Editorial This edition^ofThe South African Journal of Sports Medicine is devoted to the biennial SASMA Conference. Its contents consists of over 65 abstracts that represent the free communications that have been presented at the Conference. Publication of all the free communications in this Journal is a fs fs M A l A K ’ a r WeU as 016 SoUth SP°rts Medicine AssociationVbAbJvlA). A number of important points come to mind. SASMA r iS fS the laS eSt im;nber of£ree communications yet presented at a S ^ S M jn6iCates ^ S° Uth AfHcan SP°rts Scientists and Sports Medicine Practitioners are willing and able to conduct and present there lesearch. For any growing organization this surely is a healthy sign that t liere is interest and ability despite many constraints, including financial sup­ port for research which unfortunately seems to dwindle. Secondly, the Journal was in a position to publish the proceedings for the first time. Tins means that a research abstract can now be referenced in a scien- c T X e i^ ̂ W01 “ “ d * Thirdly tribute must be paid to the investigations who will present their research findmgs at the Conference for their high quality research. It is encouraging to page through the abstracts and come across many high quali­ ty research projects that surely will stand their ground in any International meeting. Many of these studies document novel concepts, treatment modali­ ties and scientific findings. My congratulations to all those who spent endless hours in laboratories and clinics. Tins effort must rate as one of the best ways to promote this country to the somewhat 15 International scientists who will attend the Conference I am indeed proud to be a member of SASMA, and one of the many South African Sports Medicine practitioners. Dr M P Schwellnus Co-Editor: South African Journal of Sports Medicine Reô nJcGel on-th^spot-paln relief SPORTS MEDICINE SEPTEMBER 1996 1 R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 2. ) HI-TECH THERAPY for supporting occupational and physiotherapy K in e-tec h multi fu n ction com puterised rehabilitation unit. The m ost effective lo w er extrem ity rehabilitative, sirejigine.u ns and stretching tool on the market! 1. 2 . 3. 4. 5. Over 90% of all back injuries occur at the base of the spine. Most back supports ride up leaving the base of the spine unsupported. Saunders supports won’t ride up and provide continual back support where it s rea y needed most. fir amnnH the nelvis as well as the lower back. * - — - Johannesburg: Tel. (O il) 706-7420/1 Cape Town: C ell. (083) 653-2221 £ £ j -| y E R f l P Y Durban: Tel. (031) 21 7797 R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 2. ) T in ; SOI TIL AFRICAN J O U M V L OF SPORTS MEDICINE VOLUME 4 NUMBER 1 MARCH 1997 Editors ProJ'TD N oa k es Dr M P Schu'ellnus Editorial Board D r M E Moolla D r P de Jciger Dr ,J S kow no D r P Schw artz P r o f R Stretch D r C de Ridder P r o f B ( 'A n d r e w s D r E U’ Derm an Mr R 11 Far man Dr R H Mars D r C A Noble International Advisory Board L yle rtsmen and women (19-25 years old) in Potchefstroom continued on page 4 The Editor The South African Journal of Sports Medicine PO Box 115, Newlands 7725 PRODUCTION' Andrew Thomas PUBLISHING Glcnbarr Publishers tv Private Bag X I 4 Parklands 2196 Tel: (O il) 442-9759 Fax: (011) 880-7898 ADVERTISING M arika vered. Interventive measures include ischaemic compression, Jce and stretch techniques, intramuscular injection. The indications and contraindications o f each technique may be covered. Exercises, both in treatment rooms and at home, Postural modifications and activity stress.procedures to conclude. 3 APPLIED KINESIOLOGY FOR SPORTSMEN V Boston, Johannesburg South Africa My goal was to find the best techniques for both patient and practitioner in the treatment and prevention o f sport’s injuries. I used Applied Kinesiology (AK) to achieve this goal. AK is the most holistic system o f healing I have come across, as it com ­ bines the energy balancing methods o f Chinese Medicine (acupuncture or acupressure), with the structural balancing methods o f Osteopathy and Chiropractic, plus some spe­ cialised techniques o f its own. Also included is Cranial Osteopathy because the brain is attached to the sacrum via the dura mater. AK is the science o f muscle testing to give die practitioner feedback o f what corrective m ediods are required to the patient. Muscle testing again confirms the success or failure o f the technique just applied. This is because each of our muscles are connected to an organ and hence one o f the 14 acupuncture meridians. Thus every muscle in the body can be accessed via the acupuncture meridians and odier specialised techniques. This is also true for ligaments, tendons and bones. I have been using the above techniques for a year and have found that I am much more successful hi treating injuries than previously widi conventional techniques. Also the injuries don’t re-occur as with previous methods. Proof o f this is the fact that previously, trigger points would come back, but now after eliminating them in conjunction with die above methods they don’t. In conclusion both my patients and I have found the above m ediods superior to conventional methods used by me previously, as we have had quicker, more permanent results, and the treatment are not at all painful, unlike some conventional mediods. Also, some injuries only respond to the above methods and it is the only system that could clear reac­ tivity. (Reactivity is the phenomena o f a tight muscle “bully­ ing” a week muscle thus preventing d ie weak muscle from strengthening. This is spectacular to witness). Other advan­ tages are no equipment needed and AK is not restricted to injuries only-it can be used for any medical and emotional problem with out side effects; or just to balance up an athlete for optimum performance. 4 ARE ASTHMATICS FIT TO SCUBA DIVE? Dr AS Branfield - General Practice - Randburg - R.S.A To propose that under certain clearly defined criteria (i.e. effective treatment and control o f exercise - induced asdima), well controlled asthmatics can dive. To present an approach to recognizing asthma, assessing its severity', and providing effective treatment specifically in divers, both novice and expe­ rienced. To present m ediodology and a clinical approach cur- rentfy used in South Africa as well as d ie wu\ asthmatic divers or potential divers are approached in other countries. To pre­ sent clear and concise recommendations and a clinical approach to both the novice divers with asthma and experi­ enced divers with asdima. To present acceptable treatment (both acute and preventative) for asthma in a hyperbaric envi­ ronment. To present international standards and approaches to asdima aud diving.In conclusion, d ie key to assessing the asthmatic diver is to exclude exercise or cold air induced bron- chospasm and not simply excluding air trapping. A fall in mid expiratory' flow within lialf-an-hour o f stopping exercise is a more sensitive indicator o f asthma than a fall in peak expira­ tory flow or forced expiratory volume in one second, although the forced expiratory volume on one second is a more practical parameter to measure. Asthmatic divers should have an annu­ al diving medical that must include adequate pre and post strenuous exercise pulmonary function test. Only inhaled cor­ ticosteroids (rather than the less practical sodium cromogly- cate) cau be used long term preventative medication in asth- m adc divers. Asthmatic divers should be encouraged to main­ tain adequate levels o f fitness, warned that asthma may be induced under water and told to avoid pliysicallv demanding dives. SPORTS MEDICINE MARCH 1997 5 R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 2. ) 5 INTRAVASCULAR DEHYDRATION AND CHANGES IN BLOOD PRESSURE SEEN DURING ULTRADISTANCE MARATHON RUNNING AJ Bimtman, R Carter and G Mitchell. Department ofPhysiology, University o f the Witwatersraud, Medical School, Johannesburg, South Africa Exercise associated collapse (EAC) is caused by post-exercise hypotension. The Hypotension is traditionally thought to result from either intravascular voliune depletion or venous pooling. To assess these possibilities S male athletes (age 41 + 7; mean ± SD) were evaluated before and alter an ultradistance marathon for changes in blood and plasma volumes and changes in systolic blood pressuic (SI3P), diastolic blood pressure (DBP) and mean arterial pressure (MAP). Change in blood and plasma volume was estimated using changes in haematocrit and haemoglobin concentration. SDP, DBP and MAP were significantly lower after the race compared to pre-race values (131.3 ± 10,5 vs 106,4 ± 12,2 mmHg, 75,3 ± 7.4 mmHg vs 62,8 ± 11,2 mmHg and 91,8 ± 6,8 mmHg vs 76,6 ± 9,6 mmHg; P<0.05). Neither plasma volume nor blood volume was significantly changed (plasma volume increased by 1,4 ± 12,8%; blood volume decreased by 1,9 ± 3,98%). Mean cell voliune was significantly decreased (88 ± 2,5 fl vs 87,1 ± 2,3 11; p< 0.05), indicating an intra-cellular to extra­ cellular volume shift. Total body water (TBW), body mass and bodv mass index (BMI) were all significantly lower after the race. Serum osmolality remained unchanged. There were no statistically significant correlations between changes in plasma volume or in blood volume, and changes in bloocl pressure. This study indicates that athletes who collapse at the end o f ultraendurance races do so as a result of post­ exercise hypotension secondary to venous pooling, and not as a result o f intravascular volume depletion. 