS & EXERCISE ®<br />
CONCLusION: Against expectations, corticospinal and spinal excitability were<br />
similar in ST and UT, the decrease in resting MEP variability from day 1 to day 2<br />
in the ST compared with UT suggests that chronic resistance training may produce<br />
a greater degree of acute plasticity of the CNS under the present experimental<br />
conditions.<br />
1547 Board #139 May 30, 2:00 PM - 3:30 PM<br />
stiffness Quantification of human Calf Muscle during<br />
standing Wall stretching using ultrasound shear-wave<br />
Elastography<br />
Keigo Taniguchi1 , Minoru Shinohara, FACSM2 , Shuhei Nozaki1 ,<br />
Masaki Katayose1 . 1Sapporo Medical University, Sapporo,<br />
Japan. 2Georgia Institute of Technology, Atlanta, GA.<br />
(No relationships reported)<br />
Stretching for calf muscle is commonly prescribed to increase the range of motion for<br />
ankle dorsiflexion. The magnitude of changes in the stiffness of muscle belly during<br />
stretching in a weight-bearing position is unknown. Recent development of shear-wave<br />
elastography has opened the possibility for objectively quantifying muscle stiffness<br />
(Shinohara et al. 2010).<br />
PurPOsE: To quantify the changes in muscle stiffness of the triceps surae belly<br />
during standing wall stretching with the novel ultrasound shear-wave elastography.<br />
METhOds: Eleven healthy young adults performed standing wall stretching that<br />
consisted of 10 and 20 deg of ankle dorsiflexion while maintaining the right hip and<br />
knee in an extended position. Longitudinal ultrasonic images of the medial (MG) and<br />
lateral (LG) gastrocnemius and soleus (SOL) muscles of the right leg were obtained<br />
while the subjects maintained 50% of their body weight on the foot. Shear-wave<br />
elastography was applied with the ankle joint angle in neutral position (0 deg) during<br />
standing and at 10 and 20 deg dorsiflexion during stretching. Based on shear-wave<br />
propagation velocity, muscle stiffness was quantified as shear modulus in the muscle<br />
fascicular area.<br />
rEsuLTs: The reproducibility of shear modulus was confirmed by the intra-rater<br />
intraclass correlation coefficient (0.95 for MG, 0.94 for LG, 0.72 for SOL) between<br />
measurements. Shear modulus increased as the ankle joint angle changed from 0 to 20<br />
deg: 25.7 ± 9.2 vs. 90.9 ± 27.9 kPa (3.5-fold) in MG, 17.3 ± 3.9 vs. 51.0 ± 11.6 kPa<br />
(2.9-fold) in LG, and 24.7 ± 5.6 vs. 38.2 ± 8.2 kPa (1.5-fold) in SOL. Furthermore,<br />
shear modulus of MG was significantly higher than that of LG and SOL at 20 deg<br />
dorsiflexion (p < 0.05).<br />
CONCLusION: The findings indicated that the stiffness of triceps surae belly<br />
progressively increased by 1.5 to 3.5-fold in response to progressive dorsiflexion.<br />
Variability in the index of stiffness between muscles may be related to variability in<br />
passive tension between muscles during standing wall stretching. Quantification of<br />
muscle stiffness during stretching with ultrasound elastography would provide useful<br />
information to develop effective therapeutic exercise for improving joint flexibility.<br />
1548 Board #140 May 30, 2:00 PM - 3:30 PM<br />
Is Neuromuscular activation Of Vastus Intermedius Muscle<br />
Induced By hip Flexion Movement?<br />
Akira Saito, Hiroshi Akima. Nagoya University, Nagoya, Japan.<br />
(Sponsor: Katsumi Asano, FACSM)<br />
(No relationships reported)<br />
The quadriceps femoris (QF) composed of four knee extensor muscles, i.e. vastus<br />
intermedius (VI), vastus lateralis, vastus medialis (VM) and rectus femoris (RF). The<br />
RF acts as not only the knee extensor but also hip flexor. Montgomery et al. (1994)<br />
found out that activation of VI was similar to that of RF during hip and knee flexion<br />
phase of running, which reached to 17% of maximal knee extension. However,<br />
it is unclear whether the activation of VI was actually induced by the hip flexion<br />
movements. A neural pathway from the sensory nerves in the cruciate ligament to<br />
the thigh muscles was reported in humans. If the VI activity is elicited by hip flexion<br />
movement, it would be one of the factors.<br />
PurPOsE: The purpose of this study is to examine the neuromuscular activation of<br />
VI during isometric hip flexion at different hip joint angles.<br />
METhOds: Ten healthy men (age 25.3 ± 6.9 years, height 174.6 ± 6.3 cm and weight<br />
67.2 ± 10.3 kg) performed 25%, 50%, 75%, 100% of maximal voluntary contraction<br />
(MVC) of isometric hip flexion at 90°, 110° and 130° of hip joint angles (180° is<br />
fully extended). We recorded the surface electromyography (EMG) of four individual<br />
muscles of the QF as previous study (Watanabe & Akima 2009). The root mean square<br />
(RMS) of individual muscles of the QF was normalized by the RMS of MVC during<br />
isometric knee extension. Onsets of muscle activation for VI and RF were defined<br />
as 5%RMS deviation from baselines during isometric knee extension MVC, and we<br />
calculated the time lag between both muscles.<br />
rEsuLTs: Normalized EMG of the RF was significantly higher than other three<br />
synergists of the QF (all P < 0.05) and normalized EMG of the VI was significantly<br />
higher than that of the VM during MVC at 110° and 130° of hip joint angles (all P <<br />
0.05). During hip flexion tasks, activation delay comparing to the RF was observed in<br />
the VI at three hip joint angles (230 to 240 msec), and these were significantly later<br />
than during knee extensions (-19 to 6 msec) at each hip joint angle (all P < 0.05).<br />
CONCLusIONs: Neuromuscular activation of the VI appears during isometric hip<br />
ACSM May 28 - June 1, 2013 Indianapolis, Indiana
Official Journal of the American College of Sports Medicine<br />
flexion followed by the RF muscle activity. The delay of VI activity was too long in<br />
terms of the spinal reflex. The VI activation may be elicited by afferent input from the<br />
sensory receptors in the knee joint via supraspinal pathway.<br />
1549 Board #141 May 30, 2:00 PM - 3:30 PM<br />
Power and strength Training on Functionality and Maximal<br />
Isometric Contractions in Elderly<br />
Paula B. Lopes1 , Paulo C. Bento1 , Gleber Pereira2 , Jean F.<br />
Cavazza1 , Renata Wolf1 , André F. Rodacki1 . 1Federal University of<br />
Paraná, Curitiba, Brazil. 2Positivo University, Curitiba, Brazil.<br />
(No relationships reported)<br />
It has been proposed that the ability to generate force quickly (power) is more effective<br />
than the ability to produce large amounts of force (peak force) (MARSH et al., 2009),<br />
which are relevant aspects to reduce the risk of falls (MELZER et al., 2009). Studies<br />
involving strength and power training have presented conflicting results on functional<br />
ability, torque and rate o force development.<br />
PurPOsE:To compare the effects of power and strength training on the functional<br />
capacity, torque and rate of torque development of the elderly.<br />
METhOds:Thirty-seven elderly women (above 60 years) were divided into 3<br />
groups: control group (CG; n=11), power (PT; n=12) and strength (ST; n=14) training.<br />
Participants were invited to perform four functional tests: 6 minutes walking, seat<br />
and reach test, seat to stand and the foot up and go test (RIKLI & JONES, 1999). The<br />
ability to produce maximal voluntary isometric contractions (peak and rate of torque<br />
development) was determined using a maximal voluntary isometric contraction test<br />
applied to the extensor and flexor muscles of the hip, knee and ankle joints. The PT<br />
and ST groups underwent a 12-wk training period and all groups were requested<br />
not to engage in any other physical activity program during the study or to change<br />
their physical activity routines. A one-way ANOVA was used to compare the results<br />
between the groups (p
<strong>Thursday</strong>, May 30, 2013<br />
S304 Vol. 45 No. 5 Supplement<br />
1553 Board #145 May 30, 2:00 PM - 3:30 PM<br />
Practice Effects of Consecutive administrations of the<br />
sensory Organization Test in healthy College students<br />
Hyung Rock Lee1 , Jessica R. Dysart2 , Michael S. Ferrara2 .<br />
1 2 Murray State University, Murray, KY. The University of<br />
Georgia, Athens, GA.<br />
(No relationships reported)<br />
Postural control is a complex feedback process utilizing multiple sensory-motor<br />
systems, gathering input from the visual, vestibular and somatosensory receptors. The<br />
sensory organization test (SOT) assesses these sensory-motor systems and has been<br />
utilized in concussion management. However, limited research of the SOT has been<br />
conducted to evaluate the practice effect.<br />
PurPOsE: To evaluate the practice effects of four administrations of the SOT within<br />
one day compared to one test on four consecutive days.<br />
METhOds: Twenty-eight healthy college students were divided into two groups;<br />
Group A (10 males, 7 females, age 22.82 ± 5.1 years) and Group B (7 males, 4<br />
females, age 20.27 ± 1.1). Subjects in Group A performed the SOT once a day over<br />
four consecutive days. Subjects in Group B performed the SOT four times in one day<br />
with 20 minute breaks between each SOT. The SOT composite equilibrium score<br />
provided an overall determination of balance performance for each subject. Subcomposite<br />
scores were also calculated for somatosensory, visual, vestibular, and visual<br />
conflict. These scores were analyzed to determine practice effects. Repeated measures<br />
ANOVA was used with statistical significance set at p 0.05). However, the reduction in MVIC was<br />
greater for men (228 ± 18 Nm to 156 ± 18 Nm, 36% decline) than women (147 ± 14<br />
Nm to 114 ± 12 Nm, 22% decline, P < 0.05). Men and women had similar voluntary<br />
activation during control contractions when measured with electrical stimulation over<br />
the muscle (91 ± 3% vs 93 ± 2%, respectively) and with TMS (96 ± 2% vs 94 ± 3%,<br />
respectively). Voluntary activation decreased similarly for men and women after the<br />
dynamic contractions when assessed with electrical stimulation (to 85 ± 3% vs 85 ± 2%,<br />
respectively). Likewise, the increase in superimposed twitch elicited with TMS increased<br />
similarly for men and women (from 1.3 ± 1% to 3.4 ± 1% vs 1.1 ± 1% to 2.6 ±1%).<br />
CONCLusION: Despite similar reductions in power during 6 minutes of dynamic<br />
maximal-velocity knee extension, men exhibited greater fatigue of maximal isometric<br />
force than women. Central and supraspinal fatigue both contributed to the reduction in<br />
MVIC at end-exercise but did not explain the greater fatigue of MVICs exhibited by<br />
men compared with women.<br />
MEDICINE & SCIENCE IN SPORTS & EXERCISE ®<br />
D-31 Free Communication/Poster - Neuroscience<br />
May 30, 2013, 1:00 PM - 6:00 PM<br />
Room: Hall C<br />
1555 Board #147 May 30, 3:30 PM - 5:00 PM<br />
Influence Of Physical Exercise On hippocampal Cb-1<br />
receptor Expression<br />
Ricardo M. Arida, Lívia Blazechi Ferreira, Sérgio Gomes da<br />
Silva, Fabiano Guimarães Novaes Gomes, Alexandre Aparecido<br />
de Almeida, Fulvio Alexandre Scorza, Esper Abrão Cavalheiro.<br />
Universidade Federal de São Paulo, São Paulo, Brazil.<br />
(No relationships reported)<br />
It has been shown that activation of the cannabinoid receptor subtype 1 (CB-1)<br />
modulates neuronal activity and inhibits the release of some neurotransmitters in<br />
the central nervous system. A wide range of neurobiological rewards following<br />
moderate and intense aerobic activity were reported by humans, popularly referred<br />
to the ‘runner’s high’, which may function to encourage habitual aerobic exercise.<br />
Endocannabinoids are endogenous neurotransmitters that appear to play a major role in<br />
generating these rewards by activating cannabinoid receptors as CB-1 in brain reward<br />
regions like hippocampus during and after exercise.<br />
PurPOsE: To investigate the effects of different types and intensities of physical<br />
exercise on the hippocampal expression of CB-1 receptor<br />
METhOds: Animals were submitted to forced or voluntary exercise. To the forced<br />
exercise, Wistar rats were submitted to a program of 5 sessions (acute group) or 30<br />
sessions (chronic group) on a treadmill. For intensive exercise, the speed was gradually<br />
increased to 30 min at 22 m/min; to moderate exercise the speed was gradually<br />
increased to 30 min at 16m/min. For voluntary exercise, each animal was placed in<br />
a box containing a wheel connected to a shaft which has an odometer to measure the<br />
number of turns performed. The animals from chronic and acute groups were divided<br />
into good runners and bad runners, according to the number of turns marked on the<br />
odometer. Their brains were processed for analysis of CB-1 receptor by Western-Blot<br />
technique.<br />
rEsuLTs: A significant increase in the expression of CB-1 receptor was observed in<br />
acute voluntary good runner (1.30) and intensive forced runner (1.26) when compared<br />
to the control group (0.57; p=0.017 and p=0.02 respectively). It was also detected<br />
significant reduction of CB-1 receptor expression in chronic voluntary good runner<br />
(0.35) and intensive forced runner (0.55) compared to control group (1.80; p=0.027<br />
and p=0.035 respectively) and between moderate and intensive forced group (1.51 vs<br />
0.55; p=0.032).<br />
CONCLusION: Our results suggest that an intensive training is necessary to change<br />
the expression of the receptor CB-1 on hippocampus. Thus short term exercise<br />
increased (upregulation) and a long term exercise decreased (downregulation) CB-1<br />
receptor expression.<br />
Suppoted by CAPES, FAPESP and CNPq<br />
1556 Board #148 May 30, 3:30 PM - 5:00 PM<br />
Brain-derived Neurotropic Factor (BdNF) Increases More<br />
in Trained than untrained Females Following acute Exercise<br />
Rick Carter, FACSM 1 , Rachelle Barry 1 , Yunsuk Koh 1 , Allen<br />
Sexton 1 , Jason Fondrick 1 , Dan Chilek 1 , James Williams,<br />
FACSM 2 . 1 Lamar University, Beaumont, TX. 2 Texas State<br />
University, San Marcus, TX.<br />
(No relationships reported)<br />
PurPOsE: To investigate the amplitude and pattern of plasma BDNF concentration<br />
shifts between trained and untrained females, following an acute bout of exercise.<br />
METhOds: Thirteen (7 soccer players; 6 controls) (mean ± SD: age 20.7±1.8 yrs;<br />
height 65.3±2.3 in; weight 147.2±30.5 lbs; BMI 24.2±4.7 kg/m 2 ; waist/hip ratio .7 ±<br />
.1 ) college age women who were free from chronic disease consented to participate<br />
in the study. All subjects completed a cycle ergometry protocol to peak effort with<br />
controls averaging 80% of age, gender specific predicted VO 2peak while soccer players<br />
averaged 138% of predicted. Blood specimens were collected before, immediately<br />
following, and 30 minutes after completing a half hour of cycle exercise at 60% of the<br />
measured VO 2peak .<br />
rEsuLTs: Baseline BDNF (T0) and cortisol values were equivalent (P > .05). A<br />
significant increase in plasma BDNF was noted from baseline to immediately post<br />
exercise (p < .05) with no other statistical differences noted. Trends did appear with<br />
respect to BDNF changes with soccer players maintaining higher values at 30 minutes<br />
of recovery as compared to controls (Plasma BDNF declined 14% in soccer players<br />
and 28% for controls). However, the rate of disappearance did not reach statistical<br />
significance.<br />
CONCLusION: These data confirm that acute moderate to high intensity exercise<br />
elevated plasma BDNF values. Chronically trained females (soccer) had a greater<br />
increase in BDNF as compared to controls with plasma concentrations remaining<br />
ACSM May 28 - June 1, 2013 Indianapolis, Indiana
Official Journal of the American College of Sports Medicine<br />
higher following exercise. Thus, exercise by stimulating the release of BDNF may<br />
impart protective effects on neurons, facilitate repair, while improving memory and<br />
cognitive attributes, as noted in prior studies. Further, chronic training appears to<br />
enhance plasma BDNF values.<br />
Keywords: Acute Exercise, Chronic Training, Neurotropins<br />
1557 Board #149 May 30, 3:30 PM - 5:00 PM<br />
Cognitive Load Induced response Variability in young<br />
adults with a history of Concussion<br />
Andrew C. Parks1 , Robert D. Moore2 , Steven P. Broglio3 ,<br />
Tracey Covassin1 , Charles H. Hillman2 , Matthew B. Pontifex1 .<br />
1 2 Michigan State University, East Lansing, MI. University of<br />
Illinois at Urbana-Champaign, Urbana, IL. 3University of<br />
Michigan, Ann Arbor, MI.<br />
(No relationships reported)<br />
As sport-related concussions have become a growing health concern, a greater<br />
understanding of the long-term cognitive deficits associated with a concussion is of<br />
increasing importance.<br />
PurPOsE: The current study examined the persistent effect of concussion on<br />
neurocognitive variability to determine if cognitive load mediates intra-individual<br />
variability in performance in those with and without concussion history.<br />
METhOds: Ninety-eight college-aged young adults were separated into groups<br />
according to their concussion history (50 healthy control; 48 with a history of one<br />
or more concussions). Intra-individual variability of performance was assessed in<br />
response to a low-cognitive load oddball task and a high-cognitive load flanker task,<br />
which requires greater levels of cognitive control.<br />
rEsuLTs: Analyses revealed no significant differences between groups for mean<br />
level performance or any measure of variability in response to the oddball task.<br />
However, in response to the flanker task, individuals with a history of concussion<br />
exhibited decreased overall response accuracy, and an increase in the standard<br />
deviation and coefficient of variation for reaction time.<br />
CONCLusIONs: This study suggests that the level of cognitive load imposed by<br />
a given task is an important consideration for understanding the persistent influence<br />
of concussive history on cognitive performance. Young adults with a concussion<br />
history likely hold enough cognitive reserve to compensate on simple tasks, but falter<br />
as task complexity increases. Further, intra-individual variability appears to be more<br />
sensitive than mean-level reaction time in detecting deficits associated with a history<br />
of concussion.<br />
1558 Board #150 May 30, 3:30 PM - 5:00 PM<br />
hippocampal Glycogen dynamics with acute Moderate<br />
Exercise in Type 2 diabetic rats<br />
Takeru Shima, Takashi Matsui, Hideaki Soya. University of<br />
Tsukuba Institute of Health & Sports Sciences, Ibaraki, Japan.<br />
(No relationships reported)<br />
Cognitive decline can be a complication induced by type 2 diabetes mellitus (T2DM)<br />
probably due to lowered hippocampal glucose metabolism; T2DM rats shows<br />
lowered glycogen (Gly) levels and metabolic activity and inhibition of hippocampal<br />
glycogenolysis induces cognitive decline. Thus hippocampal Gly would be a crucial<br />
energy source for maintaining hippocampal functions. We recently reported exerciseinduced<br />
Gly decreases in the hippocampus and muscle, and there is subsequent<br />
supercompensation. In T2DM, muscle Gly decreases but its supercompensation does<br />
not occur via lower muscular glucose metabolism, so we postulated that this is also the<br />
case in the T2DM hippocampus.<br />
PurPOsE: We aim to clarify the dynamics of hippocampal Gly metabolism during<br />
acute exercise in T2DM.<br />
METhOds: Male Otsuka Long Evans Tokushima Fatty rats (OLETF; T2DM model)<br />
with cognitive decline and Long Evans Tokushima rats (LETO; control) exercised for<br />
30 min on a treadmill at moderate intensity (based on lactate threshold: OLETF: 12.5,<br />
LETO: 20.0 m/min), an intensity used in human T2DM therapy. Rats were sacrificed<br />
pre-exercise at rest, and at 0,1, 3, 6 and 24 h post-exercise using high-power (10 kW)<br />
microwave irradiation (MI), as the golden standard for brain Gly detection, to measure<br />
the Gly levels in the hippocampus and soleus muscle.<br />
rEsuLTs: OLETF showed hyperglycemia (9.51±0.32 mM) with hyperphagia and<br />
obesity, and higher basal levels of hippocampal Gly as compared with LETO (p <<br />
0.01). Soleus Gly levels decreased with acute exercise, and supercompensated after<br />
exercise in LETO but not in OLETF as with previous studies. Hippocampal Gly<br />
levels decreased in LETO and OLETF. Further, the percentage of decrease in OLETF<br />
was higher than that in LETO (p < 0.01). Hippocampal Gly supercompensation after<br />
exercise occurred in LETO but not in OLETF.<br />
CONCLusIONs: Surprisingly, we found for the first time that T2DM rats have a<br />
high hippocampal Gly levels, unlike previous result. This result is likely due to the<br />
use of MI. Further, hippocampal Gly in T2DM decreased significantly during exercise<br />
but there was no supercompensation after exercise. The T2DM rat hippocampus could<br />
compensate for decreased blood glucose utilization via its high level of Gly, implying a<br />
new clinical target for treating cognitive decline as a complication of T2DM.<br />
Vol. 45 No. 5 Supplement S305<br />
1559 Board #151 May 30, 3:30 PM - 5:00 PM<br />
Modulation of Brain Function in Children during and after<br />
Exercise<br />
Eric S. Drollette, Christopher E. Komisarz, Mark R. Scudder,<br />
Lauren B. Raine, Charles H. Hillman. University of Illinois<br />
Urbana-Champaign, Urbana, IL.<br />
(No relationships reported)<br />
Previous research on acute exercise has demonstrated that children can effectively<br />
maintain and improve aspects of cognition during and following the cessation of a<br />
single bout of exercise. However, the underlying neural processes that contribute to<br />
such outcomes are not well understood.<br />
PurPOsE: The present study examined the effects of moderate cycling (60% of<br />
heart rate max) on behavioral and neuroelectric outcomes of cognitive control in 9- to<br />
10-year-old children.<br />
METhOds: Event-related brain potential (ERP) analysis of 40 children employed<br />
a modified no-go/flanker task on two separate days (i.e., exercise, rest). Task<br />
performance and ERPs were measured before, during, after, and 40 minutes following<br />
cycling or resting on the bike without pedaling. The task involved three types of<br />
equiprobable trials (i.e., congruent, incongruent, no-go) that necessitate a behavioral<br />
response for congruent and incongruent trials and inhibition of a response for no-go<br />
trials. Cycling and rest days were counterbalanced across participants. Analysis was<br />
completed using a repeated measures within-subjects design.<br />
rEsuLTs: Cycling resulted in no change in task performance relative to seated rest<br />
across all trials and time periods. Increased P3 amplitude was observed during, after,<br />
and 40 minutes following exercise over the parietal scalp region compared to rest.<br />
Additionally, P3 amplitude was largest immediately following exercise compared to<br />
during and 40 minutes after exercise.<br />
CONCLusIONs: Results indicated that children effectively maintain cognitive<br />
control performance both during and following exercise relative to rest, suggesting<br />
the maintenance of cognitive function during a dual task environment. Although<br />
differences in behavioral results were not realized following exercise, the larger P3<br />
amplitude indicates greater recruitment of neuroelectric resources, suggesting that<br />
exercise may be beneficial for improving the cognitive control of attention following<br />
the cessation of an exercise bout. Such findings have implications for how exercise<br />
might be inserted into the classroom to compliment the educational environment.<br />
1560 Board #152 Withdrawn<br />
1561 Board #153 May 30, 3:30 PM - 5:00 PM<br />
Blood Flow in the Frontal Cerebral Cortex during Cascade<br />
Juggling<br />
Shuji Shimonagata, Keisuke Koizumi, Katsuo Sugita. Chiba<br />
University, Chiba, Japan.<br />
(No relationships reported)<br />
With the global increase in the aged population, cognitive disorders, such as dementia,<br />
are becoming a big social problem. These days, there is some research that suggests<br />
that juggling exercises have beneficial effects on the function of a brain and nerve<br />
systems (Jan Scholz et al., 2009, Janina Boyk et al., 2008, Nakahara et al., 2007).<br />
These studies showed the effect of juggling exercise from the comparison between pre-<br />
and post-training, using fMRI, diffusion imaging and scores of psychological tests.<br />
However they did not evaluate the change, state and effect during juggling.<br />
PurPOsE: The purpose of this study was to evaluate the blood flow in the frontal<br />
cerebral cortex during the cascade juggling of three balls, using Near-infrared<br />
spectroscopy (NIRS).<br />
METhOds: The subjects were 12 healthy men(age: 22.17±1.59 years), and they<br />
were able to continue the three balls cascade juggling for 30 seconds or more. The<br />
oxygenated hemoglobin (oxy-Hb), de-oxygenated hemoglobin (deoxy-Hb) and total<br />
hemoglobin (total-Hb) were measured by using the Pocket NIRS by Dynascense<br />
Inc. Heart rates (HR) were measured by a Heart Rate Monitor, RS800CX by Polar.<br />
The NIRS probe was attached to each subject on the prefrontal cortex (Fp1, Fp2,<br />
International ten-twenty EEG system), and their blood flow was measured during the<br />
juggling in two minutes. Before the juggling, we indicated that they did not move their<br />
heads during their play, because the hemoglobin values were changed by nodding<br />
actions. After the juggling, the subjects pedaled bicycle ergometer with incremental<br />
load test.<br />
rEsuLTs: The %HR reserve during juggling was 26.60±9.22(%). The oxy-Hb(Fp1,<br />
Fp2) increased 34.37±16.35% and 37.34±16.18% respectively and the total-Hb(Fp1,<br />
Fp2) increased 24.16±15.39% and 27.07±12.91% respectively during juggling. The<br />
oxy-Hb(Fp1,Fp2) were 6.22±14.43% and 7.59±14.88%, and the total-Hb(Fp1,Fp2)<br />
were 5.02±11.51% and 4.38±11.23% during pedaling bicycle ergometer at the same<br />
%HR reserve during juggling. The oxy-Hb and total-Hb during juggling were higher<br />
than the oxy-Hb and total-Hb during pedaling exercise significantly (p
<strong>Thursday</strong>, May 30, 2013<br />
S306 Vol. 45 No. 5 Supplement<br />
D-32 Free Communication/Poster - Physical<br />
Activity Interventions in Older Adults<br />
May 30, 2013, 1:00 PM - 6:00 PM<br />
Room: Hall C<br />
1562 Board #154 May 30, 2:00 PM - 3:30 PM<br />
Effect of Continuous Versus discontinuous aerobic Exercise<br />
on hemodynamics in young and Older adults<br />
Marco Meucci 1 , Michael J. Landram 1 , Alan C. Utter, FACSM 2 ,<br />
Steven R. McAnulty 2 , Carlo Baldari, FACSM 3 , Laura Guidetti,<br />
FACSM 3 , Scott R. Collier, FACSM 2 . 1 University of Rome “Foro<br />
Italico”, Rome, Italy. 2 Appalachian State University, Boone, NC.<br />
3 University of Rome, Rome, Italy.<br />
(No relationships reported)<br />
It has been shown that four weeks of exercise are effective in decreasing blood<br />
pressure in older pre-to-stage-one hypertensive adults. However, little is known how<br />
exercise intensity effects age-related change in blood pressure following an exercise<br />
intervention.<br />
PurPOsE: The aim of this study was to examine the changes in systolic (SBP),<br />
diastolic blood pressure (DBP) and maximal oxygen consumption (VO2max), in<br />
continuous vs. discontinuous exercise in college-aged versus middle-aged adult<br />
subjects.<br />
METhOds: Forty-five male and female subjects (18 young adults, 21.6±0.4 years;<br />
27 older adults, 48.3±0.8 years) were recruited for this study. Each subject was<br />
randomly assigned to one of two protocols prior to baseline testing for VO2max<br />
and hemodynamic measurements. Participants were then given a four week, nonintervention<br />
control period before repeating the testing for a second time and starting<br />
one month of either 30 minutes continuous aerobic treadmill work at 70-75% of<br />
maximal heart rate (HRmax) or three bouts of 10 minutes of exercise at 70-75%<br />
HRmax with two 10 minute break periods in between (a total of 30 minutes of aerobic<br />
work).<br />
rEsuLTs: Both continuous and discontinuous exercise groups demonstrated a<br />
significant improvement in VO2max (p
Official Journal of the American College of Sports Medicine<br />
1566 Board #158 May 30, 2:00 PM - 3:30 PM<br />
Pulmonary Function Changes In The aged Following Pilates<br />
Exercise Training<br />
Brandon S. Shaw1 , Gertruide M. Gildenhuys2 , Marinda Fourie2 ,<br />
Ina Shaw3 , Gregory A. Brown, FACSM4 . 1Tshwane University of<br />
Technology, Johannesburg, South Africa. 2Tshwane University of<br />
Technology, Pretoria, South Africa. 3Monash South Africa and<br />
Tshwane University of Technology, Johannesburg, South Africa.<br />
4University of Nebraska at Kearney, Kearney, NE.<br />
(No relationships reported)<br />
With the passage of time, declining pulmonary function leads to a progressive fall in<br />
maximal strength, maximal oxygen uptake, and therefore reduced exercise capacity,<br />
physical function and health resulting in a detrimental cycle of decreasing pulmonary<br />
function, exercise capacity, physical function and health. Pilates, with its emphasis on<br />
controlled breathing during exercise, may prevent or reverse the functional reductions<br />
associated with age related pulmonary decline.<br />
PurPOsE: The purpose was to determine the effects of Pilates on pulmonary<br />
function in the aged.<br />
METhOds: Fifty sedentary, apparently healthy females aged 60 years and older were<br />
randomly assigned to a non-exercising control (n = 25) or a Pilates intervention (n =<br />
25) group. While the non-exercising control group maintained their usual activities and<br />
did not partake in any structured exercises, the Pilates intervention group took part in<br />
an eight-week supervised progressive exercise program. The Pilates program consisted<br />
of three weekly, non-consecutive, 60-minute sessions being conducted by a qualified<br />
Pilates instructor. All sessions commenced with breathing, followed by a flowing<br />
system from standing, to sitting, to lying exercises.<br />
rEsuLTs: Following Pilates training, significant (p ≤ 0.05) improvements were<br />
found in maximum expiratory flow at 25% forced vital capacity (FVC) (MEF 25%)<br />
(3.59±1.26% vs. 4.16±1.25%; p=0.008) and peak expiratory flow (PEF) (4.06±1.32<br />
L.sec-1 vs. 4.55±1.46 L.sec-1; p=0.049), but not in FVC (2.45±0.47 L vs. 2.41±0.49 L;<br />
p=0.484), forced expiratory volume in 1 second (FEV1) (1.93±0.39 L vs. 1.92±0.37 L;<br />
p=0.937), MEF 50% (2.49±0.81% vs. 2.59±0.75%; p=0.312), MEF 75% (0.96±0.38 vs.<br />
0.90±0.29; p=0.347), FEV1/FVC% (80.07±5.72 % vs. 81.72±4.80 %; p=0.157), peak<br />
inspiratory flow (3.22±1.33 L.sec-1 vs. 3.08±1.40 L.sec-1; p=0.543) and forced midexpiratory<br />
flow (FEF 25-75%) (1.93±0.59 L.sec-1 vs. 1.98 ± 0.55 L.sec-1; p=0.495).<br />
CONCLusIONs: Exercise training programs utilizing Pilates can improve<br />
pulmonary function in the aged and may improve the associated impaired exercise<br />
capacity, physical function and health consequences.<br />
1567 Board #159 May 30, 2:00 PM - 3:30 PM<br />
short-term step aerobic Exercise Training and detraining<br />
Effects On Functional Fitness In Postmenopausal Women<br />
Huei-Jhen Wen1 , Tzai-Li Li2 , Pao-Sheng Yen3 . 1Tzu Chi<br />
University, Hualien City, Taiwan. 2National Taiwan Sport<br />
University, Taoyuan County, Taiwan. 3Tzu Chi General Hospital,<br />
Taichung, Taiwan. (Sponsor: Chodzko-Zajko, Wojciech, FACSM)<br />
(No relationships reported)<br />
PurPOsE: To explore the effects of 10 weeks group-based step aerobic (GBSA)<br />
intervention and 6 weeks detraining on functional fitness and body composition in<br />
healthy postmenopausal women (PMW).<br />
METhOds: Twenty-two healthy PMW (age 60.05 ± 2.68 years) were recruited and<br />
randomly assigned to either an exercise group (EG, n=11) or a control group (CG,<br />
n=11). The participants in EG performed a GBSA exercise program including 10-<br />
15 minutes warm-up, 40-45 minutes high-intermediate intensity (75-85% heart rate<br />
reserve) GBSA exercise, and 30 minutes balance/stretching for 10 weeks and then<br />
followed a 6-week detraining. The participants in CG remained their regular lifestyle<br />
and did not participate in regular exercise. Body composition (body fat, lean body<br />
mass, and bone mineral content) determined by dual-energy X-ray absorptiometry and<br />
functional fitness (chair-stand test [CS], back scratch [BS], arm curl test [AC], 8-ft upand-go,<br />
chair sit-and-reach, and 2-minute knee-up [2MK]) were measured before the<br />
intervention and upon completion of the 10-week exercise intervention and the 6-week<br />
detraining. All data were analyzed by a mixed two-way ANOVA. Significant level was<br />
set at α= .05.<br />
rEsuLT: The results showed that body weight (EG: ↓1.2%; CG:↑0.5%; p=0.02),<br />
CS (EG:↑61.9%; CG:↓2.2%, p=0.00), AC (EG:↑43.0%; CG:↑6.8%, p=0.01), and<br />
2MK (EG:↑33.2%; CG:↑3.5%, p=0.00) were significantly influenced by the 10-week<br />
of GBSA; whereas no significant difference between groups was found in body<br />
composition. After the 6-week of detraining, the levels in CS (EG: 17.18 ± 2.75 vs.<br />
26.73 ± 4.76 times/30 sec., CG: 22.91 ± 7.50 vs. 24.77 ± 7.13 times/30 sec., p=0.00),<br />
AC (EG: 14.49 ± 4.42 vs. 24.55 ± 5.07 times/ 30 sec., CG: 20.64 ± 4.30 vs. 24.45<br />
± 4.11 times/ 30 sec., p=0.02) and 2MK (EG: 82.18 ± 14.89 vs. 107.36 ± 12.73<br />
times/ 2min., CG: 96.91 ± 16.61 vs. 103.91 ± 19.13 times/ 2 min., p=0.02) remained<br />
significantly elevated whereas the levels of body weight (53.62 ± 4.78 vs. 52.40 ±<br />
5.07 kg, p=0.002) and BMI (22.25 ± 1.94 vs. 21.68 ± 1.99 kg/m2, p=0.004) remained<br />
significantly lower compared to baseline in EG.<br />
Vol. 45 No. 5 Supplement S307<br />
CONCLusION: The findings of this study suggest that a 10-week GBSA appears to<br />
improve functional fitness in PMW and these advantages remain steady after a 6-week<br />
period of detraining.<br />
Supported by National Council of Science NSC 100-2410-H-320-014.<br />
1568 Board #160 May 30, 2:00 PM - 3:30 PM<br />
Effect of Transcutaneous Electrical Nerve stimulation on<br />
Cardiopulmonary responses during Endurance Exercise in<br />
healthy subjects<br />
Fernanda P. Tomasi1 , Gaspar R. Chiappa2 , Vinicius M. da Silva1 ,<br />
Marianne L. da Silva1 , Alexandra Lima1 , Ross Arena3 , Gerson<br />
Cipriano Jr. 1 . 1University of Brasilia, Brasilia, Brazil. 2Clinical Hospital of Porto Alegre, Porto Alegre, Brazil. 3University of<br />
New Mexico, Albuquerque, NM.<br />
(No relationships reported)<br />
PurPOsE: This study evaluated the hypothesis that application of transcutaneous<br />
electrical nerve stimulation (TENS) at the ganglionic region improves aerobic exercise<br />
performance in healthy subjects.<br />
METhOds: 11 healthy males (age: 21.3 ± 2.4 years) performed two high-intensity<br />
constant work exercise test (CWT) sessions on a cycle ergometer. The intensity for the<br />
CWT sessions was determined by maximal exercise testing in the following way: the<br />
level of oxygen consumption (VO2) that exceeded the first ventilatory threshold (VT)<br />