7 CARDIAC I) RUT DURING INCREMENTAL ROWING TESTS I Chan tier and R Carter. Department o f Physiology', University o f the Witwatersrand, Johannesburg, South Africa Traditionally, laboratory' rowing tests utilise incremental protocols with workloads varying between 1 and 8 minutes. The heart rates achieved in the tests are used to provide training guidelines for the athletes. Inaccuracy in determining training heart rate zones may arise i( insufficient time elapses during each step for a physiological plateau to be attained. Thirteen elite rowers (ten males and three females) underwent an incremental test on a Concept II ergometer at 4 different workloads (low intensity, low-moderate intensity, moderate intensity and high intensity). Each workload lasted 6 minutes and heart rate was recorded throughout The 3 minute and 6 minute heart rates were significantly different at all 4 exercise intensities (P< 0.05). There was no significant increase in heart rate from the fourth to the sixth minute during the low and high intensity workloads (P< 0.05), suggesting that the heart rate may be approaching a physiological plateau. Subsequently, 5 elite rowers (4 males and 1 female) underwent an incremental rowing test on a Concept 11 ergometer at 3 stages of moderate to high intensity work, each workload lasting (or 8 minutes. Significant differences between the heart rates at 3 minutes mid at 6 minutes, and between heart rates at 3 minutes and at 8 minutes were confirmed (P<0.05). However, for each o( the 3 worldoads, no significant difference was found between heart rates at 6 minutes and at 8 minutes (P< O.Oo). This study has confirmed the phenomenon o f cardiac drill during steady- state rowing tests lasting between 3 and 6 minutes. However, no significant further drift in heart rate occurs between the 6th and 8th minutes o f an 8-minute stage, indicating a physiological plateau. 6 MODEL FOR THE PREDICTION OF OPTIMAL STROKE MECHANICS IN SWIMMERS Dr R oderick Carter. Department o f Physiology; University o f the Witwatersrand, Johamiesburg, South Africa The speed o f forward propulsion in any medium is determined by the |:>roduct o f strok e/stride frequency (SF) and stroke/stride length (SL). SF and SL are inversely related. Individual swimmers attain optimal swimming speed through unique combinations ol SF and SL, dependent on both physical mid physiological factors. Most swimmers select this combination subconsciously. It may b e advantageous for both training and competition to be able to determine the optimal combination o f SF and SL for an individual swimmer. A mathematical model is proposed in which the results of sim ple field tests may be used to predict the ideal combination o f SF and SL which result in peak swimming speed (PSS). Maximum ef fort sprints at variable SLs and SFs are timed over a known distance. A regression equation is determined for the SF:SL relationship (the “ performance line” ) describing the swimmers unique biom echanical characteristics. A line ol equal gradient (the peak performance line” ) is constructed through the data point with the greatest positive deviation from the “ performance line . Differentiation o f the equation defining the area o f a rectangle subtending the “ peak performance line’ to maximise the area o f the rectangle yields the individual swimmer’s PSS, and hence the optimal combination o f SF and SL. The proposed model may be o f value in providing swimmers with guidelines for determining their unique optimal stroke mechanics. 8 EXERCISE TOLERANCE AND SKELETAL MUSCLE FUNCTION IN PATIENTS WITH CARCINOMA: EFFECTS OF EXERCISE TRAINING KL Coleman; M Emms; TD Noakes; A Smith; EW Dennan UCT, Spoi-ts Scicnce Institute o f SA, Cape Town, South Africa Tli is studv examined changcs in exercise performance and skeletal muscle (SM) structiue and function in 6 patients with carcinoma (Ca) following a 12wk training programme, imme- diatclv after completion o f chemotherapy treatment. Prior to, and after the 12wk training programme patients tuidenvent i) graded exercise to exhaustion on a cycle ergometer for deter­ mination o f peak oxygen consumption (V02 peak) and peak work load (WLpeak) ii) isometric and isokinetic tests of SM strength and endurance iii) SM biopsies for light mid electi on microscopy analysis. Results were compared with those obtained from a sedentary', age and gender matched control group (C) tested on initiation o f the study. Before training, V02 peak (24.24 ± 2.39 vs 33.02 ± 4.47 m l/0 2/kg/m in; p<0.05) was lower in patients with cancer (Ca) when compared with C. However WLpeak (147.50 ± 21.33 vs 185 ± 28.25 \V, p=NS) was not significantly different between groups. Peak torque generated in the quadriceps (PKTQ) corrected for lean thigh volume (LTV) (44.28 ± 4.45 vs 44.88 ± 5.24 Nm/L; p=NS) and total power (TP) in a 60 second isometric test o f SM endurance (25.67 + 3.61 vs 40.45 + W/L; p=NS) were not significantly dif­ ferent between groups, however I T tended to be lower in the patients with Ca (p=0.08). SM biopsies performed on the Ca group did not show significant structural abnonnalities and therefore were not repeated after training. After training, patients with Ca decreased their resting heart rate (80.50 ± 4.31 vs 72.67 ± 4.31 b/m hi; p=0.05) and increased their V02 peak (24.24 ± 2.62 vs 28.43 ± 1.88m l/02/k g/m in ) so that dif­ ferences between Ca and C were no longer apparent. Patients with Ca improved WLpeak achieved (147.50 ± 23.37 vs 190.83 ± 27.82 W; p<0.05) and tended to Improve TP (25.67 ± 3.96 vs 32.45 ± 4.21 W/L; p = 0.08) after training. The results o f this study suggest that patients with Ca have only mildly impaired exercise tolerance and SM structure and function compared to C, these patients show significant physiological improvements after a 12wk training programme, despite recent high dosages o f chemotherapeutic agents. 6 SPORTS MEDICINE MARCH 1997 R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 2. ) 9 EXERCISE INTOLERANCE AND SKELETAL MUSCLE (SM) ABNORMALITIES IN PATIENTS WITH CHRONIC OBSTRUCTIVE AIRWAYS DISEASE (COAD) KL Coleman, R Raine; M Emms, C St Claire-Smith, TD Noakes & EW Derman UCT, Sports Science Institute ol South Africa, Cape Town, South Africa Patients with COAD commonly experience fatigue and exercise Intolerance which is thought to be clue to pulmonaiy factors. However, few studies describe both the structural and function­ al status of SM in patients with COAD. This study examines 10 patients with moderate to severe COAD and 6 sedentary, healthy control subjects (C) underwent i) graded exercise test to exhaus­ tion for determination o f peak oxygen consumption (V02 peak), peak work load (WLpeak) and peak ventilation (VEpeak); ii) iso­ kinetic tests o f SM strength and endurance and ii) SM biopsy for determination o f skeletal muscle structure. VO., peak (18.0 + 1.59 vs 25,40 + 1.15 ml/Oo/lcg/min; p<0.05), WLpeak (88.56 ± 21.57 vs 214.17 ± 30.47 W; p<0.001), VEpeak (43.95 + 5.40 vs 74.44 ± 8.22 L; p<0.001) and total work performed by the quadriceps 'muscle (TWQ) in a 60 sec isokinetic test (2113.08 + 376.48 vs 378o.86 ± 364.19 I: ] i< O.OOo) were all lowrer in patients with COAD. Furthermore, VEpeak and peak blood lac­ tate (5.29 ± 1.25 vs 10.71 ± 0.35 p<0.001) w7ere lower in patients with COAD when compared with C. Peak torque achieved dur­ ing a 30 second isometric test W'as not different between groups (169.92 ± 31.82 vs 217.75 ± 24.17 Nm; p=NS) before or after cor­ rection for lean thigh volume (LTV) however, when TWQ was cor­ rected for LTV values tended to be different between groups (766.73 ± 101.24 vs 978.80 ± 114.78 J/L; p=NS). Profound his­ tological and ultrastructural abnormalities were found in all SM biopsies from patients with COAD. Abnormalities included: Type H fibre atrophy, Type n fibre predominance, Type I fibre hyper­ trophy, necrotic fibres and diffuse mitochondrial abnormalities. These data support the hypothesis that (i) severe SM structural abnormalities are present in patients with COAD (ii) functional abnormalities are present in tests o f SM endurance in patients with COAD and (iii) these SM structural and Junctional abnor­ malities may play a role in exercise intolerance in