by a value of 60% of the difference between peak VO2 and VT (~80% peak work rate).<br />
TENS or placebo was randomly administered on each side of the vertebral process<br />
at C7 (channel 1) and T4 (channel 2) for 30 min at rest prior to and during the entire<br />
CWT sessions. Sessions were separated by 72 hours of rest. Peak oxygen pulse (VO2/<br />
heart rate), gross mechanical efficiency (ME), and time to exercise fatigue (Tlim) were<br />
obtained during both CWT sessions. Paired t-testing was used to compare variables of<br />
interest between the two CWT sessions. The level of statistical significance was set at<br />
p < 0.05 for all tests.<br />
rEsuLTs: Tlim was significantly longer (390 s ± 41 vs. 321 ± 41 s; p < 0.05)<br />
during the application of TENS in comparison with placebo. TENS also significantly<br />
decreased oxygen pulse at peak exercise (17.96 ± 1.9 vs. 20.38 ± 1 ml/beat, p < 0.05)<br />
in comparison to placebo. Lastly, ME improved during Tlim with TENS (3.95 ± 0.67<br />
vs. 3.77 ± 0.45 %, p < 0.05).<br />
CONCLusIONs: These results suggest TENS application results in improved<br />
exercise performance in healthy subjects. Future research should determine if similar<br />
effects are observed in patient populations with exercise limitations, such as heart<br />
failure, diabetes and peripheral arterial disease.<br />
1569 Board #161 May 30, 2:00 PM - 3:30 PM<br />
The Effect Of Variety On Time spent In Moderate- To<br />
Vigorous-intensity Physical activity<br />
Hollie A. Raynor 1 , Dale S. Bond 2 . 1 University of Tennessee,<br />
Knoxville, TN. 2 Brown Medical School, Providence, RI.<br />
(No relationships reported)<br />
Incorporating a variety of activities into a physical activity program may be a<br />
strategy to increase moderate- to vigorous-intensity physical activity (MVPA). While<br />
observational research has shown that performing a variety of activities is associated<br />
with higher MVPA levels, the effect of variety on amount of MVPA performed has not<br />
been previously tested within an experimental paradigm.<br />
PurPOsE: To conduct a laboratory-based investigation examining the effect<br />
of having access to a greater variety of active videogames on minutes of MVPA<br />
performed in non-obese, regularly active young adults.<br />
METhOds: Twelve participants (age = 21.9 + 4.0 yrs; body mass index = 22.6<br />
+ 3.0 kg/m2; 58.3% female; 66.7% white) who self-reported a history of playing<br />
active videogames and habitual MVPA (293.8 + 103.6 min/wk), participated in<br />
two experimental sessions, VARIETY (access to 4 different active videogames<br />
during 4, 15-minute bouts) and NON-VARIETY (access to only the most highly<br />
liked active videogame during 4, 15-minute bouts), with order of experimental<br />
sessions counterbalanced across participants. According to 100 mm visual analogue<br />
scales, participants liked the four Xbox 360 Kinect active videogames used in the<br />
investigation (adventure game = 77.6 + 12.8 mm; dance = 76.8 + 16.0 mm; soccer<br />
= 75.6 + 17.9 mm; tennis = 68.8 + 15.8 mm). During each bout, participants could<br />
choose to engage in the active videogame or sit quietly and read magazines. The<br />
Sensewear Mini Armband assessed MVPA duration.<br />
rEsuLTs: Mixed-factor ANOVAs (between-subject factor of counter-balanced order<br />
and within-subject factors of experimental session and bouts) indicated a significant<br />
main effect of session, with VARIETY performing more MVPA than NON-VARIETY<br />
(9.0 + 2.8 min vs. 5.8 + 4.2 min, p < 0.05). A significant main effect of bout was found<br />
for MVPA-related energy expenditure, with bout 1 significantly greater than bout 4<br />
(202.5 + 82.7 kcal vs. 111.0 + 62.3 kcal, p < 0.05), and a non-significant trend (p <<br />
0.08) for a main effect of session, with VARIETY producing greater MVPA-related<br />
energy expenditure than NON-VARIETY (179.5 + 90.3 kcal vs. 107.5 + 83.7 kcal).<br />
CONCLusION: Providing access to a greater variety of activities within an exercise<br />
session can increase amount of time engaged in MVPA.<br />
<strong>Abstracts</strong> were prepared by the authors and printed as submitted.<br />
<strong>Thursday</strong>, May 30, 2013
<strong>Thursday</strong>, May 30, 2013<br />
S308 Vol. 45 No. 5 Supplement<br />
\1570 Board #162 May 30, 2:00 PM - 3:30 PM<br />
Comparing The health Outcomes among Fitness Center<br />
Members From high and Low Education and Income<br />
Groups<br />
Rebecca Abaddi1 , Olivia Smith2 , Kisha Virgil3 , NiCole Keith,<br />
FACSM3 . 1Hamilton Southeastern High School, Indianapolis,<br />
IN. 2Pike High School, Indianapolis, IN. 3Indiana University-<br />
Purdue University, Indianapolis, Indianapolis, IN.<br />
(No relationships reported)<br />
Socioeconomic status has been shown to influence health.<br />
PurPOsE: We evaluated whether health differences between income and education<br />
groups persisted when common fitness center barriers (location and cost) were<br />
eliminated.<br />
METhOds: Members completed a Demographics and Health History Questionnaire.<br />
One-way ANOVA and T-tests were used to analyze cross-sectional data.<br />
rEsuLTs: Of the 323 evaluated, 13% were not high school graduates (LE), 54.52%<br />
had a high school diploma or some college (ME), 33% had a college degree (HE),<br />
27.86% were below (LI) and 72% were above the poverty threshold (HI). LI people<br />
had a higher RHR (81.06+13.10 vs. 75.21+12.39, p
Official Journal of the American College of Sports Medicine<br />
1574 Board #166 May 30, 2:00 PM - 3:30 PM<br />
Effect Of a Very Low-calorie diet On Weight Loss and<br />
selected Measures Of Physical health<br />
Andy Matthews 1 , Jordan Glenn 1 , Casey Sams 2 , Robert Feezell 2 ,<br />
Matt Ganio 1 . 1 University of Arkansas, Fayetteville, AR. 2 New<br />
Directions Weight Loss, Bentonville, AR. (Sponsor: Stavros<br />
Anastassios Kavouras, FACSM)<br />
(No relationships reported)<br />
American obesity rates have dramatically increased with multiple theories and factors<br />
considered to contribute to this epidemic. Research indicates that controlled caloric<br />
restriction can lead to weight loss and improved physical health, but limited data<br />
is available on the effect of a very low-calorie diet (VLCD) on body mass loss and<br />
standard health measures.<br />
PurPOsE: The purpose of this study was to determine the effect of a physician<br />
supervised VLCD on weight loss and selected measures of physical health.<br />
METhOds: Twenty-one males (47±13 years, 158±7 cm) and forty-five females<br />
(44±13 years, 144±5 cm) participated in a meal replacement VLCD program (1,000<br />
and 600 kcal/day, respectively). Prior to starting the VLCD, subjects were evaluated<br />
on body mass, percent body fat (BF; bioelectrical impedance analysis), triglycerides<br />
(TRY), cholesterol (CHOL), and blood glucose (BG) levels. Follow-up measures were<br />
taken after 12 and 24 weeks of being on the VLCD. Due to scheduling, not all subjects<br />
participated at all time-points. Repeated measures analysis of variance (ANOVA) tests<br />
were performed to compare changes from base line to 12 weeks and from 12 to 24<br />
weeks.<br />
rEsuLTs: Significant reductions in body mass (112.3±4.3 vs 94.1±3.5 kg, n =24),<br />
BF (36.2±1.0 vs 29.6±1.2 %, n =23), TRY (161.7±27.5 vs 77.4±8.0 mg/dL, n =12),<br />
and CHOL (191.2±18.1 vs 152.7±12.2 mg/dL, n=12) occurred from baseline to 12<br />
weeks, respectively (all p
<strong>Thursday</strong>, May 30, 2013<br />
S310 Vol. 45 No. 5 Supplement<br />
1578 Board #170 May 30, 2:00 PM - 3:30 PM<br />
development of Family-Based Obesity Prevention and<br />
Control approaches Through Community Engagement and<br />
Intervention Mapping<br />
Joel Edward Williams1 , Stephanie Mihaly1 , Maciel U. Gonzáles1 ,<br />
Adam Yates1 , Sarah F. Griffin1 , Sarah T. Agate2 . 1Clemson University, Clemson, SC. 2Southern Illinois University,<br />
Carbondale, IL.<br />
(No relationships reported)<br />
A critical step in developing successful interventions to increase physical activity (PA)<br />
and healthy eating involves understanding how the family environment influences<br />
these weight-regulating behaviors, detection of barriers and facilitators of these<br />
behaviors, and identification of the best ways to engage families for comprehensive<br />
health promotion efforts.<br />
PurPOsE: To develop a family-centered obesity prevention and control intervention<br />
for low-income families based on formative participatory research and guided by the<br />
Intervention Mapping protocol.<br />
METhOds: In-depth interviews and focus groups were used to elicit information<br />
from community informants (administrators and staff) and potential intervention<br />
participants (low-income, African American families) associated with the Expanded<br />
Food and Nutrition Education Program (EFNEP). Interviews with administrators<br />
(n=4) and focus groups (n=7) with EFNEP staff and low-income families were<br />
recorded and transcribed verbatim. An initial coding dictionary was developed and<br />
additional codes were added during transcript coding, which occurred in three steps.<br />
First, pairs of coders independently applied codes to segments of text then met to<br />
resolve discrepancies. Next, a separate team member, not involved in the first step of<br />
coding, reviewed the initial pair’s codes. Finally, all three coders met to come to final<br />
consensus. Consensus codes were electronically applied to the transcripts and major<br />
themes were extracted using NVivo qualitative software.<br />
rEsuLTs: Answers to four important questions emerged from the data related to:<br />
who to target (e.g., entire communities including “established” sub-groups); what<br />
to include as essential elements (e.g., parenting behaviors, family PA opportunities,<br />
nutrition education and healthy cooking); how to focus intervention messages (e.g.,<br />
emphasizing healthy lifestyle vs. losing weight); and where intervention meetings<br />
should occur (e.g., community centers, churches).<br />
CONCLusIONs: This study highlights several important theoretical and practical<br />
issues for informing the development of a culturally-appropriate family-centered<br />
obesity intervention. Related program objectives, performance objectives and<br />
intervention strategies are presented.<br />
1579 Board #171 May 30, 2:00 PM - 3:30 PM<br />
Factors related To Partner Involvement In The development<br />
Of The u.s. National Physical activity Plan<br />
Daniel B. Bornstein 1 , Cheryl Carnoske 2 , Rachel Tabak 3 , Jay<br />
Maddock 4 , Steven Hooker 5 , Kelly Evenson 6 , Russell Pate,<br />
FACSM 1 . 1 University of South Carolina, Columbia, SC.<br />
2 Washington Univeresity at St. Louis, St. Louis, MO. 3 Washington<br />
University at St. Louis, Sr. Louis, MO. 4 University of Hawai’i,<br />
Honolulu, HI. 5 Arizona State University, Phoenix, AZ.<br />
6 University of North Carolina at Chapel Hill, Chapel Hill, NC.<br />
(No relationships reported)<br />
PurPOsE: Physical activity coalitions (PACs) are increasingly forming to meet<br />
the demands associated with increasing population levels of physical activity. Little<br />
is known about what makes PACs successful, however some evidence suggests that<br />
factors related to each organization that joins a coalition may explain coalition success/<br />
failure. The purpose of this study was to employ qualitative methods to understand the<br />
factors related to organizations’ decisions to commit to the coalition that developed the<br />
U.S. National Physical Activity Plan (NPAP).<br />
METhOds: Qualitative semi-structured interviews were conducted with key<br />
informants from NPAP’s partner organizations. The interview guide was designed to<br />
elucidate the key factors explaining why and how partner organizations decided to<br />
commit to the NPAP coalition. Interviews were transcribed verbatim and were coded<br />
separately by two members of the research team.<br />
rEsuLTs: : Five primary factors emerged: (1) Strategic Alignment; (2)<br />
Organizational Alignment; (3) Provide Input; (4) Seminal Event; (5) Cost/Benefit<br />
Ratio.<br />
CONCLusIONs: Building and maintaining a PAC with highly committed partners<br />
may hinge upon the ability to fully understand how each current or prospective partner<br />
believes it could benefit from the five factors identified in this study.<br />
MEDICINE & SCIENCE IN SPORTS & EXERCISE ®<br />
1580 Board #172 May 30, 2:00 PM - 3:30 PM<br />
Effect Of Face-to-face Vs. E-mail Communication In an<br />
Employee-based Walking Program<br />
Doug K. Miller1 , Amy Faus2 . 1Messiah College, Grantham, PA.<br />
2Drexel University School of Public Health, Philadelphia, PA.<br />
(Sponsor: Stephen Simons, FACSM)<br />
(No relationships reported)<br />
PurPOsE: Effective modes of communication are an integral part of the success of<br />
work-site wellness programs. Email communication offers advantages of affordability<br />
and convenience, but can lack the motivational power of social support provided via<br />
face-to-face contact between the program participant and leader. The purpose of this<br />
study was to compare the effectiveness of face-to-face and email communication styles<br />
on fitness and quality of life outcomes in a work-site walking program.<br />
METhOds: Twenty sedentary employees (age = 49 + 6.8 yr), participated in a 10week<br />
walking program. Subjects were asked to walk 4 days per week, at a moderate<br />
intensity, with duration progressing from 20 to 45 minutes. All workouts were recorded<br />
on an exercise log. Eleven subjects were randomly assigned to an email (E) group<br />
and received weekly email motivational information and walking prescriptions. The<br />
other nine subjects were assigned to a face-to-face (F) group and met with an exercise<br />
instructor and other subjects once a week for a group walk. During the walk, the<br />
instructor verbally delivered the same messages that the email group received. Prior<br />
to and following the 10-week program, resting blood pressures were recorded, and<br />
subjects completed the WHOQOL-BREF quality of life questionnaire, the Rockport<br />
Walk Test, and a 5-minute sub-maximal treadmill walk at 1% grade and 3.5 mph.<br />
rEsuLTs: All participants showed significant improvement on Rockport time (15.89<br />
+ .94 vs 14.56 + .89 min, p
Official Journal of the American College of Sports Medicine<br />
1582 Board #174 May 30, 2:00 PM - 3:30 PM<br />
The Effects of Progressive resistance Exercise versus a<br />
Power-Periodization Exercise approach to Training Very<br />
Old adults at risk for sarcopenia<br />
Dennis Hunt, Kathy Swanick, Andrew Hovanec. Florida Gulf<br />
Coast University, Fort Myers, FL.<br />
(No relationships reported)<br />
PurPOsE: The purpose of this study was to determine the most effective resistance<br />
training program to enhance overall function in very old adults who are at risk for<br />
experiencing sarcopenia-related health declines. Sarcopenia, a term that describes the<br />
involuntary loss of lean muscle mass that occurs during the aging process beginning<br />
in middle adulthood. Two exercise programs were examined in this study, progressive<br />
resistance exercise (PRE) and periodized-power resistance (PPRT).<br />
METhOds: The study randomized participants into two intervention groups: one<br />
group receiving progressive resistance exercise training without a power component<br />
and one group receiving periodized-power resistance training. The duration of each<br />
intervention was 12 weeks, including a shared one-week familiarization phase. Pretesting<br />
was performed prior to the beginning of the intervention and post-testing was<br />
conducted at the conclusion of the intervention. Outcome measures included strength<br />
assessment, functional power assessment, balance assessment, and body composition<br />
analysis.<br />
rEsuLTs: Nine participants completed the PRE program (mean age = 83 years)<br />
and six participants completed the PPRT program (mean age= 81 years). The PRE<br />
group experienced significant (p < .05) gains in strength as measured by the Leg press<br />
1RM (+27.6%) and Chest Press 1RM (+28.7%). The PPRT group also experienced<br />
significant (p < .05) gains in strength in Leg Press 1RM (+29.9%) and Chest Press<br />
1RM (+20.8%). However, the PPRT group also demonstrated significant (p < .05)<br />
improvements in functional power as measured by the Five-Times-Sit-To-Stand Test<br />
(FTSTS).<br />
CONCLusIONs: Both PRE and PPRT groups experienced similar significant gains<br />
in upper and lower extremity strength. The FTSTS assessment was the only outcome<br />
measure where there was significant difference between groups, suggesting that the<br />
PPRT program was more effective than the PRE program in yielding adaptations in<br />
functional power production in the study population. The study results also suggest<br />
that a Periodized power resistance training program is safe and effective for yielding<br />
both strength and power gains in the older adult population.<br />
1583 Board #175 May 30, 2:00 PM - 3:30 PM<br />
stability Of Pedometer-determined Physical activity In<br />
2-, 4-, and 9-year Follow-up studies Of healthy Elderly<br />
Japanese<br />
Naofumi Yamamoto1 , Mieko Shimada2 , Naoki Nakagawa3 ,<br />
Yasuo Kimura4 , Mamoru Nishimuta2 , Susumu S Sawada,<br />
FACSM5 , Hidenori Asai1 , Yutaka Yoshitake6 . 1Ehime University,<br />
Matsuyama, Japan. 2Chiba Prefectural University of Health<br />
Sciences, Chiba, Japan. 3SANNO University, Isehara, Japan.<br />
4 5 Saga University, Saga, Japan. National Institute of Health and<br />
Nutrition, Tokyo, Japan. 6National Institute of Fitness and Sports<br />
in Kanoya, Kanoya, Japan.<br />
(No relationships reported)<br />
BaCKGrOuNd: Understanding the stability of physical activity later in life is<br />
important for predicting the future physical activity levels of the elderly and planning<br />
appropriate intervention with physical activities. However, as far as we know, there<br />
are no reports examining the stability of physical activity in the elderly using objective<br />
measures.<br />
Vol. 45 No. 5 Supplement S311<br />
PurPOsE: The purpose of this study was to examine the stability of physical activity,<br />
as assessed with pedometry, in healthy elderly Japanese over a follow-up period of<br />
nine years.<br />
METhOds: The participants included 191 elderly (115 males and 76 females) aged<br />
71 at baseline who were followed from 2000 to 2008. The participants wore a waistmounted<br />
pedometer (Yamasa, MP-300, Japan) for seven consecutive day or more at<br />
ages 71, 73, 75, and 80. The stability of physical activity, defined as the maintenance<br />
of the relative rank of daily steps, was examined using Spearman’s rho. In this<br />
study, “inactive” was defined as a level of less than 4,000 steps per day (Aoyagi and<br />
Shephard, 2010).<br />
rEsuLTs: Compared with the baseline levels of daily steps (males; 6,946 ± 2,604<br />
steps/day, females; 6,438 ± 2,443 steps/day), the percentages of daily steps taken at<br />
ages 73, 75 and 80 were 89.8% (6,235 ± 2,979 steps/day), 84.4% (6,056 ± 2,808 steps/<br />
day) and 71.1% (4,836 ± 2,559 steps/day), respectively, in the males, and 90.0% (5,795<br />
± 2,199 steps/day), 82.9% (5,235 ± 1,846 steps/day) and 72.4% (4,810 ± 2,104 steps/<br />
day), respectively, in the females. The stabilities of daily steps (Spearman’s rho) at<br />
ages 73, 75 and 80 were 0.76, 0.72 and 0.67, respectively, in the males, and 0.72, 0.65,<br />
and 0.62, respectively, in the females. The values of Spearman’s rho were larger than<br />
0.60, suggesting a high stability of daily steps. The results of a logistic regression<br />
analysis using gender, BMI and grip strength as the items of covariance showed<br />
that the participants who were low in daily steps at baseline were more likely to be<br />
“inactive” at ages 73, 75, and 80.<br />
CONCLusION: In this study, although the number of daily steps declined with age,<br />
the stability of the daily steps remained high over the nine years follow-up period.<br />
Moreover, the results suggested that, even in the elderly, the current level of physical<br />
activity is a strong predictive factor of the future level of physical activity later in life.<br />
D-33 Free Communication/Poster - Physical<br />
Activity Interventions/Promotion in Adults<br />
May 30, 2013, 1:00 PM - 6:00 PM<br />
Room: Hall C<br />
1584 Board #176 May 30, 3:30 PM - 5:00 PM<br />
The Effects of Concurrent Circuit Exercise Training on<br />
Metabolic syndrome in Middle-aged Woman<br />
Mien Mien Lee 1 , Ting Yao Wang 2 , Shao Zeng Hu 1 , Kuei Hui<br />
Chan 1 . 1 National Taiwan Sport University, Taoyuan, Taiwan.<br />
2 National Yang-Ming University, Taipei, Taiwan.<br />
(No relationships reported)<br />
Metabolic syndrome is a cluster of metabolic risk factors that comprises<br />
hyperglycemia, dyslipidemia, abdominal obesity, and hypertension. Recent data<br />
suggest that the prevalence of metabolic syndrome in woman is higher than in men.<br />
Concurrent circuit exercise (CCE) is a program that combines aerobic exercise and<br />
hydraulic resistance exercise in circuit mode.<br />
PurPOsE: To determine the CCE program on weight, body fat percentage, waist-tohip<br />
ration (WHR), blood pressure, fasting glucose (GLU), and lipid profile in middleaged<br />
woman.<br />
METhOd: Twenty-four middle-aged women were randomly assigned to CCE (45.58<br />
± 9.09 yrs) and control (CON, 43.50 ± 10.38 yrs) groups. Subjects in CCE group<br />
performed CCE 30 min (including 3 min warm up, 24 min main activity keeping<br />
heart rate at 60%~80% HRmax and 3 min stretching exercise) 3 times per week for<br />
12 weeks. Subjects in CON group did not training during the experimental period and<br />
were asked to keep their daily life and diet as usual. Pre- and post experimental period,<br />
the body weight, body fat percentage, WHR, blood pressure of subjects were assessed.<br />
Fasting blood sample were also taken to determine the GLU, triglyceride (TG), total<br />
cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), as well as calculated<br />
the low-density lipoprotein cholesterol (LDL-C) and atherosclerosis index (AI). The<br />
effects of the intervention (time and groups) were evaluated by two-way ANOVA with<br />
mixed design.<br />
rEsuLT: There were no differences between groups at pre and post of the study.<br />
However, after the CCE training, blood GLU and TG in CCE group significantly<br />
decreased (80.75 ± 7.84 to 74.33 ± 4.89 mg/dl, and 81.00 ± 42.92 to 67.75 ± 30.88 mg/<br />
dl, respectively, p < 0.05).<br />
CONCLusION: Twelve weeks of CCE training may be an effective exercise program<br />
to prevent metabolic syndrome by reducing GLU and TG in middle-aged woman.<br />
Key words: aerobic exercise, hydraulic resistance exercise, glucose, triglyceride<br />
<strong>Abstracts</strong> were prepared by the authors and printed as submitted.<br />
<strong>Thursday</strong>, May 30, 2013
<strong>Thursday</strong>, May 30, 2013<br />
S312 Vol. 45 No. 5 Supplement<br />
1585 Board #177 May 30, 3:30 PM - 5:00 PM<br />
Concurrent Exercise Training restores heart rate<br />
Variability in Methamphetamine-dependent Individuals<br />
Brett A. Dolezal1 , Marlon Abrazado1 , Michael Lau1 , Joy<br />
Chudzynski2 , Rick Rawson2 , Alan Garfinkel3 , Christopher<br />
B. Cooper1 . 1David Geffen School of Medicine at UCLA, Los<br />
Angeles, CA. 2Integrated Substance Abuse Program, Semel<br />
Institute, Los Angeles, CA. 3Department of Integrative Biology<br />
and Physiology, Los Angeles, CA.<br />
(No relationships reported)<br />
INTrOduCTION: Healthy, trained individuals exhibit high heart rate variability<br />
(HRV) reflecting the ability of the autonomic nervous system (ANS) to adapt quickly<br />
to physical challenges. Methamphetamine (MA) dependency causes ANS dysfunction<br />
and diminished (HRV) but it is unknown whether HRV can be restored with exercise<br />
training.<br />
PurPOsE: In recently abstinent MA-dependent individuals in a residential facility:<br />
(i) to assess HRV compared with drug-free, age-matched sedentary controls (DF),<br />
and (ii) to assess HRV before and after 8-weeks supervised endurance and resistance<br />
training (ET) compared with those who did not receive training (EA).<br />
METhOds: In 50 subjects (DF=22; ET=14, EA=14) resting heart rate was recorded<br />
over 5 min while seated using a monitor affixed to a chest strap. Previously reported<br />
time- and frequency-domain parameters of HRV (LFn, HFn, L/F ratio, SDNN,<br />
RMSSD and pNN50) were calculated with customized software. MA-dependent<br />
individuals were randomized to 3 days/week of exercise training (ET) or equal<br />
attention without training (EA) over 8 weeks. An analysis of variance (ANOVA) with<br />
Duncan’s post-hoc testing was performed to compare HRV indices between and within<br />
groups. Significance was set at P ≤ 0.05.<br />
rEsuLTs: Subject characteristics were matched between groups: age 34 (5) years;<br />
height 1.76 (0.06) m, and BMI 26.0 (3.5) kg/m2, mean (SD). The EA and ET groups,<br />
compared with DF, had significantly higher resting heart rate, LF, and LF/HF ratio<br />
(P
Official Journal of the American College of Sports Medicine<br />
change between controls and active intervention at 6 or 18 months. Average attendance<br />
was 33% through month 6 and 22% for the 144 classes offered between months 7 and<br />
18. On treatment analyses (n=117) indicated significant association of class attendance<br />
with test time (p=0.02) and stage 1 HR response (p=0.05) at 18 months.<br />
CONCLusION: Participation in group exercises classes resulted in long-term<br />
cardiorespiratory fitness benefits for adults with SMI. Supported by NIMH Grant<br />
5R01MH080964.<br />
1589 Board #181 May 30, 3:30 PM - 5:00 PM<br />
The Effect Of high-intensity Intermittent Exercise On<br />
Postprandial Lipaemia<br />
Martin Thong Soon Tan, Rachel Moy Fat Chan, Yati N.<br />
Boutcher, Stephen H. Boutcher, FACSM. University of New<br />
South Wales, Sydney, Australia.<br />
(No relationships reported)<br />
Moderate aerobic exercise attenuates postprandial lipemia, however, the effect of highintensity<br />
intermittent exercise (HIIE) on postprandial lipemia is undetermined.<br />
PurPOsE: The effects of a 20-min bout of HIIE on blood triacylglycerol levels after<br />
the consumption of a high-fat meal were examined.<br />
METhOds:<br />
Twelve young, untrained, overweight female volunteers (BMI 25.1 ± 0.2 kg m-2;<br />
aged 21.3 ± 0.6 years) underwent a maximal oxygen uptake test and then on different<br />
days underwent either an exercise or a no-exercise lipemic condition. Both conditions<br />
involved digesting a high-fat meal after a 12-hour fast. The high-fat meal was in<br />
milkshake form and consisted of 275 mL of thickened cream, 50 g of specialty ice<br />
cream, and 2 g of artificial sweetener. The meal provided 4169.5 kJ (992.7 kcal)of<br />
energy, 97.7 g fat (63.6 g saturated, 0.35 g monounsaturated, 0.75 g polyunsaturated),<br />
24.0 g carbohydrate, and 8.4 g protein. Order was counter-balanced. In the exercise<br />
condition participants completed a 20-min HIIE cycling protocol consisting of repeated<br />
bouts of 8 s sprint cycling (60-65% maximal oxygen uptake at 100-115 revolutions per<br />
minute) and 12 s recovery (40 revolutions per minute) 14 hours before consuming the<br />
high-fat meal. Blood samples were collected after the high-fat meal every hour for 4<br />
hours and triacylglycerol levels were assessed using an AccutrendPlus analyser.<br />
rEsuLTs: Fasting triacylglycerol was significantly lower by 14.8% in the exercise<br />
compared to the no-exercise condition, P = 0.02. Postprandial triacylglycerol,<br />
measured by total area under the curve, was 13.0% lower, P = 0.004, in the exercise<br />
(5.84 ± 0.31mmol·hr L-1) compared to the no-exercise condition (6.71 ± 0.47<br />
mmol·hr L-1). There was a significant correlation (r = 0.74; P = 0.006) between<br />
energy expenditure during HIIE and the difference in exercise and no-exercise fasting<br />
triacylglycerol values.<br />
CONCLusIONs: HIIE attenuated postprandial triacylglycerol levels after the<br />
consumption of a high-fat meal in young untrained females.<br />
1590 Board #182 May 30, 3:30 PM - 5:00 PM<br />
Effects Of a self-directed, Multicomponent Exercise<br />
Program For adults With arthritis<br />
Sara Wilcox, FACSM 1 , Bruce McClenaghan 1 , Patricia A.<br />
Sharpe 1 , Katherine Leith 1 , Jennifer M. Hootman, FACSM 2 ,<br />
Meghan Baruth 1 , Ellen Wingard 1 , Andrew Ortaglia 1 . 1 University<br />
of South Carolina, Columbia, SC. 2 Centers for Disease Control<br />
and Prevention, Atlanta, GA.<br />
(No relationships reported)<br />
Physical activity (PA) plays an important role in arthritis disease self-management,<br />
but adults with arthritis are less active than the general population. Self-directed,<br />
pre-packaged PA programs, if effective, could meet the needs of this population in a<br />
relatively low cost manner.<br />
PurPOsE: To investigate the impact of a 12-wk, self-directed, multicomponent PA<br />
program, First Step to Active Health®, on functional outcomes, arthritis symptoms and<br />
management, and PA.<br />
METhOds: Adults with arthritis (n=401, 56±10 yrs, 86% women) were randomized<br />
to a 12-wk PA program or an attention control group (self-directed nutrition education).<br />
The PA program included aerobic, strength, flexibility, and balance exercises and<br />
emphasized a self-paced, stepped approach. Primary outcomes were measured at<br />
baseline and 12-wks. Functional performance measures were the 30-sec chair stand,<br />
6-min walk, and seated reach. A visual numeric scale measured pain, fatigue, and<br />
stiffness. Lorig’s Arthritis Self-Efficacy Scale measured arthritis management selfefficacy.<br />
The CHAMPS questionnaire measured hrs/wk of self-reported moderate- to<br />
vigorous-intensity PA (MVPA) and leisure-time MVPA. Repeated measures linear<br />
regression models tested group, time, and Group x Time effects in outcomes. Due to<br />
normality violations for MVPA and leisure-time MVPA models, these outcomes were<br />
dichotomized as < or ≥ a1.5 hr/wk increase, and logistic regression was used instead.<br />
Models adjusted for marital status due to baseline group differences.<br />
rEsuLTs: 12-wk retention was 80% and did not differ by group. Time effects<br />
indicated statistically significant improvements in chair stands, 6-min walk, seated<br />
reach, pain, fatigue, and arthritis self-management (p values < .01). A Group x Time<br />
interaction indicated greater improvement in stiffness in the attention control group<br />
Vol. 45 No. 5 Supplement S313<br />
(p = .02). Participants randomized to the PA group were significantly more likely than<br />
those in the control group to show a ≥ 1.5 hr/wk increase in MVPA and leisure-time<br />
MVPA (p values < .01).<br />
CONCLusION: A 12-wk, self-directed, multicomponent PA program improved<br />
function, reduced pain and fatigue, enhanced disease management self-efficacy, and<br />
increased MVPA in adults with arthritis. With the exception of MVPA, however,<br />
results did not differ by randomization group.<br />
1591 Board #183 May 30, 3:30 PM - 5:00 PM<br />
The relationship between Electronic Lifestyle selfmonitoring<br />
and Weight Loss<br />
Vaughn W. Barry1 , Amanda McClain2 , Jihong Liu3 , J. Larry<br />
Durstine, FACSM3 , Gregory Hand3 , Sara Wilcox3 , Steven<br />
N. Blair, FACSM3 . 1Middle Tennessee State University,<br />
Murfreesboro, TN. 2Cornell University, Ithaca, NY. 3University of<br />
South Carolina, Columbia, SC.<br />
(No relationships reported)<br />
PurPOsE: It is unclear what lifestyle self-monitoring (SM) dose is needed for<br />
successful weight loss. We aimed to quantify the frequency and duration of electronic<br />
lifestyle SM, via the SenseWear Armband, needed for clinically significant weight loss<br />
(i.e. >5%).<br />
METhOds: This analysis was limited to two of four randomization groups of a larger<br />
weight loss trial where participants (n = 77) wore the SenseWear Armbands to SM<br />
physical activity (PA) and dietary intake (DI). One randomization group (n = 38) also<br />
attended 14 group weight loss sessions. After completing a 9 month intervention, low<br />
(SM PA and DI 50% of days and DI 50% of days) categories were created according<br />
to the participant armband adherence data. The SM categories were compared to<br />
percentage weight change using the general linear model. Fractional polynomial<br />
models were used to evaluate the association of the frequency and duration of armband<br />
wear and the DI SM needed for more than 5% of weight loss.<br />
rEsuLTs: Participants with moderate (n = 20) or high (n = 33) SM lost -4.5%, (95%<br />
CI, -8.0 - -1.1 %) and -9.0% (-12.8 - -5.2%) of their weight, respectively, while those<br />
with low (n = 24) SM lost 0% (-3.7 - 3.7%) of their weight. Participants were more<br />
likely to experience clinically significant weight loss if they wore the armband 14<br />
hours per day, 80% of the days (i.e. 178 of 222 days), and monitored DI 47% of the<br />
days (i.e. 104 of 222 days).<br />
CONCLusIONs: Individuals can experience modest weight loss through moderate<br />
electronic SM (i.e. SM PA > 50% of the time); however, for greater weight loss,<br />
participants need to monitor both PA and DI the majority of the time. To aid in<br />
clinically significant weight loss, users of the SenseWear armband should consistently<br />
wear the device while regularly monitoring DI.<br />
1592 Board #184 May 30, 3:30 PM - 5:00 PM<br />
The Impact Of Cell Phone use On The Intensity and Liking<br />
Of a Bout Of Treadmill Exercise<br />
Michael J. Rebold 1 , Gabriel Sanders 2 , Jacob E. Barkley 1 . 1 Kent<br />
State University, Kent, OH. 2 Northern Kentucky University,<br />
Highland Heights, KY. (Sponsor: Dr. Ellen Glickman, FACSM)<br />
(No relationships reported)<br />
Cellular telephones (cell phones) possess a variety of functions that have historically<br />
been classified as sedentary behaviors (e.g. talking on the phone) which are known to<br />
be inversely related to exercise behavior. However, other cell phone functions (e.g.,<br />
playing music) may have a positive effect on exercise behavior.<br />
PurPOsE: This project compared the average speed and liking of 30-minute bouts<br />
of treadmill exercise during which participants utilized common cell phone functions<br />
(texting, talking, listening to music).<br />
METhOds: Twenty five adults (N = 19 females and 6 males, 21.9 ± 1.3 years)<br />
each participated in four, separate, 30-minute exercise conditions on a treadmill, in<br />
a random order. During each condition, the time and speed displays on the treadmill<br />
were shielded from the participants. However, participants were able to alter the speed<br />
whenever they wished. Treadmill grade was set at zero and not altered. For two of the<br />
conditions, research personnel used a pre-determined script to interview participants<br />
over their cell phone by text message (texting condition) and voice conversation<br />
(talking condition) for the duration of the conditions. During another condition,<br />
participants used their cell phone to listen to music (music condition) of their own<br />