patients with COAD. 11 PHYSIOLOGICAL PROFILES AND THE ESTABLISHMENT OF NO R MS FOR UNDER PROVINCIAL RUGBY PLAYERS IN NATAL Coopoo Y and Govender AN. University o f Durban-Westville, Durban, South Africa This study obtained data on fitness profiles o f under 21 provincial rugbv players in order that normative tables could be compiled for the forwards, backs and the combined team. The study also provided an insight into the fitness demands of' under 21 provincial rugby players on the basis o f the two major playing units in a rugby game, the forwards and the backs! It further established physiological readiness for senior rugby. The test battery evaluated body composition, flexibility, explosive strength, dynamic strength, cardio-respiratory endurance,anaerobic capacity and agility at the beginning o f a regular season. Data from 112 players were categorised in three groups: forwards (57), backs' (55) and the combined team (112) and were statistically analysed. Means and standard deviations were computed for all tests. The t-test was applied to the means o f both the forwards and backs for each test to establish the differences. Normative tables were established for the forwards, backs and the combined team. In the assessment o f the fitness demands o f the under 21 provincial rugby player, no significant differences were found between backs and forwards, except for percent body fat, lean body mass and grip strength (p<0.05). The fitness demands for backs and forwards appeared to be uniform, suggesting that a single set o f fitness norms will suffice for the whole team. The comparison o f the two sets o f norms for three similar tests indicated that the under 21 provincial norms compare favourably with senior norms. The implications o f the findings on a descriptive basis indicated that d ie under 21 provincial player is physiologically ready to participate at senior level. With careful guidance and mentoring, and o f course, effective training, the potential for participation at national level is evident. 10 ENDURANCE RATIOS AND TOTAL WORK: ARE THEY VALID MEASURES OF FATIGUE RESISTANCE? Ian Cook. University o f the North, Sovenga, South Africa The puiposc o f tiiis investigation was to evaluate popular methods for determining in \ivo skeletal muscle (quadriceps) concentric fatigue resistance (FR) on an isokinetic dynamometer. The study was divided Into two parts. Part 1: The records o f one hundred and four patients (82 M, 22 F) were analysed retrospectively. /Ml patients had been tested on a Cybex 340 dynamometer. The protocol included 4 serial repetitions at 6 0 ’/,, and 20 serial repetitions at 180/s, for unilateral knee ext/flex. Only the results o f the tuiinvolved limbs were analysed. Patients were placed into four categories: team sports (n = 21); endurance sports (n = 25); strength/sprint sports (n = 10); and non-participants (n = 33). The dependant variable being total work performed in the 20 repetitions (TW20). PTQ (N.m) 6 0 /, (P60), FTQ (N.m) 1 8 0 /, (P180) correlated significantly (p<0.01) in all groups (0.6244-0.8763 and 0.8836-0.9448 respectively). Endurance ratio (ER) did not correlate significantly (p>0.05) in any group (-0.0008-0.3919). Multiple linear regression (MLR) for pooled data found Sample 1 and 2 explained 98.70% o f the variation in TW20. Part 2: Fourteen patients (7 M, 7 F) were recruited and tested according to the above protocol and an additional protocol- 10 sets o f l5 repetitions @ 180’/,, with 5 seconds between sets. A logarithmic function | Joules = A + B.Log (Set number)] was used to obtain a FR measure (B; gradient) and strength measure (A; v-intercept). B and A correlated significantly (p<0.01) with P60 (0.9513 and 0./303, respectively). Identical correlational patterns as for the retrospective analysis were found. MLR found P180, and Sample 2 (Joules) explained 99.47% o f the variation in TW20. furthermore, B and A explained 92.79% o f the. variation in TW20. Total w'ork for 100 repetitions could be predicted by B and A (99.27%). These data suggest firstly that the popular measure of FR, ER, is not a valid measure. Secondly, the total Work performed in 20-100 repetitious, by itself, is not a measure of fatigue resistance. Thirdly, the use o f correct terminology' is advocated. 12 THE EFFECT OF SCHEUERMANN’S DISEASE ON THE TOTAL BODY BIOMECHANICS L Crous. Department o f Physiotherapy, University o f Stellenbosch, P 0 Box 19063, Tygerberg, 7505 During my research to determine w'hether palpation is useful in diagnosing Sch euermami’s disease, I realised the devastating effects o f this disease. Early recognition and diagnosis is therefore absolutely imperative in order to limit and/or treat the effects it has on the biomechanics o f the body. The pathology o f Scheuermann's includes hvpornobility o f 3 to 5 consecutive vertebrae o f the thoracic and/or thoraco-lumbar spine. The wedge shape o f the vertebrae and the resultant kyphosis are clearly visible on X-ray. Iliis paper will discuss the consequences o f Scheuermann’s disease on the body’s biomechanics. This wedge-shaped, hypomobile area in the thoracic spine results in changes o f the head-on-neck and neck-on-thorax positions resulting in the following problems: tempero-mandibidar dysfunction, headaches and atrophy o f the deep neck flexors. The kyphosis leads to weakness o f the scapular muscles and hvpornobility o f the glenohumeral joint. Full range of movement at the glenohumeral joint requires normal mobility o f the thoracic vertebrae. The kyphosis displaces the glenoid which results in glenohumeral joint dysfunction. The above plays an important role in the impingement syndrome with instabilities o f the glenohumeral joint. The centre o f gravity is displaced more anteriorly as a result of the kyphosis, which affects one’s balance in an upright position. Disturbance o f balance leads to a decrease in proprioception. In conclusion, it is therefore essential to diagnose Scheuermann’s disease as early as possible in order to maintain optimum functional biomechanics o f the body. SPORTS MEDICINE MARCH 1997 7 R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 2. ) 13 MEDICATION USE AND ABUSE PRIOR TO INTERNATIONAL SOCCER COMPETITION. EW Dennan, H Alii, N Bengu, W Otto, P Schwartz, KOP Matseke & MP Schwellnus. University o f Cape Town & Sport Science Institute o f South Africa. Despite publicity o f the side effects and possible dangers o f var­ ious medications on the athlete during prolonged vigorous exer­ cise, it is believed that medications are still widely prescribed immediately prior to sporting events. Flie purpose o f this study was to determine the patterns o f prescribing medications by team physicians during the 1996 African Cup o f Nations .Soccer Tournament. As part o f the FIFA & IOC drug testing procedure, the team physicians o f the 15 teams were asked to complete a questionnaire prior to each match. Each o f the 16 squad mem­ bers was listed and any prescribed medication or supplement ingested, injected or taken per rectum in the 72 hr period pre­ ceding the match was declared by the physician. 32 matches involving 544 player/match exposures occurred during the tour­ nament. Non-steroidal anti-inflammatory medications (NSALDS) were the most commonly prescribed medications with 31% o f players having ingested these agents in the period prior to the match. O f the NSALDS diclofenac was the most common (19%), followed by ibuprofen (5.6%), indomethacin (3.3%), piroxicarn (2.7%) & aspirin (0.7%). 11% o f players ingest­ ed paracetamol and 2% ingested, polycomponent analgesic preparations in the pre match period. 3.8% o f players were ingesting antibiotic medications. Vitamin and mineral supple­ mentation was also very common with 30% o f players ingesting a multivitamin, 11.7% ingesting creatine, 4% ingesting magne­ sium supplementation, 5.8% ingesting inosine, 3% ingesting guarana,l% ingesting alpha-keto glutamate, 0.7% ingesting iron supplementation, & 0.2% chromium picolonate. Other medica­ tions declared included nasal decongestants (1.8%), anti-diar­ rhoea medication (1.3%), laxatives (0.4%), anti-histaminics (0.4%) and hydrocortisone cream (0.4%). At four occasions diclofenac and paracetamol was prescribed for the entire squad twice daily, for the three day period between matches. At seven occasions more than one NSAID was prescribed for a player. These results suggest i) prescribing habits vary greatly prior to competition; ii) NSALD and analgesic use/abuse is very common during international soccer competition. As these medications are not without significant side effects, improved dissemination o f knowledge regarding the use o f these agents should be directed at both the team physicians and players. 