choosing. Finally, participants completed a control condition where they did not have<br />
access to their cell phone. Upon completion of each condition, average speed and<br />
liking (via visual analog scale) of the condition was assessed.<br />
rEsuLTs: One-way repeated measures ANOVAs revealed a significant (p < 0.001)<br />
main effect of condition for average speed and liking. Speed in the music (3.4 ±<br />
1.4 miles·hour-1) and control conditions (3.2 ± 1.3 miles·hour-1) was significantly<br />
(p ≤ 0.02) greater than both texting (2.8 ± 1.2 miles·hour-1) and talking (2.9 ± 1.1<br />
miles·hour-1). Liking of exercise during the listening to music condition (7.7 ± 1.4 cm)<br />
was significantly greater (p < 0.001) than all other conditions (4.6 ± 2.2 cm texting, 5.8<br />
± 1.6 cm talking, 4.1 ± 2.4 cm control).<br />
CONCLusION: Cell phones have some features (playing music) that have the ability<br />
<strong>Abstracts</strong> were prepared by the authors and printed as submitted.<br />
<strong>Thursday</strong>, May 30, 2013
<strong>Thursday</strong>, May 30, 2013<br />
S314 Vol. 45 No. 5 Supplement<br />
to increase the intensity and liking of a bout of exercise. However, other cell phone<br />
functions (texting, talking) may interfere with exercise by reducing intensity.<br />
1593 Board #185 May 30, 3:30 PM - 5:00 PM<br />
The Effects Of Green Tea Extract Consumption and highintensity<br />
Intermittent Exercise On Body Composition Of<br />
Overweight Men<br />
Ehsan Gahreman, Mehrdad Heydari, Yati Boutcher, Stephen H.<br />
Boutcher, FACSM. University of New South Wales, Kensington,<br />
Australia. (Sponsor: Stephen H. Boutcher, FACSM)<br />
(No relationships reported)<br />
The ability of high-intensity intermittent exercise (HIIE) and green tea consumption to<br />
influence body composition of young adult males is undetermined.<br />
PurPOsE: Thus, the effect of a 12-week HIIE intervention with and without daily<br />
green tea extract consumption on body composition of sedentary overweight men was<br />
assessed.<br />
METhOds: Inactive young men (26.1 ± 0.8 years; N = 48) were randomly assigned<br />
to control, HIIE, green tea, or HIIE plus green tea groups. In the green tea group<br />
males consumed a capsule of green tea three times per day, whereas subjects in the<br />
HIIE group performed 20 minutes of intermittent sprinting (8 s sprint, 12 s recovery),<br />
three times per week. Controls performed no structured exercise for 12 weeks. Body<br />
composition was assessed by dual energy x-ray absorptiometry.<br />
rEsuLTs: Maximal oxygen uptake was significantly improved, P < 0.05, by an<br />
increase of 15% in the HIIE (34.1 ± 1.4 to 39.3 ± 0.7 ml·kg-1·min-1) and 18% in the<br />
HIIE plus green tea (34.2 ± 2.1 to 40.4 ± 0.7 ml·kg-1·min-1) groups but was unchanged<br />
in the green tea only and control groups. Total fat mass was significantly reduced, P<br />
< 0.05, by 7% after the intervention for the exercise (29.6 ± 2.3 to 27.7 ± 2.3 kg) and<br />
green tea and exercise groups by 6% (28.5 ± 3.6 to 26.2 ± 3.5 kg) with no significant<br />
change in the control and green tea only groups. Abdominal fat was significantly<br />
reduced, P < 0.05, by 6% after the intervention for the exercise (2.33 ± 0.2 to 2.20± 0.2<br />
kg), and green tea and exercise groups by 11% (2.31 ± 0.3 to 2.07 ± 0.2 kg) with no<br />
significant change in the control and green tea only groups. A non-significant increase<br />
in fat free mass was found after the intervention for the exercise (+.56 ± 0.4 kg) and<br />
green tea and exercise groups (+.55 ± 0.5kg) but a small decrease in fat free mass<br />
occurred in the control and green tea only groups.<br />
CONCLusION: Twenty minutes of HIIE, with or without green tea consumption,<br />
three times a week for 12 weeks, led to significant increases in maximal oxygen uptake<br />
and a significant reduction in total and abdominal fat mass in overweight, young males.<br />
The consumption of green tea extract without exercise did not result in any body<br />
composition change.<br />
1594 Board #186 May 30, 3:30 PM - 5:00 PM<br />
The Effects of a six-month Pedometer-based Physical<br />
activity Intervention on Body Composition Characteristics<br />
in a u.s. university Worksite setting: The asuKI step<br />
study<br />
Jenelle Walker 1 , Ali Soroush 2 , Michael Belyea 1 , Barbara<br />
Ainsworth, FACSM 1 , Pamela Swan, FACSM 1 , Agneta Yngve 3 ,<br />
Agneta Yngve 3 . 1 Arizona State University, Phoenix, AZ.<br />
2 Karolinska Institutet,; Kermanshah University of Medical<br />
Sciences (KUMS), Stockholm, Sweden. 3 Karolinska Institutet;<br />
Oslo and Akershus University College of Applied Sciences,<br />
Stockholm, Sweden.<br />
(No relationships reported)<br />
Background: Physical activity is important for weight maintenance and improvements<br />
in health.<br />
PurPOsE: This study determined the effects of a six month pedometer-based<br />
walking intervention on body composition characteristics in 712 employees at Arizona<br />
State University. Participants were encouraged to reach a goal of 10,000 steps per day.<br />
METhOds: Randomly selected employees (n = 142; age = 41±11.5) from the<br />
walking cohort participated in supplemental body composition testing sessions.<br />
Anthropometric measurements [height, weight, waist circumference (WC), percent<br />
body fat (BF), and sagittal abdominal diameter (SAD)] were taken at months one,<br />
three, and six. A multi-level growth modeling approach was used to explore change<br />
over time and predict change by steps, age, gender, and body fat categories for body<br />
composition measures (BMI, BF, WC and SAD). Each body composition measure was<br />
analyzed as an unconditional model (1), in conditional models [age (2), gender (3)] and<br />
in a final conditional model (4) (with steps taken, age groups, gender, and initial body<br />
fat as predictors of body composition changes).<br />
rEsuLTs: In the unconditional model (1), individual differences were observed in<br />
all body composition variables at the start of the study(reflected by the intercepts) (p<br />
.05).<br />
CONCLusION: The six-month walking program resulted in changes in abdominal<br />
MEDICINE & SCIENCE IN SPORTS & EXERCISE ®<br />
adiposity measures in the unconditional model. Despite differences in initial<br />
descriptive and body composition measures, no differences in body composition<br />
measures were observed during the six-month study after accounting for the predictor<br />
variables.<br />
1595 Board #187 May 30, 3:30 PM - 5:00 PM<br />
heated Pool Exercise Training reduces Office Blood<br />
Pressure In Patients With resistant hypertension: a Casecontrol<br />
study<br />
Guilherme V. Guimaraes1 , Lais Galvani de Barros Cruz2 ,<br />
Emmanuel Gomes Ciolac1 , Egidio Lima Dorea1 , Miguel Morita<br />
Fernades-Silva1 , Edimar Alcides Bocchi1 . 1Heart Institute -<br />
HCFMUSP, São Paulo, Brazil. 2Laboratory of Physical Activity<br />
and Health, São Paulo, Brazil.<br />
(No relationships reported)<br />
BaCKGrOuNd: Regular exercise lowers office BP in patients with mild-tomoderate<br />
hypertension, but there is very little available information on its effects<br />
in patients with resistant hypertension. There is no data concerning the effects of<br />
exercise training in heated pool in hypertensive patients. Our purpose was to evaluate<br />
the effects of short-term exercise training in heated pool on office BP in resistant<br />
hypertension patients.<br />
METhOds: We studied 16 patients (8 female), age 55 ± 6 years, BMI 29 ± 4 kg/<br />
m2, peak VO2 25 ± 4 ml/kg/min, systolic and diastolic office blood pressure 163 ± 21<br />
and 90 ± 8 mmHg, respectively, with the diagnosis of resistant hypertension in use of<br />
three or more antihypertensive agents of different classes. All patients were monitored<br />
for 24-hour ambulatory blood pressure monitoring (ABPM) before and after having<br />
participated of a two-week exercise program in a controlled (32oC) temperature pool.<br />
rEsuLTs: The systolic and diastolic office BPs at the second week of training was<br />
145 ± 8, and 87 ± 8 mmHg, respectively, with a significant decrease from its baseline<br />
value (p
Official Journal of the American College of Sports Medicine<br />
CONCLusION: The 12-week SCT intervention is effective in improving moderate<br />
PA, as well as perceptions of self-efficacy, outcome expectation, and perceived barriers<br />
toward PA in AID.<br />
1597 Board #189 May 30, 3:30 PM - 5:00 PM<br />
Injury Prevention In Veteran soccer Players: a Clusterrandomized<br />
Trial<br />
Daniel Hammes, Karen aus der Fünten, Stephanie Kaiser, Eugen<br />
Frisen, Tim Meyer, FACSM. Saarland University, Saarbrücken,<br />
Germany.<br />
(No relationships reported)<br />
About 27% of all German soccer players are registered in veteran soccer clubs. They<br />
compete within a league system and friendly matches. A pilot study indicated a high<br />
injury risk in that population, but effectiveness of preventive programs has not been<br />
evaluated yet.<br />
PurPOsE: To determine the preventive effects of the FIFA injury prevention program<br />
“11+” in veteran soccer players.<br />
METhOds: 20 veteran soccer teams (n = 265) of Saarland county were recruited for<br />
a 9 months (one season) cluster-randomized trial. The intervention group (INT, n =<br />
146; 45 ± 8 years; BMI kg/m 2 : 27 ± 3) performed the 11+ program once a week at the<br />
beginning of each training session supervised by trained sport scientists. The control<br />
group (CON, N = 119; 43 ± 6 years; BMI kg/m 2 : 26 ± 3) followed its regular training<br />
routine usually without a structured warm-up. During the study, player exposure<br />
hours (training and match) and injuries were recorded according to the FIFA/UEFA<br />
consensus statement.<br />
rEsuLTs: The 11+ were completed in 96.9% of all team training sessions and 14.4<br />
± 8.2 times by each player. 89 soccer injuries occurred. No significant difference was<br />
found between the INT and the CON group in overall injury incidence (injuries per<br />
1000 h) (12.2; 95% confidence interval CI: [8.9 15.6] vs. 12.9 [8.8 17.1]; incidence<br />
rate ratio IRR: 0.94 [0.62 – 1.44]; p = 0.79). Similarly, there was no significant effect<br />
on training (5.5 [2.8 – 8.1] vs. 8.1 [4.0 – 12.1.]; IRR: 0.68 [0.33 – 1.37]; p = 0.28) or<br />
match injury incidence (28.3 [18.9 – 37.7] vs. 21.4 [12.7 – 30.2]; IRR: 1.32 [0.78 –<br />
2.23]; p = 0.30). The same applied to contact (3.9 [2.0 – 5.7] vs. 5.1 [2.5 – 7.7]; IRR:<br />
0.75 [0.37 – 1.52]; p = 0.43) and non-contact injuries (8.4 [5.6 – 11.2] vs. 7.8 [4.6 –<br />
11.0]; IRR: 1.07 [0.63 – 1.81]; p = 0.80).<br />
CONCLusION: The 11+ program, performed at the beginning of each training<br />
session, did not exert a significant preventive effect on injury incidence in veteran<br />
soccer players. Given that neuromuscular improvements from prevention programs<br />
are considered helpful for preventing injuries, limited amount of training sessions per<br />
week may have limited such effects and therefore injury prevention.<br />
Supported by grants from F-MARC (FIFA) and the German Soccer Federation (DFB).<br />
1598 Board #190 May 30, 3:30 PM - 5:00 PM<br />
Pedometer Feedback Interventions Increase Total<br />
Physical activity on days Patients do not attend Cardiac<br />
rehabilitation<br />
Cemal Ozemek1 , Wonwoo Byun1 , Katrina Riggin2 , Scott J.<br />
Strath3 , Leonard A. Kaminsky, FACSM1 . 1Ball State University,<br />
Muncie, IN. 2IU Health Ball Memorial Hospital, Muncie, IN.<br />
3University of Wisconsin-Milwaukee, Milwaukee, WI.<br />
(No relationships reported)<br />
Maintenance cardiac rehabilitation (CR) programs have been shown to be effective in<br />
increasing physical activity (PA) on days patients attend CR, while having little effect<br />
on days patients do not attend CR. Pedometer feedback has previously been shown to<br />
increase total PA and may be a viable tool in increasing steps on days patients do not<br />
attend CR.<br />
PurPOsE: To examine the effect of PF and/or motivational messaging interventions<br />
on total PA (steps/day) on days cardiac patients do not attend CR.<br />
METhOds: A total of 79 (61 men and 18 women, 61±10 years) patients entering<br />
a maintenance CR program participated in a 12-week PA intervention. Patients were<br />
randomized to one of four groups; usual care (UC), PF, motivational messaging (MM),<br />
or PF with individualized MM. PF and PF+MM groups were given step goals each<br />
week which increased by 10% of the patient’s baseline value when the step goals<br />
were achieved. MM and PF+MM groups received weekly motivational newsletters<br />
containing strategies to increase PA. Lifecorder PLUS monitors (Kenz, Nagoya, Japan)<br />
were used to assess patients’ baseline PA before beginning CR as well as throughout<br />
the intervention. Only average steps taken during the last week of intervention on days<br />
patients did not attend CR were compared with baseline. Time × group interaction was<br />
tested using two-way mixed ANOVA. Dependent t tests and one-way ANOVA were<br />
used to test within- and between-group differences in average steps/day on days not<br />
attending CR.<br />
rEsuLTs: There were no group differences in daily step counts at baseline (p=0.88).<br />
A significant time × group interaction was found (p=0.02). PF and PF+MM groups<br />
significantly increased steps/day from baseline to the last week of intervention (PF:<br />
5407 ± 2773 to 7110 ± 3525, p=0.02 and PF+MM: 5409 ± 1955 to 7547± 3584,<br />
p=0.01). PF and PF+MM groups had greater increases in step counts on days not<br />
Vol. 45 No. 5 Supplement S315<br />
attending CR compared with UC and MM groups (PF: 1702±3487 and PF+MM:<br />
2137±3321 steps/day, p24 weeks were included.<br />
Standardized effect sizes (g) were calculated and pooled using random-effects models,<br />
Z-score alpha values and 95% confidence intervals (CI). Heterogeneity was examined<br />
using Q and I-squared. Statistical significance was set at a two-tailed alpha value (p) of<br />
0.05 to < 0.10.<br />
rEsuLTs: A moderate and statistically significant improvement was found at the<br />
FN (3 g’s, 187 participants, g=0.583, 95% CI=0.031, 1.135, p=0.04, Q=5.6, p=0.06,<br />
I-squared=64%) while a small trend was observed at the LS (5 g’s, 275 participants,<br />
g=0.190, 95% CI = -0.036, 0.416, p=0.10, Q=3.0, p=0.55, I-squared=0%). Results<br />
were sensitive to influence analysis as well as collapsing multiple groups from the<br />
same studies so that only one g represented each study.<br />
CONCLusIONs: There is currently insufficient evidence to recommend ground and/<br />
or joint reaction force exercise for improving and/or maintaining FN and LS BMD in<br />
men. Additional well-designed randomized controlled trials are needed before any final<br />
recommendations can be formulated.<br />
1600 Board #192 May 30, 3:30 PM - 5:00 PM<br />
Multifaceted Pedometer Program results In Favorable<br />
Changes In sitting Time, Physical activity, and Weight<br />
Saurabh S. Thosar, Sylvanna Bielko, Jeanne D. Johnston.<br />
Indiana University Bloomington, Bloomington, IN. (Sponsor: Dr.<br />
Janet P. Wallace, FACSM)<br />
(No relationships reported)<br />
Physical inactivity is a prime risk factor for metabolic and cardiovascular disease and a<br />
public health crisis. Decreasing sitting time (ST) and increasing physical activity (PA)<br />
are unique behaviors which historically have been addressed separately. Pedometer<br />
interventions which are able to target both behaviors simultaneously may be effective<br />
to improve health related outcomes.<br />
PurPOsE: To study the impact of a campus wide self-guided pedometer program on<br />
ST, PA, weight (WT) and body mass index (BMI).<br />
METhOds: 4 men and 22 women (53.0 ± 12.4 years) completed a pedometer<br />
program at a Midwestern University. Participants received a pedometer (Omron HJ-<br />
720 ITC) and were instructed to wear the pedometer throughout the 12 week program.<br />
Subjects were provided with software and education on using the pedometer output<br />
(hourly step count) as a cue to reduce their ST, and to increase PA. Subjects were asked<br />
to be active during the hours for which they had zero steps. They were encouraged<br />
to download their data every week to observe and make behavior changes for the<br />
subsequent week. They received 2 emails·week-1 with tips on PA, nutrition, goal<br />
setting, and stress reduction. The program also included weekly health related trivia<br />
questions and competitions among groups. Pre- and post-intervention PA (steps·day-1)<br />
and ST (no. of hours with step count equal to zero) were recorded via Omron HJ-720<br />
ITC pedometer and the Omron Health Management Software. WT and height were<br />
recorded using standard procedures and BMI was calculated. Descriptive statistics and<br />
repeated measures ANOVA were performed to analyze the changes in ST, PA, WT and<br />
BMI. Significance was set at p < 0.05.<br />
rEsuLTs: A significant decrease in ST (4.0±2.2 to 3.3±2.2 hr. day-1; p=0.041) was<br />
observed as a result of the intervention. PA significantly increased (6454±2602 to<br />
7485±2870 steps.day-1; p=0.008) whereas a significant reduction was observed in WT<br />
(76.9±14.9 to 75.8±15.3 kg; p=0.005) and BMI (28.77±6.04 to 28.36±6.19 kg/m2;<br />
p=0.004).<br />
CONCLusION: A 12 week pedometer program targeted at reducing ST and<br />
increasing PA resulted in positive changes in weight and BMI. Pedometers can be used<br />
in an innovative fashion to decrease sedentary time and promote favorable metabolic<br />
profiles.<br />
<strong>Abstracts</strong> were prepared by the authors and printed as submitted.<br />
<strong>Thursday</strong>, May 30, 2013
<strong>Thursday</strong>, May 30, 2013<br />
S316 Vol. 45 No. 5 Supplement<br />
1601 Board #193 May 30, 3:30 PM - 5:00 PM<br />
Parkinson’s disease Patients Tolerate Multifaceted Exercise<br />
Intervention While Improving health-related Physical<br />
Fitness<br />
Corey A. Peacock1 , Kayla A. Wilson2 , Gabriel J. Sanders3 , Duane<br />
B. Corbett2 , Emily J. Fickes-Ryan4 , Ellen L. Glickman, FACSM2 ,<br />
Angela L. Ridgel2 . 1Nova Southeastern University, Fort<br />
Lauderdale, FL. 2Kent State University, Kent, OH. 3Northern Kentucky University, Highland Heights, KY. 4West Virginia<br />
Univesity, Morgantown, WV.<br />
(No relationships reported)<br />
Parkinson’s disease (PD) is a progressive neurological disorder ensuing impaired<br />
physical fitness and neuromuscular function. Multiple studies have demonstrated<br />
physical improvements associated with either aerobic exercise or anaerobic exercise.<br />
However, little research exists demonstrating the effects of an exercise program<br />
combining both.<br />
PurPOsE: To determine if PD patients can tolerate sessions of combined anaerobic<br />
and aerobic training over the course of an eight week intervention.<br />
METhOds: 13 PD patients completed the preliminary 24-session, cohesive<br />
anaerobic and aerobic exercise protocol fixed over an eight week period. Our protocol<br />
consisted of 30 min bouts of aerobic cycle ergometry at an active-assisted pace of<br />
85 RPM. In addition, participants completed 40 min of anaerobic resistance training<br />
(55-67% of their 1-RM for sets ranging between 12-15 repetitions), balance training,<br />
and flexibility training. As accepted by the ACSM, we collected pre- and post- healthrelated<br />
physical fitness data including cardiovascular health (modified YMCA 3-min<br />
step test), muscular strength (1-RM chest press), muscular endurance (curl-up test),<br />
and flexibility (sit-n-reach).<br />
rEsuLTs: Repeated-measures analysis of variance demonstrated a significant (p ≤<br />
0.002) improvement in cardiovascular health (102 beats·min-1 pre, 94 beats·min-1<br />
post), muscular strength (61.5±30.9 lbs. pre, 83.2±38.5 lbs. post), muscular endurance<br />
(22 reps. pre, 34 reps. post), and flexibility (9.0±2.3 in. pre, 10.5±3.1 in. post).<br />
CONCLusION: Our preliminary multi-facet intervention program demonstrated<br />
both tolerance and health-related physical fitness improvements in PD patients. Further<br />
research needs to be explored observing neurological changes from this tolerated<br />
intervention.<br />
1602 Board #194 May 30, 3:30 PM - 5:00 PM<br />
resistive Breathing Effects On Pulmonary Function, aerobic<br />
Capacity and Medication usage In adult asthmatics<br />
Ina Shaw 1 , Brandon S. Shaw 2 , Gregory A. Brown, FACSM 3 .<br />
1 Monash South Africa and Tshwane University of Technology,<br />
Johannesburg, South Africa. 2 Tshwane University of Technology,<br />
Pretoria, South Africa. 3 University of Nebraska at Kearney,<br />
Kearney, NE.<br />
(No relationships reported)<br />
The number of individuals with asthma continues to grow. In the United States of<br />
America, 1 in 12 individuals (about 25 million, or 8% of the U.S. population) had<br />
asthma in 2009, compared with 1 in 14 (about 20 million, or 7%) in 2001. Resistive<br />
breathing is a non-pharmacological treatment for asthma that is attractive both<br />
financially and as a more holistic approach to managing a chronic condition.<br />
PurPOsE: The purpose was to determine the effects of resistive breathing on<br />
pulmonary function, aerobic capacity and medication usage in adults with asthma.<br />
METhOds: Sedentary asthmatics were assigned to either a non-exercising control<br />
group (n = 22) or eight-week resistive breathing group (n = 22). Following five<br />
minutes of easy walking and eight minutes of stretching, resistive breathing group<br />
participants inspired and expired maximally in the semi-recumbent position through<br />
a tube 10cm in length and 1cm in diameter. Participants performed these breathing<br />
exercises for three sets of five to 10 repetitions at a 1:2 second inspiration to expiration<br />
ratio, three sets of 10 to 15 repetitions at a 2:4 ratio and three sets of 15 to 20<br />
repetitions at a 3:6 ratio.<br />
rEsuLTs: Eight weeks of resistive breathing significantly (p≤0.05) increased forced<br />
vital capacity (FVC) (3.01±0.58 L vs. 3.52±0.74; p=0.000), forced expiratory volume<br />
in one second (FEV1) (2.85±0.57 L vs. 3.22±0.63 L; p=0.000), peak expiratory<br />
flow (PEF) (7.1±1.57 L.sec-1 vs. 7.68±1.26 L.sec-1; p=0.008) and FEV1/FVC%<br />
(94.86±4.94% vs. 90.64±6.67%; p=0.003), while significantly decreasing medication<br />
usage, but not FEF-25 (2.51±0.87 L.sec-1 vs. 2.19±0.63 L.sec-1; p=0.067), FEF-50<br />
(4.51±1.23 L.sec-1 vs. 4.32±1.16 L.sec-1; p=0.431), FEF-75 (6.39±1.56 L.sec-1 vs.<br />
6.72±1.50 L.sec-1; p=0.175), FEF 25-75 (4.07±1.13 L.sec-1 vs. 3.87±1.04 L.sec-1;<br />
p=0.308), MVV (107.43±34.65 L.min-1 vs. 109.62±38.91 L.min-1; p=0.701) and<br />
aerobic capacity (38.45±8.45 mL.kg-1.min-1 vs. 38.76±7.57 mL.kg-1.min-1; p=0.702).<br />
CONCLusION: These findings suggest that resistive breathing training has some<br />
success at improving pulmonary function and reducing medication usage in adults with<br />
asthma, but does not increase aerobic capacity.<br />
MEDICINE & SCIENCE IN SPORTS & EXERCISE ®<br />
1603 Board #195 May 30, 3:30 PM - 5:00 PM<br />
Influence Of aerobic Exercise On Non-exercise Physical<br />
activity: Midwest Exercise Trial-2 (MET-2)<br />
Erik A. Willis1 , Stephen D. Herrmann1 , Jeffrey J. Honas1 ,<br />
Jaehoon Lee2 , Richard A. Washburn, FACSM1 , Joseph E.<br />
Donnelly, FACSM1 . 1University of Kansas Medical Center,<br />
Kansas City, KS. 2University of Kansas, Lawrence, KS.<br />
(No relationships reported)<br />
INTrOduCTION: Compensatory changes in non-exercise physical activity (NEPA)<br />
in response to an aerobic exercise training program may impact weight loss.<br />
PurPOsE: To examine changes in NEPA in response to 2 levels of aerobic exercise<br />
training.<br />
METhOds: Ninety-two overweight/obese (BMI 25-39.9) sedentary young adults<br />
(18-30 yrs.) completed (i.e. ≥ 90% scheduled exercise sessions) a 10-mo. trial of<br />
aerobic exercise (5 days/wk.,70-80% max heart rate, supervised ≥4 days/wk.) at<br />
either 2,000 (n = 37; 19 females) or 3,000 (n = 37; 18 females) kcal/wk. or served as<br />
non-exercise controls (n = 18, 9 females. NEPA was assessed over 7 consecutive days<br />
by accelerometer (ActiGraph Model GT1M) at baseline, 3.5, 7 and 10 mos. Mixed<br />
modeling was used to examine differences between groups (group effect), within<br />
groups (time effect) and group-by-time interaction for NEPA assessed as average<br />
counts/min, and time spent sedentary ( 5999 counts/min) intensity PA.<br />
rEsuLTs: Within the exercise groups (2,000 and 3,000) N=74, there were no<br />
significant effects (all p > 0.05) of group, time, or group- by-time interactions for<br />
NEPA assessed as counts/minute, sedentary time, or time spent in light, moderate or<br />
vigorous intensity PA. However, activity counts/min were significantly higher (p <<br />
0.001) in the 3,000 kcal/wk. group (346±141min.) vs. controls (290±106min.) at 7<br />
mos. and significantly higher (p < 0.001) in both the 3,000 kcal/wk. (345±163min.) and<br />
2,000 kcal/wk. groups (317±146min.) vs. controls (277±116min.) at 10 mos. Although<br />
non-significant, sedentary time increased slightly (+2.3%) in controls and decreased in<br />
both the 2,000 kcal/wk. (-6.2%) and 3,000 kcal/wk. groups (-4.3%).<br />
CONCLusION: A 10-mo. aerobic exercise training program at either 2,000 or 3,000<br />
kcal/wk. was not associated with compensatory changes in NEPA. However, the<br />
observation of significantly higher levels of NEPA (counts/min) and lower sedentary<br />
time in exercisers vs. controls suggest that, contrary to conventional wisdom,<br />
overweight and obese individuals do not become less physically active or spend more<br />
time in sedentary pursuits in response to exercise.<br />
supported by NIh r01 dK49181<br />
1604 Board #196 May 30, 3:30 PM - 5:00 PM<br />
Effect Of Training In Chi-running On running<br />
Biomechanics<br />
Deepak Kumar, Kelly McDermott, Haojun Feng, Veronica<br />
Goldman, Anthony Luke, FACSM, Richard Souza, Frederick M.<br />
Hecht. University of CA San Francisco, San Francisco, CA.<br />
(No relationships reported)<br />
Running injuries are reported by up to 80% of runners. ChiRunning is an approach<br />
to running form that is thought to reduce the rate of injuries through encouraging a<br />
mid-foot strike, forward lean, shorter strides and other variations. No studies report<br />
the effect of ChiRunning training on running biomechanics in individuals without a<br />
current running practice .<br />
PurPOsE: To evaluate kinematic and kinetic patterns before and after training in<br />
ChiRunning .<br />
METhOds: Data were drawn from a randomized pilot study evaluating a running<br />
program for participants with pre-hypertension. The 12-week study had 3 arms: 1)<br />
intervention, group-based training in ChiWalk/Run lead by a certified ChiRunning<br />
coach (n=9); 2) active control, a group-based training in walk/run approach covering<br />
general topics about running (excluding running form) (n=5); 3) usual care, a group<br />
provided with educational materials about adopting a walk/run program (n=6). 3-D<br />
kinematic [over-ground (OG), treadmill] and kinetic (OG) data were collected from all<br />
subjects pre- and post-intervention. At the moment, OG stance phase data have been<br />
analyzed from 7 individuals (Age: 53±8 yr; Weight: 79.3±16.8 kg, M:F= 4:3) in the<br />
chi-running group, compared using paired t-tests.<br />
rEsuLTs: Post-intervention, the subjects had slightly slower running velocity (Pre:<br />
3.1±0.6 m/s, Post: 2.9±0.4 m/s, p = 0.04), greater forward lean (p = 0.04) and less<br />
over-striding (p = 0.02). Other differences included a lower external knee adduction<br />
moment (p = 0.03), greater ankle eversion (p = 0.02) and greater external ankle<br />
eversion moment (p = 0.01). There were trends for a more anterior strike index (9% to<br />
14 % foot length, p = 0.08), lower power generation at the ankle during preswing (p =<br />
0.08), lower power absorption at the knee (p = 0.07), greater knee flexion (p = 0.09),<br />
greater power absorption at the hip (p = 0.08) and shorter sagittal hip excursion (p =<br />
0.06). There were reductions in vertical instantaneous loading rate, vertical average<br />
loading rate and vertical impact loading but the differences did not reach significance.<br />
CONCLusIONs: ChiRunning intervention leads to changes in running<br />
biomechanics, which may lead to lower stress on distal lower extremity joints and<br />
tissues (ankle, tibia, knee) but the impact on proximal joints (hip, lower back) needs<br />
further investigation.<br />
ACSM May 28 - June 1, 2013 Indianapolis, Indiana
Official Journal of the American College of Sports Medicine<br />
1605 Board #197 May 30, 3:30 PM - 5:00 PM<br />
descriptive Evaluation Of a Low-Frequency running<br />
Program<br />
Angela Lanier1 , Erica Jackson, FACSM2 . 1Berry College, Mount<br />
Berry, GA. 2Delaware State University, Dover, DE.<br />
(No relationships reported)<br />
The Furman Institute of Running and Scientific Marathon Training program may be<br />
ideal for preparing individuals with limited time for a half marathon because it is based<br />
on a three-day-per-week training schedule.<br />
PurPOsE: The purpose of the study was to examine the effects of a low-frequency<br />
running program on health-related fitness and psychological factors related to exercise<br />
participation of college staff and students.<br />
METhOds: Participants were nine men and 37 women aged 18-55 years. The fortysix<br />
novice participants completed the half marathon training program. Body mass,<br />
peak oxygen uptake, flexibility, body fat composition, decisional balance, outcome<br />
expectations, physical activity enjoyment, and exercise confidence were assessed<br />
before and after the 20 weeks of training. Ten of the participants were assessed seven<br />
months following the race.<br />
rEsuLTs: Participants experienced increases in peak oxygen uptake from 42.1±7.1<br />
to 44.3±6.8 ml/kg/min (p=0.001). Although there was a slight decrease in body mass<br />
(p=0.032), body fat composition decreased from 29.6±8.6 to 27.1±11.2% (p=0.027).<br />
Flexibility did not change over the five months of training (p = 0.25). Psychological<br />
factors associated with future exercise participation increased over the 20 weeks of<br />
training (p ≤ 0.01). Moreover, there were no changes in measures of fitness (p ≥ 0.29)<br />
and psychological factors (p ≥ 0.08) in thirteen of the participants who were assessed<br />
seven months after the race.<br />
CONCLusIONs: Participation in a low-frequency training program such as the<br />
Furman Institute of Running and Scientific Marathon Training appears to be effective<br />
for individuals who have limited time for running but want to complete a half<br />
marathon. Additionally, completion of the low-frequency program over five months<br />
resulted in health-related fitness benefits and improvement in factors related to future<br />
exercise adherence.<br />
1606 Board #198 May 30, 3:30 PM - 5:00 PM<br />
Effect of diet and Exercise-Induced Weight Loss on Physical<br />
Function<br />
Brian B. Parr1 , Roop C. Jayaraman2 , Katie C. Elder3 , Richard<br />
B. Parr, FACSM2 . 1University of South Carolina Aiken, Aiken,<br />
SC. 2Central Michigan University, Mt. Pleasant, MI. 3Albion College, Albion, MI.<br />
(No relationships reported)<br />
Previous research suggests that obesity is associated with physical function limitations<br />
which may interfere with activities of daily living.<br />
PurPOsE: To determine the effect of weight loss on physical function in overweight<br />
and obese adults.<br />
METhOds: Forty-eight subjects (14 male, 34 female), ages (mean±SD) 52±11 y<br />
and BMI 35.7±8.0 kg•m-2, participated in one of two 8 week weight loss programs.<br />
Subjects followed a low-calorie diet (~1200 kcals•day-1) and participated in daily<br />
exercise, progressing to 60 min•day-1 of walking. Physical function was assessed<br />
using the timed get-up and go test (TGUG), in which the time required to rise from<br />
a chair, walk 3 m, and return to the chair was measured. A subset of 18 subjects also<br />
completed the physical functioning domain of the Short-Form 36 Health Status Survey<br />
(SF-36).<br />
rEsuLTs: The diet and exercise programs resulted in significant weight loss<br />
(98.3±24.7 kg to 92.2±22.3 kg, p
<strong>Thursday</strong>, May 30, 2013<br />
S318 Vol. 45 No. 5 Supplement<br />
bioelectrical impedance analysis (BIVA method; BIA Analyzer STA, AKERN, Florence,<br />
Italy), lipid profile, muscle strength by handgrip strength test (JAMAR hand dynamometer,<br />
Fred Sammons, Brookfield, IL) and the Mental (MSC) and Physical (PSC) Summary<br />
Component using SF-36. Assessments were conducted at enrollment and after a supervised<br />
progressive exercise training performed three-weekly for 12 weeks.<br />
rEsuLTs: A significant reduction in fat mass weight (14.1 ± 10.8 vs. 19.9 ± 9.6, p
Official Journal of the American College of Sports Medicine<br />
1614 Board #206 May 30, 3:30 PM - 5:00 PM<br />
The Effectiveness Of Wii Fit Plus strength Training In<br />
Community dwelling Older adults<br />
Chandrasekhar Bulusu. University of Texas at El Paso, El<br />
Paso, TX.<br />
(No relationships reported)<br />
PurPOsE: To identify whether Wii Fit Plus strength training would improve physical<br />
fitness in community dwelling older adults comparing a Wii strength-training group<br />
(Wii SG) to a control group (CG) over a twelve-week period.<br />
METhOds: 18 older adults (mean ± SD age: 71.06±10.04; BMI: 29.91±5.19)<br />
interested in exercising with Wii Fit Plus strength training were recruited from the<br />
community and randomly assigned to the Wii strength-training group (Wii SG) and<br />
control (CG). The subjects in the Wii SG performed three sets of ten repetitions for<br />
each exercise weekly twice for twelve weeks. The subjects in Wii SG started with five<br />
exercises in first week and progressed to nine exercises by the end of twelve weeks.<br />
The duration of each exercise session was 90 minutes. The subjects in CG did not<br />
participate in any kind of exercise activities. Pre, Mid and Post testing sessions were<br />
conducted to assess subjects physical fitness. The tests included dynamic handgrip<br />
strength, 30-second chair stand; 30-second arm curl, timed up and go (TUG) and<br />
gallon jug transfer tests. Data was analyzed between the Wii SG and CG using general<br />
linear mixed model and alpha level was set at p
<strong>Thursday</strong>, May 30, 2013<br />
S320 Vol. 45 No. 5 Supplement<br />
METhOds: A total of 43 females participated (control vs. pain groups: 23 vs. 20<br />
individuals, age 36.83±8.04 vs. 46.65±12.66 yrs, BMI 22.77±2.99 vs. 24.07±3.32,<br />
& WHR .76±.05 vs. .80±.069). As subjective measures of the pain rating, Visual<br />
Analogue Scale(VAS score 0~10; Huskisson, 1979) and Oswestry back pain disability<br />
index (ODI score 0~45; Fairbank et al., 1980) were employed. As an objective<br />
measure, a mean of Time Up and Go test(TUG; Podsiadlo et al., 1991) was employed,<br />
which is a 3m round-trip walk from the sit position (second) performing three times. A<br />
pedometer(HJ720IT, Omron; Zhu & Lee, 2010) was worn for 7 consecutive days. After<br />
running descriptive analysis, ANCOVA was applied to examine the group difference<br />
adjusted for age. To scrutinize the construct and convergent validity of the pain scales,<br />
the spearman correlations were calculated. ROC curves were calculated to determine<br />
the cut-off of pain scores for setting the walking steps with SPSS 20 and α=.05.<br />
rEsuLTs: The means of major variables by groups(control vs. pain) were as follows:<br />
Total steps: 8164±3473 vs. 7632±3586; VAS 1.00±1.04 vs. 3.25±1.89; ODI 2.96±2.27<br />
vs. 10.05±6.07; TUG7.43±0.49 vs. 8.22±0.78, respectively. After adjusted for age,<br />
VAS, ODI, and TUG showed the statistical difference by groups with p
Official Journal of the American College of Sports Medicine<br />
1622 Board #214 May 30, 3:30 PM - 5:00 PM<br />
Translating health Promotion research Into Community<br />
Practice: The Manup Project<br />
Cristina M. Caperchione 1 , Mitch J. Duncan 2 , Gregory S.<br />
Kolt 3 , Corneel Vandelanotte 2 , Anthony Maeder 3 , Richard R.<br />
Rosenkranz 4 , Manny Noakes 5 , Karunanithi Mohanraj 6 , W.<br />
Kerry Mummery 7 . 1 Univerisity of British Columbia, Kelowna,<br />
BC, Canada. 2 Central Queensland University, Rockhampton,<br />
Australia. 3 Univerisity of Western Sydney, Sydney, Australia.<br />
4 Kansas State University, Manhattan, KS. 5 CSIRO Food<br />
and Nutritional Sciences, Adelaide, Australia. 6 CSIRO The<br />
Australian eHealth Research, Brisbane, Australia. 7 Univerisity<br />
of Alberta, Edmonton, AB, Canada. (Sponsor: Karen Croteau,<br />
FACSM)<br />
(No relationships reported)<br />
Understanding the process of translating evidence-based interventions into longterm<br />
community practice and the impact that this process has on the population is<br />
paramount to the future development of health promoting initiatives.<br />
PurPOsE: The aim of this study was to examine this impact by using the RE-<br />
AIM evaluation on the ManUp Project, a physical activity (PA) and healthy eating<br />
intervention for middle-aged males.<br />
METhOds: Data were collected for each RE-AIM measure using a computer<br />
assisted telephone interview survey (N=312), interviews with key individuals from<br />
local organisations (N=12), and examination of project related statistics and findings.<br />
Reach was assessed by level of individual awareness of ManUp and the number of<br />
organisations that requested ManUp information/resources (N=108). Efficacy was<br />
assessed by changes in PA and nutrition behaviours. Adoption was assessed by number<br />
of individuals who registered for the program (and their recall of the program).<br />
Implementation was assessed by number of organisations that implemented the<br />
program in their workplace. Maintenance was assessed by website usage patterns<br />
and number of organisations that made ManUp part of their general workplace health<br />
initiative<br />
rEsuLTs: In terms of Reach, the overall level of awareness was 46.5%, and all<br />
organisations requested subsequent ManUp information/resources; Efficacy, the<br />
intervention was successful in increasing the weekly mins (p
<strong>Thursday</strong>, May 30, 2013<br />
S322 Vol. 45 No. 5 Supplement<br />
1626 Board #218 May 30, 3:30 PM - 5:00 PM<br />
rural Veterans Telerehabilitation Initiative for rural<br />
Veterans with Multiple sclerosis<br />
Sean C. McCoy1 , Toni Chiara1 , Huanguang Jia1 , David Omura2 ,<br />
Charles Levy1 , Paul Hoffman1 . 1Gainesville VAMC, Gainesville,<br />
FL. 2William Jennings Bryan Dorn VAMC, Columbia, SC.<br />
(No relationships reported)<br />
BaCKGrOuNd: Multiple sclerosis (MS) is the most common cause of nontraumatic<br />
disability in young adults. Participation in structured and monitored physical<br />
activity programs found improvements in the functional capacity of persons with<br />
MS. However, access to such programs is limited for some MS patients due to their<br />
geographic locations and/or mobility restraint.<br />
PurPOsE: To evaluate the efficacy of a televideo health care delivery model to<br />
maintain functional capacity in persons with MS while providing a high degree of<br />
patient satisfaction.<br />
METhOds: This is a retrospective evaluation of the Rural Veterans Telerehabilitation<br />
Initiative (RVTRI). All participants of the RVTRI were referred by<br />
local VA primary care providers. The Veterans’ participated in the tele-rehabilitation<br />
program were assessed using the following outcome measures: Montreal Cognitive<br />
Assessment (MOCA), Functional Independence Measure (FIM), Quick DASH,<br />
and health-related quality of life (VR 12), Patient and Provider Satisfaction. These<br />
outcomes were collected both at baseline/admission and discharge. The WilCoxon<br />
signed rank test was applied to compare each outcome measure between baseline and<br />
follow-up scores.<br />
rEsuLTs: The RVTRI included 9 participants with MS (8 male/1 female) aged<br />
between 50-65 years. These participants lived an average 71 miles away from the VA<br />
Medical Center. On the average, they spent 116 days in the program with an average<br />
of 10 visits by the allied professionals (PT, OT, RT). With the RVTRI program, the<br />
travel time saved was an average of 22 hours driving time, 1,300 road miles, and<br />
$537 of reimburseable travel per patient (p
Official Journal of the American College of Sports Medicine<br />
strength was placement of the individual at the core of both development and<br />
implementation. We would endorse further attempts at face-to-face communication<br />
during public health promotion and would encourage others to think of it as a brief<br />
intervention, meriting formal evaluation.<br />
1630 Board #222 May 30, 3:30 PM - 5:00 PM<br />
differences in health Choices and Fitness scores Between<br />
Fully Online and Blended Instruction of health and Fitness<br />
Course<br />
Karen K. Dennis, Dale D. Brown, FACSM, Shannon E. O’Hara,<br />
Ali M. Lierman. Illinois State University, Normal, IL.<br />
(No relationships reported)<br />
Many colleges and universities offer or require courses on healthy activity, nutrition,<br />
and chronic-disease prevention techniques. These classes often consist of both lecture<br />
and activity components. Generally, these classes are taught in traditional face-to-face<br />
environment. However, given the trend of increased enrollment in online classes, and<br />
projected increases in non-traditional student population in post-secondary institutions<br />
that may further increase online class demand, it is worthwhile to consider alternative<br />
methods of delivery for this type of class.<br />
PurPOsE: The purpose of this study was to identify which was more effective:<br />
teaching a health and fitness course 100% online (OL) or blended (lecture online,<br />
activity face-to-face, each 50% of class) (BL), for encouraging positive health choices<br />
and improving fitness scores.<br />
METhOds: Study participants were 12 students, 75% female, 58% upperclassmen<br />
with six enrolled in a 100% OL and six enrolled in a BL personal health and fitness<br />
course during spring 2012 semester. Data sources used were a survey of activity,<br />
nutrition, and chronic disease prevention choices, and pre- and post-class fitness testing<br />
results.<br />
rEsuLTs: Survey results show that 100% of students in the BL and 67% of students<br />
in the OL class increased physical activity levels from prior to beginning the course.<br />
100% of students in both classes indicated intent to maintain regular physical activity<br />
after the course was completed. Additionally, 100% of students in both classes<br />
indicated that as a result of the class, they believed the choices they make regarding<br />
physical activity, nutrition, and other lifestyle factors is important for health and<br />
chronic disease prevention, with 33% in both the OL and BL classes “Almost Always”<br />
and 50% “Often” intentionally making choices that may reduce their risk of chronic<br />
diseases. An independent samples t-test on changes in fitness scores from pre- to postclass<br />
indicated that waist circumference was the only score statistically significant<br />
(p
<strong>Thursday</strong>, May 30, 2013<br />
S324 Vol. 45 No. 5 Supplement<br />
foundation for further study on the impact clergy may have on the health beliefs and<br />
habits of their congregations.<br />
1634 Board #226 May 30, 3:30 PM - 5:00 PM<br />
Effects of Combined Exercise Program 0n Functional Fitness<br />
For Community-dwelling Japanese Women with Knee Pain<br />
Hiroshi Kohno1 , Hidenori Asai2 . 1Toyo Univ. Human Life Design,<br />
Asaka-Shi, Saitama, Japan. 2Ehime Univ., Matsuyama-Shi,<br />
Ehime, Japan.<br />
(No relationships reported)<br />
PurPOsE:To examine the effects of a combined exercise program for a functional<br />
fitness promotion program composed of exercise program and facilitating program for<br />
elderly Japanese women with knee pain.<br />
METhOds:Participants: The subjects were asked to participate in an anti-knee<br />
pain class for community-dwelling people. The subjects were 24 females (64.5±1.2<br />
yrs, BMI25.7±2.5) in the intervention group (IG) and 20 females (65.1±2.8 yrs, BMI<br />
25.4±3.0) in the control group (CG). Intervention:The home-based exercise program<br />
was composed of stretching, resistance exercise, and a self-care relaxation program<br />
for muscle stiffness. The facilitating program was designed to enhance subjects’ selfefficacy<br />
for the exercise program using stages of change model. The classes were held<br />
once a week for 6 months. assessments: Information on knee muscle strength, thigh<br />
muscle flexibility measured by hip-to-heel distance, functional fitness for ADLs and<br />
pain score (modified-WOMAC) were measured using standardized tests before and<br />
after the intervention period. The CG received a stretching exercise advice booklet.<br />
Comparison of two groups were made by ANCOVA.<br />
rEsuLTs:Physical fitness level and pain score in the IG was not significantly<br />
different from those in the CG at pre data. The program adherence at the home,<br />
calculated from exercise records and class participation were 80.9±22.0% and<br />
75.3±13.3% at the end of the intervention period, respectively. IG showed significant<br />
improvement in knee muscle strength(IG: 230.0±90.8 to 276.4± 65.4N ,P
Official Journal of the American College of Sports Medicine<br />
12,000-19,999 steps per day and 0.05), small variations in week-to-week PA did exist. Post-survey<br />
data indicated that 85.0% of participants believed that they benefited from the social<br />
media group and 80.0% would “absolutely” participate again in this, or a similar,<br />
program.<br />
CONCLusION: Although respondents were in strong support of the social media<br />
platform to deliver the program, participation rates were low and PA behavior was not<br />
impacted. Future studies should examine how to increase participation in social mediadelivered<br />
programs, and investigate the linkages between social media facilitation and<br />
PA behavior change.<br />
1639 Board #231 May 30, 3:30 PM - 5:00 PM<br />
What Intensity of Physical activity should We Be<br />
Prescribing to Manage Weight-related health risk?<br />
Emily Knight, Melanie I. Stuckey, Robert J. Petrella, FACSM.<br />
Western University, London, ON, Canada.<br />
(No relationships reported)<br />
PurPOsE: Traditionally, physical activity (PA) interventions have focused on<br />
increasing the amount and intensity of activity and little attention has been given to<br />
reducing physical inactivity or modifying behavioural factors to engage in healthy<br />
lifestyles. The purpose of this study was to test the effectiveness of a home health<br />
monitoring study with tailored exercise prescription targeting changes in various<br />
intensities of PA (e.g. exercise, sedentary behaviour, or both). The program and<br />
baseline characteristics will be presented.<br />
METhOd: 61 older adults (55-75 years of age) participated in a 12-week health<br />
behaviour intervention involving personalized activity prescriptions tailored to baseline<br />
aerobic fitness using the Step Test and Exercise Prescription (STEP) tool. During<br />
enrolment, participants were randomized to either control or one of three intervention<br />
groups each targeting a specific intensity of PA: increasing high-intensity PA (i.e.<br />
exercise prescription); decreasing low-intensity PA (reducing sedentary behaviour<br />
prescription); or both (comprehensive PA prescription). At baseline, clinical measures<br />
for risk of cardiovascular disease were recorded, including blood pressure, fasting<br />
glucose, cholesterol, body mass index, waist circumference, and aerobic capacity.<br />
rEsuLTs: Data is presented as mean (+SD). The average age of the sample was 62.6<br />
(+4) years, and the sample was 59% female. Body mass index was 31.4 (+5) kg/m2.<br />
Waist circumference was 101.6 cm (+13) for females, and 113.6 cm (+16) for males.<br />
Aerobic fitness was 25.96 ml/kg/min (+5.4) for females, and 32.76 ml/kg/min (+ 7.4)<br />
for males. No significant differences were found between groups for baseline clinic<br />
measures.<br />
CONCLusIONs: On average, our sample had undesirable anthropometric and<br />
aerobic fitness. This novel intervention aimed to explore the effect of prescribing<br />
various intensities of PA on changes in clinical risk for cardiovascular disease. Results<br />
from this study will help to inform future programs for activity prescription by health<br />
care professionals.<br />
Vol. 45 No. 5 Supplement S325<br />
1640 Board #232 May 30, 3:30 PM - 5:00 PM<br />
Changes In Physical activity, Fitness and Perceptions due<br />
To Participation In a Corporate Wellness Program<br />
Elizabeth G. Groendal 1 , Jeremy L. Knous 1 , Samantha J.<br />
Danbert 2 , Rebecca A. Schlaff 1 , Joshua J. Ode 1 . 1 Saginaw<br />
Valley State University, University Center, MI. 2 Michigan State<br />
University, East Lansing, MI.<br />
(No relationships reported)<br />
Exercise is Medicine (EIM), a national initiative aimed at improving physical activity<br />
(PA) and health, is often promoted through the development of employee wellness<br />
programs. Evaluating changes in individuals who have consistently participated in<br />
wellness programs can demonstrate success and identify areas for improvement.<br />
PurPOsE: Therefore, the purpose was to evaluate changes in components of fitness,<br />
PA levels, perception of program components, and barriers to PA in employees who<br />
participated in a wellness program.<br />
METhOds: Participants included 44 employees enrolled in a wellness program, who<br />
had baseline and follow-up components of fitness and survey data within a single year.<br />
Physical assessments included anthropometrics with a calculation of body mass index,<br />
body composition, flexibility, muscular endurance, muscular strength, and an estimated<br />
aerobic capacity test. PA, perceptions, and barriers were all assessed via online survey.<br />
Descriptive data were reported as mean±SD. Repeated measures ANOVA was used to<br />
compare individual fitness assessment measures. Chi-square analyses and T-tests were<br />
used to assess gender differences.<br />
rEsuLTs: Mean age was 43±11 years at follow-up with 63% of participants being<br />
female. All component of fitness measures showed a trend for improvement at followup,<br />
with only push-ups (#1: 27±14; #2: 29±14) and estimated aerobic capacity (#1:<br />
35±10 ml/kg/min, #2: 39±9 ml/kg/min) reaching statistical significance (p≤0.05).<br />
Additionally, a statistical difference in systolic blood pressure (#1: 129±15mmHg;<br />
#2: 123±11mmHg) was found in males. Aside from the electronic exercise log being<br />
beneficial to the participants’ overall wellness, no change was found in PA levels,<br />
barriers to PA, or perceptions of program components.<br />
CONCLusION: While neither PA levels nor the barriers to PA changed as a result of<br />
the wellness program, there were trends of improved component of fitness measures at<br />
follow-up. While not statistically significant, this improvement highlights the impact of<br />
the employee wellness program. Further, participants did not show a decline in health<br />
and fitness measures which implies stability throughout a year. Finally, data show that<br />
wellness program improvements should aim to increase PA levels and decrease barriers.<br />
1641 Board #233 May 30, 3:30 PM - 5:00 PM<br />
The Virtual Trainer: Facilitating Physical activity and<br />
Fitness Improvement Through Internet and Mobile Phones<br />
Stanley Sai-chuen Hui, FACSM 1 , Ron Chi-wai Kwok 2 , Jacky<br />
Ka-wai Chan 1 , Emmanuel A. Hui 1 . 1 The Chinese University of<br />
Hong Kong, Shatin, Hong Kong. 2 The City University of Hong<br />
Kong, Kowloon Tong, Hong Kong.<br />
(No relationships reported)<br />
Health promotion websites have become popular means to motivate people to do more<br />
exercise. By applying various cyber-psychological theories and integrating smartphone<br />
technology, a free interactive website called “Virtual Trainer” (VT) was developed<br />
to help foster a physically active lifestyle. Given a participant’s self reported data,<br />
personal exercise prescriptions, online health and fitness evaluations, and text message<br />
reminders for adherence to the self-determined training schedule are some ways<br />
through which VT promoted exercise.<br />
PurPOsE: To evaluate the effectiveness of the VT program in increasing physical<br />
activity (PA) knowledge, practice, and health-related fitness.<br />
METhOds: Registered VT users (n=126; age=20.98 +/- 5.35 yrs.), who completed<br />
at least 8 weeks of online exercise training as well as online pre-post questionnaires on<br />
PA knowledge and practice, were extracted for analysis. Another 140 users completed<br />
the online pre-post health-related fitness assessments. The online questionnaire<br />
included 29 items on PA knowledge and PA participation measured by the International<br />
Physical Activity Questionnaire (IPAQ). For online health fitness assessment users<br />
were asked to follow online instructions and animations for self-administered fitness<br />
tests. Fitness items included a 3-min stepping test for aerobic fitness, sit-and-reach<br />
flexibility, cadence curl-up, push up, blood pressure and a stress inventory.<br />
rEsuLTs: Users demonstrated 37% increase in PA knowledge scores (from<br />
16.5 to 22.6, p
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S326 Vol. 45 No. 5 Supplement<br />
1642 Board #234 May 30, 3:30 PM - 5:00 PM<br />
Motivation to Integrate Physical activity into daily Life:<br />
2012 JaM World record<br />
Miriam Skrade, Spyridoula Vazou. Iowa State University, Ames,<br />
IA. (Sponsor: Panteleimon Ekkekakis, FACSM)<br />
(No relationships reported)<br />
The problem of physical inactivity and the epidemic of obesity among children around<br />
the world are well-documented. As several organizations have highlighted, efforts<br />
should be strengthened for the norm of physical inactivity to be reversed. Schools are<br />
often portrayed as having the potential to influence children’s physical activity (PA)<br />
levels. However, research on the motivation of stakeholders to integrate PA into daily<br />
school life is limited.<br />
PurPOsE: To examine the motivational profile and intentions of adult participants at<br />
a world-record activity break.<br />
METhOds: After the 2012 Just-A-Minute (JAM) World Record, 686 adults (90 M, 591<br />
F; 293 PE teachers, 230 classroom teachers, 87 school admin and staff, 69 non-school<br />
related, 7 missing) anonymously completed an online survey about their motivation to<br />
participate (Situational Motivation Scale; Standage et al., 2003), their intention to use<br />
the JAM routines in the future and their intention to participate in a new record-breaking<br />
attempt next year. Ninety-four percent of the responders participated for others, the<br />
majority (76.1%) of whom was children under the age of 10.<br />
rEsuLTs: All participants reported high intrinsic motivation and low extrinsic<br />
motivation and amotivation for participation in the next JAM World Record. Groups<br />
were compared with one-way ANOVA on motivational factors and intention.<br />
Participants that had a role in schools were more intrinsically motivated (Identified<br />
regulation; F=9.15, p
Official Journal of the American College of Sports Medicine<br />
Table. Variety of physical activity * and its association with meeting the aerobic<br />
guideline overall and by sex, 2010<br />
Overall Boys Girls<br />
Variety of physical activity *<br />
Mean (95% CI)<br />
6.5 (6.3, 6.7) 6.8 (6.6, 7.1) 6.2 (6.0, 6.4)<br />
AOR † (95% CI) AOR † (95% CI) AOR † (95% CI)<br />
1-2 1.0 1.0 1.0<br />
3-4 1.7 (1.1, 2.4) 1.7 (1.1, 2.6) 1.6 (0.9, 2.9)<br />
5-6 2.5 (1.7, 3.6) 2.5 (1.6, 4.0) 2.3 (1.4, 3.7)<br />
7-8 3.2 (2.2, 4.5) 2.5 (1.5, 4.2) 4.0 (2.2, 7.0)<br />
9+ 4.4 (2.8, 6.8) 4.1 (2.5, 6.9) 4.3 (2.6, 7.1)<br />
CI = confidence interval<br />
* Variety of physical activity is the sum of reported activities among students<br />
reporting ≥ 1 activity † AOR: odds ratio adjusting for covariates<br />
CONCLusION: Boys and girls who participated in a larger variety of activities<br />
were more likely to meet the aerobic activity guideline. Our findings support<br />
encouraging youth to participate in a variety of physical activities.<br />
1646 Board #238 May 30, 2:00 PM - 3:30 PM<br />
Meeting Physical activity Guidelines and health Outcomes<br />
James R. Morrow, Jr., FACSM, Allen W. Jackson, FACSM,<br />
Earlynn Lauer, Scott B. Martin. University of North Texas,<br />
Denton, TX.<br />
(No relationships reported)<br />
The 2008 US Physical Activity Guidelines (PAG) for Americans suggest improved<br />
health benefits with increasing physical activity (PA). Some amount of PA is reported<br />
to be better than no PA. The PAG suggest min/week (150) and METmin/week (500)<br />
as thresholds for substantial health outcomes. Additional health benefits are reportedly<br />
gained with additional PA (i.e., 300 min/week and 1000 METmin/week).<br />
PurPOsE: To relate health markers (blood pressure, percent fat, BMI, blood<br />
glucose, cholesterol, and cardiorespiratory fitness [CRF]) to levels of self-reported PA<br />
associated with PAG recommendations.<br />
METhOds: Participants were Cooper Clinic (Dallas TX) physical examination<br />
patients. 506 non-smoking participants (367 M; 139 F) completed self-reported PA<br />
behaviors and completed medical screening for health markers. CRF was estimated<br />
from maximal treadmill time. Self-reported PA behaviors were recoded consistent with<br />
PAG (Group 1:
<strong>Thursday</strong>, May 30, 2013<br />
S328 Vol. 45 No. 5 Supplement<br />
Physical activity was assessed by using ActiGraph GT3X+ accelerometers for seven<br />
consecutive days. Mode of travel to school was investigated by questionnaire. Parents<br />
were encouraged to help the children to fill out the questionnaire.<br />
rEsuLTs:The mean (SD) physical activity level was 731 (200) counts/min among<br />
girls and 817 (216) counts/min among boys (p
Official Journal of the American College of Sports Medicine<br />
rEsuLTs:In K-6 data, moderate to strong correlations were found between OW/OB<br />
and Behavior (0.40), Clinical Care (0.28) and SES (0.37). Significant individual items<br />
included Smoking (0.30), Diet and Exercise (0.26), Alcohol (0.45), Education (0.52),<br />
Employment (0.39), Air Quality (-0.34) and Clinical Quality (0.31). When SES was<br />
controlled the correlations became non-significant. For 7-12 grade, the only factor<br />
that was significantly correlated with OW/OB was SES (0.27). Significant individual<br />
factors included Employment (0.34), Quality of Care (0.24) and Air Quality (-0.31).<br />
When SES was controlled for correlations between OW/OB and Clinical Care (0.24)<br />
and Environment (-0.28) became significant.<br />
CONCLusIONs: County health rankings may provide useful indicators to evaluate<br />
social and environmental factors influencing health outcomes such as obesity.<br />
Monitoring of these factors may help evaluate large-scale policy and environmental<br />
interventions but SES needs to be controlled.<br />
1654 Board #246 May 30, 2:00 PM - 3:30 PM<br />
Obesity-related health risk In asian-subgroups In Canada:<br />
a Cross-sectional analysis<br />
Chris I. Ardern, Jason X. Nie. York University, Toronto, ON,<br />
Canada.<br />
(No relationships reported)<br />
PurPOsE: Obesity-related health risk has been shown to vary across ethnicity and<br />
time-in-country; however, reliance on broad categories of ethnicity in populationbased<br />
surveys have limited epidemiological insight. The purpose of this study was to<br />
therefore examine the association between the World Health Organization’s Asianspecific<br />
cut-offs of overweight (Body Mass Index (BMI) ≥23 kg.m-2) and obesity<br />
(BMI ≥27.5 kg.m-2) with self-reported cardiovascular-related conditions (high blood<br />
pressure, diabetes, heart disease, and ‘at least one’ condition) in Asian-Canadian subgroups<br />
(Chinese, South Asian, Filipino, Southeast Asian, Arab, West Asian, Japanese,<br />
and Korean) who are at elevated risk for cardiometabolic disease.<br />
METhOds: Six cycles of the Canadian Community Health Survey (2001-2009;<br />
N=18,794) were pooled, and weighted to represent the Asian-Canadian population<br />
across 9 years. Multivariable logistic regression, adjusting for demographic and<br />
lifestyle characteristics, was used to estimate the odds of cardiovascular outcomes<br />
across each of eight Asian sub-groups.<br />
rEsuLTs: Overall, compared to South Asians (OR=1.00), Filipinos had higher<br />
odds of having ‘at least 1’ chronic condition (OR=1.29, 95% CI: 1.04-1.62), whereas<br />
Chinese (0.63, 0.474-0.9) and Arab-Canadians had lower odds (0.38, 0.28-0.51).<br />
Compared to the normal weight BMI category in each respective ethnic group, the<br />
association between overweight and obesity on ‘at least 1’ chronic condition was<br />
highest amongst Chinese (overweight: 3.6, 2.34-5.63; obese: 8.9, 3.6-22.01), whereas<br />
no significant gradient was observed in Japanese, Arab, and West Asian sub-groups.<br />
Using normal weight South Asians as the referent, obese Chinese, South Asian,<br />
Filipino, West Asian, and Korean groups were approximately 3-times as likely to<br />
report ‘at least 1’ chronic condition.<br />
CONCLusIONs: The relationship between overweight, obesity, and health risk<br />
varied within Asian-Canadian subgroups, and was strongest for Chinese-Canadians.<br />
Reliance on traditional BMI thresholds and broad categories of ethnicity may mask<br />
cardiometabolic health risk in need of targeted intervention.<br />
1655 Board #247 May 30, 2:00 PM - 3:30 PM<br />
Changes in Walking for Transportation among u.s. adults<br />
2005-2010, National health Interview survey<br />
Prabasaj Paul, Susan A. Carlson, Dianna D. Carroll, Janet E.<br />
Fulton, FACSM. Centers for Disease Control and Prevention,<br />
Atlanta, GA.<br />
(No relationships reported)<br />
Walking is the most commonly reported physical activity among U.S. adults and is one<br />
of the ways to obtain adequate aerobic physical activity for substantial health benefits.<br />
PurPOsE:To estimate changes in prevalence of participation in, and mean volume<br />
of, transportation walking among U.S. adults from 2005 to 2010, by demographic<br />
characteristics and BMI category.<br />
METhOds: Data from the core and Cancer Control Supplement of the National<br />
Health Interview Survey - an interviewer-administered survey of U.S. adults - from<br />
2005 (n=26,372) and 2010 (n=23,147) were examined for transportation walking<br />
prevalence (≥1 ≥10-minute bout in the previous 7 days) and for mean walking volume.<br />
Data were examined by sex, age group, race/ethnicity, education, BMI category and<br />
adherence to the aerobic component of the 2008 Physical Activity Guidelines for<br />
adults.<br />
rEsuLTs: In almost every group examined, transportation walking prevalence did<br />
not change significantly whereas transportation walking volume decreased significantly<br />
from 2005 to 2010. Overall, the change in prevalence of transportation walking [2005:<br />
29.2%; 95% CI (28.2%, 30.1%); 2010: 30.2% (29.3%, 31.1%)] was not significant,<br />
but the population mean volume (minutes/week) of transportation walking decreased<br />
significantly [2005: 44.1 (41.3, 46.9); 2010: 32.1 (29.6, 34.6)]. Some groups, however,<br />
increased prevalence and decreased volume of transportation walking, including men<br />
[prevalence 2005: 30.8% (29.7%, 31.9%); 2010: 32.6% (31.4%, 33.8%) and volume<br />
2005: 52.7 (48.3, 57.2); 2010: 36.4 (33.0, 39.9)], and Hispanic Americans [prevalence<br />
Vol. 45 No. 5 Supplement S329<br />
2005: 30.4% (28.5%, 32.3%); 2010: 33.3% (31.4%, 35.1%) and volume 2005:<br />
57.0 (49.9, 64.0); 2010: 45.1 (38.2, 52.0)]. Findings are similar for mean volume of<br />
transportation walking among those who walk for transportation.<br />
CONCLusIONs: From 2005 to 2010, prevalence of participation in transportation<br />
walking remained the same; however, mean time spent walking for transportation<br />
decreased. These findings demonstrate that prevalence and mean volume are<br />
distinct measures that should both be included for a more comprehensive view of<br />
transportation walking behavior. The distinction between the measures should be<br />
considered when designing surveillance systems, setting health behavior targets and<br />
targeting interventions.<br />
1656 Board #248 May 30, 2:00 PM - 3:30 PM<br />
association Between 25-hydroxyvitamin d and<br />
Cardiorespiratory Fitness In The National health and<br />
Nutrition Examination survey<br />
Patrick B. Wilson, John Fitzgerald, Stacy J. Ingraham. University<br />
of Minnesota, Minneapolis, MN.<br />
(No relationships reported)<br />
BaCKGrOuNd: Low cardiorespiratory fitness (CRF) and serum 25-hydroxyvitamin<br />
D (25[OH]D) are associated with cardiovascular morbidity/mortality. Studies suggest<br />
that 25(OH)D is associated with CRF but have come from selective samples.<br />
PurPOsE: To examine the association between CRF and serum 25(OH)D from<br />
a nationally representative sample, the National Health and Nutrition Examination<br />
Survey (NHANES).<br />
METhOds: Participants aged 12-49 were eligible for a CRF test, which involved a<br />
submaximal walking protocol to estimate VO . Participants were assigned to one of<br />
2max<br />
eight protocols based on sex, age, body mass index (BMI), and self-reported physical<br />
activity. Estimated VO values > 75 ml/kg/min were recoded as 75 ml/kg/min 2max .<br />
Serum 25(OH)D was assessed with the Diasorin assay. The Pearson correlation was<br />
used to examine the bivariate association between CRF and serum 25(OH)D. SPSS<br />
Complex Samples general linear model was used to adjust for potential covariates and<br />
account for the complex sampling design of NHANES. Means and standard errors for<br />
descriptive statistics were calculated using Complex Samples.<br />
rEsuLTs: CRF, serum 25(OH)D, and covariate data were available from 5,392<br />
participants from the 2001-2002 and 2003-2004 NHANES (out of 21,161).<br />
Approximately 48% of the sample was female, and the average age and BMI were 28.9<br />
± 0.2 years and 26.0 ± 0.1 kg/m2. Mean serum 25(OH)D was 24.8 ± 0.3 ng/ml, with<br />
33.4% classified as deficient (< 20 ng/ml). Mean VO2max was 40.4 ± 0.3 ml/kg/min.<br />
Serum 25(OH)D was significantly positively correlated with estimated VO2max (r =<br />
.099, p < .001). In a multivariate model including age, gender, race/ethnicity, season<br />
(winter vs. summer), self-reported physical activity, and BMI, serum 25(OH)D was not<br />
significantly associated with estimated VO2max (Beta = .03, p = .277). However, when<br />
classifying serum 25(OH)D in terms of deficiency (< 20 ng/ml), there was a significant<br />
effect, with deficient participants having a 1.14 ml/kg/min lower estimated VO2max<br />
(p = .005).<br />
CONCLusIONs: Among healthy individuals, 25(OH)D analyzed as a continuous<br />
measure is not significantly associated with CRF after adjusting for relevant covariates.<br />
In contrast, when analyzed in terms of deficiency, 25(OH)D does show a significant<br />
association with CRF, although the clinical significance is unknown.<br />
1657 Board #249 May 30, 2:00 PM - 3:30 PM<br />
If you Build It, Who Will Come? analysis of 1710 activity<br />
areas in 50 Community Parks<br />
Thomas L. McKenzie, FACSM 1 , Deborah A. Cohen 2 ,<br />
Williamson Stephanie 2 , Terry Marsh 2 , Kathryn P. Derose 2 . 1 San<br />
Diego State University, San Diego, CA. 2 RAND Corporation,<br />
Santa Monica, CA.<br />
(No relationships reported)<br />
Community parks are important resources for population level leisure time physical<br />
activity (PA), especially for those in low-income areas. Few studies have examined<br />
how specific activity area types within parks serve community residents.<br />
PurPOsE: To assess relationships among park area/facility types and observed area<br />
and user characteristics (e.g., PA, gender, and age, race/ethnicity).<br />
METhOds: Trained observers used the System for Observing Physical Activity and<br />
Recreation in Communities (SOPARC) to assess the use and PA of 1710 activity areas<br />
in 50 parks that served a wide diversity of racial/ethnic groups and income levels in<br />
Los Angeles. Each area was observed 4 times/day for each day of the week (7d).<br />
rEsuLTs: We made 47,732 activity area visits and observed 104,101 park users,<br />
including children (32%), adolescents (14%), adults (51%), and seniors (4%). Over 60<br />
activity area types were seen; all parks had playgrounds, and most had gymnasiums<br />
(92%), outdoor basketball courts (88%), and baseball/softball fields (80%). Areas<br />
were accessible (91%) and usable (98%) most of the time, but rarely equipped (3%),<br />
supervised (2%), or organized (2%) and were often empty (67%). Area types were used<br />
differentially by gender, age, and race/ethnicity groupings. Most park visitors were<br />
male (62%), and they dominated sport facilities, including basketball (91%), soccer<br />
(82%), and baseball/softball (71%) areas and accrued greater person-MET values than<br />
females in all areas except playgrounds (overall observed number x MET intensity =<br />
<strong>Abstracts</strong> were prepared by the authors and printed as submitted.<br />
<strong>Thursday</strong>, May 30, 2013
<strong>Thursday</strong>, May 30, 2013<br />
S330 Vol. 45 No. 5 Supplement<br />
159,191 vs. 88,900). Males were less sedentary (overall, 58% vs. 66%), and engaged<br />
in more vigorous PA in all area types (overall, 15% vs. 11%). Few seniors (4%) used<br />
parks, but were more prevalent on walking paths (8%), picnic areas (11%), and tennis<br />
courts (13%).<br />
CONCLusIONs: Findings shed light on how specific spaces in community<br />
parks serve area users. Sport facilities and programs dominated all 50 parks, and<br />
differentially served males. Facilities were unused most of the time; strategic<br />
programming might attract more users, especially females and seniors who were<br />
underserved.<br />
Supported by Grant R01HL083869<br />
D-53 Thematic Poster - Functional Rehabilitation<br />
May 30, 2013, 3:15 PM - 5:15 PM<br />
Room: 207<br />
1717 Chair: Tamerah Hunt. The Ohio State University, Columbus, OH.<br />
(No relationships reported)<br />