1 4 COMPARATIVE EFFECTS OF ZOPICLONE AND LOPRAZOLAM ON HAND-EYE CO-ORDINATION & PHYSICAL PERFORMANCE IN ATHLETES. L Grobelar, M Schw ellnus, C Trichard, S Calder, T D Noakes & EW D erm an*. UCT Dept, o f S p ort S cien ce & S p ort Science Institute o f South Africa. B enzodiazepines are com m only used by athletes, due to frequent international travel, p re-com p etition anxiety and insomnia. However, little is known about tlieir effects oil exercise perform ance. In dou ble b lin d , p lacebo (P ) con trolled , cross-over trial, tile effects o f z opiclone (Z ) and lop ra zolam (L) on p hysical p erform an ce in 12 active individuals w ere studied. Subjects ingested eith er I1, Z (/.5 in g ) or L at 22 h 0 0 on three occasions w ith a one w k w ashout p eriod betw een trials. Eye-liand co-ordin ation tests (A ccuvision 1000), a 30m sprint test, a T-test and a graded exercise test to exhaustion w as p e rfo rm e d 10 hrs after ad m in­ istration. T h ere was a significantly greater hangover e ffe ct 10 hours after ingestion of' L (8 /1 1 subjects) than after ingestion o f Z (3 /1 1 ; p < 0 .001 ). Subjects w ere significantly m ore alert after ingestion o f P (9 /1 1 ) and Z (9 /1 1 subjects) than after L (4 /1 1 subjects; p < 0 .001 ). T he 30m sprint tim e, tim e to com p lete a T-test and th e peals oxygen uptake during graded increm entaf exercise to exhaustion w ere not different foliow ing ingestion o f P, Z, and L. However, b o th th e num ber o f correct resp onses during th e Accuvision 1000 te st (8 7 ± 1 0 ; 8 7 ± / ; 80 ±18 : P vs Z vs L), and th e tim e to fatigue during graded exercise (7 0 5 ± 5 4 ; 68 0±3 8; 669±'50; sec P vs Z vs L) tended to decrease follow ing ingestion o f L com p ared to Z and P T h e tim e to com p iete a turntable test te n d e d to b e increased follow in g ingestion o f both L and Z com p ared to P Th esc results suggest: (i) Ingestion o f L le a d s to hangover effects .10 hrs aftei ingestion. Ingestion o f Z however, is w ithout th ese effects: (ii) athletes experien ce significantly greater alertness follow ing ingestion o f Z c o m ­ pared witli I,: (iii) W hilst exercise p erform an ce follow in g ingestion o f eith er Z or L was n ot significantly altered, tim e to fatigue during incre­ m ental exercise and th e num ber o f co rre ct resp onses during visual- m otor tests tend ixrwards im pairm ent follow ing ingestion o f L com pared w ith Z and P; (iv) H and-eye c oord ination how ever, ten d s to be im paired follow in g ingestion o f both L and Z. 15 THE EFFECTS OF ACEBUTELOL ON EXERCISE TOLERANCE, SKELETAL MUSCLE RECRUITMENT AND FUEL SUBSTRATE UTILIZATION DURING EXERCISE OF VARYING INTENSITIES EW Derman*, M Zambrasis, JA Hawley, S Dennis, A Sinclair-Gibson, & TD Noakes. University o f Cape Town & Sport Science Institute o f South Africa. Previous research has indicated that ingestion o f beta-block- ers adversely affect the exercise performance tolerance of physically active hypertensive patients. It has been postulated that this effect is due to altered metabolic response to pro­ longed submaximal exercise. The effects o f acebutelol (A), a betal-selective blocker with intrinsic S3Tiipathomimetic prop­ erties, on exercise tolerance, skeletal muscle function and metabolism during prolonged exercise are unknown. In a dou­ ble blind placebo (P) controlled trial, we determined the effects o f A (400 mg daily for 7 days) in 7 healthy volunteers on i) cardiorespiratory, ii) plasma lactate (La], glucose [G], and free fatty acid concentrations [FFA] and iii) skeletal mus­ cle electromyographic activity (EMG) during incremental sub- maximal exercise at 30, 50, and 70% o f their relative Peak Power Output (PPO) at .15, 30, and 45 minutes respectively. Thereafter workload was increased every minute by 15 Watts to exhaustion to measure PPO. During submaximal exercise, subjects showed significant differences in heart rate (HR) and systolic blood pressure (SBP) (p < 0,01; A vs P). Following ingestion o f P, subjects achieved significantly (p<0,05) higher PPO in contrast to A. [La] concentrations between treatments were not different, however lower concentrations o f [G], (p < 0.01) (3,3 ± 0.2 vs. 4.5 ± 0,2 mmol/1) ŵ ere found at rest and during exercise, [FFA] concentrations at rest, 12 min; and 21 inin were similarly lower following ingestion o f A (p < 0 .0 5 ; vs P). No significant difference was found in total carbohydrate (CHO) oxidation, glucose oxidation, and estimated muscle glycogen. Changes between treatments were observed in rate o f perceived exertion and integrated EMG activity after 30 minutes o f submaximal exercise. These findings suggest that i) A is effective in decreasing SBP and H R during submaximal exercise, ii) exercise tolerance is decreased following ingestion o f A, iii) [G] and [TEA] are low er during exercise following ingestion o f A, iv) EMG and RPE are increased during exercise following ingestion o f A. However, CHO oxidation during exer­ cise is unaltered following ingestion o f A. 16 KNOWLEDGE ATTITUDE, AND NUfRLENT INTAKE OF ELITE SPORTSMEN AND -WOMEN (19-25 years old) IN POTCHEFSTROOM Anna du Plessis, PU for CHE, Potchelstroom, RSA. Little is knowTi about knowledge, attitude and nutrient intakes o f South African sportsmen and woman, while nutrient supplementation usage is suspected to b e high. In a cross sectional study including 143 subjects, knowledge and attitude were investigated by means o f validated questionnaires. Nutrient intakes w'ere measured by means of a validated food frequency questionnaire. Nutritional status was determined by the physical activity index as ŵ ell as anthropometric measurements. A pilot study (n=10) was conducted to determine the reliability o f all instruments used. The results indicated that 80% o f the subjects reflected inadequate diet-related knowledge; only 3.5% subjects reflected a positive attitude towards sports nutrition while the rest showed a highly positive attitude tow-ards supplementation. Most o f the subjects did not meet their recommended diet allowances. Tlieir nutrient intakes wrere characterized by elevated protein, fat and cholesterol intakes, as we 11 as inadequate carbohydrate intakes. This dietary pattern was related to inadequate micronutrient intakes. Anthropometric deviations from published normal ranges occurred more frequently among male sports participants. Therefore, this study indicated that elite young sportsmen and women manifested inadequate nutritional status based on inadequate knowledge and negative attitudes towards sports nutrition. The prominent “ compensatory” role ol supplements, underlined the highly underutilized role o f dietitians and the high risk o f suboptimal performance and health hazards, even among elite sportsmen and women in this study. 8 SPORTS MEDICINE MARCH 1997 R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 2. ) 17 THE CARNITINE STATUS OF ATHLETES PREPARING FOR AN ULTRAMARATHON OF 90 KM Du Plooy WJ, Kahler CP, ‘ Kennedy R. Departments o f Pharmacology and *IIunian Nutrition, Medunsa, Soutli Africa. Carnitine supplementation before or during exercise failed to show any improvement in exercise performance in humans. A deficiency (48%) in rats did not affect their exercise performance. Although data is available for normal subjects and resting athletes none is available for athletes training for a running endurance event o f 90 km. The aim o f this study was to assess the carnitine status o f such athletes over a 45-week period. Pen athletes volunteered for the assessment. A group o f 10 sedentary individuals served as controls. Blood samples for total carnitine, acyl carnitine, free carnitine, cholesterol, triglycerides and Theological parameters were collected every 8 weeks up to 2 weeks prior to the event. Body mass index and percentage body fat were also measured. Questionnaires reflecting medication, disease and training were collated weekly. The percentage body fat o f two athletes with the highest kilometre training distance decreased with 12 and 13% respectively. The bound carnitine (acyl carnitine fraction) remained constant in the control group. In the training group the acyl carnitine levels increased steadily from baseline 12,48 ± 3,68,(iM to reach a maximum o f 23,01 ± 0,01 p,M (p< 0,001) at week 30 and thereafter decreased to 16,53 ± 3,16 |j.M, 2 weeks before the event, with a corresponding decrease in free carnitine from 46,82 ± 10,49 at baseline to 39,28 ± 4,82 at the interval ol biggest change. The decrease in free carnitine and increase in acyl carnitine reflect the demands on the metabolic system to transport acyl groups formed during p-oxidation. It is concluded that monitoring carnitine levels could be used to ascertain the demands on acyl transport during p-oxidalion, but it is unclear which degree o f carnitine deficiency would impede endurance performance. 