1718 Board #1 May 30, 3:15 PM - 5:15 PM<br />
Physical Training- related Injuries and Illnesses In a<br />
sergeants Major academy Class<br />
Ludmila M. Cosio-Lima 1 , Kathleen Brown 2 , Katy Reynolds 1 ,<br />
Ricky A. Perry 1 . 1 University of West Florida, Pensacola, FL.<br />
2 U.S. ARMY (retired), U.S. ARMY (retired), MA.<br />
(No relationships reported)<br />
PurPOsE: This study examined the incidence of and risk factors for training injuries<br />
and illnesses for 149 male and female U.S. Army Sergeants Major Academy (SGMA)<br />
students.<br />
METhOds: This was a retrospective report based in data collected during the<br />
9.5-month training program. Only data from injuries and illnesses incurred during<br />
physical fitness training were included in the present study.<br />
rEsuLTs: During this time period, 49.7% (74/149) of the students were injured at<br />
least once. The crude incidence rate (initial injuries) was 5.2 injuries (68.9%), and<br />
accounted for a total of 1749 limited duty days. The three most common overuse<br />
injuries were pain, muscle strain, and tendinitis/bursitis. For illnesses, 63.1% (94/149)<br />
of the SGMA students had one or more illness visits to a medical treatment facility.<br />
The crude incidence rate (initial illnesses) was 6.6 illnesses per 100 soldiers per<br />
month. Infectious illnesses was the most frequent illness category reported (48.3%),<br />
and 94 students had a total of 311 days of illness-associated limited duty days. The<br />
most frequent types of infectious illnesses were bacterial and viral and these illnesses<br />
primarily affected the respiratory system.<br />
CONCLusIONs: Major conclusions drawn from this study include the following<br />
1) musculoskeletal injuries were the major cause of limited duty days during physical<br />
fitness training, 2) overuse lower extremity and lower back injuries were the most<br />
commonly reported injuries, 3) respiratory bacterial and viral infectious illnesses were<br />
the most commonly reported illnesses, 4) alcohol consumption was a risk factor for the<br />
development of infectious illnesses, 5) smoking was associated with slower 2-mile run<br />
times when compared with nonsmokers, and 6) smokers had higher cholesterol levels<br />
than nonsmokers.<br />
1719 Board #2 May 30, 3:15 PM - 5:15 PM<br />
reach asymmetry during y-Balance Test associated with<br />
Injury in division I athletes<br />
Craig Smith 1 , Nicole J. Chimera 2 , Ryan Pinson 1 , Meghan<br />
Warren 1 . 1 Northern Arizona University, Flagstaff, AZ. 2 Daeman<br />
College, Amherst, NY.<br />
(No relationships reported)<br />
The Y Balance Test (YBT) is a screen of single leg balance assessed with stance leg<br />
stability while the contralateral leg reaches in anterior (ANT), posteromedial (PM),<br />
posterolateral (PL) directions. YBT composite score (CS) and ANT asymmetry have<br />
been associated with future injury in high school athletes, but research is needed to<br />
support YBT use in college athletics.<br />
PurPOsE:To determine the association between YBT CS and asymmetrical reach<br />
distances with non-contact and overuse injury in Division I (DI) collegiate athletes<br />
during an athletic season.<br />
METhOds: 184 DI athletes (20.2 ± 1.5 yrs, 1.78 ± 0.11 m, 80.2 ± 21.1 kg), injury<br />
free at the time of testing, performed the YBT to determine asymmetry (absolute<br />
difference between legs in ANT, PL and PM), and CS (summed average of right and<br />
left ANT, PM and PL normalized to leg length). Athletic trainers recorded injury<br />
throughout the season that caused the athlete to report to the athletic training room.<br />
Contact injuries were excluded from analysis. Sensitivity (SN) and specificity (SP) at<br />
different cut-points (94, 98, 101, 104, 106% for CS and 1, 2, 3, 4, 5 cm for asymmetry)<br />
were calculated, and ROC curves were created to determine best cut-points for<br />
MEDICINE & SCIENCE IN SPORTS & EXERCISE ®<br />
predicting injury. Logistic regression models were used to determine the odds of injury<br />
with CS and asymmetry. Previous injury and sport were included as confounders.<br />
rEsuLTs: 81 athletes were injured with no difference in mean CS between injured<br />
(101.3 ± 7.9%) and not injured (101.2 ± 7.1%; t-test p=0.95). The best cut-points for<br />
predicting injury were CS < 106% of leg length (SN= 73%; SP=24%) and asymmetry<br />
> 4 cm (SN=59%; SP=72%). After adjusting for confounders, ANT asymmetry was the<br />
only variable found to be significantly associated with injury (odds ratio = 0.43, 95%<br />
confidence interval [0.21-0.87]).<br />
CONCLusIONs: As found in previous research, only ANT asymmetry was<br />
associated with increased risk of non-contact and overuse injury in this group of<br />
athletes. CS was a poor predictor of injury in DI athletes due to low specificity and<br />
similar scores between injured and non-injured; however, published data of high school<br />
athletes found females with CS < 94% were at greater risk to be injured. Therefore,<br />
CS may not be consistent across different ages and not useful for injury screening with<br />
college athletes.<br />
1720 Board #3 May 30, 3:15 PM - 5:15 PM<br />
Individual FMs Tests differ between Collegiate Women<br />
rowers and soccer Players despite similar Total scores<br />
Monique Mokha. Nova Southeastern University, Davie, FL.<br />
(No relationships reported)<br />
Total scores of .05, for all tests except rotary instability (ROW<br />
2.33+0.48; SOC 2.10+0.31; p=0.38).<br />
CONCLusION: ROW and SOC performed similarly on the FMSTM. However, more<br />
individual SOC were at risk for injury, and SOC scored lower on the rotary instability<br />
test. Examining individual test scores within the FMSTM provides more specific injury<br />
risk information that can be used for exercise programming.<br />
1721 Board #4 May 30, 3:15 PM - 5:15 PM<br />
sex differences In Functional Movement screen and y<br />
Balance Test In division I Collegiate athletes<br />
Nicole Chimera 1 , Craig Smith 2 , Meghan Warren 2 . 1 Daemen<br />
College, Amherst, NY. 2 Northern Arizona University, Flagstaff, AZ.<br />
(No relationships reported)<br />
The Functional Movement Screen (FMS) and Y Balance Test (YBT) have been<br />
suggested to predict injury risk. Most literature included only male or adolescent<br />
participants and only evaluated composite score, (FMS: sum [max 21] of 7 components<br />
[0-3]; YBT: sum of 3 reach directions normalized as % leg length). Sex differences<br />
exist in movement patterns; thus, before assuming injury risk is similar it is important<br />
to evaluate if females and males perform equally on these screens.<br />
PurPOsE: To determine the effect of sex on FMS composite (CS) and component<br />
scores and YBT composite score (CS) and asymmetries.<br />
METhOds: 200 Division I athletes [F: 92; M: 108; 20.0 (1.4) vs. 20.0 (1.5) yrs,<br />
22.8 (3.1) vs. 27.0 (4.6) kg/m2] were screened for participation (excluded if not in<br />
correct attire or injured). FMS assessed performance of fundamental (components)<br />
movements (squat, lunge, hurdle step, straight leg raise [SLR], shoulder mobility,<br />
trunk stability, rotary stability). YBT assessed stance leg balance while reaching with<br />
the contralateral limb (anterior [ANT], posteromedial [PM], posterolateral [PL]) and<br />
asymmetry (absolute difference between limb reach in each direction). Independent<br />
t-tests established differences in mean FMS CS, YBT CS, and YBT asymmetry; Mann<br />
Whitney U determined differences in mean ranks of FMS components.<br />
rEsuLTs: 170 (F: 81; M: 89) participants completed FMS; no difference in mean CS<br />
(14.3 ± 2.4 vs.14.0 ± 2.5; p = 0.37), deep squat (p = 0.10), or hurdle step (p = 0.871).<br />
Females performed significantly worse in trunk stability (p < 0.001) and rotary stability<br />
(p = 0.01), but significantly better in lunge (p = 0.008), shoulder mobility (p < 0.001),<br />
and SLR (p < 0.001). 190 (F: 87; M: 103) participants completed YBT; no difference<br />
in mean CS (100 ± 6% vs. 102 ± 8%; p < 0.52). Females demonstrated significantly<br />
less asymmetry than males in ANT (2.7 ± 2.3 cm vs. 4.3 ± 6.7 cm; p = 0.02); no<br />
asymmetry differences occurred in PM (3.1 ± 2.7 cm vs. 3.8 ± 3.5 cm; p = 0.14) and<br />
ACSM May 28 - June 1, 2013 Indianapolis, Indiana
Official Journal of the American College of Sports Medicine<br />
PL (3.7 ± 2.8 cm vs. 3.6 ± 2.8 cm; p = 0.75).<br />
CONCLusION: While females and males may perform similarly in FMS and YBT<br />
CS, differences appear in some FMS components and YBT ANT asymmetry. Females<br />
performed better on FMS components involving flexibility and balance, but worse on<br />
components associated with core strength. Researchers should consider sex stratified<br />
analysis.<br />
1722 Board #5 May 30, 3:15 PM - 5:15 PM<br />
Physical Contributors to Glenohumeral Internal rotation<br />
deficit in high school Baseball Players<br />
Elizabeth E. Hibberd1 , Casey E. Shutt2 , Sakiko Oyama3 , J. Troy<br />
Blackburn1 , Joseph B. Myers1 . 1UNC-Chapel Hill, Chapel Hill,<br />
NC. 2U.S. Army-Baylor University, San Antonio, TX. 3University of Texas- San Antonio, San Antonio, TX. (Sponsor: Kevin<br />
Guskiewicz, FACSM)<br />
(No relationships reported)<br />
Glenohumeral Internal Rotation Deficit (GIRD) of the throwing shoulder relative to<br />
the non-throwing shoulder in baseball players is a risk factor for shoulder and elbow<br />
injury. Although this evidence forms a basis for recommending stretching exercises<br />
to prevent injuries, clinical measures of internal rotation range of motion (ROM) do<br />
not differentiate if GIRD is due to muscular, capsuloligamentous, or bony factors.<br />
Understanding the contributions of these components is important for the development<br />
of targeted interventions.<br />
PurPOsE: The purpose of this study was to determine the extent to which the<br />
muscular, capsuloligamentous, and bony components contribute to GIRD in high<br />
school baseball players.<br />
METhOds: 166 baseball players (age=15.9 ± 1.4yrs, height=178.4 ± 6.5cm,<br />
mass=74.1±12.2kg) were evaluated on internal rotation ROM (digital inclinometer),<br />
teres minor, infraspinatus, and posterior deltoid muscle stiffness (muscle compliance<br />
probe), posterior capsule thickness (diagnostic ultrasound), and humeral retrotorsion<br />
(diagnostic ultrasound). A side-to-side difference in each variable was calculated<br />
as dependent variables. Variables were entered into a stepwise linear regression to<br />
determine the predictors of GIRD, where only variables that significantly contributed<br />
to the model (p
<strong>Thursday</strong>, May 30, 2013<br />
S332 Vol. 45 No. 5 Supplement<br />
rEsuLTs: 74 athletes were injured during their sport season. FMS total score was<br />
not different between those who sustained an injury (14.3±2.5) and those who did<br />
not (14.1±2.4; p = 0.57). No ROC curve maximized sensitivity and specificity, so<br />
previous published cut-point of 14 or less (n=92) vs. greater than 14 (n=78) was<br />
used for analysis with injury (sensitivity = 54%, specificity 46%). After adjustment<br />
for confounders, no statistically significant association between FMS total score<br />
(dichotomoized at 14) and injury (odds ratio [OR] = 1.02, 95% confidence interval<br />
[CI] 0.54 - 2.0) existed. Lunge was the only component that was statistically associated<br />
with injury; those scoring 3 were less likely to have an injury compared with those<br />
who scored 2 (OR = 0.21, 95% CI 0.08 - 0.58).<br />
CONCLusIONs: Using a clinically relevant definition of injury, FMS total score was<br />
a poor predictor of non-contact and overuse injury in this group of DI athletes. The<br />
lunge was able to predict injury.<br />
D-54 Thematic Poster - Injury Epidemiology<br />
May 30, 2013, 3:15 PM - 5:15 PM<br />
Room: 208<br />
1726 Chair: Carlo Baldari, FACSM. University of Rome, Rome, Italy.<br />
(No relationships reported)<br />
1727 Board #1 May 30, 3:15 PM - 5:15 PM<br />
The Eagle Tactical athlete Program reduces<br />
Musculoskeletal Injuries in the 101st airborne division (air<br />
assault)<br />
Timothy C. Sell1 , John P. Abt1 , Takashi Nagai1 , Jennifer B.<br />
Deluzio1 , Mita Lovalekar1 , Michael D. Wirt2 , Scott M. Lephart,<br />
FACSM1 . 1University of Pittsburgh, Pittsburgh, PA. 2U.S Army’s<br />
101st Airborne Division (Air Assault), Fort Campbell, KY.<br />
(No relationships reported)<br />
The Eagle Tactical Athlete Program (ETAP) was scientifically developed specifically<br />
for the U.S Army’s 101st Airborne Division (Air Assault) to counter the significant<br />
number of sustained unintentional musculoskeletal injuries. ETAP was previously<br />
demonstrated to improve human performance characteristics, but the capability of<br />
ETAP to reduce injuries had not been studied.<br />
PurPOsE: To determine if ETAP would reduce unintentional musculoskeletal<br />
injuries in garrison in a group of 101st Airborne Division (Air Assault) Soldiers.<br />
METhOds: Non-commissioned officers led their respective units during physical<br />
training following certification in the training components of ETAP as taught during<br />
an ETAP Instructor Certification School. A total of 1641 Soldiers were enrolled (N =<br />
1106 experimental group, N = 540 control group) to evaluate changes in injury data.<br />
Injuries were tracked for 5 months prior to and after ETAP participation during a<br />
pre-deployment workup phase. ICD-9CM codes were used to categorize preventable<br />
musculoskeletal injuries (total, regional distribution, acute or overuse). A McNemar<br />
analysis was conducted to evaluate the effect of ETAP on the overall injury rate within<br />
each group.<br />
rEsuLTs: There was a significant reduction in overall injury rates (pre-ETAP:<br />
209/1106 (18.9%), post-ETAP: 177/1106 (16.0%), p = 0.045) in the experimental<br />
group while no differences in the control group were found. A reduction in injury rates<br />
were also observed in overuse injuries and specific injuries to the lower extremity,<br />
knee, and lumbopelvic region in the experimental group.<br />
CONCLusIONs: The Eagle Tactical Athlete Program was scientifically designed<br />
to optimize performance and reduce injuries. The current analysis demonstrated that<br />
ETAP reduces preventable musculoskeletal injuries in garrison. The capability of<br />
ETAP to reduce injuries confirms the vital role of a scientifically designed training<br />
program on force readiness and health.<br />
Supported by USAMRMC #W81XWH-11-2-0097<br />
1728 Board #2 May 30, 3:15 PM - 5:15 PM<br />
association of Physical Fitness assessments and Injury risk<br />
among u.s. army soldiers<br />
Timothy T. Bushman, Tyson Grier, Michelle Chervak, Morgan<br />
Anderson, Bruce Jones, FACSM. United States Army Institute of<br />
Public Health, Aberdeen Proving Ground, MD.<br />
(No relationships reported)<br />
PurPOsE: Physical fitness assessments are commonly used to determine an athlete’s<br />
performance abilities. It has been suggested that such assessments can also be used<br />
to predict injury risk. To investigate the association of multiple physical fitness<br />
assessments with injury risk among U.S. Army Soldiers.<br />
METhOds: Male Soldiers aged 17-58 years completed the Functional Movement<br />
Screening Test (FMS) (n = 1078), Army Physical Fitness Test (APFT) (n = 1265),<br />
2-mile run (part of the APFT) (n = 1537), Y-Balance (n = 1135), weighted 300-yard<br />
shuttle run (n = 367), un-weighted 300-yard shuttle run (n = 1125), crossover hops (n<br />
MEDICINE & SCIENCE IN SPORTS & EXERCISE ®<br />
= 1132), pull-ups (n = 1033), and vertical jump (n = 1140). Medical record data for<br />
injuries nine months before and after fitness testing were obtained from the Defense<br />
Medical Surveillance System; demographic and health behavior data were collected by<br />
survey. A majority of the fitness assessment variables were categorized into quartiles<br />
where Q1 = highest performance and Q4 = lowest performance. Multivariate odds<br />
ratios (OR) and 95% confidence intervals (95% CI) were calculated.<br />
rEsuLTs: After controlling for age, body mass index (BMI), smoking, and previous<br />
injury; higher injury risk was associated with: FMS total score (OR(≤14/19-21)=1.62,<br />
95%CI 1.04-2.54), Y-Balance posteromedial difference (OR(≥7.01 centimeters/≤2.00<br />
centimeters)=1.53, 95%CI 1.02-2.28), and un-weighted 300-yard shuttle run<br />
(OR(≥73.81 seconds/≤66.00 seconds)=1.86, 95%CI 1.19-2.91). Controlling for the<br />
same variables, higher overuse injury risk was associated with: FMS total score<br />
(OR(≤14/19-21)=1.86, 95%CI 1.13-3.05), (OR(15-16/19-21)=1.67, 95%CI 1.02-2.72),<br />
Y-Balance posteromedial difference (OR(≥7.01 centimeters/≤2.00 centimeters)=1.91,<br />
95%CI 1.21-3.00), and un-weighted 300-yard shuttle run (OR(≥73.81 seconds/≤66.00<br />
seconds)=2.00, 95%CI 1.22-3.28).<br />
CONCLusIONs: The FMS, Y-Balance, and un-weighted 300-yard shuttle run had<br />
the highest risk for those who performed poorly or had asymmetries. These tests may<br />
help identify Soldiers at risk of musculoskeletal injuries, such that interventions can be<br />
put into place to reduce injury risk.<br />
1729 Board #3 May 30, 3:15 PM - 5:15 PM<br />
The utility of accessing Emergency department data for<br />
sport and recreational Injury surveillance<br />
Alex F. Howard, Julia F. Costich, Carl G. Mattacola, Svetla S.<br />
Slavova, Heather M. Bush, F. Douglas Scutchfield. University of<br />
Kentucky, Lexington, KY.<br />
(No relationships reported)<br />
Participation in sport and recreational physical activity carries with it an inherent risk<br />
of injury, thereby necessitating the need for injury prevention efforts and identification<br />
of risk factors. Surveillance systems are an effective means to identify injury risk<br />
factors and develop appropriate injury prevention services. In 2009, Kentucky’s<br />
Governor, Steve Beshear, signed into law House Bill 383 which called for a safety<br />
assessment of all interscholastic athletics in Kentucky’s high schools and middle<br />
schools. This action reiterated the importance of a dedicated sport injury surveillance<br />
system (SISS); however, this legislative action was never implemented, prompting an<br />
examination of injury risk factors, using emergency department data.<br />
PurPOsE: To investigate the epidemiology of sport and recreational injury (SRI)<br />
among middle and high school-aged Kentucky youth, using a population-based<br />
surveillance technique.<br />
METhOds: We analyzed unintentional injuries from the 2008-2010 Kentucky<br />
emergency department (ED) administrative records for patients age 10-18 using<br />
descriptive statistics. SRIs were identified based on external codes of injuries<br />
(E-codes), according to International Classification of Diseases, Clinical Modification,<br />
ninth revision (ICD-9-CM).<br />
rEsuLTs: A total of 135,287 ED visits occurred between 2008-2010, of which<br />
28,225 (20.9%) were related to participation in physical activity. Males accounted<br />
for 73.1% of SRIs, with overall injury events peaking at age 14 for this age group.<br />
The primary mechanisms for SRIs were being struck by or against something (55%),<br />
falls (21.2%), cycling (12.2%), and overexertion ( 8.1%). Superficial contusions and<br />
abrasions (32.9%), sprains and strains (30.2%), and fractures (14.6%) were the primary<br />
ED diagnoses, and the total charges billed for SRIs were more than $31.7 million, or<br />
21.2% of the total charges billed for all unintentional injuries.<br />
CONCLusIONs: The present study illustrates the use of ED data, specifically<br />
E-codes, as surveillance tools to provide information on the distribution of injuries,<br />
risk factors for injury, and an estimate of their economic impact. In the absence of a<br />
dedicated SISS, ED data could be used to inform decision making about youth sports<br />
and physical activity related injuries and their prevention.<br />
1730 Board #4 May 30, 3:15 PM - 5:15 PM<br />
What are The risk Factors For running-related<br />
Musculoskeletal Injuries? a systematic review<br />
Bruno T. Saragiotto, Tiê P. Yamato, Luiz Carlos Hespanhol<br />
Junior, Alexandre Dias Lopes. Universidade Cidade de São<br />
Paulo, São Paulo, Brazil.<br />
(No relationships reported)<br />
The number of runners has grown significantly over the past decade and the health<br />
benefits of running are already well known. However, the number of running injuries is<br />
high. Despite several studies have been conducted on running injuries, the risk factors<br />
for running-related injuries is still not clear in the literature.<br />
PurPOsE:The aim of this study is to systematically review the risk factors for<br />
overall running-related musculoskeletal injuries.<br />
METhOds:: We conducted an electronic search on EMBASE (1981 to May<br />
2012), MEDLINE (1973 to May 2012), SPORTDiscus (1977 to May 2012), Latin<br />
American and Caribbean Centre on Health Sciences Information (LILACS) (1986 to<br />
May 2012) and Scientific Electronic Library Online (SCIELO) (1998 to May 2012)<br />
databases, without a limit on date of publication. Only prospective studies aimed to<br />
ACSM May 28 - June 1, 2013 Indianapolis, Indiana
Official Journal of the American College of Sports Medicine<br />
investigate the risk factors for running-related injuries were included in this review.<br />
We excluded articles that studied specific injuries on running (e.g. stress fractures),<br />
studies aimed to analyse risk factors and/or injuries of other sports (e.g. triathlon) and<br />
studies comparing the effectiveness of interventions on running injuries or prevention<br />
programs. Each article was screened by three independent reviewers and, if they did<br />
not reach a consensus, a fourth reviewer decided whether or not the article should be<br />
included. The risk factors were divided into intrinsic and extrinsic factors.<br />
rEsuLTs:A total of 1934 studies were found through the database search. After the<br />
analysis of the title, abstract and full text 12 articles were eligible to be included in<br />
this systematic review. The main intrinsic risk factor reported was previous injury in<br />
the past 12 months and the main extrinsic factor reported was weekly running distance<br />
more than 64 km. BMI, age and running experience showed conflicting results.<br />
Biomechanical factors, behaviour and running shoes showed limited evidence, i.e. few<br />
studies reported an association with running injuries. There was no evidence for an<br />
association between stretching and running injuries.<br />
CONCLusIONs:The main risk factors identified in this review were previous injury<br />
and weekly running distances. We observed that majority of risk factors are still<br />
inconclusive, which reflects the lack of prospective studies investigating risk factors on<br />
running injury<br />
1731 Board #5 May 30, 3:15 PM - 5:15 PM<br />
Physical activity Injuries: Not so Bad after all!<br />
Erica N. Howard 1 , Laura F. DeFina 1 , Michelle A. Custodio 1 ,<br />
James R. Morrow, FACSM 2 . 1 The Cooper Institute, Dallas, TX.<br />
2 University of North Texas, Denton, TX.<br />
(No relationships reported)<br />
PurPOsE: Increased injury rates have been associated with increased physical<br />
activity (PA); however, it is not known if the types of musculoskeletal injuries (MSI)<br />
resulting from PA are substantially different from those occurring within the same<br />
timeframe, yet are unrelated to PA. The purpose of this study is to qualitatively and<br />
quantitatively describe the pattern of PA and non-PA MSI incurred by communitydwelling<br />
women.<br />
METhOds: Data were extracted from The Women’s Injury Study (WIN), a<br />
web-based observational study that tracked PA behaviors and self-reported MSI of<br />
community-dwelling adult women during 2007-2009. Data were collected via a<br />
secure website where participants reported weekly PA and injury occurrence. An MSI<br />
was defined as “an injury (new, old, or recurrent) this week that caused you to see a<br />
health care provider or interrupt your daily activities for 2 or more days.” Follow-up<br />
telephone reporting of a PA-related MSI including body part, self-treatment, specific<br />
activity, and other relevant information provided the opportunity to fully describe the<br />
MSI.<br />
rEsuLTs: A total of 323 and 330 musculoskeletal injuries were reported during PA<br />
and non-PA events respectively across 83,241 person-weeks of reporting. Communitydwelling<br />
women injured during non-PA events were more likely to incur injuries of<br />
the head/jaw/neck; however, lower limb injuries were the most prevalent PA-related<br />
MSI. The risk of injury coming “...on suddenly with no apparent cause” was 54% for<br />
non-PA MSI vs. 8% for PA-related MSI. Reported PA-related MSIs were generally<br />
minor and less likely to require treatment from health care providers (60% vs. 80%)<br />
and resulted in less initial reporting of missed days of work/school (11%) compared to<br />
non-PA MSIs (17%).<br />
CONCLusION: Overall, the nature of MSIs occurring during PA is not dramatically<br />
different than MSIs reported during community-dwelling non-PA behaviors. This<br />
provides additional validation of the important role that PA behaviors can have on<br />
quality of life without substantially increasing the MSI risk beyond that in general<br />
living activities.<br />
This work was supported in part by a grant from the National Institute of Arthritis and<br />
Musculoskeletal and Skin Diseases R01<br />
AR052459.<br />
1732 Board #6 May 30, 3:15 PM - 5:15 PM<br />
Incidence, Mechanisms, and severity of Collegiate Women’s<br />
soccer Injuries on artificial Turf Versus Natural Grass<br />
Michael C. Meyers, FACSM. College of Western Idaho, Nampa,<br />
ID.<br />
Supported by M.C. Meyers: Contracted Research - Including Principle<br />
Investigator; Partial support by FieldTurf, USA.<br />
Numerous injuries have been attributed to playing on artificial turf. Newer generations<br />
of artificial turf, however, were developed to duplicate the playing characteristics<br />
of natural grass. Minimal long-term studies have been conducted comparing matchrelated<br />
collegiate women’s soccer injuries between the two surfaces.<br />
PurPOsE: To quantify incidence, mechanisms, and severity of match-related<br />
collegiate women’s soccer injuries on artificial turf versus natural grass.<br />
METhOds: A total of 13 universities were evaluated over 5 competitive seasons for<br />
injury incidence, injury category, time of injury, injury time loss, player position, injury<br />
mechanism and situation, primary type of injury, injury grade and anatomical location,<br />
field location at time of injury, injury severity, head and lower extremity trauma, cleat<br />
design, turf age, and environmental factors.<br />
Vol. 45 No. 5 Supplement S333<br />
rEsuLTs: A total of 797 collegiate matches were evaluated for soccer injuries<br />
sustained on artificial turf or natural grass during 5 seasons, with 355 team matches<br />
(44.5%) played on artificial turf versus 442 team matches (55.5%) played on natural<br />
grass. A total of 693 injuries were documented, with 272 (39.2%) occurring during<br />
play on artificial turf, and 421 (60.8%) on natural grass. Multivariate analysis per<br />
10 team matches indicated a significant playing surface effect, F 2,690 = 6.435,<br />
P = .002, n - β = 0.904. Significantly lower total injury incidence rates (IIR), 7.7<br />
(95% confidence interval [CI], 7.2-8.1) versus 9.5 (95% CI, 9.3-9.7, P = .0001), and<br />
substantial IIRs, 0.7 (95% CI, 0.5-1.0) versus 1.5 (95% CI, 1.2-1.9, P = .001), were<br />
documented on artificial turf versus natural grass, respectively. Analyses also indicated<br />
significantly less trauma (P = 0.040 to 0.0001) on artificial turf when comparing injury<br />
time loss, player position, injury situation, injury grade, injuries under various field<br />
conditions and temperature, cleat design and turf age.<br />
CONCLusION: Although similarities existed between artificial turf and natural grass<br />
during competitive match play, artificial turf is a practical alternative when comparing<br />
injuries in collegiate women’s soccer. It must be reiterated that the findings of this<br />
study may be generalizable to only collegiate women’s competition and this specific<br />
artificial surface.<br />
D-55 Thematic Poster - Mechanics of Strike<br />
Patterns in Running<br />
May 30, 2013, 3:15 PM - 5:15 PM<br />
Room: 104<br />
1733 Chair: Irene Davis, ACSM. Harvard Medical School, Boston, MA.<br />
(No relationships reported)<br />
1734 Board #1 May 30, 3:15 PM - 5:15 PM<br />
No differences in self-reported Injuries or Performance<br />
Between Characterized Foot-strike Patterns amongst us<br />
army soldiers<br />
Bradley J. Warr 1 , Rebecca E. Fellin 1 , Peter N. Frykman 1 ,<br />
Shane G. Sauer 1 , Donald L. Goss 2 , Joseph J. Seay 1 . 1 U.S. Army<br />
Research Institute of Environmental Medicine, Natick, MA.<br />
2 U.S. Army/Baylor University Physical Therapy Program, San<br />
Antonio, TX. (Sponsor: Dr. Edward J. Zambraski, FACSM)<br />
(No relationships reported)<br />
There is currently little data characterizing Soldiers’ foot-strike (FS) patterns and<br />
the potential relationship to running related injuries and performance. Literature has<br />
characterized FS pattern distribution in marathon runners reporting a heel-strike (HS)<br />
prevalence of 75%-94% in marathoners, with the remainder (6-25%) exhibiting a midfoot<br />
or fore-foot pattern (non heel-strike, NHS). Recent studies have reported that NHS<br />
runners had fewer running related injuries and better performance.<br />
PurPOsE: To characterize the distribution of FS patterns in US Army Soldiers and<br />
determine if FS patterns are related to self-reported running injuries and performance.<br />
METhOds: 342 male Soldiers (24.7±5.1 y/o, 177.3+7.3 cm, 81.7+16.9 kg) from a<br />
US Army Combined Arms Battalion completed a FS analysis and survey. Multiple<br />
foot-strikes were recorded in the sagittal plane using a high-definition video camera<br />
as each Soldier ran through a designated lane at a typical training pace. Soldiers<br />
then completed a survey related to training habits and injury history. The association<br />
between FS and the occurrence of a running-related injury was analyzed using a Chisquared<br />
test. Kruskal-Wallis test evaluated relationship between reported days that<br />
training was modified due to injury as well as 2-mile run time between Soldiers with<br />
NHS and HS patterns.<br />
rEsuLTs: 13% of the participating Soldiers were characterized as NHS runners<br />
and 87% were characterized as HS. There was no significant difference (p≥.05) in the<br />
percentage of Soldiers reporting a running-related injury between those characterized<br />
with a NHS versus a HS (55.6 v 51.0%). There were no significant difference between<br />
NHS pattern versus HS pattern in the number of days training was modified due to<br />
injury (21.8±78.4 v 13.9±49.5 days/yr), or 2-mile run time (14.8±1.6 v 14.8±1.7 min).<br />
CONCLusIONs: This cohort of US Army Soldiers demonstrated a prevalence of<br />
HS similar to what has previously been reported in marathon runners. Based on this<br />
preliminary analysis, neither FS pattern is advantageous in terms of impact on selfreported,<br />
retrospective injury or performance.<br />
<strong>Abstracts</strong> were prepared by the authors and printed as submitted.<br />
<strong>Thursday</strong>, May 30, 2013
<strong>Thursday</strong>, May 30, 2013<br />
S334 Vol. 45 No. 5 Supplement<br />
1735 Board #2 May 30, 3:15 PM - 5:15 PM<br />
Foot strike Pattern during a 161-km ultramarathon<br />
Mark E. Kasmer 1 , Jeremy J. Wren 2 , Martin D. Hoffman,<br />
FACSM 3 . 1 Medical College of Wisconsin, Milwaukee, WI.<br />
2 University of California - Davis, Sacramento, CA. 3 VA Northern<br />
California Health Care System and University of California -<br />
Davis, Sacramento, CA.<br />
(No relationships reported)<br />
PurPOsE: The purpose of this study was to characterize the foot strike pattern of<br />
ultramarathon runners during a 161-km mountain trail run; examine the effect of<br />
fatigue on foot strike pattern; examine the effect of a downhill gradient on foot strike<br />
pattern; determine if foot strike pattern is related to performance; and ascertain if postrace<br />
blood creatine phosphokinase (CK) concentrations differ by foot strike pattern.<br />
METhOds: Foot strike pattern was determined for race participants of the 2012<br />
Western States Endurance Run at three level sites and one downhill site (9% gradient).<br />
Post-race blood samples were collected immediately after finishing and analyzed for<br />
CK concentration. Chi-square analyses were used to compare foot strike patterns at<br />
each level site with prior published data from road marathons. Finish time and blood<br />
CK concentration were compared among foot strike group categories for each filming<br />
location and collectively across all three sites with Kruskal-Wallis tests followed by<br />
Dunn’s multiple comparison post-tests as data did not pass the normality test and could<br />
not be successfully normalized.<br />
rEsuLTs: Observed rear-foot strike (RFS) prevalence was 79.9% at 16.5 km, which<br />
was less than (p=0.02) previously observed in one study at a road marathon. RFS<br />
prevalence increased significantly to 89.0% at 90.3 km (n=246, p=0.04), then decreased<br />
significantly to 83.9% at 161.1 km (n=225, p=0.03). RFS prevalence was 84.8% at the<br />
downhill site (90.7 km), which was not significantly different (p=0.8) from the level site<br />
at 90.3 km. There was no significant effect (p=0.3) of foot strike pattern on performance.<br />
There was a trend toward greater blood CK values among non-RFS compared to RFS<br />
runners, reaching statistical significance (p
Official Journal of the American College of Sports Medicine<br />
models to estimate internal knee loads during running, and have shown that increasing<br />
step rate (i.e. shortening step length) can reduce patellofemoral (PF) loading. However,<br />
many clinics do not have sophisticated modeling technology available, and would<br />
benefit from a simpler way to assess PF loads.<br />
PurPOsE: To determine what kinematic and kinetic variables predict PF loads when<br />
running.<br />
METhOds: 30 healthy runners (35±15 yrs, 69.6±10.8 kg, 1.76±0.10 m) had<br />
whole body kinematics and ground reaction forces measured while running on an<br />
instrumented treadmill. Each ran at his/her preferred speed (2.79±0.48 m/s) at three<br />
step rates: 90, 100, and 110% of preferred. Running mechanics were analyzed using<br />
a musculoskeletal model that included a 1-degree of freedom PF joint. Inverse<br />
kinematics and dynamics were used to compute joint angles and moments. Numerical<br />
optimization was then used to estimate muscle, patellar tendon and joint reaction<br />
forces. Peak PF force was calculated over five strides from each condition. A forward<br />
step-wise fitted repeated measures-ANOVA model was created with PF force per unit<br />
body weight as the response variable.<br />
rEsuLTs: PF force was significantly increased (+15%) at the 90% step rate, and<br />
decreased (-14%) at the 110% condition (p
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compared to 85% VO2max (2.54 ± 0.73 vs. 2.01 ± 0.45 ml min-1 mmHg-1, resp).<br />
CVC increased (p 0.05) for both conditions. The amount of RMF was related (r=0.61; p 0.05)<br />
between the ΔFEV1% pre-post exercise and %EFL at VO2max. However, in children<br />
MEDICINE & SCIENCE IN SPORTS & EXERCISE ®<br />
that demonstrated clinically relevant EIB (i.e.,>10% decrease in FEV1; n=22), there<br />
was a significant relationship (r = 0.66, p < 0.05) between EIB and EFL. In study<br />
two (n=16), with training, children improved pre-post exercise ΔFEV1% (pre:-7.60 ±<br />
2.10%, post:-1.10 ± 1.80%, p < 0.05). There was an association between ΔFEV1% and<br />
Δ%EFL from pre- to post-training (r = 0.77, p < 0.05) in the TRG only.<br />
CONCLusION: These data suggest that pre-adolescent children who exhibit<br />
clinically relevant EIB also demonstrate the most severe expiratory flow limitation<br />
during exercise. With exercise training, reductions in EIB are associated with reduced<br />
EFL. These findings may be important in prevention and treatment of exercise<br />
intolerance in pre-adolescent children.<br />
1746 Board #4 May 30, 3:15 PM - 5:15 PM<br />
Peak Oxygen uptake differs Between Obese Women With<br />
Vs. Without dyspnea On Exertion<br />
J. Todd Bassett, Vipa Bernhardt, Santiago Lorenzo, Raksa<br />
B. Moran, Sarah F. Haller, Jessica M. Pineda, Tony G. Babb,<br />
FACSM. Institute for Exercise and Environmental Medicine,<br />
Texas Health Presbyterian Hospital Dallas and University of<br />
Texas Southwestern Medical Center, Dallas, TX.<br />
(No relationships reported)<br />
PurPOsE: During constant load exercise, some otherwise healthy obese women<br />
experience dyspnea on exertion (+DOE), while others do not (-DOE). In previous<br />
studies, we observed exercise capacity to be similar in -DOE and +DOE. We<br />
questioned whether this would remain true if we sampled a larger number of obese<br />
women.<br />
METhOds: To investigate, we recruited 80 otherwise healthy obese women who<br />
were divided into groups based on their Ratings of Perceived Breathlessness (RPB,<br />
Borg 0-10 scale) at the end of 6 minutes of constant load cycling (60W), as in prior<br />
studies. 24 women were designated as -DOE (RPB≤2, 32±8 yr, 37±4 BMI, mean±SD)<br />
and 34 women were classified as +DOE (RPB≥4, 34±7 yr, 36±5 BMI). 22 women<br />
with RPB=3 were excluded to better delineate the groups. Peak oxygen uptake was<br />
determined during maximal incremental cycle ergometry. Data were analyzed between<br />
groups by independent t-test. The relationship between variables was determined by<br />
linear regression analysis.<br />
rEsuLTs: While peak oxygen uptake was within normal limits in both groups,<br />
exercise capacity (as % of predicted) was greater (p
Official Journal of the American College of Sports Medicine<br />
ERS guidelines. Maximal inspiratory and expiratory pressures were also determined.<br />
Data were analyzed between groups by independent t-tests. The relationships between<br />
variables were determined by linear regression analysis.<br />
rEsuLTs: There were no meaningful relationships between pulmonary function<br />
parameters and RPB during constant load cycling within the groups or when<br />
combined. Differences in maximal voluntary ventilation between the -DOE (112±13)<br />
and +DOE (104±15) groups approached significance (p=0.0553). Only maximal<br />
expiratory pressure reached significance (p=0.0258) between the groups (108±26<br />
%predicted and 94±22, respectively).<br />
CONCLusION: As in previous studies, pulmonary function, with only a few<br />
exceptions, does not differ between otherwise healthy obese women without vs. with<br />
DOE.<br />
Supported by NIH Grant Funding #HL096782 and The King Charitable Foundation<br />
Trust.<br />
1748 Board #6 May 30, 3:15 PM - 5:15 PM<br />
Impact of Expiratory Flow Limitation on Performance at<br />
simulated altitude<br />
Joshua C. Weavil, Jonathon L. Stickford, Joseph W. Duke,<br />
Robert F. Chapman, FACSM, Joel M. Stager, FACSM, Timothy<br />
D. Mickleborough, FACSM. Indiana University, Bloomington,<br />
IN.<br />
(No relationships reported)<br />
Many athletes exhibit expiratory flow limitation (FL) during heavy exercise and<br />
consequently may be additionally challenged when exercising at moderate altitude.<br />
PurPOsE: To determine how FL affects aerobic performance at modest altitude.<br />
We hypothesized that NFL athletes will be at a competitive advantage where altitudeinduced<br />
declines in SaO2 present less of a consequence than the coincident increases<br />
in ventilation and work of breathing experienced by the non-flow limited athlete.<br />
METhOds: Flow limited (FL n=7) and non-flow limited (NFL n=7) male cyclists<br />
performed three 5-km time trials on a Velotron cycle ergometer on separate days.<br />
Expired gases were measured at rest and throughout each time trial. Participants<br />
performed a familiarization trial followed by a single-blinded normoxic (FiO 2 = 0.21)<br />
and hypoxic (FiO 2 = 0.17, approximately 2000m altitude) trial in random order. Time to<br />
completion (T TT ) and average power output (P TT ) were used to assess performance.<br />
rEsuLTs: Metabolic, ventilatory, and performance measures were similar between<br />
groups (FL vs. NFL) in normoxia. However, when comparing the normoxic and<br />
hypoxic trials, the FL group had a significantly smaller (p
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collegiate runners during treadmill locomotion.<br />
METhOds: Subjects gave informed consent to procedures approved by the<br />
Eastern Michigan University CHHS Human Subject Review Committee. 9 female<br />
(22.4±2.2yr, 52.2±5.5kg, 55.9±6.8ml/kg/min) and 8 male NCAA D-I intercollegiate<br />
runners (23.6±2.2yr, 69.1±5.9kg, 67.4±6.7ml/kg/min) performed incremental<br />
VO2max trials while wearing lumbar mounted HRA (Microstrain, VT; 617 Hz).<br />
Aggregate acceleration for VT, AP, and ML axes were recorded and Euclidian<br />
resultants were computed (RES). Trials started at 8kph and increased 2 kph every 3<br />
min until exhaustion. Group comparisons were made from 12-16 kph, as all subjects<br />
completed these stages. Axial root mean square (RMS) and ratio of RMS/RES (RA)<br />
were compared between women and men to identify differences in running mechanics<br />
between groups. Expired gases were collected using an Oxycon Mobile (Viasys, CA).<br />
VO2 and RER were used to determine O2 cost (O2C) and energy expenditure (EE).<br />
MANOVAs were performed using PASW 17.0 (SPSS, IL) α = 0.05.<br />
rEsuLTs: VT (p=0.032) and VT ratio (VT/RES) (p=0.002) were significantly lower<br />
in women than men. ML and AP accelerations were not significantly different between<br />
groups. During tests, VO2, RER, O2 Cost, and EE were significantly higher for women<br />
(46 ml/kg/min, 1.00, 180.87 ml/kg/min, 0.913 kcal/kg/min) compared to men (43.728<br />
ml/kg/min, 0.924, 161.9 ml/kg/min, 0.799 kcal/kg/min) across all speeds.<br />
CONCLusION: These data show that women accelerate less in the VT axis than<br />
men. At the same time, they are less metabolically economical in all measures (VO2,<br />
RER, O2C, and EE) then men. Therefore, gender differences in running economy<br />
between similarly trained runners could come more from the VT accelerations rather<br />
than the AP or ML.<br />
1753 Board #3 May 30, 3:15 PM - 5:15 PM<br />
Precooling By Ice slurry Ingestion reduces Core<br />
Temperature and Thermal sensation during 5km running<br />
Emily J. Sauers, Nicole A. Lisicky, Donald Cummings, Molly<br />
Winke, Chad A. Witmer, Shala E. Davis, FACSM. East<br />
Stroudsburg University, East Stroudsburg, PA.<br />
(No relationships reported)<br />
Previous evidence suggests that precooling an athlete’s core temperature prior to<br />
physical activity may reduce the negative effects of heat on performance<br />
PurPOsE: The purpose of the present study is to examine the impact of pre-race<br />
ice slurry ingestion on core temperature and performance in competitive well-trained<br />
runners.<br />
METhOds: The subjects in this study included 14 competitive male (n=11; age:<br />
28.00±1.7yrs; height: 69.50±1.4in; weight: 70.42±2.7kg; body fat: 10.92±1.4%;<br />
VO2max: 67.70±1.9 ml/kg/min) and female (n=3; age: 33.00±5.0yrs; height:<br />
65.00±0.6in; weight: 58.4±2.9kg; body fat: 15.87±1.7%; VO2max: 58.57±2.3ml/<br />
kg/min ) distance runners currently involved in an endurance-training program. All<br />
runners completed two 5km race, consuming either cold water (CW; 4°C) or an ice<br />
slurry (IS; -1°C) prior to the trial. Core temperature was recorded using an ingestible<br />
capsule containing a radiotelemetry temperature sensor (VitalSense System, Philips<br />
Respironics, Bend, Oregon) 4 hours before each race. Thermal sensation was assessed<br />
prior to warm-up, after warm-up, and immediately after trial completion. Urine<br />
specific gravity will be determined by refractometer (Antago, Bellvue, WA). A oneway<br />
repeated measures ANOVA was used to evaluate performance, core temperature,<br />
thermal sensation and RPE. Significance was defined as p
Official Journal of the American College of Sports Medicine<br />
5 mph,tests started at 7 mph and increased speed by 1 mph every 2 min till voluntary<br />
exhaustion and were separated by a minimum of 7 days. LT tests started at 5 mph and<br />
increased speed to 6, 7, 7.5, 8.0, 8.5, 9.0 (additional stages increase speed by 0.5 mph)<br />
every 3 min until the subject reached ≈85% of. LT tests were separated by a minimum<br />
3 days. Plasma lactate concentrations were determined from venous blood samples (4<br />
ml) obtained at rest and during the last minute of each exercise stage. Lactate threshold<br />
was determined from a log-log plot of lactate concentration (mM) and relative (ml<br />
O2•min-1•kg-1 BW). Results. determined during running at 100% and 80% loading<br />
were similar ( 52.3 ± 0.9 and 52.7 ± 0.7 ml O2•min-1•kg-1 BW, respectively). The<br />
energy cost of running at 9 mph (all subjects completed stages between 5 and 9<br />
mph) was reduced by 12% at 80% body weight (37.2 ± 2.9 ml O2•min-1•kg-1 BW)<br />
compared to running at 100% body weight (42.3 ± 1.7 ml O2•min-1•kg-1 BW,<br />
p
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providing an antagonistic force that resists joint translation.<br />
PurPOsE: To determine if differences in dorsiflexion (DF) and plantar flexion (PF)<br />
isokinetic strength exist between subjects with self-reported ankle instability (AI), a<br />
coper (COP) group, and healthy (HEA) subjects free from previous ankle injury.<br />
METhOds: A total of 135 (65 females & 70 males) intercollegiate athletes were<br />
screened prior to the beginning of their athletic careers. Using CAIT scores, subjects<br />
were divided into AI (32), COP (46), and HEA (57) categories. Isokinetic strength<br />
assessment included tests of peak torque (PT) at 30 and 120 deg/sec and involved both<br />
concentric (CON) and eccentric (ECC) muscle actions. A between groups ANOVA<br />
was conducted using normalized (lean body mass) PT to determine if differences in<br />
isokinetic strength existed between the 3 groups.<br />
rEsuLTs: For contrast, the raw PT values regardless of group status<br />
averaged (Mean±SD in Nm) DFCON30=49.7±16.9, DFECC30=71.9±23.0,<br />
DFCON120=32.2±13.2, DFECC120=74.9±24.5, PFCON30=157.3±53.8,<br />
PFECC30=235.0±83.2, PFCON120=96.7±34.8, PFECC120=126.2±41.3. There was a<br />
significant difference in the normalized PT ratios between the groups for DFCON120,<br />
with those in the HEA group (.24±.09) having higher ratios (stronger) than either the<br />
COP (.21±.06) and AI groups (.20±.05). There were no significant differences between<br />
any of the other 7 measures of isokinetic strength.<br />
CONCLusION: This is the first large scale strength study to involve a COP group<br />
of subjects who have suffered an ankle injury, but have not developed AI. DF strength<br />
deficits were evident in the AI and COP groups at the highest isokinetic velocity tested;<br />
indicating quite possibly a functional discrepancy between the groups. This finding<br />
has implications for the clinician in dealing with both AI and COP patients; high speed<br />
strength redevelopment may be of extreme importance.<br />
1761 May 30, 3:30 PM - 3:45 PM<br />
Time Trial Pacing Characteristics Of Junior Team sport<br />
Players<br />
David B. Pyne, FACSM1 , Philo U. Saunders1 , Michael J.<br />
Davies1 , James P. Veale2 , Markus U. Deutsch3 . 1Australian Institute of Sport, Belconnen, Australia. 2Australian Football<br />
League, Melbourne, Australia. 3Fusion Sport Pty Ltd, Brisbane,<br />
Australia.<br />
(No relationships reported)<br />
Time trials are occasionally used in field-based team sports to assess the endurance<br />
fitness of players. Anecdotally it appears some junior team sport players are naïve to<br />
pacing strategies underpinning optimal running performance.<br />
PurPOsE: To characterize relationships between 3 km time trial performance and<br />
variability in pacing, and between manual (stopwatch) and automated (RFID timing<br />
system) timed splits.<br />
METhOds: Junior Australian Football players (males n=64, age 19 ± 1 y; height 1.88<br />
± 0.08 m; mass 81 ± 8 kg; mean ± SD) were tested during the annual National Draft<br />
Combine. Splits times for the 3 km time trial over the six laps were recorded both<br />
manually and with an automated chip system outdoors (18 ºC, 50% humidity) on a<br />
non-standard distance (476 m) synthetic running track.<br />
rEsuLTs: The final 3 km time was 11:09 ± 0:47 min:s (mean ± SD) with a<br />
coefficient of variation (CV) in pacing of laps of 6.5% ± 2.3%. Players exhibited the<br />
classic fast start and end spurt pattern in split times - the first lap was 8.5%, ±0.7%<br />
(mean, ±90% confidence limits) faster than the second, and the final lap 9.1%, ±1.0%)<br />
faster than the penultimate lap. In contrast to the documented even-pace strategies of<br />
international middle-distance runners, there was a gradual slowing of up to 3% per<br />
lap split in the 3rd, 4th and 5th laps. The fastest runners had the lowest variability in<br />
pacing of lap splits with a large correlation (r=0.73, ±0.10) between variability in split<br />
times and 3 km running performance time. The fastest quartile of runners had two-fold<br />
less variability in lap split times (CV 4.9%, ±0.4%) than the slowest quartile (10.6%,<br />
±2.5%). There was a perfect correlation (r=1.00, ±0.00) in final time between manual<br />
(stopwatch) and automated RFID timing systems.<br />
CONCLusION: Junior football players could improve 3 km time trial performance<br />
by adopting a more consistent pacing strategy.<br />
1762 May 30, 3:45 PM - 4:00 PM<br />
Importance Of standardized dXa Protocol For assessing<br />
Body Composition Changes In athletes<br />
Alisa Nana1 , Gary J. Slater2 , Will G. Hopkins, FACSM3 , Louise<br />
M. Burke, FACSM1 . 1Australian Institute of Sport, Bruce,<br />
Australia. 2University of the Sunshine Coast, Maroochydore,<br />
Australia. 3Auckland University of Technology, Auckland, New<br />
Zealand.<br />
(No relationships reported)<br />
PurPOsE: We investigated the implications of undertaking DXA scans using the<br />
Best Practice Protocol (subjects fasted and rested) or a less precise but more practical<br />
protocol in assessing chronic changes in body composition following training and a<br />
specialized recovery technique (cold water immersion therapy).<br />
METhOds: Twenty-one nationally competitive male cyclists completed an overload<br />
training program, in which they were randomized to four sessions per week of either<br />
MEDICINE & SCIENCE IN SPORTS & EXERCISE ®<br />
cold water immersion therapy or control groups. Whole-body DXA scans were<br />
undertaken with Best Practice (BEST) or Random Activity (RANDOM) Protocols<br />
at baseline, after 3 weeks of overload training and after a 2 week taper. Magnitudes<br />
of changes in total, lean and fat mass from baseline-overload, overload-taper and<br />
baseline-taper were assessed by standardization.<br />
rEsuLTs: The standard deviations of change scores for total and lean mass from<br />
RANDOM scans (2-3%) were approximately double those observed in the BEST<br />
protocol (1-2%), owing to extra random errors associated with RANDOM scans at<br />
baseline. There was little difference in change scores for fat mass. The effect of cold<br />
water immersion therapy on baseline-taper changes in lean mass was possibly harmful<br />
(-0.7%; 90% confidence limits ±1.2%) with BEST scans but unclear with RANDOM<br />
scans (0.9%; ±2.0%). Both BEST and RANDOM protocols gave similar possibly<br />
harmful effects of cold water immersion therapy on changes in fat mass (6.9%, ±13.5%<br />
and 5.5%, ±14.3%, respectively).<br />
CONCLusIONs: An interesting effect of cold water immersion therapy on traininginduced<br />
changes in body composition might have been missed with a less precise<br />
scanning protocol. Therefore, DXA scans should be undertaken with the Best Practice<br />
Protocol consisted of fasted and rested subjects, as well as standardized subject<br />
positioning on the scanning bed and regional demarcating analysis techniques.<br />
1763 May 30, 4:00 PM - 4:15 PM<br />
swimsuit Constraints Favor Women at the 2012 Olympic<br />
swim Competition<br />
Chris Brammer, Joel Stager, FACSM. Indiana University,<br />
Bloomington, IN.<br />
(No relationships reported)<br />
INTrOduCTION: Modeling of athletic performance suggests that men will continue<br />
to outperform women by the same margin well into the future (Peronnet, 1989).<br />
However, competitive rule changes may affect performance, favoring improvement in<br />
one sex over the other. Unlike at the 2008 Games, current suit policies in swimming<br />
dictate men to have considerably less skin coverage by their swimsuit than women.<br />
PurPOsE: To determine, relative to 2008, if the women performed differently<br />
than the men during the 2012 Olympic swim competition following new suit design<br />
constraints.<br />
METhOds: The top eight times from the men’s and women’s finals of Olympic<br />
swim events from 2008 and 2012 were obtained from the public domain. A two-way<br />
mixed design ANOVA was used to test the interaction between sex and Olympic year<br />
for swim performance, with Olympic year as the within-subjects factor. Separately,<br />
for both men and women, paired t-tests were used to compare 2008 and 2012 Olympic<br />
swim performances for each event.<br />
rEsuLTs: ANOVA revealed a significant sex by year interaction (F(1,14) = 14.47, p<br />
< .01). Simple effect analysis showed the women were significantly faster in 2012 than<br />
in 2008 (p < .001), whereas the men were not different. Paired t-tests for each event<br />
revealed 61% (8/13) of women’s events in 2012 were significantly faster than in 2008,<br />
and the remaining five events were not different. For the men, 15% (2/13) of all events<br />
were significantly faster in 2012 than in 2008, 54% (7/13) were not different, and 31%<br />
(4/13) were actually slower.<br />
CONCLusIONs: The results indicate that, relative to the 2008 Games, the<br />
women outperformed the men in London. Given a performance bias observed in<br />
2008 (Brammer, 2012), it was expected, as a result of the new suit constraints, that<br />
performances would not improve. However, the women continued to improve on<br />
historical performances while the men did not. Therefore, the rule change imposed a<br />
greater constraint on performances of the men relative to the women.<br />
1764 May 30, 4:15 PM - 4:30 PM<br />
Comparisons of Training session and In-Game heart rates<br />
in division I Collegiate Ice hockey Players<br />
Emily A. Niemyjski, Christopher P. Connolly, James M.<br />
Pivarnik, FACSM, Elizabeth Watson, Michael Vorkapich.<br />
Michigan State University, East Lansing, MI.<br />
(No relationships reported)<br />
Heart rate (HR) monitoring has been used recently by some collegiate ice hockey<br />
teams to assess the intensity of training sessions. However, the extent to which heart<br />
rate (HR) during preseason and in-season training sessions compares to ice hockey<br />
game HR response is unknown.<br />
PurPOsE: To compare the intensity of off-ice training, on-ice practices, and games<br />
through HR monitoring throughout a season.<br />
METhOds: HR monitors were worn by members of a Division I collegiate men’s<br />
ice hockey team (n = 24) for 22 on-ice practices, 55 off-ice training sessions, and four<br />
games. On-ice practices consisted of game-type situational simulations and highintensity<br />
drills. Off-ice training sessions consisted of either total-body circuit resistance<br />
training or interval cycling. HR zones included for analysis were 50-59%, 60-69%,<br />
70-79%, 80-89%, and 90-100% of maximal HR, which was determined for each player<br />
during previously completed graded exercise tests. Averages (±SD) for the percentage<br />
of training time spent in each HR zone were computed for September, December,<br />
January, and February. Averages (±SD) for the percentage of game time spent in each<br />
HR zone were found for pre-game activity and each period of play.<br />
ACSM May 28 - June 1, 2013 Indianapolis, Indiana
Official Journal of the American College of Sports Medicine<br />
rEsuLTs: On-ice practice time gradually increased as the season progressed<br />
from 102.0 ± 0 minutes preseason to 131.2 ± 23.4 minutes during the final month.<br />
Off-ice training time decreased from 141.4 ± 66.4 minutes preseason to 31.0 ± 27.8<br />
minutes during the final month. Intensity of both on and off-ice training decreased<br />
from preseason into the season and as the season progressed (percentage of on-ice<br />
practices at 90-100% of maximal HR: 15.6 ± 10.6 preseason vs. 1.2 ± 1.7 final<br />
month, percentage of off-ice training sessions from 90-100% of maximal HR:10.1 ±<br />
9.3 preseason vs. 1.3 ± 4.2 final month). Percentage of game time spent in each HR<br />
zone indicated similar intensity for each period, including 9% of game time spent at<br />
90-100% of maximal HR. Preseason off and on-ice training/practices most closely<br />
resembled game HR zone averages.<br />
CONCLusION: Intensity of preseason training closely simulates game intensity. Inseason<br />
training is less intense than games and decreases as the season progresses.<br />
1765 May 30, 4:30 PM - 4:45 PM<br />
Tracking Changes In Body Composition Within Elite<br />
Wheelchair Basketball Players<br />
Mhairi Keil1 , Alan M. Batterham, FACSM2 , Vicky Goosey-<br />
Tolfrey3 . 1English Institute of Sport/Loughborough University,<br />
Birmingham, United Kingdom. 2Teesside University, UK,<br />
Middlesborough, United Kingdom. 3Loughborough University,<br />
Loughborough, United Kingdom.<br />
(No relationships reported)<br />
Practical methods for monitoring body composition changes are important when<br />
preparing wheelchair basketball players for competition.<br />
PurPOsE: To evaluate the tracking of within-athlete changes in criterion measures<br />
of body composition (dual energy X-ray absorptiometry; DXA) with simple skinfold<br />
thickness measures over a 15-month competitive training period.<br />
METhOds: Participants were male Great Britain Wheelchair Basketball players<br />
(n=16) who underwent body composition assessments at 5 time points over 15 months.<br />
The primary outcome was DXA-derived body fat percentage, with sum of 4, 6, or 8<br />
skinfolds (mm) as the predictor variable. Data were analysed using a linear mixed<br />
model (random slope and intercept) to derive the within-athlete typical error of the<br />
estimate in predicting criterion body fat percentage from sum of skinfolds. This typical<br />
error allowed us evaluate how well a simple measure of the sum of skinfolds could<br />
track criterion changes in body fat percentage; that is, we derived the change in sum<br />
of skinfolds that would have to be observed in an individual athlete to conclude that<br />
a substantial change in body fat percentage had occurred (greater than the minimum<br />
important difference given by a standardised mean difference of 0.2 standard<br />
deviations). All data were log-transformed prior to analysis.<br />
rEsuLTs: The sum of 8 skinfolds was the most precise practical measure for<br />
tracking changes in body fat percentage. The within-subject correlation (r) between the<br />
sum of 8 skinfolds and DXA body fat percentage was 0.86 (95% confidence interval,<br />
0.81 to 0.90). For the monitoring of an individual male wheelchair basketball player,<br />
a change in sum of 8 skinfolds by a factor of greater than 1.13 (multiply or divide by<br />
1.13) is associated with a practically meaningful change in body fat percentage. For<br />
example, an athlete whose sum of 8 skinfolds decreased from 114 mm to 100 mm (a<br />
reduction greater than 114/1.13) could be said to have become leaner. Reductions in<br />
sum of skinfolds lower than this value would be considered trivial, given the typical<br />
prediction error observed.<br />
CONCLusIONs: A measure of the sum of 8 skinfolds can track changes in body fat<br />
percentage within individual wheelchair athletes with adequate precision, providing a<br />
useful field monitoring tool in the absence of often impractical criterion measures.<br />
1766 May 30, 4:45 PM - 5:00 PM<br />
differences In skeletal Muscle Contractile Properties among<br />
Power and Endurance Elite athletes<br />
Irineu Loturco1 , Hamilton Roschel2 , Carlos Ugrinowitsch2 ,<br />
Cristiano Laurino3 , Saulo Gil1 , Ronaldo Kobal1 , Valmor Tricoli2 .<br />
1Pão de Açúcar Group - Nucleus of High Performance in Sports,<br />
São Paulo, Brazil. 2University of São Paulo, São Paulo, Brazil.<br />
3BM&F - Bovespa Track & Field Club, São Paulo, Brazil.<br />
(No relationships reported)<br />
Measurements of muscle belly responses to electrical stimuli using a displacement<br />
sensor provide valuable information about the skeletal muscle contractile properties.<br />
In this regard, it has been proposed that muscle contraction time (Tc) could be used as<br />
an accurate non-invasive predictor of fiber type composition. Additionally, the muscle<br />
radial displacement (Dm) is considered as a reliable measurement of muscle stiffness.<br />
Thus, it is conceivable that power and endurance elite athletes present significant<br />
differences between these skeletal muscle mechanical properties.<br />
PurPOsE: The purpose of this study was to evaluate if there are significant<br />
differences in muscle contractile properties among power and endurance elite athletes.<br />
METhOds: Thirty-four elite male track and field athletes were divided into two<br />
different groups: power athletes (PA) (sprinters and jumpers; n=18; age: 26 ± 3, 8<br />
years; height: 179 ± 6, 8 cm; weight: 77, 8 ± 8, 2kg) and endurance athletes (EA)<br />
(endurance runners and triathletes; n=16; 26, 4 ± 7, 2 years; height: 168 ± 9, 2 cm;<br />
Vol. 45 No. 5 Supplement S341<br />
weight: 61 ± 12, 2 kg). Dm and Tc were measured in both the rectus femoris (RF) and<br />
the biceps femoris (BF) muscles from the dominant leg, using a Tensiomyographer<br />
device (TMG Measurement System, TMG-BMC Ltd., Ljubljana, Slovenia).<br />
Unpaired t-tests were used to compare the differences between the groups. Statistical<br />
significance was set at P
<strong>Thursday</strong>, May 30, 2013<br />
S342 Vol. 45 No. 5 Supplement<br />
D-59 Clinical Case Slide - Cardiovascular<br />
May 30, 2013, 3:15 PM - 5:15 PM<br />
Room: 103<br />
1768 Chair: Aaron L. Baggish. Massachusetts General Hospital,<br />
Boston, MA.<br />
(No relationships reported)<br />
1769 discussant: Sandra J. Hoffmann, FACSM. Idaho State University,<br />
Pocatello, ID.<br />
(No relationships reported)<br />
1770 discussant: Warren B. Howe, FACSM. Bellingham, WA.<br />
(No relationships reported)<br />
1771 May 30, 3:15 PM - 3:35 PM<br />
sudden Cardiac death--running<br />
Kenneth Leclerc, James Watts, Mark Peele, Kevin Steel, Michael<br />
Rose. San Antonio Military Medical Center, Fort Sam Houston, TX.<br />
(No relationships reported)<br />
hIsTOry: A 51-year-old male had sudden loss of consciousness while running on<br />
a treadmill at the gym. He had been evaluated 4 months prior for a neurocardiogenic<br />
syncopal event following a colonoscopy. Patient found to be without a pulse.<br />
Bystander CPR was performed and the use of an automated external defibrillator<br />
(AED) with successful restoration of a regular pulse. Interrogation of the AED<br />
revealed ventricular fibrillation appropriately defibrillated to normal sinus rhythm.<br />
PhysICaL EXaMINaTION: Heart rate 60, Blood pressure 130/81, Respiratory<br />
rate 12. His breath sounds were clear to auscultation. His heart was regular in rate and<br />
rhythm, normal S1 and S2 without murmur. He had no elevation in his jugular venous<br />
pulsation and was without lower extremity edema.<br />
PhysICaL EXaMINaTION:<br />
1. Acute coronary syndrome<br />
2. Arrhythmogenic right ventricular cardiomyopathy<br />
3. Catecholaminergic polymorphic ventricular tachycardia<br />
4. Brugada syndrome<br />
5. Long QT syndrome<br />
6. Torsades de Pointe<br />
TEsT aNd rEsuLTs:<br />
EKG<br />
--Normal sinus rhythm, right axis deviation, and right bundle branch block<br />
Echocardiogram<br />
--Normal left ventricular size, wall thickness and function with moderate dilation of<br />
the right ventricle and right atrium.<br />
Coronary Angiography<br />
--Luminal irregularities<br />
Cardiac MRI<br />
--Mildly dilated right ventricle with a mildly low right ventricular ejection fraction of<br />
46.4% without other evidence for arrhythmogenic right ventricular dysplasia<br />
Electrophysiology Study<br />
--No accessory pathway found, no evidence of dual AV node physiology, and<br />
normal corrected QT interval after epinephrine infusion. A monomorphic ventricular<br />
tachycardia occurred after high dose (20mcg/min) isoproterenol infusion<br />
Genetic Testing<br />
--4 novel gene mutations coding for sarcomeric proteins (actinin, myosin, and titin).<br />
FINaL WOrKING dIaGNOsIs:<br />
Catecholamine sensitive ventricular tachycardia with aborted sudden death secondary<br />
to apparent RV cardiomyopathy<br />
TrEaTMENT aNd OuTCOMEs:<br />
1. AICD placed for secondary prevention of sudden cardiac death<br />
2. Suppressive long-acting beta-blocker therapy<br />
3. Cardiac rehabilitation without recurrence of symptoms<br />
4. Genetic counseling for the patient and first degree relatives<br />
5. Further evaluation as to the role that the genetic variants may play into malignant<br />
arrhythmias<br />
1772 May 30, 3:35 PM - 3:55 PM<br />
syncope and abnormal Electrocardiogram in an adolescent<br />
Basketball Player<br />
Jodi L. Zilinski, Miranda E. Contursi, Patricia A. Lowry, Caitlin<br />
H. O’Callaghan, Michael A. Fifer, Gregory D. Lewis, Aaron L.<br />
Baggish. Massachusetts General Hospital, Boston, MA.<br />
(No relationships reported)<br />
hIsTOry: A 17 year old Caucasian male basketball player presented following a<br />
syncopal episode, which occurred during basketball practice. He had just completed<br />
MEDICINE & SCIENCE IN SPORTS & EXERCISE ®<br />
sprinting drills and was walking to the bench when he felt lightheaded and lost<br />
consciousness for approximately 30 seconds. He sustained no injuries. He had recently<br />
completed a course of azithromycin for an upper respiratory tract illness. He denied<br />
antecedent chest pain, palpitations, and prior syncope.<br />
PhysICaL EXaMINaTION:<br />
Vital signs: Ht 1.78 meters, Wt 68.0 kg, Heart rate 50 bpm, Blood Pressure 112/62<br />
mmHg<br />
Healthy appearing. Lungs clear. Bradycardic regular rate, normal S1 and S2 without<br />
murmur or gallop. Nonfocal neurologic examination.<br />
PhysICaL EXaMINaTION:<br />
Neurally mediated syncope<br />
Cardiac arrhythmia<br />
Anomalous origin of coronary artery<br />
Structural heart disease (HCM, ARVC)<br />
Athletic remodeling<br />
Myocarditis<br />
TEsT aNd rEsuLTs:<br />
ECG: (Fig. a)<br />
- Sinus bradycardia<br />
- QTc 428 ms<br />
- Increased precordial voltage<br />
- Diffuse repolarization abnormalities<br />
Echocardiogram:<br />
- LV- asymmetric hypertrophy (LV mass 107 g/m 2 , wall measurements: interventricular<br />
septum 9 mm, posterior wall thickness 12 mm)<br />
- RV- normal structure and function<br />
- Coronary Arteries- well visualized, normal coronary origins and proximal courses<br />
Cardiac MRI: (Fig. B)<br />
-LV mass 115 g/m 2<br />
- Asymmetric LV hypertrophy (max wall thickness = 15 mm in inferior region)<br />
- No T2 weighted edema, early or late gadolinium enhancement<br />
- No RV hypertrophy<br />
Cardiopulmonary Exercise Test (CPET):<br />
- Exercise time: 12:54 min<br />
- Peak workload 196 Watts<br />
- Maximal oxygen uptake (VO2) 33.4 ml·kg -1 ·min -1 (75% predicted)<br />
- Decreased peak O2 pulse consistent with abnormal stroke volume augmentation<br />
- No arrhythmias<br />
WOrKING dIaGNOsEs:<br />
Hypertrophic cardiomyopathy vs. Athletic remodeling with neurally mediated syncope<br />
TrEaTMENT aNd OuTCOMEs:<br />
1. Prescribed detraining x 6 months<br />
2. Repeat EKG (Fig. C): Persistent although less marked repolarization abnormalities<br />
3. Repeat Cardiac MRI (Fig. d): Marked regression of LV wall thickness (max = 10<br />
mm in inferolateral region) and LV mass 79 g/m 2 (Δ = -36 g/m 2 , % Δ = -31%)<br />
Discussion with patient and family regarding prognostic uncertainties surrounding<br />
“bizarre” ECG patterns in the absence of structural heart disease. Ultimately cleared<br />
for participation with close follow-up.<br />
1773 May 30, 3:55 PM - 4:15 PM<br />
decreased Ejection Fraction - Baseball<br />
Peter H. Seidenberg, Wayne J. Sebastianelli. Penn State<br />
University, State College, PA. (Sponsor: Francis G. O’Connor,<br />
FACSM)<br />
(No relationships reported)<br />
hIsTOry: A 19 year old freshman baseball catcher underwent routine screening<br />
2D echocardiography as part of his initial preparticipation evaluation. He reports no<br />
history of chest pain, syncope, dizziness, palpitations, or shortness of breath. His past<br />
medical history is unremarkable. There is no history of recent illness. There is a history<br />
of a severe flu-like illness 2-3 years ago, for which he did not seek medical attention.<br />
There is no significant family medical history. He has no current or prior history of<br />
smoking, alcohol use, drug use, or anabolic steroid use.<br />
ACSM May 28 - June 1, 2013 Indianapolis, Indiana
Official Journal of the American College of Sports Medicine<br />
PhysICaL EXaMINaTION:<br />
Height 6’ 1.5”, Weight 175 lbs, BP 114/64, HR 58<br />
General: WD, WN, NAD, A&O x 3<br />
HEENT: WNL<br />
Neck: no JVD, bruit, thyromegaly, or lymphadenopathy<br />
CV: RRR without murmur, rub or gallop - auscultated in supine and upright positions;<br />
equal peripheral pulses; normal chest wall<br />
Lungs: CTAB<br />
ABD: ND, BS(+), NT, no HSM<br />
EXT: no edema or cyanosis<br />
Skin, MSK, and Neuro: WNL<br />
2D screening echocardiogram: Moderately dilated LV, with EF 40%. No wall motion<br />
abnormalities. No LVH. Normal LVOT. Mild mitral regurgitation. Mild tricuspid<br />
regurgitation. Normal pulmonary pressure. Patent foramen ovale with left to right shunt.<br />
PhysICaL EXaMINaTION:<br />
1. Myocarditis<br />
2. Idiopathic cardiomyopathy<br />
3. Prior stimulant or anabolic steroid abuse<br />