18 THE FORCE ABSORPTION AND REBOUND CHARACTERISTICS OF CRICKET BATTING PADS DE du Toit*, R Stretch** and T Edwards* * Department o f Human Movement Science, University7 o f Port Elizabeth, * * Sport Bureau, University o f Port Elizabeth Impact injuries in cricket, although not reaching alarming proportions, are on the increase. The cricket player needs maximum protection against impact injuries from the ball when batting, while still maintaining mobility and reducing die risk ol being dismissed, particularly to bat-pad decisions. A study was conducted to compare the efficiency to absorb impact forces, as well as the rebound characteristics o f four types o f cricket batting pads (PI, P2, P3 and P4) at four impact velocities: Slow-medium (S I), Fast-medium (S2), Fast (S3) and Express (S4). The impact forces were measured using the drop test (Nigg 1990) where a weighted ball was dropped vertically onto the surface o f the batting pads with the vertical forces measured by a Kistler piezoelectric multicomponent force platform type 9281 A l l . The rebound characteristics were determined by measuring the horizontal distance (ni) the ball reboimded o ff the pad when delivered from a bowling machine at the four velocities. A two-way analysis o f variance, with Iukey’s method o f multiple comparison, was used to test for significant differences (P<0.05) between the pads at the four impact velocities. When evaluating the impact forces it was foimd that PI provided significantly less protection than all the other pads at the four velocities with the exception of similar results to P4 at S2. Further, at SI and S3, P2 was significantly better than P3 and P4 and P2 was significantly better than P4. At S2, P2 was significantly better than P2 and P3, while P3 was significantly better than P4. At S4, P2 and P3 showed similar results which were, significantly better than P4. When comparing the rebound characteristics, the results showed significantly smaller rebound distance for PI at all the velocities. The differences in the force absorption and rebound characteristics were as a result o f the differences in the structure and composition of the protective part o f the batting Pads. The results show an inverse correlation between the ability to absorb force and the rebound distance after the ball has struck the pads, something that the manufacturers need to address. 19 THE EFFECT OF A LO W INTENSITY AEROBIC EXERCISE PROGRAM ON PATIENTS USING ANTIDEPRESSANTS DE du Toit*, S Roux** and N Hurr** * Department o f Human Movement Science, University of Port Elizabeth ** Department o f Biochemistry, University of Port Elizabeth Determining the effectiveness o f aerobic exercise in the control of the adipose tissue of subjects utilizing antidepressant medication is due to the common complaint o f undesired mass gain caused by pharmacological treatment for major affective disorders (Garland Remick and Zis, 1988, Russ and Ackerman, 1988; Rang and Dale’ 1991 and Stimmel, 1992). The aerobic exercise program for the subject on antidepressant medication must be manageable with regards to intensity, frequency, and duration as exceeding the capabilities of die subjects is a certain path to nonadherence (Brownell, 1984). Factors such as insulin, cholesterol levels and metabolic rate which effect body composition were taken into consideration, while the skinfold, circumference and mass measurements were monitored to determine the effectiveness of aerobic exercise. The intensity o f the exercise program was determined according to the workload corresponding to a respiratory quotient o f just below 0.85. The duration o f the aerobic exercise session was 35 minutes and performed 3 times per week over a period o f 12 weeks. The heart rate decreased consistently (P<0,05), while the blood pressure remained relatively stable. The mean insulin levels of the experimental group decreased though insignificandy 30 minutes after glucose ingestion over the 12 weeks, but the corresponding insulin levels of the control group increased. All the patients exhibit higher than normal "total cholesterol and LDL levels. The study was o f benefit since the exercise group had a mean loss o f 0.086 mmol/1 for cholesterol and 0.007 mmol/1 for LDL while the non-exercise group had a mean increase o f 0.940 mmol/1 cholesterol and 0.64mmol/l LDL. Over 12 weeks the control group displayed a constant increase in skinfolds for the triceps, subscapula and medial calf. This emphasizes that the mass gain is an increase in adipose tissue. The non-exercising group also showed an increase o f 4.26cm around the waist over this period. The waist-to-hip ratio increased consistently from 0.94 to 0.97 in the non-exercising group while the waist-to-hip ratio for the exercising group remained constant. This emphasizes the positive effects o f low intensity aerobic exercise for patients utilising antidepressants. 20 POLLUTION, WATER CONTACT AND “ DUSI GUTS” Foreman S and Mars M. Dept, o f Physiology, University o f Natal Medical School, Durban, South Africa. The Msindusi canoe marathon has always been associated with post race illness, “Dusi Guts” . Severe flooding in Pietermaritzburg in die week preceding the 1996 race raised faecal coliform counts in the river to high levels. There appeared to be a higher than usual incidence o f race associated illness and infection. The aims o f this study were to determine the incidence of illness and infection, the relationsliip o f water contact with illness, and to provide guidelines for participants o f future Dusi’s raced in flood years. Four weeks after the race, a questionnaire was sent to all competitors (n = 1302). 652 participants replied (50.1%), o f whom 46% were ill at some stage during or after the race with diarrhoea (149) and infected wounds (113) being most common. 20% o f all respondents required treatment by a doctor. There was no difference in the incidence o f illness or infection between those who fell out o f their canoes during the race and those who did not, nor was there a relationship between the number o f times a paddler fell out and subsequent illness. Relative canoeing experience and competitive grading were also not related to illness. While the A grade paddlers fell out significantly less often than the E grade paddlers (P< 0.0001) there was no difference in the incidence o f illness in the grades. The faeeal coliform levels on the race days were up to 30 times higher than the level deemed high risk, in South Africa and 150 higher than the levels set by the European Economic Community. E. coli counts repeated at the same sites during the race showed large daily variation. The accepted maximum illness index for recreational use o f water in the USA is set at 8 illnesses per 1000 swimmers. For this race the index was 460/1000 participants, and 606/1000 competitors who fell out during the race. In summary, in flood years, there is an almost 50% chance o f suffering some form o f illness when participating in Dusi and a 20% chance of requiring medical treatment. The pollutant and washing out effect of rain during the race makes pre-race prediction o f pollution levels very difficult. Further studies are required to compare these findings with non flood year races. SPORTS MEDICINE MARCH 1997 9 R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 2. ) 21 LOW POST-RACE MARKERS OF LIPID PEROXIDATION IN ULTRAMARATHON RUNNERS WITH HIGH ANTI­ OXIDANT STATUS. EM Futre-Peters*, RD Anderson**, AJTheron**, TO Noakes. ‘ Division o f Physical Education, University of Witwatersrand, Johannesburg “ Institute for Pathology, Department o f Immunology', University o f Pretoria ***MRC Bioenergetics o f Exercise Unit in the Sport Science Institute' o f South Africa, Medical School, University' o f Cape Tow'll Previous studies conducted by our group have show'll a significantly reduced post-race infection incidence following supplementation with anti-oxidant nutrients during the three weeks prior to participation in the 90km Comrades Marathon. Ten successful participants (9 men, 1 Woman. X age: 43.4+9.44 yrs) in the 1996 Comrades Marathon were monitored 18hrs before and within 1 hour following completion of the 90 km running event in order to establish their post-race anti-oxidant status and relate this to markers o f immediate post-race free radical production and die incidence o f infection symptoms occuring during the post­ race fortnight. Tweutv-four hour pre-race dietary' recalls and analyses of intake nutritional supplements revealed a mean total dailv Vit C intake of430(±378.4)mg on the day preceding the race, while plasma Vit C levels rose significantly (p>0.05) from 16.5 (±3.9) pre-race to 21.9 (±5.0)ug.in]1 |Mist:-race. Pre-race plasma Vit E levels (X=8.89 ±1.3)ng.ml1 failed to show' a consistent rise or fall following completion o f die 90 Ion event, w hereas pre-race beta- carotene levels (X=241.6±78.5ng.ml') dropped significantly (p>0.05) to 231.1 (± 82.8)mg.ml'. Despite mi absolute post-race ueutrophilia (X=86.3%) in each o f the subjects, quantification o f lipid peroxide levels by colorimetric measurement of methylene blue in serum samples revealed littie evidence o f the accumulation of tree radicals post exercise. This marker of lipid peroxidation rates did not rise significantiy (p>0.05). The significant, but small rises in C-Reactive Protein (from 1.3±2.4 mg.l'1 pre-race to 3.4± 2.2m g.l' post race) indicate lesser inflammatory response than previously reported in die literature. Only one subject reported symptoms o f Upper Respiratory' Tract Infection during the post-race fortnight. This study' reveals a possible protective effect of high pre-race plasma anti-oxidant status against previously reported free radical damage following participation in prolonged competitive running events. 22 EFFECT’S OF HIGH INTENSITY EXERCISE ON LYMPHOCYTE DNA AND PLASMA VITAMIN C. Govender SN, Bux S, Weston A, Chuturgoon A, and Mars M. Department o f Physiology', Faculty o f Mediciue, University of Natal, Durbau, South Africa Hartmann et ah recently described a chance observation of DNA strand breaks in lymphocytes following short duration, high intensity exercisc to exhaustion in 1 of 3 subjects of differing fitness levels. If tiiis is a consistent finding in trained individuals it mav provide further insight into changes in immune status with overtraining. The aim of this study was to determine die relative frequency o f DNA strand breaks in lymphocytes in trained individuals following a single bout of exercise to exhaustion, and to examine associated changes in plasma vitamin C concentration. Eleven subjects in regular training were subjected to a ramped treadmill run to exhaustion. They were asked not to exercisc for 48 hours preceding the test and for 48 hours after the test. Venous blood samples were collected before and immediately after exercisc, and 24 hours mid 48 hours after exercisc. Vitamin C concentration w'as determined by the 2,4 dinitrophenylhydrazine mediod while the single cell gel electrophoresis (SCGE) assay was carried out on all blood samples to determine DNA strand breaks. Immediate post exercise samples showed DNA damage in lymphocytes of all subjects as evidenced by fluorescent strands of DNA outside die cell. No DNA strand breaks were observed in subsequent samples. In the pre-exercise sample, DNA was visualised as a central core whereas in all samples taken after exercise, DNA was found located around the periphery, or confincd to one pole o f the cell. Vitamin C levels showed a non significant decrease immediately after exercise which returned to baseline levels after 48 hours. This did no coirelate with DNA damage. In summary' exhaustive high intensity' exercise produced changes in DNA in lymphocytes lasting 48 hours in all subjects. The different pattern o f DNA distribution observed in lymphocytes following exercise has not previously been reported. Further studies are required to determine the fate o f the lymphocytes, do they die or do they undergo a reparative process, and is this damage the same in all lymphocyte subsets? 23 A CONSERVATIVE APPROACH OF GRADE H & III 1ATERAL LIGAMENT ANKLE INJURIES. JHB Hattingh, Dr JJ Hugo. Potchefstroom, S.A. Research project over a three year period was done oil grades II and III lateral ligament injuries o f the ankle. The aim o f the study was to establish a standardized, dynamic, conservative multi-disciplinary rehabilitation regime. The program followed consisted o f standard treatment and covered the phases from die onset o f the injury until the pat ient returned to competitive sport. The study included 216 patients, 156 male and 60 female, o f ages varying between 16 and 40 years with d ie mean age 22,7" years. Sports background: hockey, rugby, squash, netball, cricket, track and field. Criteria of acceptance: first injury', no fractures, Brustrom grades 11-111, intact inferior tibiofibular joint, medial ligament intact, injury' seen by die medical team-within 48 hours. After thorough initial examination the aim during the first 48 hours was to address swelling, immobilize the ankle and relieve pain. Rehabilitation by means o f bodi physiotherapy and bioltinetics w'as divided into a six week period. The treatment w'as divided in three phases for bodi physiotherapy and bioltinetics. During the first phase W'e mainly addressed swelling, pain and activity. In the second phase die emphasis was on mobility. The aim o f third phase was to clear die injured joint and to prepare d ie patient to return to competitive sport. At d ie end o f die third .phase the patient had to pass a sport-specific fitness test. During the study the following complications one noted: 11 gutter syndromes and lour medial tarsal svndroutcs. Ten weeks post-injury the patients underwent a final examination where six patients still complained o f pain 111 the ankle during exercise. They were all referred to an orthopaedic surgeon mid eventually all underwent ankle orthroscopy. O f the six, four were diagnosed as suffering from medial tarsal syndromes and two from gutter syndromes. The most important outcome ol tiiis study' wras d ie fact that 97.2% o f die patients returned to competitive sport after six weeks. 24 DELAYED MUSCLE SORENESS IN SPRINT ATHLETES JHB Hattingh. University o f Pretoria, PU FOR CHE In diis study the appearance o f delayed muscle soreness w as determined after repetitive sprint events in male and female athletes. 'Hie effect o f post-exercise sports massage on die athletes’ lower limbs was also evaluated. Kinesiology studies w ere done on day 1 and 5 after the events by making use o f die “ Akron” isokinetic apparatus as well as die Busco Padana to evaluate torque, explosive power and reaction time. Flexibility studies were also done with the stretch apparatus. Delayed muscle soreness wras established in a mild form, but only in specific muscle groups, namely the prime movers in sprint running. Sports massage w'as advantageous, but also more to the prime movers. The massage technique as applied ill this studv seem s to be advantageous to sprint athletes in improving their performance. 10 SPORTS MEDICINE MARCH 1997 R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 2. ) 25 EFFECT OF CARBOHYDRATE SUPPLEMENTATION ON MUSCLE GLYCOGEN CONTENT AND UI'ILISATION DURING ONE HOUR CYCLING PERFORMANCE John A Hawley, Garry S Palmer, Steven C Dennis and Timothy D Noakes. MRC/UCT Bioenergetics o f Exercise Research Unit, Department o f Physiology, University o f Cape Town Medical School, South Africa. This study compared the effects o f supplementing the normal diets ol 6 trained cyclists with additional carbohydrate (CHO) 011 muscle glycogen utilisation during a 1 li cycle time-trial (TT). Using a random crossover design, subjects consumed either their normal diet (NORM) for 3 d (426 ± 137 g«d 1 CHO [5.9 ± 1.4 g«kg ' bodymass, BM]) or additional CHO (SUPP) to increase tlieir intake to 661 ± 76 g»cl ‘ [9.3 ± 0.7 g*kg 1 BM|. SUPP elevated muscle glycogen content from 459 ± 83 to 565 ± 62 mmol*kg 1 d.w. (P<0.05). However, despite the increased pre-exercise muscle glycogen stores, there was 110 difference in the distance cycled during the TT (40.41 ± 1.44 vs. 40.18 ± 1.76 kin«h ' for NORM and SUPP respectively). During NORM, muscle glycogen declined from 459 ± 83 to 175 ± 64 m m ol»kg‘ d.w., whereas with SUPP the corresponding values were 565 ± 62 and 292 ± 113 nmiol»kg 1 d.w. Accordingly, both muscle glycogen utilisation (277 ± 64 vs. 273 ± 114 mniol.«kg ' d.w.) and total CHO oxidation (169 ± 20 vs. 165 ± 30g*60 min 1 for NORM and SUPP respectively) were similar. The results o f this study show that when well-trained subjects increase (lie CHO content ol their diet for 3 d from 6 to 9 g*kg 1 B.M. there is only a modest increase in muscle glycogen content. As supplementary CLIO did not improve TT performance, we conductc that CHO loading has 110 benefit to performance for athletes who compcte in intense, continuous events lasting I h. Furthermore, the substantial muscle CHO reserves at the termination ol exercise indicate that muscle glycogen depletion does not determine fatigue at this exercise intensity and duration. 27 THE RESPONSE OF HEART RATE AND BLOOD LACTATE CONCENTRATION TO CONTINTTm^ INCREMENTS IN RUNNING SPEED UI Jb M Hirner, T Trowbridge. Sheffield University Sheffield, England J’ The relationship betw een heart rate and blood lactate concentration in response to incremental increases in running speed, was determined in 10 elite endurance runners. Starting at 16.5km /hr or 17.5km /hr the athletes ran continuously until exhausted, 011 a treadmill increasing the speed even' 400 meters by 0.5km /hr to reach a sub maximal speed,depending on ability'. Heart rate was recorded every' 15 seconds with a polar 3000 sport tester. Blood was taken for lactate analysis alter the athletes had been running at each speed for 60 seconds. All the athletes showed a linear increase in heart rate with increases in running speed. No heart rate deflection point was identified for any athlete. The coefficients o f determination, rr, ranged from (0.81-0.98). The lactate concentration increased as a quadratic function with increase in running speed. No lactate balance point was identified for any athlete. The coefficients o f determination, i~, for the 10 runners ranged from (0.90-0.98). These results were used to link heart rate and lactate through a simple quadratic equation. Lactate = a(heart rate)2 +b(heart rate) + c, where a, b and c are constants which vary from athlete to athlete. A simple analysis o f variance showed that the lactate and heart rate relationship can be reliably reproduced using this protocol. 