TEsT aNd rEsuLTs:<br />
Stress echocardiogram: Physiologic hemodynamic response to exercise. HRR at 1<br />
minute 52. EF at rest 45%. Improved global LV function with exercise but does not<br />
get as hyperdynamic as expected for age, HR, and MET level achieved. No ischemic<br />
changes. Rare PAC’s. No arrhythmias.<br />
Cardiac MRI: LV dilated with diffuse hypokinesis. LVEF = 46%. RV dilated with mild<br />
diffuse hypokinesis. RVEF 51%. Trivial pericardial effusion. No myocardial edema.<br />
Diffuse myocardial fibrosis. Consistent with nonischemic cardiomyopathy.<br />
FINaL WOrKING dIaGNOsIs:<br />
Resolved myocarditis with resultant myocardial scarring<br />
TrEaTMENT aNd OuTCOMEs:<br />
Athlete is withheld from sports participation and exercise. He was placed on a low<br />
dose ACE-I. A repeat echocardiogram is scheduled for 3 months and follow up cardiac<br />
MRI is scheduled in 6 months.<br />
1774 May 30, 4:15 PM - 4:35 PM<br />
heart Murmur- Basketball<br />
Michael R. Tiso, Luis Salazar. Ohio State, Columbus, OH.<br />
(Sponsor: Thomas M. Best, FACSM)<br />
(No relationships reported)<br />
hIsTOry: A 19-year-old African American college sophomore basketball player<br />
presented for a routine pre-participation physical. He reported no previous medical<br />
conditions or injuries, syncope with exercise, or previous loss of consciousness. He<br />
stated he had never had chest pain, shortness of breath, or palpitations while playing<br />
basketball. The athlete had no family history of sudden death but reports his mother<br />
had a “heart valve problem with prior surgeries.”<br />
PhysICaL EXaMINaTION: Vitals: Blood pressure 120/80, pulse 55, respiratory<br />
rate 14, and BMI 25. The patient was a physically fit athlete in no distress. A<br />
musculoskeletal exam showed normal strength, tone, and sensation. Respirations were<br />
clear to auscultation bilaterally. Cardiac exam revealed a regular rate and rhythm with<br />
normal S1/S2 and no gallop, rub, S3, or S4. JVD was not present, he had brisk carotid<br />
upstrokes bilaterally, and peripheral pulses were 2+ throughout. A 3/6 systolic murmur<br />
was heard loudest along the left sternal border which decreased in intensity with<br />
squatting and increased for 3-5 beats upon standing.<br />
PhysICaL EXaMINaTION:<br />
1. Physiologic murmur<br />
2. Hypertrophic obstructive cardiomyopathy<br />
3. Mitral regurgitation<br />
4. Ventricular septal defect<br />
5. Aortic stenosis<br />
TEsTs aNd rEsuLTs:<br />
ECG:<br />
-Sinus bradycardia with LVH and T wave inversions in V3 - V5<br />
Echocardiogram:<br />
-Normal LV function with EF of 65%.<br />
-Intraventricular septal wall 1.1cm in diameter, left ventricular posterior wall 1.4cm.<br />
Cardiac MRI:<br />
-Concentrically hypertrophied LV with normal cavity size and EF of 65%.<br />
-RV minimally hypertrophied with prominent trabeculations.<br />
-Septal thickness 1.4cm, LV free wall thickness 1.3cm<br />
-Anatomically normal valves.<br />
FINaL / WOrKING dIaGNOsIs:<br />
Hypertrophic obstructive cardiomyopathy<br />
TrEaTMENT aNd OuTCOMEs:<br />
1. Case was discussed between cardiology and sports medicine as the posterior wall<br />
thickness was in a diagnostic indeterminate zone.<br />
2. Imaging did not meet criteria for hypertrophic cardiomyopathy; therefore athlete<br />
could not be disqualified from play.<br />
3. Recommended deconditioning for six months with follow up echocardiogram /<br />
cardiac MRI.<br />
4. Athlete decided to continue to play the season without incident.<br />
Vol. 45 No. 5 Supplement S343<br />
1775 May 30, 4:35 PM - 4:55 PM<br />
Thigh Pain--cyclist<br />
Brian C. Liem, Mark A. Harrast. University of Washington,<br />
Seattle, WA. (Sponsor: Stanley Herring, FACSM)<br />
(No relationships reported)<br />
hIsTOry: A 49 year old competitive cyclist presented with progressively worsening<br />
10 year history of right anterior thigh pain with exercise. She experienced a severe<br />
cramping sensation that would start in the anterior thigh and travel into the posterior<br />
thigh and calf with cycling and after several minutes. During more aggressive time<br />
trials or faster sprints her symptoms could present just after 30 seconds. She noted that<br />
when her heart rate reached 155 bpm symptoms would worsen and her leg would “shut<br />
down.” By slowing down and resting her pain improved. She had not been able to race<br />
at the level she wanted to for the prior 2 years specifically due to this right leg pain.<br />
She denied pain or weakness with regular ambulation.<br />
PhysICaL EXaMINaTION:<br />
Normal gait. Normal lumbar and hip range of motion without reproduction of<br />
symptoms. No tenderness to palpation over the groin or anterior thigh. Strength is<br />
5/5 lower extremities bilaterally, sensation is normal and reflexes are symmetric.<br />
Negative dural tension signs. FABER and FADIR maneuvers negative. Normal pedal<br />
and popliteal pulses. Femoral pulses intact in supine but with hip flexion right femoral<br />
pulse diminishes.<br />
PhysICaL EXaMINaTION:<br />
1. Hip Pathology<br />
2. Lumbar radiculopathy<br />
3. Vascular claudication<br />
4. Femoral neuropathy<br />
TEsT aNd rEsuLTs:<br />
1. Pelvis and Right femur X-rays: Normal. No fracture or osteoarthritis<br />
2. Right Ankle Brachial Indexes: 1.29 pre-exercise, 0.38 post exercise<br />
3. Duplex Doppler: Post exercise external iliac artery velocity 231 cm/sec, 50-99%<br />
stenosis.<br />
4. CT angiogram: No stenosis. Minimal narrowing right external iliac artery<br />
FINaL WOrKING dIaGNOsIs:<br />
Right External Iliac Artery Endofibrosis<br />
TrEaTMENT aNd OuTCOMEs:<br />
1. Given her desire to return to high level competition, referred patient for consultation<br />
with vascular surgery.<br />
2. Underwent saphenous vein patch angioplasty.<br />
3. Returned to cycling competition.<br />
1776 May 30, 4:55 PM - 5:15 PM<br />
Concerns Of The heart In a Professional Football hopeful<br />
Leonie Prao 1 , Andrew Tucker 2 . 1 Union Memorial Hospital and<br />
University of Maryland Medical Center, Baltimore, MD. 2 Union<br />
Memorial Hospital, Baltimore, MD.<br />
(No relationships reported)<br />
hIsTOry: 22 year old AA male presents for a professional football free agent<br />
PPE . He denies any current complaints, but admits to history of a heart murmur.<br />
Awareness of his heart murmur resulted from a syncopal episode at the age of 16.<br />
While standing during a wedding, he felt dizzy, and fainted. This syncopal episode<br />
was thought to be vasovagal or neurocardiogenic in origin. Pediatric cardiology<br />
evaluation and echocardiogram in May of 2008 revealed mild MV prolapse and trivial,<br />
hemodynamically insignificant MV regurgitation. He was cleared to participate in<br />
college football and has had no cardiac symptoms throughout college. He currently<br />
denies any chest pain, palpitations, easy fatigability, or peripheral edema.<br />
PhysICaL EXaMINaTION:<br />
The player was noted to have normal blood pressure and heart rate. Cardiac<br />
examination revealed a 3/6 holosystolic murmur with a mid-systolic click, best heard<br />
at the base, but able to be heard at the apex and bilateral sternal borders. Murmur<br />
increased with squatting. Normal S1, S2. No diastolic murmurs. No JVD. No<br />
peripheral edema, 2+ distal pulses bilaterally. Pulmonary exam normal.<br />
PhysICaL EXaMINaTION:<br />
1) Persistent/Worsening Mitral Valve Prolapse/Regurgitation<br />
2) Mitral/Aortic Stenosis<br />
3) Atrial Myxoma<br />
4) HOCM<br />
TEsT aNd rEsuLTs:<br />
EKG: Sinus bradycardia, HR 56, LVH, normal QRS<br />
aP/Lateral CXr-- mild cardiomegaly, rounded cardiac appearance<br />
TTE-Normal LV function w/ estimated LV EF 60%. No obvious segmental wall<br />
motion abnormalities. Mild tricuspid regurgitation. Pulmonary artery pressure<br />
48mmHg consistent with pulmonary hypertension. 3+(Moderate) mitral regurgitation.<br />
Prominent prolapse of the posterior mitral valve. Normal intra-atrial and intraventricular<br />
septum.<br />
FINaL WOrKING dIaGNOsIs:<br />
Persistent/Progressive Mitral Valve Prolapse/Regurgitation<br />
<strong>Abstracts</strong> were prepared by the authors and printed as submitted.<br />
<strong>Thursday</strong>, May 30, 2013
<strong>Thursday</strong>, May 30, 2013<br />
S344 Vol. 45 No. 5 Supplement<br />
TrEaTMENT aNd OuTCOMEs:<br />
1) Referred to cardiology for further evaluation<br />
2) TEE completed- progressive MV prolapse/regurgitation with the development of<br />
pulmonary HTN, the player underwent MV annuloplasty.<br />
3) Repeat TTE 5 weeks status-post annuloplasty revealed normalization of PA<br />
pressures, resolved MV prolapse, but persistent mild-to-moderate MR.<br />
4) Player was not cleared for participation. He was asked to return for<br />
re-evaluation 12 weeks after surgery to allow for ring stabilization.<br />
D-60 Clinical Case Slide - Pediatric Issues<br />
May 30, 2013, 3:15 PM - 5:15 PM<br />
Room: 117<br />
1777 Chair: Nailah Coleman, FACSM. Phoebe Putney Memorial<br />
Hospital, Albany, GA.<br />
(No relationships reported)<br />
1778 discussant: Andrew Gregory, FACSM. Vanderbilt University,<br />
Nashville, TN.<br />
(No relationships reported)<br />
1779 discussant: Angela Smith, FACSM. Bryn Mawr, PA.<br />
(No relationships reported)<br />
1780 May 30, 3:15 PM - 3:35 PM<br />
head Injury In youth Football (FB) - a Case report<br />
Verle D. Valentine1 , Jason C. Dorman2 , Shanna L. Kindt2 ,<br />
Thayne A. Munce2 , Morgan M. Avery2 , Caitlin J. Pearl2 , Hannah<br />
K. Nelson2 , Tryg O. Odney2 , Michael F. Bergeron, FACSM2 .<br />
1 2 Sanford Health, Sioux Falls, SD. National Institute for Athletic<br />
Health & Performance, Sioux Falls, SD.<br />
(No relationships reported)<br />
hIsTOry: A 12-year-old FB running back presented about one hour after he was<br />
hit at nearly the same instant by two defenders while attempting to run the ball. Both<br />
hits involved helmet-to-helmet contact to the frontal area of his helmet and were the<br />
first head impacts he sustained during the game. The athlete was wearing a helmet<br />
instrumented with Riddell® HITSystem accelerometers at the time of the injury.<br />
There was no LOC, but he appeared dazed with poor balance and was removed from<br />
the game immediately. Symptoms included headache, fogginess, feeling slowed down,<br />
and dizziness. No history of previous head injury.<br />
PhysICaL EXaMINaTION:Patient was alert & oriented, answered questions<br />
slowly and appeared dazed. Cranial nerves were intact, and neck was non-tender with<br />
normal ROM. No focal neurological deficits were noted. No amnesia. Immediate<br />
memory and 5-minute recall were normal, however concentration was poor. King-<br />
Devick (K-D) testing and reaction time were slower than baseline. Postural stability<br />
was poor compared to baseline.<br />
PhysICaL EXaMINaTION:<br />
- Concussion<br />
- Intracranial bleed<br />
- Second-impact syndrome<br />
TEsT aNd rEsuLTs:<br />
- Helmet accelerometers: two simultaneous impacts (peak linear accelerations) of 52.4<br />
& 52.2 g’s.<br />
- ImPACT testing: abnormal at day 0, 2, 6 & 12; normal at day 20<br />
- Reaction time: abnormal at day 0, 2, 6 & 12; normal at day 20<br />
- K-D testing: abnormal at day 0, 2, 6 & 12; normal at day 20<br />
- Postural stability testing: abnormal at day 0, 2, 6 & 12; normal at day 20<br />
- NeuroCom® SOT scores: abnormal at day 2, 6 & 12; normal at day 20<br />
- Post Concussion Symptom Score: abnormal at day 0, 2, 6, 12 & 20.<br />
FINaL WOrKING dIaGNOsIs:<br />
Concussion from two simultaneous head impacts of moderate magnitude.<br />
TrEaTMENT aNd OuTCOMEs:<br />
Physical rest and cognitive rest were advised. He was gradually returned to school<br />
after one week with accommodations as symptoms improved. His testing scores and<br />
physical examination returned to normal after 20 days; however, symptoms persisted<br />
past four weeks.<br />
dIsCussION: These data are particularly unique in that the breadth of baseline,<br />
immediate post-concussion and recovery evaluations is extensive. Moreover, this is the<br />
first report of quantifiable head impact data leading to a concussion in youth football.<br />
MEDICINE & SCIENCE IN SPORTS & EXERCISE ®<br />
1781 May 30, 3:35 PM - 3:55 PM<br />
subtle Wrist pain - dance<br />
Chae Ko, Kyle Cassas, FACSM. Steadman Hawkins Clinic of<br />
the Carolinas, Greenville, SC. (Sponsor: Delmas Bolin, FACSM)<br />
(No relationships reported)<br />
hIsTOry: 10 year old female dancer. She complains of pain and swelling to left<br />
wrist. This has been intermittent since 6 months ago with no known injury. She<br />
actively participates in dance and has been in competition. Five months ago, she<br />
experienced swelling. She does not have any history of rheumatologic disease but this<br />
does run in the family. Denies any fevers or redness. No other joint involvement. She<br />
reports pain primarily along the distal radius.<br />
PhysICaL EXaM: Hand/wrist exam: On examination there is soft tissue swelling<br />
involving the left wrist. Her range of motion is limited because of pain. Pain with full<br />
pronation and supination. There is warmth but no erythema. She does have diffuse<br />
tenderness along the left wrist but no focal area that seems to be the most painful. She<br />
is neurovascularly intact. No other joint involvement.<br />
General exam is negative<br />
DIFFERENTIAL DIAGNOSES:<br />
1. Distal radius physeal injury<br />
2. Rheumatologic disease<br />
3. Leukemia (Acute lymphocytic leukemia)<br />
4. Post-infectious arthritis<br />
5. Septic arthritis<br />
6. Lyme disease<br />
7. Behcet Syndrome<br />
8. SLE<br />
TEsTs aNd rEsuLTs:<br />
1. CBC with diff (Heme Profile with diff, HP with diff) neg<br />
2. Sed Rate (ESR) 12<br />
3. CRP Non Cardiac (C Reactive Protein) 2.8<br />
4. Antinuclear Antibodies (ANA), reflex to titer positive (1:160)<br />
5. Rheumatoid Factor (RA Factor, RF Factor) neg<br />
6. ASO Quantitative (ASO Screen, Anti-streptolysin O Ab), serum neg<br />
7. Comprehensive Metabolic Panel (CMP, CMET) neg<br />
8. Lyme Disease AB Total w/reflex Western Blot neg<br />
9. Hep B Core IgM ab neg<br />
10. Hep B surf Ag neg<br />
11. Hep A IgM ab neg<br />
12. Hep C IgG ab neg<br />
13. HLA B27 neg<br />
14. Native DNA ab neg<br />
IMAGING:<br />
Xrays of AP, oblique, and lateral of left wrist is negative<br />
MRI left wrist:<br />
Swelling to radiocarpal joint space. Inflammation along dorsum of wrist and proximaly<br />
along distal radius. Subarticular bone marrow edema of scaphoid, lunate, and radial<br />
epiphysis. Tenosynovitis of 2 nd -5 th extensor compartments. Mild tenosynovitis of flexor<br />
tendons. Preserved articular cartilage. Sever/active inflammatory arthropathy, likely<br />
juvenile idiopathic arthropathy.<br />
FINaL/WOrKING dIaGNOsIs:<br />
Juvenile Idiopathic Arthritis<br />
TrEaTMENT aNd OuTCOME:<br />
1. Immobilization and bracing for protection<br />
2. Physical Therapy<br />
3. Naprosyn BID<br />
4. Pediatric rheumatology referral<br />
5. Methotrexate 15mg PO q week<br />
6. Follow up with pediatric rheumatology<br />
ACSM May 28 - June 1, 2013 Indianapolis, Indiana
Official Journal of the American College of Sports Medicine<br />
1782 May 30, 3:55 PM - 4:15 PM<br />
hip Injury – Football<br />
Joseph Mitchell, Robert Hosey, FACSM, Wade Rankin,<br />
Raymond Wright. University of Kentucky, Lexington, KY.<br />
(No relationships reported)<br />
hIsTOry: 10 year-old football player presented with left hip pain following a contact<br />
football injury. He reported that another player fell on his leg at the bottom of a pile.<br />
He had sharp pain in the area and limped after the injury. Reported improvement over<br />
next 2-3 weeks, but worsened when he tried to return to football and felt a “pop” in his<br />
hip while running. He localized the pain to the groin region and lateral side of the hip.<br />
He had no history of bruising or swelling, and denied radiating pain or neuralgias.<br />
PhysICaL EXaMINaTION: Patient had full ROM of his back without discomfort.<br />
He had no tenderness to palpation to left hip, and had symmetric leg lengths. He<br />
ambulated with antalgic gait, especially on the left. Pain and decreased range of<br />
motion were elicited with internal and external rotation of left hip when compared<br />
to right hip, especially in a flexed position. Motor strength testing was 5/5 in both<br />
lower extremities. Sensation was grossly intact to light touch throughout bilateral<br />
lower extremities. Patient had negative straight-leg raise testing bilaterally, and intact<br />
palpable DP/PT pulses bilaterally.<br />
PhysICaL EXaMINaTION:<br />
1.Labral Tear<br />
2.Legg-Calve-Perthes disease<br />
3.Slipped capital femoral epiphysis<br />
4.Femoral neck stress fracture<br />
5.Left hip dislocation<br />
6.Acetabular fracture<br />
TEsTs aNd rEsuLTs:<br />
AP/Lateral radiographs of left hip and AP pelvis:<br />
-No acute bony injuries with the normal physis<br />
MRI/CT of left hip:<br />
-comminuted, mildly displaced fracture of the left posterior acetabular wall<br />
-punctate loose bodies within the superior joint space<br />
-subchondral fracture of medial femoral head<br />
-posterior labrum attached to the fracture piece of the acetabulum<br />
Final Working Diagnosis:<br />
1.Left posterior hip dislocation with posterior wall acetabular fracture with attached<br />
labrum<br />
2.Subchondral fracture of femoral head<br />
TrEaTMENT/OuTCOME:<br />
1.Non-weight bearing with crutches<br />
2.An open fixation of posterior acetabular wall fracture piece by a 5-hole pelvic<br />
reconstruction plate was performed using a Kocher-Langenbeck approach one week<br />
after diagnosis<br />
3.Treatment plan:<br />
-Discharged on crutches with toe-touch only weight bearing precautions.<br />
-Plan to follow-up in 2 weeks with orthopedic surgery for repeat radiographs. Will base<br />
advancement of physical therapy program on condition at that visit.<br />
1783 May 30, 4:15 PM - 4:35 PM<br />
Bilateral Knee Injuries- soccer<br />
Ben Locke1 , David Soma2 , Aaron Provance1 . 1Children’s Hospital Colorado, Aurora, CO. 2University of Colorado,<br />
Aurora, CO. (Sponsor: John Hill, FACSM)<br />
(No relationships reported)<br />
hIsTOry: 14 year old female soccer player sustained a left knee injury playing<br />
soccer. It was later discovered that she injured her right knee playing soccer 4 weeks<br />
prior. During a soccer practice, she attempted to kick the ball but while planting her left<br />
leg she felt a twist and a pop. She was unable to fully flex or extend her left knee due<br />
to mechanical symptoms. Patient had pain and swelling. Patient was initially evaluated<br />
by athletic trainer as well as team physician. Due to concern of injury, patient was<br />
referred for prompt evaluation at sports medicine clinic. During evaluation the next<br />
day, she shared details of a right knee injury that occurred 4 weeks prior. Initially, she<br />
was evaluated in an urgent care and diagnosed with a right knee sprain. She attempted<br />
to return to sport with continued pain and mild instability of right knee. The patient<br />
reported a similar twisting and pop of her right knee following a kick during practice.<br />
She developed swelling within a few hours of injury.<br />
PhysICaL EXaMINaTION: Initial examination of left knee following injury:<br />
Left knee without deformity. Tenderness along medial joint line. ROM limited to 75<br />
degrees of flexion and extension lacking 15 degrees. Unable to perform Lachman’s.<br />
Medial joint line pain with McMurray’s.<br />
Examination in the sports medicine clinic the next day: Left knee: Same exam as<br />
previous now with large effusion. Right Knee: Trace effusion present. ROM limited to<br />
100 degrees flexion. Lachman’s revealed laxity with spongy endpoint.<br />
PhysICaL EXaMINaTION:<br />
1. Patellar dislocation<br />
2. Complex meniscal injury<br />
Vol. 45 No. 5 Supplement S345<br />
3. ACL tear<br />
4. MCL sprain<br />
5. PCL tear<br />
TEsT aNd rEsuLTs:<br />
Left knee radiographs<br />
- Moderate joint effusion<br />
- No bony abnormalities<br />
Right knee radiographs<br />
- No bony abnormalities<br />
MRI of left knee<br />
- Complete tear of ACL<br />
- Complex radial/vertical longitudinal tear of posterior horn of lateral meniscus<br />
- Grade II sprain of MCL<br />
MRI of right knee<br />
- Complete tear of ACL<br />
FINaL WOrKING dIaGNOsIs:<br />
Right ACL tear. Left ACL tear with complex meniscus tear and grade II MCL sprain<br />
TrEaTMENT aNd OuTCOMEs:<br />
1. Patient will undergo right ACL reconstruction following physical therapy targeted at<br />
increased knee flexion<br />
2. Following right ACL reconstruction and adequate healing of left MCL, patient<br />
will undergo left ACL reconstruction with meniscus repair. Goal interval of 2 months<br />
between surgeries<br />
1784 May 30, 4:35 PM - 4:55 PM<br />
Painful Lumps Of The Lower Leg While Weight Bearing -<br />
Cheerleading<br />
Stacy A. Frye. Geisinger Medical Center, Danville, PA.<br />
(No relationships reported)<br />
hIsTOry: 12 year-old female presents due to 2 lumps on the right anterolateral<br />
shin. They are intermittent - only visible when standing. The first bulge was noticed<br />
6 months ago. The second, inferior and smaller, was noticed 2 weeks ago. They are<br />
painful when present; she describes the discomfort as “pressure”. Unable to continue<br />
cheerleading due to pain with acting as base for stunts and prolonged standing. No<br />
overlying skin changes. No recent illness, known animal/insect exposures or recent<br />
trauma. No similar condition in left leg.<br />
PhysICaL EXaMINaTION: Vital signs within normal limits. Right anterolateral<br />
mid-shin with 2 masses, visible only with weight bearing. Both easily compressible<br />
and with distinct margins. Overlying skin without bruising, abrasion, redness or sign<br />
of injury. No surrounding swelling. Superior mass about 1.5 cm diameter; inferior and<br />
more lateral mass about 2 cm. Tender to compression/palpation. Nonmobile. Pain with<br />
resisted dorsiflexion more so than plantarflexion; no pain with passive range of motion.<br />
Strength 4/5 with dorsiflexion and plantarflexion of right ankle. Normal heel-toe gait;<br />
not antalgic. Sensation, reflexes normal. Left lower leg unremarkable.<br />
PhysICaL EXaMINaTION:<br />
1. Muscle herniation<br />
2. Sebaceous cyst<br />
3. Chronic compartment syndrome<br />
4. Ganglion cyst<br />
5. Soft tissue tumor<br />
TEsTs aNd rEsuLTs:<br />
Ultrasound of right lower leg:<br />
• Hernia of the tibialis anterior and extensor hallucis longus muscles through the<br />
anterior compartment fascia measuring 1.7 x 0.6 x 0.9 cm at maximal herniation.<br />
• Hernia of the peroneus brevis muscle through the lateral compartment fascia<br />
measuring 0.9 x 0.2 x 0.8 cm at maximal herniation.<br />
FINaL/WOrKING dIaGNOsIs:<br />
Transfascial muscle hernias of the tibialis anterior, extensor hallucis longus and<br />
peroneus brevis muscles through the anterior and lateral compartment fasciae.<br />
TrEaTMENT aNd OuTCOMEs:<br />
1. Referral to plastic surgery. Treatment options discussed - including (1) observation<br />
with compression wrap/orthosis during physical activity, (2) herniation repair, likely<br />
with biological patch, (3) fasciotomy.<br />
2. Family chose to observe for now. Elected to use compression wrap as needed for<br />
comfort during activity.<br />
3. Education provided regarding concerning signs that should prompt return.<br />
4. Returned to full activity, no restrictions.<br />
1785 May 30, 4:55 PM - 5:15 PM<br />
Chronic hip Pain - In an active 21 year Old<br />
Julie A. Kafka, Ken Bielak, FACSM. University of Tennessee<br />
Knoxville, Knoxville, TN.<br />
(No relationships reported)<br />
hIsTOry: A 21-year old female presented to the orthopedic clinic complaining of<br />
longstanding bilateral hip and knee pain. Her hip pain was worse than the knee pain<br />
and she said the right side bothered her the most. The pain has been evident since<br />
middle school. She denied trauma prior to the noted pain. Exercise did worsen the<br />
<strong>Abstracts</strong> were prepared by the authors and printed as submitted.<br />
<strong>Thursday</strong>, May 30, 2013
<strong>Thursday</strong>, May 30, 2013<br />
S346 Vol. 45 No. 5 Supplement<br />
pain, especially running. She found running greater than two miles led to increased<br />
right hip pain. The location of pain was in the deep groin region. She denied lateral hip<br />
pain and lower leg numbness or tingling. Also she felt that her hips would snap with<br />
movement.<br />
PhysICaL EXaMINaTION: Examination revealed ambulation without limping.<br />
She denied pain with palpation of her hip and lumbar spine. Pain was elicited with<br />
internal and external rotation of both hips. Range of motion was limited with this<br />
movement. A snapping sensation was noted with right hip flexion and extension.<br />
Straight leg test bilaterally was negative. She complained of medial joint line<br />
tenderness of both knees and anterior knee pain. No obvious effusion. Range of motion<br />
was appropriate. Stability was noted with varus and valgus stressing and Lachman’s.<br />
PhysICaL EXaMINaTION: Iliopsoas tendinopathy, Labral Tear, Femoral Stress<br />
Fracture, Hip Joint Instability, Chondral Lesion of the Hip<br />
TEsT aNd rEsuLTs: X-Ray - AP, Lateral Bilateral Knees: No significant<br />
abnormality, maintenance of joint space, no fractures or dislocations. X-Ray - AP<br />
Pelvis, Lateral Right and Left Hip: Significant hip dysplasia, right hip worse, spur at<br />
femoral neck region of right hip, good maintenance of joint space, but a significant<br />
portion of her femoral heads are uncovered bilaterally, valgus orientation of hips.<br />
MRI Bilateral Hip without contrast: Development dysplasia of the bilateral hips,<br />
more pronounced on the right. No evidence of osteoarthritic changes, labral tear, or<br />
chondromalacia<br />
FINaL WOrKING dIaGNOsIs: Bilateral Congenital Hip Dysplasia<br />
TrEaTMENT aNd OuTCOMEs: Stop impact activities, such as running. Can proceed<br />
with non-impact exercises, like biking. Referral was made to a specialist that specialized in<br />
peri-acetabular osteotomy (PAO). Surgery is planned over the winter and spring.<br />
D-61 Clinical Case Slide - Shoulder Injury II<br />
May 30, 2013, 3:15 PM - 5:15 PM<br />
Room: 123<br />
1786 Chair: James Borchers, FACSM. The Ohio State University,<br />
Columbus, OH.<br />
(No relationships reported)<br />
1787 discussant: Christopher C. Kaeding. The Ohio State University<br />
Medical Center, Columbus, OH.<br />
(No relationships reported)<br />
1788 discussant: Eugene Hong. Drexel University, Newtown Square, PA.<br />
(No relationships reported)<br />
1789 May 30, 3:15 PM - 3:35 PM<br />
shoulder Injury-Ice hockey<br />
Richard Wilson, Cynthia Schroeder. Lindenwood University, St.<br />
Charles, MO.<br />
(No relationships reported)<br />
hIsTOry: A 19-year-old male collegiate ice hockey player presented with history of<br />
persistent anterior shoulder dislocations. These injuries occurred while participating in<br />
ice hockey practices and competition, upon sleeping and while performing activities of<br />
daily living. Two years prior he suffered a right shoulder dislocation while diving head<br />
first into home plate during a high school baseball game. Only physical therapy was<br />
prescribed at this point to increase general shoulder strength focusing on periscapular,<br />
rotator cuff, and trapezius areas of the shoulder. This therapy provided some relief,<br />
however, over the next 2 years the athlete experienced persistent right shoulder joint<br />
instability, increasing pain and frequent dislocations.<br />
PhysICaL EXaMINaTION: Examination of right shoulder revealed no erythema,<br />
bruising or swelling. Pain with palpation over anterior<br />
shoulder region. No AC or SC joint tenderness. Positive test for apprehension and<br />
relocation test, negative posterior jerk test. Full strength in deltoids, supraspinatus, and<br />
subscapularis muscles with maximal grip strength. No scapular<br />
dyskinesia or winging. Neurological signs normal and circulatory tests revealed 2+<br />
wrist pulse and good capillary refill.<br />
PhysICaL EXaMINaTION:<br />
1. Proximal humerus fracture<br />
2. Capsular tear<br />
3. Rotator cuff tear<br />
4. Scalloping of anterior glenoid<br />
TEsT aNd rEsuLTs:<br />
X-ray:<br />
-Humeral head intact<br />
-Scalloping of anterior glenoid<br />
CT scan:<br />
-Comminuted long linear fracture arising from inferior aspect of glenoid<br />
-Joint bodies present anterior to glenoid, medial to coracoid process<br />
-Localized deformity of contour of humeral head posteriolaterally- Hill-Sach’s<br />
deformity<br />
MEDICINE & SCIENCE IN SPORTS & EXERCISE ®<br />
-Bony fragment medial to humeral neck (2x5mm)<br />
FINaL WOrKING dIaGNOsIs:<br />
Chronic right shoulder anterior-inferior instability with Hill-Sach’s deformity<br />
TrEaTMENT aNd OuTCOMEs:<br />
1. Surgical intervention - Latarjet procedure.<br />
2. Immobilization - 4 weeks post-surgery, gentle ROM exercises.<br />
2 weeks - AROM 10 degrees external rotation, 60 degrees abduction, no numbness and<br />
tingling<br />
4 weeks - AROM 20 degrees external rotation, 90 degrees abduction<br />
3. Active/assisted strength program initiated 6 weeks<br />
post-surgery.<br />
4. Along with specific shoulder rehabilitation, a general lower body strengthening and<br />
conditioning program initiated.<br />
1790 May 30, 3:35 PM - 3:55 PM<br />
shoulder Pain: remember The red Flags<br />
Stephan Esser 1 , Robert Shannon 1 , Robert Johnson, FACSM 2 .<br />
1 Mayo Clinic, Jacksonville, FL. 2 Hennepin County Medical<br />
Center, Minneapolis, MN. (Sponsor: Robert Johnson, FACSM)<br />
(No relationships reported)<br />
hIsTOry: 88-year-old, right-handed female, with 2 years of worsening left<br />
postero-lateral shoulder pain and 3 months of rapidly progressive shoulder weakness.<br />
Treatment to date included glenohumeral and subacromial steroid injections without<br />
improvement.<br />
Past medical History: Bilateral Breast Cancer, s/p mastectomy/ radiation, Colon cancer,<br />
s/p hemicolectomy. Squamous Cell Skin Cancer. Pertinent Meds: Flexeril, Tramadol<br />
PhysICaL EXaMINaTION: Gait: non-antalgic, mild ataxia. BP 108/60, RR 18, P<br />
76, SPO2 96%. A and O x 3. No increased work of breathing. Cervical spine: limited<br />
rotation bilaterally. Spurling’s on the left causes posterior neck and left shoulder pain<br />
without radiation to the arm. Shoulder exam: atrophy of the left deltoid, inferospinatus,<br />
teres minor and supraspinatus. Shoulder range of motion is normal on the right and<br />
limited on the left with abduction and flexion of 70 degrees, external rotation to 40<br />
and internal rotation limited by pain. Muscle testing shows 3/5 strength in the C5-<br />
C7 myotomes with preserved 5/5 strength in the distal C8-T1 muscles. Decreased<br />
sensation to light touch in the C6-C7 dermatomes of the left forearm and hand.<br />
Reflexes: on left are limited by guarding and appear reduced throughout. The right arm<br />
and bilateral legs demonstrate normal strength, reflexes and sensation without evidence<br />
of myelopathy.<br />
PhysICaL EXaMINaTION:<br />
1. Brachial Plexopathy<br />
-Tumor, Post-Radiation Changes<br />
2. Multilevel Cervical Radiculopathy<br />
3. Mononeuritis Multiplex<br />
4. Cervical Spinal Stenosis<br />
5. Cervical Myelopathy<br />
6. Brachial Amyotrophy<br />
7. Rotator Cuff Dysfunction<br />
TEsT aNd rEsuLTs:<br />
EMG Left brachial plexopathy with involvement of the posterior cord and<br />
suprascapular nerve<br />
Comprehensive lab panel: HCT: 10.7<br />
M. R. cervical spine: Multilevel spondylosis most significant at C3-C4 and C6-C7 levels.<br />
Bone Scan: Negative for osseous metastasis.<br />
M.R. Brachial Plexus:5x4x5cm lobulated cystic mass with rim of soft tissue within the<br />
left axilla encasing the traversing neurovascular bundle.<br />
IR CT Guided Biopsy: Positive for Squamous Cell Carcinoma<br />
FINaL WOrKING dIaGNOsIs:<br />
Squamous Cell Carcinoma in the Axilla with brachial plexus involvement.<br />
TrEaTMENT aNd OuTCOMEs:<br />
Aggressive pain management<br />
Palliative Radiation<br />
Referral to Hospice<br />
ACSM May 28 - June 1, 2013 Indianapolis, Indiana
Official Journal of the American College of Sports Medicine<br />
1791 May 30, 3:55 PM - 4:15 PM<br />
shoulder Pain in a Golfer<br />
Jothi Murali1 , Michel Arcand2 . 1Brown University/Rhode Island<br />
Hospital, Providence, RI. 2Center for Orthopaedics, Johnston, RI.<br />
(No relationships reported)<br />
hIsTOry: A 67-year-old man played 18 holes of golf. That evening, he woke up<br />
from sleep with pain in his right shoulder. He did not feel any sensation that his<br />
shoulder had dislocated. He went to the emergency room for evaluation, had xrays<br />
taken, was given a sling, and came to the office for follow-up one week later. He<br />
reported the pain to be on the superior aspect of his shoulder and denied any numbness<br />
or tingling.<br />
PhysICaL EXaMINaTION: Obvious deformity with prominence and ecchymosis<br />
over the distal clavicle. Tenderness to palpation over the distal clavicle. Positive Neer<br />
and Hawkins impingement signs. Pain with cross-body adduction. No subluxation or<br />
dislocation. No rotator cuff weakness.<br />
PhysICaL EXaMINaTION:<br />
1. Acromioclavicular arthritis<br />
2. Subacromial bursitis/impingement syndrome<br />
3. Rotator cuff tear<br />
4. Glenohumeral arthritis<br />
5. Acromioclavicular separation<br />
TEsT aNd rEsuLTs: Xrays show a type III AC joint separation.<br />
FINaL WOrKING dIaGNOsIs: Type III AC joint separation.<br />
TrEaTMENT aNd OuTCOMEs: The patient was slowly weaned out of the sling<br />
and allowed to use his arm as tolerated. At one month follow-up, the patient was<br />
started on physical therapy for passive, active-assisted, and active range-of-motion<br />
with progression to strengthening as tolerated. He will be seen again at a ten-week<br />
follow-up to evaluate his progress. It was discussed with the patient that he could be<br />
successfully treated non-operatively with good results. With failure of non-operative<br />
management, a coracoclavicular ligament reconstruction would be done.<br />
1792 May 30, 4:15 PM - 4:35 PM<br />
shoulder Pain - Basketball<br />
Yogesh V. Kolwadkar, Paul Sherbondy, Peter H. Seidenberg.<br />
Penn State University, State College, PA. (Sponsor: Scott<br />
Magnes, FACSM)<br />
(No relationships reported)<br />
hIsTOry: 23 year - old left hand dominant male fell on his abducted right shoulder<br />
while playing basketball. He had the sensation that the shoulder dislocated and<br />
spontaneously relocated. He also experienced dead arm syndrome that resolved 2 days<br />
later. He continued to play, but later had to stop because of pain. He had a previous<br />
instability injury 2 years ago treated with physiotherapy, and remained asymptomatic<br />
until the current episode.<br />
PhysICaL EXaMINaTION: He had full AROM in forward flexion and abduction,<br />
but lacked 3 vertebral levels with adduction and IR. He had mild tenderness in the<br />
posterior aspect of shoulder and scapular winging. He had positive apprehension<br />
and relocation signs as well as a positive O’Brien’s test. Sensation and strength were<br />
normal. His Speed’s test and sulcus sign were negative.<br />