26 PROFILE OF INJURIES AT THE DUZI CANOE RACE Dr MJ Heystek, REK Kirkby. Department o f Family Medicine, University' o f Pretoria. The Duzi Canoe race is a three day endurance event over 120 km. The medical support consisted o f a medical tent at the end o f each stage and 3 field stations 011 the route next to the river. The main objective o f this study was to describe the type of injuries sustained by the participants during this event. A prospective descriptive study was undertaken at the 1997 Duzi. Each participant who reported to the-medical tent or field station were included in this study. Over the 3 days 220 participants were treated, 128 the first day, 74 the second day and only 18 011 the last day. The most frequent encountered problems were: 1) abrasions on the hands, arms and legs (n = 55) 2) muscle spasms o f the neck, shoulders and back (n = 44) 3) tendinitis (n = 14) 4) cramps 11 = 13) 5) ankle ligament injuries (n = 11). The most serious injuries were a suspected ankle fracture and a big laceration over the popliteal area. The treatment most frequently used were 1) massage o f painful muscles (66) and 2) cleaning o f wounds/abrasions. Over the 3 days 4 partieip;mts were treated for heat exhaustion and dehydration and 1 for heatstress (temp = 38.5’C). The only explanation for the 128 participants treated on the first dav was that 011 the lirst day the temperature was 35‘C, (lie second day was overcast and rainy and the last day partially overcast. 28 ANNUAL INCIDENCE AND RISK FACTORS FOR ROCK CLIMBING INJURIES IN SOUTH AFRICA Holtzhausen L-M, Pam ' C, Constant D, Schwellnus M. University o f Cape Town Medical School, South Africa. The aim ol this study is to determine [lie composition o f the climbing population in South Africa, the prevalence o f injury' amongst this population and some o f the possible risk factors for injury'. Data collection, by means o f a self-administered questionnaire, addressed the clim bers’ personal details, grade/experience o f climbing; the hours o f climbing done; climbing style/technique; training sessions; and warm-up and stretch activities. Climbers also reported on any injuries sustained during the period January 1992 to December 1992 that could be attributed to tlieir cliinbiiig.Two hundred and seven climbers (male 87.4% and female 12.6%) responded (response rate 21%). The annual incidence o f injury was 4 1 ,7%.Bivaiiate analysis o f injured climbers (1) versus non- injured clim bers (N) indicated a significant difference (PcO.OS) in those who climb at grades >26 (1 = 8, N = 21 climbers); climb more flays per month ((1 = 9, N = 6 days); climb more hours per day on weekdays (1 = 2, N = 1 hrs); do more hard rock (sport) climbing (1 = 50, N = 32%); do more overhang climbing (1 = 31, N = 18%); do more hours per month 011 formal training (I = 18, N = 11 hrs); do more outdoor training on rock (1 = 31, N = 11%); and spend more time 011 warm-up (1 = 7, N = 4 min) and stretching exercises (1 = 8, N = 4 min). Discriminant analysis identified four variables that could distinguish between the injured and noil- injured groups: grade o f climbing < 20 (Wilkes’ \ = 0.847, p = 0.0000), formal training 011 outdoor rock face (Wilkes’ \ = 0.783, p = 0.0000), days per month spent climbing (Wilkes’ X = 0.744, p = 0.0000), and percent o f time spent 011 hard rock (sport) climbing (Wilkes’ \ = 0.721, p = 0.0000). These lour variables correctly classified climbers as having sustained injuries in 72.8% o f cases. In conclusion we have found the annual incidence o f South African climbing injuries to be 41.7% a figure in keeping with other highly competitive sports. More experienced climbers, climbing at higher grades, more often per week and per month, 011 more off-the-vertical, overhanging outdoor rock walls are more likely to sustain injur)'. SPORTS MEDICINE MARCH 1997 11 R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 2. ) 29 ANATOMICAL DISTRIBUTION AND NATURE OF ROCK CLIMBING INJURIES IN SOUTH AFRICA Hohzhausen L-M, Parry C, Schwellnus M. University ol Cape Town Medical School, Sovitli Africa. The aim o f this study was to investigate the anatomical distribution, nature, mechanism and severity o( injuries in rock climbers. Questionnaires were mailed to eighty-five climbers who had indicated in an initial survey that they had sustained injuries attributable to a climbing activity. Fifty-one climbers (60%) reported on a total ol 85 injuries. The anatomical distribution o f these injuries was as follows: digits (42%); elbow (11%); shoulder and ankle (7% each); arm, foot and back (4.7% each); forearm (3.5%); vertebral column, pelvis, thigh, knee, wrist and hand (2.4% each). The nature o f these injviries was o f sudden onset in 60% of cases and of gradual onset in 40% o f cases. Very few sudden onset injuries represented fractures (8%) or dislocations (5.5%). These bony injuries were sustained during falls from the climbing surface. The majority o f injuries were reported as muscle strains and tears, ligament sprains, and tendonitis. Sixty' seven percent of climbers with sudden injury' indicated that a specific climbing move could explain the mechanism o f injury'. Severity ol these injuries, as assessed by climbing day's lost, averaged 52 days (std = 84, range = 0 - 400 days). We conclude diat injuries sustained whilst climbing affect mainly the upper limb (73%) with d ie digits (42%) and the elbow (11%) predominating. They are more likely to be acute than chronic injviries and more commonly involve sofl tissues than bones. In most cases o f sudden onset injury, the mechanism o f injury can be explained by a specific climbing manoeuvre. The range of injury severity is very wide with most injuries averaging 7 weeks in lost climbing days. This figure is in keeping with time to healing for most soft tissue injuries. 30 ELECTROMYOGRAPHIC ANALYSIS OF UPPER LIMB MUSCULATURE DURING ROCK CLIMBING Ilollzliauseii L-M, O’Shaughnessy K, Bridger B and Schwellnus M. University o f Cape Town Medical School, South Africa. The aim o f this study was to determine the electromyographic activity profiles o f six forearm muscles commonly used during sport rock climbing. Six intei-mediate (>grade 20) male climbers volunteered for die study. Two indoor artificial climbing w'alls were erected - one oil the vertical and one angled at 30' o ff the vertical. Climbers were tested oil the two w'alls using four different handhold types most commonly used by climbers : an open grip, cling (crimp) grip, two-finger pocket grip and an undercling grip. Electromyographic (EMG) data were recorded during a 30 second period using an EM8 EMG unit linked to a personal computer with custom written software. Two groups o f three muscles each w'ere chosen for analysis: group 1 = brachialis (B), 11 ex or digitorum superficialis (FDS) and pronator quadratus (PQ); group 2 = flexor carpi ulneris.(FCU), brachioradialis (BR) and extensor digitorum (ED).Tlie table below summarizes the EMG results o b t a i n e d : Vertical wall Musclc o|>cti crimp pocket undcrcling Overhang wall open crimp |KK.:kel undcrcling. B 71 ±36 61 ±30 71±33 66± 39 28±17 57±22 69+30 51±36 PQ 59±34 53±40 71 ±37 58±40 46±31 41 ±31 34±29 54±35 EDS 51±31 54±29 75±36 57±20 41 ±17 56±25 8o±30 52±23 fcu 82±23 82±20 47±30 45±30 66±22 80±16 59±34 +is BR 47+33 46±35 66±24 65±23 41±32 50±29 68±38 58±12 ED 59±37 57±34 41±30 44±21 50±38 50±31 3!