dIFFErENTIaL dIaGNOsIs<br />
1. Bankart lesion<br />
2. HAGL lesion<br />
3. SLAP lesion<br />
4. Rotator cuff tear<br />
TEsT aNd rEsuLTs:<br />
Vol. 45 No. 5 Supplement S347<br />
X- ray - AP, supraspinatus outlet and axillary lateral were normal.<br />
MRI ARTHROGRAM - Hill - Sachs and soft tissue Bankart lesions.<br />
FINAL WORKING DIAGNOSIS: Recurrent anterior - inferior instability of right<br />
shoulder, soft tissue Bankart lesion, HAGL lesion, SLAP lesion, Hill - Sachs lesion.<br />
TrEaTMENT aNd OuTCOMEs:<br />
1. Arthroscopic SLAP repair, open Bankart and HAGL lesion repairs, loose body<br />
removal, no treatment for non- engaging Hill - Sachs lesion.<br />
2. 6 months post - op: pain free, full AROM except 5 degrees loss of ER.<br />
3. Continue home exercise program to maintain ROM and progress with strengthening.<br />
4. He may chip and putt golf balls, swim, and perform low intensity basketball<br />
shooting.<br />
5. No contact or collision activities.<br />
6. Reevaluate in 2 months for return to play decision.<br />
1793 May 30, 4:35 PM - 4:55 PM<br />
shoulder Injury-Motocross rider<br />
Kelly L. Evans-Rankin, Robert Hosey, FACSM, Rebecca<br />
Mercer. University of Kentucky, Lexington, KY. (Sponsor: Robert<br />
Hosey, FACSM)<br />
(No relationships reported)<br />
hIsTOry: A 15-year-old male motocross rider sustained a right shoulder injury<br />
after falling off his motorbike. He took a jump and landed on the ground square onto<br />
his right shoulder with his arm in adduction. He had immediate pain to his shoulder<br />
and shortness of breath with deep inspiration. There was no numbness, weakness,<br />
tingling, or paresthesias of the upper extremity. He initially presented to the ER where<br />
radiographs showed only a widened acromioclavicular (AC) joint . He was placed in a<br />
sling and given analgesics.<br />
Two days later, he presented to the sports medicine clinic with continued pain at the<br />
sternoclavicular (SC) joint, increased shortness of breath, and dysphagia.<br />
PhysICaL EXaM: Exam noted mild tachypnea, and soft tissue swelling at the SC<br />
joint. He had TTP over the AC joint, mid-clavicle, and SC joint. The medial aspect of<br />
the clavicle was felt to be slightly depressed at the SC joint on palpation. He had full<br />
active range of motion (ROM) of neck but neck extension and flexion were painful. He<br />
had overall decreased ROM of his right shoulder secondary to pain. Lungs were CTA<br />
with good air movement. He had 2+ distal pulses and sensation intact to light touch.<br />
PhysICaL EXaMINaTION:<br />
1. AC Sprain/Separation<br />
2. SC Sprain/Dislocation<br />
3. Rib Fracture<br />
4. Clavicle Fracture<br />
5. Sternal Fracture<br />
6. Pneumothorax<br />
TEsTs/rEsuLTs<br />
Chest A/P and lateral radiographs (CXR):<br />
-widening of the right AC joint, concerning for type II AC separation.<br />
CXR (2 days later):<br />
-symmetric appearing SC joints, although minimally rotated limiting evaluation.<br />
CT of chest without contrast:<br />
-posterior displacement of the medial end of the clavicle near the trachea.<br />
FINaL/WOrKING dIaGNOsIs:<br />
Posterior SC dislocation<br />
AC separation<br />
TrEaTMENT aNd OuTCOMEs:<br />
1. Operating room for closed reduction under anesthesia.<br />
2. Normal appearing SC joint with slight widening of AC joint on post reduction films.<br />
3. Placed in sling and given prescription analgesics.<br />
4. Overhead ROM activities and pendulum exercises started 10 days post-op.<br />
5. Clavicle and serendipity view radiographs showed no change at 1 month.<br />
6. Cleared to ride at 2 months post-op.<br />
7. Cleared to race and participate in full contact sports at 4 months.<br />
1794 May 30, 4:55 PM - 5:15 PM<br />
shoulder Injury - Men’s Ice hockey<br />
Matthew Hall 1 , Giselle Aerni 1 , Robert Arciero 2 . 1 University<br />
of Connecticut, Hartford, CT. 2 University of Connecticut,<br />
Farmington, CT. (Sponsor: Thomas Trojian, FACSM)<br />
(No relationships reported)<br />
hIsTOry: 21 year old male freshman ice hockey player presents with shoulder<br />
instability. He reports a history of frank anterior dislocations and is status-post an<br />
arthroscopic repair in 2009. He began having instability episodes again approximately<br />
two years after the procedure. These events have increased in frequency, and he is<br />
now reporting instability with trivial events such as sleeping and once with sneezing.<br />
He has continued to play through several hockey seasons without significant pain or<br />
limitations.<br />
PhysICaL EXaMINaTION:<br />
Examination of the shoulder revealed no asymmetry or muscle atrophy. He had mild<br />
tenderness to palpation over the greater tuberosity and biceps tendon. There was full<br />
<strong>Abstracts</strong> were prepared by the authors and printed as submitted.<br />
<strong>Thursday</strong>, May 30, 2013
<strong>Thursday</strong>, May 30, 2013<br />
S348 Vol. 45 No. 5 Supplement<br />
active range of motion with 5/5 strength testing of the rotator cuff, and 5/5 strength of<br />
the deltoid. There was some discomfort with supraspinatus strength testing. Negative<br />
for impingement. On stability testing, sulcus sign was equal bilaterally. There was a<br />
positive apprehension/relocation test on exam. No significant anterior or posterior shift<br />
was noted with load-shift testing, however the patient guarded extensively. No sensory<br />
deficits noted over the lateral shoulder/deltoid area.<br />
PhysICaL EXaMINaTION:<br />
1. Recurrent shoulder instability<br />
2. Glenoid fracture<br />
TEsT aNd rEsuLTs:<br />
Plain radiographs left shoulder - 3 views<br />
- Read by radiology as normal.<br />
CT scan left shoulder with 3D reconstruction: chosen to evaluate bony anatomy given<br />
the number of instability episodes, and for surgical planning.<br />
- Broad Hill-Sachs lesion of moderate depth.<br />
- Approximately 40% anterior glenoid bone loss.<br />
FINaL WOrKING dIaGNOsIs:<br />
Recurrent anterior-inferior shoulder instability with bone loss.<br />
TrEaTMENT aNd OuTCOMEs:<br />
1. Patient made an informed decision to attempt to play the season.<br />
2. Allowed to return to play with Sully brace for support.<br />
3. Continue with rotator cuff strengthening rehabilitation.<br />
4. Monitor number of instability episodes, if continues to have multiple instability<br />
episodes during the season, will need to consider surgical treatment sooner. Otherwise,<br />
plan for open Laterjet procedure at the end of the current season.<br />
D-66 Basic Science Poster Reception<br />
May 30, 2013, 5:45 PM - 6:45 PM<br />
Room: Sagamore 1 Lobby<br />
1803 Board #1 May 30, 5:45 PM - 6:45 PM<br />
The Influence of respiratory Muscle Fatigue on Inactive<br />
arm Blood Flow during Cycling Exercise<br />
Joshua Smith, Carl J. Ade, Ryan M. Broxterman, Benjamin C.<br />
Skutnik, Craig A. Harms, FACSM. Kansas State University,<br />
Manhattan, KS.<br />
Leg blood flow decreases during heavy exercise with an increased work of breathing<br />
(Wb). Increased Wb contributes to respiratory muscle fatigue (RMF) during sustained<br />
exercise > 85%VO2max. During heavy exercise, blood flow increases to inactive arm<br />
muscle 2-3 fold. It is not known, however, if RMF influences blood flow to inactive<br />
muscle.<br />
PurPOsE: To determine if RMF during cycling exercise would reduce blood<br />
flow and vascular conductance to inactive arm muscle. Also, to examine if similar<br />
reductions occur in skin blood flow.<br />
METhOds: Twelve healthy men (23 ± 2 yrs) completed baseline pulmonary function<br />
tests followed by an incremental cycle test to VO2max. Subjects then cycled at both<br />
70% and 85% VO2max (randomized) for 20 minutes. Maximum inspiratory pressures<br />
(PImax) were measured prior to and immediately following each exercise trial to<br />
determine RMF. During exercise, brachial artery blood flow (BABF) was measured<br />
via Doppler ultrasound and arm skin blood flow was assessed by laser-Doppler<br />
flowometry. Cutaneous vascular conductance (CVC) was calculated as flux/mean<br />
arterial pressure and scaled as % maximal CVC (sites heated to 430C). Mean arterial<br />
pressure (MAP) was measured manually.<br />
rEsuLTs: Significant RMF occurred with the 85%VO2max trial (12.7± 9.8%),<br />
but not with 70% VO2max (p >0.05). BABF significantly increased from baseline<br />
to end exercise in both conditions (70% VO2max 194.7 ± 80.4%; 85% VO2max<br />
144.7 ± 57.9%), and was significantly lower (25%) at 85% VO2max. The amount of<br />
RMF at 85% VO2max was related to the change in BABF (r= 0.66, p
Official Journal of the American College of Sports Medicine<br />
1806 Board #4 May 30, 5:45 PM - 6:45 PM<br />
Myofiber Composition and Fiber Type-specific Expression of<br />
Oxidative Capacity-related Genes Following acute aerobic<br />
Exercise<br />
Miranda Undem, Adam R. Konopka, Bozena Jemiolo, Scott<br />
W. Trappe, FACSM, Matthew P. Harber, FACSM. Ball State<br />
University, Muncie, IN.<br />
PurPOsE: To examine the relationship between myofiber composition and the<br />
expression of genes involved in skeletal muscle oxidative capacity in response to a<br />
single bout of aerobic exercise in slow and fast myofibers.<br />
METhOds: Recreationally active men (n=6, 25±1y, 54±3ml·kg-1·min-1) underwent<br />
60 minutes of cycling at 72±1% VO2max. Gene expression was assessed by qPCR<br />
in slow (MHC I) and fast (MHC IIa) myofiber pools isolated from vastus lateralis<br />
muscle biopsy samples obtained at rest and 2h after exercise. Pearson correlations<br />
were performed to analyze relationships between myofiber composition and exerciseinduced<br />
gene expression.<br />
rEsuLTs: The composition (%) of hybrid myofibers (range 1.6 to 18.0%) was<br />
correlated (P
<strong>Thursday</strong>, May 30, 2013<br />
S350 Vol. 45 No. 5 Supplement<br />
1810 Board #8 May 30, 5:45 PM - 6:45 PM<br />
Mitochondrial related Gene Expression is suppressed after<br />
simulated high altitude Exposure<br />
Dustin Slivka 1 , Matthew Heesch 1 , John Cuddy 2 , Walter Hailes 2 ,<br />
Charles Dumke, FACSM 2 , Brent Ruby, FACSM 2 . 1 University<br />
of Nebraska at Omaha, Omaha, NE. 2 University of Montana,<br />
Missoula, MT.<br />
Short term exposure to altitude / hypoxia (train high / live low) has demonstrated an<br />
increase in mitochondrial function whereas chronic exposure (train high / live high)<br />
has shown a decrease in mitochondrial function.<br />
PurPOsE: To determine the acute gene response after exercise when exposed to<br />
simulated high altitude during recovery.<br />
METhOds: Ten recreationally active males (25 ± 2 yrs, 78.9 ±8.6 kg, 178 ± 8 cm,<br />
13.1 ± 4.5 % fat, 4.3 ± 0.6 L·min-1 VO2 max) cycled for 90 minutes in laboratory<br />
conditions and then either recovered for 6 hours in laboratory conditions (975 m;<br />
normoxia) or at a high simulated high altitude (5000 m; hypoxia). Skeletal muscle<br />
biopsies from the vastus lateralis were obtained before exercise, after exercise, and<br />
6 hours after exercise for the measurement of metabolic gene expression and muscle<br />
glycogen. Blood oxygen saturation was measured via pulse oximetry before exercise,<br />
after exercise, and during recovery. Participants received a liquid carbohydrate<br />
beverage immediately after exercise (1.2 g ·kg-1) and solid feedings (1.28 g · kg-1<br />
carbohydrate, 0.15 g · kg-1 fat, and 0.29 g · kg-1 protein) at 2 and 4 hours into<br />
recovery.<br />
rEsuLTs:Blood oxygen saturation was lower during hypoxia trials than normoxia<br />
trials (p < 0.05). Muscle glycogen decreased with exercise (61 ± 13%, p < 0.05) and<br />
increased with recovery (78 ± 35%, p < 0.05) with no difference between trials (p ><br />
0.05). HIF1α, HIF2α, OPA1, MFN2, NRF2, SOD, COX, and PGC1α gene expression<br />
were suppressed after altitude exposure (p < 0.05) while FIS1, HO1, PFK, and HK<br />
were unaffected by altitude exposure (p > 0.05).<br />
CONCLusIONs: High altitude exposure during recovery from exercise inhibits<br />
gene expression associated with mitochondrial development without affecting muscle<br />
glycogen resynthesis. These data may explain the mechanism by which mitochondrial<br />
function is reduced after extended stays at altitude.<br />
Supported by the Defense Medical Research and Development Program, award<br />
number W81XWH-10-2-0120.<br />
1811 Board #9 May 30, 5:45 PM - 6:45 PM<br />
Effect Of systemic hypoxia On aMPK/PGC-1α signaling<br />
Pathway<br />
Ming-Chiang Lai 1 , Chien-Wen Hou 1 , Chung-Yu Chen 1 , Yi-<br />
Hung Liao 2 , Li-Ching Chou 3 , Sun-Chin Yang 4 , Chia-Hua Kuo,<br />
FACSM 1 . 1 Taipei Physical Education College, Taipei, Taiwan.<br />
2 National Taipei University of Nursing and Health Sciences,<br />
Taipei, Taiwan. 3 Ming Chuan University, Taipei, Taiwan. 4 Shih<br />
Hsin University, Taipei, Taiwan. (Sponsor: Kuo, Chia-Hua,<br />
FACSM)<br />
(No relationships reported)<br />
PurPOsE: Hypoxia could increase blood glucose clearance. Normobaric systemic<br />
hypoxia has been demonstrated to improve the ability of glycemic control. Moreover,<br />
stress-induced activation of AMPK and PGC-1α would enhance muscle glucose<br />
uptake. The purpose of this study was to investigate the effect of normobaric systemic<br />
hypoxia exposure on the expression of AMPK and PGC-1α in rat skeletal muscle.<br />
METhOds: Forty Sprag-Dawley rats were randomly divided into 5 groups, including<br />
control (C), 30 mins hypoxia (H-30), 60 mins hypoxia (H-60), 120 mins hypoxia<br />
(H-120) and 240 mins hypoxia (H-240). During hypoxia exposure, blood glucose<br />
was measured. After the treatment, skeletal muscles were excised to determine the<br />
phosphorylation status of AMPK and gene expression of PGC-1α and HIF-1α.<br />
rEsuLTs: Significant increase in blood glucose level was observed under acute<br />
normobaric hypoxia in H-30 (p < 0.05), and returned to the basal level after one hour.<br />
Increased phosphorylated AMPK was observed with hypoxia in H-30 (p < 0.05),<br />
H-60 (p < 0.05), H-120 (p < 0.05) but no change in H-240. Increased PGC-1α gene<br />
expression was determined under hypoxia from 60 - 240 mins hypoxia exposure (p <<br />
0.05). However, there is no difference in HIF-1α gene expression among all groups.<br />
CONCLusIONs: Acute 14% normobaric systemic hypoxia exposure can increase the<br />
PGC-1α gene expression via AMPK signaling pathway in rat skeletal muscle.<br />
MEDICINE & SCIENCE IN SPORTS & EXERCISE ®<br />
1812 Board #10 May 30, 5:45 PM - 6:45 PM<br />
differential Baroreceptor Modulation of sweat rate and<br />
Cutaneous Vascular Conductance in hyperthermic humans<br />
Zachary J. Schlader 1 , Rebekah A.i. Lucas 2 , James Pearson 2 ,<br />
Craig G. Crandall, FACSM 2 . 1 Institute for Exercise and<br />
Environmental Medicine, Dallas, TX. 2 Institute for Exercise and<br />
Environmental Medicine and University of Texas Southwestern<br />
Medical Center, Dallas, TX.<br />
PurPOsE: To test the hypothesis that the baroreceptor unloading that occurs during<br />
passive heat stress limits increases in cutaneous vascular conductance (CVC) and<br />
sweat rate.<br />
METhOds: Two protocols were performed (mean age and weight: 27 ± 5 y, 73.3 ±<br />
13.5 kg). In both protocols subjects underwent passive heat stress, eliciting an increase<br />
in intestinal temperature of ~1.8°C. Protocol 1 (N=10) - Upon attaining hyperthermia,<br />
a bolus (19 ml/kg) of warm (~38°C) isotonic saline was rapidly (5-10 min)<br />
intravenously infused to elevate central venous pressure (CVP). Primary dependent<br />
variables were: CVP, mean arterial pressure (MAP), forearm sweat rate, and forearm<br />
CVC. Protocol 2 - Upon attaining hyperthermia, phenylephrine was intravenously<br />
infused (60-120 μg/min) to elevate MAP. Dependent variables were the same as<br />
Protocol 1 except that CVP and CVC were not measured. Data are reported during<br />
normothermia, hyperthermia just prior to infusion, and during the last min of infusion.<br />
rEsuLTs:Protocol 1 - Hyperthermia reduced CVP from 3.9 ± 1.9 mmHg<br />
(normothermia) to -0.6 ± 1.4 mmHg (P
Official Journal of the American College of Sports Medicine<br />
CONCLusION: These data suggest a striking discrepancy between ATs’ perceived<br />
knowledge and competence in managing athletes with MHDs. Our findings will<br />
contribute to the currently limited sports medicine literature examining ATs’<br />
competence and experiences with MHDs. Clinical implications, including the<br />
development of standards of care and clinical decision rules will be discussed.<br />
1815 Board #2 May 30, 5:45 PM - 6:45 PM<br />
Examining Neurocognitive Function in Previously Concussed<br />
high school Female soccer Players<br />
Cameron R. Forbes, Joseph J. Glutting, Thomas W. Kaminski,<br />
FACSM. University of Delaware, Newark, DE.<br />
Care of sport-related concussions in soccer has gained recent attention in the medical<br />
community. Interestingly, purposeful heading_a unique, yet strategic and inherent<br />
part of soccer involves repeated sub-concussive blows to the head. Of importance, the<br />
developing female adolescent brain seems vulnerable to deficits in neurocognition and<br />
physical symptoms associated with sustaining a concussion.<br />
PurPOsE: To determine whether previous concussion history produces a decline in<br />
neurocognitive performance and concussion-related symptoms over the course of a<br />
competitive season when compared to healthy controls.<br />
METhOds: 210 female interscholastic soccer players were equally divided into<br />
control [CON] (never concussed) and experimental [EXP] (previously concussed)<br />
groups. We assessed neurocognitive performance using the ANAM (Automated<br />
Neuropsychological Assessment Metrics) computer program before and after their<br />
competitive season. Throughput scores, which measure cognitive speed and accuracy,<br />
were computed for seven subtests on the ANAM. In addition, total concussion<br />
symptom checklist (CSC) scores were gathered on each subject. Headers were<br />
recorded at all sanctioned matches throughout the season. Data were analyzed using a<br />
series of one-way ANCOVAs. Covariates comprised pretest scores on the dependent<br />
variables under consideration (ANAM and CSC scores), age, height, weight, and the<br />
total number of headers. Missing values were handled using multiple imputation.<br />
rEsuLTs: Despite having played in more games (16.1 vs. 12.9), the EXP had fewer<br />
total headers than the CON (24.9 vs. 28.1). Additionally, headers per game were<br />
surprisingly low in both groups (1.4 in EXP vs. 1.2 in CON). Unexpectedly, there were<br />
no significant differences between the EXP and CON across all dependent variables<br />
measured (p > .05).<br />
CONCLusION: History of previous concussion has been reported to increase<br />
subsequent concussion risk as much as fourfold. This study suggests that although<br />
previously concussed subjects involve themselves in purposeful heading (i.e. subconcussive<br />
insults) throughout a competitive season, there appears to be no additional<br />
risk for a decline of neuropsychological test performance or concussion symptoms.<br />
Additional research is needed as to what may result over the course of a playing career.<br />
1816 Board #3 May 30, 5:45 PM - 6:45 PM<br />
Vestibular and Cognitive Impairment in athletes with<br />
Protracted Concussion<br />
Anthony P. Kontos 1 , R J. Elbin 2 , Jonathan French 3 , Michael<br />
Collins 3 . 1 University of Pittsburgh- School of Medicine,<br />
Pittsburgh, PA. 2 University of Pittsburgh-School of Medicine,<br />
Pittsburgh, PA. 3 UPMC Sports Medicine Concussion Program,<br />
Pittsburgh, PA.<br />
A “miserable minority” (~20%) of athletes require more than 21 days to recover from<br />
concussion. Researchers and clinicians have speculated that vestibular impairments<br />
may play a role in this protracted or “chronic” concussion population.<br />
PurPOsE: To compare cognitive performance and symptoms of athletes with and<br />
without vestibular impairments following protracted concussion.<br />
METhOds: A comparative cross-sectional design involving 48 athletes (28 males,<br />
20 females) aged 9 to 23 yrs (M= 15.28, SD= 3.00) with a diagnosed protracted (>21<br />
days since injury) concussion. Participants completed a computerized neurocognitive<br />
test and symptom report at their initial clinic visit. At this time, a health care provider<br />
trained in sport-related concussion and vestibular assessment completed a vestibular<br />
screening form for each athlete, which includes clinical interview and exams covering<br />
three domains: vestibular dizziness, vestibulo-spinal, vestibulo-ocular. Visual<br />
convergence and accommodation distances were also measured. Analyses included<br />
ANOVAs with Bonferroni adjustment (p6 cm) convergence distance scored lower on RT (F=3.96, p=.05)<br />
than those without. A dose-response for vestibular impairments was supported for<br />
total (F=4.59, p=.007), cognitive (F=3.25, p=.03), somatic (F=8.43, p=.001) and<br />
sleep (F=3.56, p=.02) symptoms. Non-significant dose-response trends for vestibular<br />
impairment on cognitive performance were also supported.<br />
CONCLusIONs: Athletes with vestibular impairment from protracted concussion<br />
experience slower RT and more symptoms than those without. Brief vestibular<br />
Vol. 45 No. 5 Supplement S351<br />
assessments may help identify these athletes for targeted therapies. This research was<br />
supported by the Albert B. Ferguson, Jr. M.D. Orthopaedic Fund of the Pittsburgh<br />
Foundation Research Grant.<br />
1817 Board #4 May 30, 5:45 PM - 6:45 PM<br />
Test-retest and Inter-rater reliability Of The Functional<br />
Lower Extremity Evaluation<br />
Melissa Hodgins1 , Karyn Haitz1 , Rebecca Shultz2 , Gordon<br />
Matheson2 . 1Stanford University, STANFORD, CA. 2Stanford University, Stanford, CA.<br />
PurPOsE: The Functional Lower Extremity Evaluation (FLEE) is a standardized<br />
testing protocol that may be a valuable tool in return to play decision making for<br />
measuring lower extremity function and assessing re-injury risk factors. This study<br />
aimed to establish the test-retest and inter-rater reliability of the FLEE.<br />
METhOds: FLEE is a battery of tests (Table 1) that were administered and rated for<br />
40 uninjured student athletes from various disciplines. Each athlete was tested twice,<br />
one week apart, to assess test-retest reliability. The same research intern administered<br />
and scored all tests during both sessions, whereas a physical therapist and an athletic<br />
trainer scored only one session per athlete to determine inter-rater reliability. The<br />
intern was blinded to first session scores during the second session, and all raters were<br />
blinded to each other. For six of the tests (excluding “Lateral Leap and Catch” and<br />
“LEFT” tests), limb symmetry means were calculated and 95% confidence intervals<br />
of the three scores using a one-sample t-test. The LEFT (Lower Extremity Functional<br />
Test) was not included in this study as it requires a learning session.<br />
rEsuLTs: Inter-rater reliability was shown to be in the excellent range (0.80 to 1.00)<br />
for all tests (Table 1). Test-retest reliability was also excellent for all tests except for<br />
the “Timed Lateral Step Down,” for which it was moderate (0.60 to 0.80).<br />
CONCLusION: FLEE is a reliable assessment tool. Future studies should investigate<br />
the validity of FLEE to reduce re-injury rates.<br />
Table 1<br />
Results for test-retest (Pearson’s correlation), inter-rater ( Intra-class correlation<br />
coefficient (ICC)), limb symmetry means and 95% confidence interval using the FLEE<br />
test for healthy athletes.<br />
Pearson ICC<br />
Limb Symmetry Limb Symmetry<br />
(test(inter- Mean [%] 95% CI<br />
retest)rater) Timed Lateral Step<br />
0.772 0.829 114.4 [102.3, 126.4]<br />
Down<br />
Lateral Leap and<br />
0.731 0.846 -- --<br />
Catch<br />
Single Leg Hop for<br />
0.912 0.996 97.3 [97.8, 102.0]<br />
Distance<br />
Timed Hop 0.917 0.891 98.6 [97.0, 100.3]<br />
Triple Hop 0.948 0.996 98.6 [96.8, 100.4]<br />
Crossover Hop 0.942 0.997 100.2 [98.0, 102.3]<br />
Square Hop 0.833 0.982 102.2 [93.7, 110.7]<br />
1818 Board #5 May 30, 5:45 PM - 6:45 PM<br />
Tingling and Weakness - Gymnastics<br />
Nailah Coleman, FACSM. Children’s National Medical Center,<br />
Alexandria, VA.<br />
(No relationships reported)<br />
hIsTOry: 16 y/o gymnast presented with sharp right patellar tendon pain and midlower<br />
back pain after two separate vault injuries within the prior two weeks. Her pain<br />
was exacerbated by movement and use of her knee and back. She denied sedentary<br />
pain, sleep disturbance, or bowel-bladder insufficiency. She noted atraumatic “pins and<br />
needles” on her right dorsal hand over the past five days but denied neck, elbow, or jaw<br />
pain or injury.<br />
Her past medical and surgical histories were unremarkable.<br />
Her only medicine was Aleve. She had no known allergies.<br />
Exam: she was WDWN in NAD. She had symmetric appearance of her extremities<br />
and a minimal curvature of her spine. She had a normal gait and was able to heel, toe,<br />
and duck walk. She was nontender to palpation. She had full motion of her trunk and<br />
extremities but pain with lumbar extension. Strength, sensation, and neurovascular<br />
status were intact and symmetric, except for 4+/5 strength in the right upper extremity.<br />
She had right hand cramping with elevated arm stress test and right shoulder pain with<br />
empty can, O’Brien’s test, and Speed’s test.<br />
PhysICaL EXaMINaTION:<br />
•Spinal cord lesion<br />
•Nerve root compression<br />
•Peripheral nerve disease<br />
•Patellar tendinitis<br />
•Spondylolysis<br />
•Back strain<br />
TEsTs aNd rEsuLTs<br />
X-rays<br />
•Cervical spine with oblique views: increased transverse processes<br />
<strong>Abstracts</strong> were prepared by the authors and printed as submitted.<br />
<strong>Thursday</strong>, May 30, 2013
<strong>Thursday</strong>, May 30, 2013<br />
S352 Vol. 45 No. 5 Supplement<br />
•Scoliosis views: minimal curvature<br />
•Lumbar spine with oblique views: normal<br />
•Shoulder: normal<br />
•Knee: normal<br />
MRI<br />
•Spine: a lesion at C4-C5 measuring 5 mm (width) x 15 mm (cranial-caudal) with mild<br />
enhancement, which could signal a demyelinating process, tumor, or trauma.<br />
•Brain: findings suggestive of volume loss without evidence of gliosis or<br />
demyelination process.<br />
Final Working Diagnosis: transverse myelitis<br />
TrEaTMENT aNd OuTCOMEs<br />
•Urgently seen by Neurology and admitted from clinic with a progressively<br />
symptomatic exam, including hyperreflexia and clonus.<br />
•CSF and serum studies for infectious and rheumatologic diseases were normal, except<br />
for an elevated ANA. A definitive etiology has not been found.<br />
•She was given a three-day course of methylprednisolone and responded well.<br />
•She was discharged home with plans for Neuro-Ophthalmology, PM&R, and repeat<br />
imaging.<br />
•New studies are pending.<br />
1819 Board #6 May 30, 5:45 PM - 6:45 PM<br />
Functional Movement screen is a Poor Predictor of Injury in<br />
division I athletes<br />
Meghan Warren 1 , Craig A. Smith 1 , Ryan Pinson 1 , Nicole J.<br />
Chimera 2 . 1 Northern Arizona University, Flagstaff, AZ. 2 Daeman<br />
College, Amherst, NY.<br />
The Functional Movement Screen (FMS) evaluates performance in deep squat, hurdle<br />
step, inline lunge, shoulder mobility, active straight leg raise, trunk stability pushup,<br />
and rotational stability using a 4 point ordinal scale (3-0). A summed FMS score of 14<br />
or less has been associated with increased risk of serious injury (i.e., 3 wks inactivity)<br />
in professional football players and lower extremity injury in female Division II<br />
volleyball, basketball, and soccer athletes. These studies are limited to specific sports<br />
and injury definition.<br />
PurPOsE: To determine the association between FMS total score and component<br />
scores and non-contact and overuse injuries in Division I (DI) athletes.<br />
METhOds: 170 athletes (20.2 ± 1.5 yrs, 1.77±0.10 m, 79.2± 20.7 kg, n = 89 male),<br />
injury-free at the time of testing, completed the FMS prior to their respective seasons.<br />
Athletes competed in their season and any injury that caused the athlete to report<br />
to the athletic training room was collected. Contact injuries were excluded. ROC<br />
curves were created to determine the best FMS cut-points (7, 10, 12, 14, 16, 18) for<br />
predicting injury. An independent t-test assessed differences in mean FMS between<br />
those injured or not. Logistic regression determined the odds of injury with FMS total<br />
score and components. History of previous injury and sex were included in the models<br />
as confounders.<br />
rEsuLTs: 74 athletes were injured during their sport season. FMS total score was<br />
not different between those who sustained an injury (14.3±2.5) and those who did<br />
not (14.1±2.4; p = 0.57). No ROC curve maximized sensitivity and specificity, so<br />
previous published cut-point of 14 or less (n=92) vs. greater than 14 (n=78) was<br />
used for analysis with injury (sensitivity = 54%, specificity 46%). After adjustment<br />
for confounders, no statistically significant association between FMS total score<br />
(dichotomoized at 14) and injury (odds ratio [OR] = 1.02, 95% confidence interval<br />
[CI] 0.54 - 2.0) existed. Lunge was the only component that was statistically associated<br />
with injury; those scoring 3 were less likely to have an injury compared with those<br />
who scored 2 (OR = 0.21, 95% CI 0.08 - 0.58).<br />
CONCLusIONs: Using a clinically relevant definition of injury, FMS total score was<br />
a poor predictor of non-contact and overuse injury in this group of DI athletes. The<br />
lunge was able to predict injury.<br />
1820 Board #7 May 30, 5:45 PM - 6:45 PM<br />
Exercise related syncope In active duty soldiers<br />
Chad Asplund. Eisenhower Army Medical Center, Fort Gordon,<br />
GA.<br />
PurPOsE: To better characterize the prevalence of exercise related syncope (ERS)<br />
in an active duty military population as well as examine possible factors associated<br />
with ERS.<br />
Methods and Study Design: Cohort study design. The Armed Forces Health<br />
Longitudinal Technical Application (AHLTA) electronic health record was queried<br />
for all cases of syncope (780.2) seen at Eisenhower Army Medical Center in primary<br />
care clinics from 2005-2010 and charts were reviewed. Those with syncope related<br />
to exercise had charts followed prospectively until completion of specialty evaluation<br />
and diagnosis. Main outcome measure was a medical diagnosis requiring restriction<br />
from duty or from participation in sports. Demographic data analyzed with descriptive<br />
statistics and main outcome measure with multiple logistic regression.<br />
rEsuLTs: 123 total cases of syncope and 58 cases of ERS were reviewed. 40<br />
cases had witnessed collapse, 16 cases were found to have a medical etiology (6<br />
neurological, 3 pulmonary, 3 cardiac, 2 migraine, 2 heat related), 24 had unexplained<br />
etiology. Average age was 25.67 +/- 5.92 (range 18-39) years. After controlling for age,<br />
past medical history, history of collapse, and smoking, those Soldiers with a history of<br />
MEDICINE & SCIENCE IN SPORTS & EXERCISE ®<br />
migraine headaches were 11.3 times more likely to have a medical etiology associated<br />
with their exercise related syncope compared to those without migraine (p
Official Journal of the American College of Sports Medicine<br />
TTE-Normal LV function w/ estimated LV EF 60%. No obvious segmental wall<br />
motion abnormalities. Mild tricuspid regurgitation. Pulmonary artery pressure<br />
48mmHg consistent with pulmonary hypertension. 3+(Moderate) mitral regurgitation.<br />
Prominent prolapse of the posterior mitral valve. Normal intra-atrial and intraventricular<br />
septum.<br />
FINaL WOrKING dIaGNOsIs:<br />
Persistent/Progressive Mitral Valve Prolapse/Regurgitation<br />
TrEaTMENT aNd OuTCOMEs:<br />
1) Referred to cardiology for further evaluation<br />
2) TEE completed- progressive MV prolapse/regurgitation with the development of<br />
pulmonary HTN, the player underwent MV annuloplasty.<br />
3) Repeat TTE 5 weeks status-post annuloplasty revealed normalization of PA<br />
pressures, resolved MV prolapse, but persistent mild-to-moderate MR.<br />
4) Player was not cleared for participation. He was asked to return for<br />
re-evaluation 12 weeks after surgery to allow for ring stabilization.<br />
1823 Board #10 May 30, 5:45 PM - 6:45 PM<br />
Proximal Thigh swelling Precipitates Numbness, Tingling<br />
and swelling In a 38yo stunt rider<br />
Ryan S. Wagner. Avita health System, Bucyrus, OH.<br />
hIsTOry: 38yo male presents to the clinic in mid-August 2012 with a complaint<br />
of a large hematoma over his proximal right thigh and focal swelling over his right<br />
patella after wrecking his motorcycle during a stunt-riding event on four weeks prior.<br />
He was diagnosed with hematoma and pre-patellar bursitis. The pre-patellar bursa<br />
was aspirated under ultrasound guidance and fully drained with prescription for<br />
prophylactic antibiotics. The bursitis resolved.<br />
Two months later he returned with persistent swelling to the proximal, anterolateral<br />
right thigh. He had developed constant numbness and tingling over the anterolateral<br />
aspect of his thigh progressing to just superior to the knee accompanied by severe<br />
burning pain.<br />
PhysICaL EXaMINaTION:<br />
Inspection: Discrete, fluctuant mass overlying the proximal anterolateral thigh, 10cm<br />
distal to inguinal crease, 10x7cm in dimension. No associated erythema, ecchymosis or<br />
wound. Otherwise unremarkable.<br />
Palpation: Burning pain is provoked with palpation of the medial third of the mass.<br />
Otherwise no specific tenderness.<br />
Neurologic: Normal strength and reflexes, diminished sensation in the distribution of<br />
the anterior branch of the Lateral Femoral Cutaneous Nerve (LCFN).<br />
Special maneuvers: +Tinel’s over the medial third of the fluctuant mass.<br />
PhysICaL EXaMINaTION: 1) Seroma, organized hematoma, soft tissue mass; 2)<br />
HNP/Radiculitis, meralgia paresthetica.<br />
TEsT aNd rEsuLTs: Diagnostic US of the lesion demonstrated a fluid filled<br />
mass with delineation between the muscular fascia and the sub-cutaneous tissue. A<br />
structure is visualized traversing the lumen located in the medial third of the lesion<br />
in the anatomic location of the LCFN, tented. The lesion was aspirated and 90mL of<br />
serosanguinous fluid was removed.<br />
FINaL WOrKING dIaGNOsIs: Morel-Lavallee lesion causing Meralgia<br />
Paresthetica<br />
TrEaTMENT aNd OuTCOMEs: The patient continued a compression wrap for<br />
Vol. 45 No. 5 Supplement S353<br />
3 days after which the lesion recurred. Pain returned 4-5 days later. He requested a<br />
second aspiration. This was performed with 60mL of serosanguinous fluid removed<br />
and 100mg of Doxycycline reconstituted in 10mL of sterile water was injected back<br />
into the lesion for sclerodesis. He was instructed on continuing the compression wrap<br />
for 3-4 weeks. At 2 weeks the lesion has not yet recurred.<br />
<strong>Abstracts</strong> were prepared by the authors and printed as submitted.<br />
<strong>Thursday</strong>, May 30, 2013