+1% 11±11 31 THE EFFECT OF STATIC STRETCH DURATION AND FREQUENCY ON HAMSTRING MUSCULOTENDINOUS FLEXIBILITY G Hughes, M Schwellnus FACSM, University ol Cape Tow'll Medical School A study was undertaken to investigate the effect o f different durations and frequencies o f static stretch on hamstring musculotendinous flexibility. Ten subjects were studied under two conditions with one limb having the experimental stretch procedure performed on it, while the opposite limb acted as the control. The duration o f static stretch was determined by comparing die effect ol 10, 20, 30, 60, 90, 120 and 240 second duration stretches on hip joint range o f motion (ROM). The end point o f ROM was determined using a previously validated technique which defines die end point by a sudden increase in surface EMG activity. The number o f stretch repetitions (frequency) w'as determined by comparing d ie effect of 1, 2, 3, 4, 5, 7 and 9 repetitions o f a 30 second stretch each on hipjoint ROM. A significant (p<0.01) increase in hip flexion ROM from baseline (measured 5’ ) was documented after all the durations o f stretch except in the 10 second static stretch duration (0.9 ± 2.8'). No significant differences (p>0.05) were observed between the 30, 60, and 90 seconds durations, but these durations resulted in significantiy (p<0.05) larger increases in ROM than the 120 and 240 second durations. A significantly (p < 0 .0 1 ) larger increase in ROM was observed alter 2 repetitions (9.8 + 2.3') compared vvitii 1 repetition (6.5 + 2.0‘ ). A significantiy (p<0.01) larger increase was also observed with 3 repetitions (12.8 + 1.8') compared with 2 repetitions (9.8 + 2.3'). There were no differences (p>0.05) between 3, 4, 5, 7 and 9 repetitions. In conclusion, these studies indicate that the ideal static stretch session consists o f a stretch o f 30 to 90 seconds duration, repeated more tiian 3 times. Multiple linear regression analysis was done to determine w'hedier or not significant relationships existed between the grip type and level of muscle activity and the type of wall (overhang or vertical) that was climbed, hi die first analysis climber 1 on wall 1 (vertical) using muscle 1 (brachialis) on grip 1 (open grip) w'as established as the constant dependent variable. The four independent variables were: w'all (2 levels); climber (6 levels); muscle (6 levels) and grip type (4 levels). The four variables, without any interaction terms included, accounted for 28% (r=0.53) o f the variance o f the dependent variable (F=7.57, df=14 and 287, p<0.001). When the climber- muscle interaction (25 terms) was added to the model, 46% (r=0.678) o f die variance o f the dependent variable could be accounted for (f= 5.44, df=39 and 287, p<0.001). This suggests that differences in technique between different climbers are possible even when the same grip is used. When muscle-grip interaction (54 parameters) was also added to the model, 56% (r=0.749) o f the variance o f the dependent variable could be accounted for (F=5.44, df=39 and 287, p<= 0.001). The interaction between muscle and w'all made no meaningful improvement to the model. In conclusion, high levels of electrical activity were found in d ie forearm muscles under all conditions tested. The regression analysis revealed that forearm muscle EMG in rock climbing is influenced by the type o f grip used, the muscle being sampled, die individual climber and the wall. 12 SPORTS MEDICINE MARCH 1997 R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 2. ) 32 THE EFFECT OF A SINGLE STATIC STRETCIiING SESSION ON HAMSTRING MUSCULOTENDINOUS FLEXIBILITY OVER 24 HOURS G Flughes, M Schwellnus FACSM, University ol Cape row'll Medical School The aim o f this study was to determine the retention of increased range o f motion (ROM) over 24 hours after a single static stretching session o f 30 seconds duration and repeated 3 times. Hip joint ROM (in degrees), using surface EMG activity to determine the end-point, was measured before die stretching session, immediately after the stretching session, and at 1, 2, 3, 4, 5, 6, 12 and 24 hours after the stretching session. Analysis o f results showed a significant difference (p<0.05) between the pre-stretch ROM (92 ± 12‘) immediately after (106 ± 12") and at 1 (105 ± 12‘), 2 (104 ± 13‘), 3 (104 ± 11 ) and 4 hours (103 ± 11') post stretch. A significant difference (p<0.05) was also found between the immediate post stretch ROM (106 ± 12‘) and the 12 (94 ± 12‘) and 24 hours (93 ± 12‘ ) post stretch measurements. These findings indicate that increased ROM after the optimum static stretching session was retained for only 4 to 6 hours. In conclusion, this study indicates that after a static stretch session (30 seconds x 3 repetitions) the increased ROM is retained for up to 6 hours only. Stretching programs, using the static stretching technique, should therefore be modified so that stretching sessions are conducted 3 to 4 times per day. 33 EFFECTS OF SUSTAINED HIGH INTENSITY INTERVAL TRAINING (HIT) ON EXERCISE PERFORMANCE, SKELETAL MUSCLE AND CARDIAC FUNCTION IN CARDIAC REHABILITATION PATIENTS BL Hulse, EW Derman, EV Lambert, & TD Noakes. UCT Bioenergetics o f Exercise Research Unit, Sport Science Institute o f South Africa, Cape Town. This study compared the effects o f the addition o f a 10 wk HIT program o f cycle ergometer training @ 80-90% V0aillllx (HIT; n=9), to continued conventional aerobic exercise @ 50-70% V02_ (CONT; 11=8) on maximal (MAX) and submaximal (SMX) exercise performance, skeletal muscle strength and resting cardiac function, in 17 aerobically trained patients participating in a cardiac rehabilitation program. Before and after intervention both groups performed: i)graded exercise to exhaustion, for determination o f V02ranx and peak power output (PPO); ii) a six minute walk test (6WT) for distance covered; iii) tests o f isometric and isokinetic skeletal muscle function (SMF) & iv) echocardiography for determination o f ejection fraction (EF) and left vent ricular mass (LVM). At baseline, all parameters were similar between HIT and CONT groups. After intervention, PPO increased by 17% (130 ± 12 vs 156 ± 12 W; [mean ± SEM I, P <0.005) in the HIT group but was unchanged in die CONT' group (140 ± 14 vs 136 ± 14 W). Similarly V0o„lax increased by 18% after HIT (24.5 ± 1.9 vs 29.7 ± 1.9; uilO^kg m in 1; P<0.05) iu the FI1T group but was unchanged in the CONT group (23.3 ± 2 vs. 24.2 ± 2.3 mlOs kg min '). Distance covered in the 6WT increased after HIT (11%; 635 ± 27 vs. 713 ± 27 ni; p<0.01), but was unchanged in the CONT group (584 ± 45 vs. 577 ± 28 m). EF, LVM and SMF did not change in either HIT or CONT groups. These results suggest that HIT resulted in improved MAX and SMX exercise performance, which could not be attributed to enhanced resting cardiac function or SMF. These adaptations exceed those seen in the healthy athletic population performing HIT. 34 INTEGRATED ELECTROMYOGRAPHIC OFM f", ACTIVITY AND CARDIOVASCULAR RESPONSE MV PATIENTS WITH LOWER BACK PAIN (LBP)- EFFFCT n p SLEEP SURFACE. BL Hulse, A St Clair Gibson, TD Noakes & EW Derman. UCT Bioenergetics o f Exercise Research Unit, S)x>rts Science Institute o f South Africa, Cape Town. We have recently show'll that patients with chronic LBP have decreased IEMG activity o f the erector spinae muscles, hnver heart rates (IIR) & increased perception o f comfort (ROC) when lying on a locally designed, triple density, contoured, lumber body support (LBS) compared with a regular flat sur­ face mattress (CM). In order to determine a mechanism for these effects, we studied patients with LBP after an acute, ran­ dom order, 30 min exposure to 4 sleep surfaces: LBS, CM, a low density, flat, Egg Box Foam Mattress (EBM) and a Polystyrene Shape Mould (PM), identical to the shape o f the LBS. Patients ware divided into 2 groups: i) LBS, EBM & CM (n=10) & ii) LBS, PM & CM (n=10). Each patient acted as h is/her own control. Recordings o f IEMG activity', HR & ROC were measured at 5 min intervals for each patient. At baseline, patients w'ere included only if deep palpation o f the erector spinae musculature clicited pain. After acute exposure to the LBS, average HR i by 13 b/m in over d ie 30 min period (58.72 ± 3.87; b/m in; P<0.05), but was unchanged for the EBM and CM groups (62.83 ± 4.02; b/m in) & (62.89 ± 3.78; b/m in). Average ROC reported after acute exposure to the LBS wras sig­ nificantly improved (1.86 ± 0.33; P<0.05), compared to ROC after exposure to the EBM (4.22 ± 0.43) & CM (4.6 ± 1.67). Average IEMG measurements w'ere significantlv reduced oil the LBS (3.88 ± 0.76; niv; P<0.05) compared to die CM (13.81 ± 2.16; niv) and EBM (16.44 ± 2.86; mv). ii) In die second group, HR 4- significantly after exposure to d ie LBS, (60 ± 2.3; b/min; P<0.001), while there was no significant change for PM (66 ± 2.9; b/m in) & CM (68.15 ± 2.97: b/m in). ROC was sig- nificandv improved on the LBS (1.83 ± 0.18, P<0.01) vs PM (5.6 ± 0.78) & CM (4..1.3 ± O.o6). Average IEMG measurements w'ere signilicandy reduced on die LBS (3.83 ± 0.72; niv; P<0.05) vs CM (14.35 ± 5.66; niv) & PM (27.6 ± 9.24; mv)! These residts suggest that patients with LBP have I IEMG & H R measurements & Improved ROC wiien lying on a LBS com ­ p ared w idi a CM; EBM and PM. These findings indicate that die effect o f die LBS is likely due to a combination o f both its density' and contour features. 35 METABOLIC COST OF TRAMPOLINE EXERCISE IN RELATION T O TREADMILL E XERCISE AT COMPARABLE H E A R T RATES A Klian, A k Weston, M Mars, D epartm ent o f Physiology, University of Natal M cd ical S chool, Durban. South Africa Exercising 011 th e mini-Lraiiipolinc lias b e co m e increasingly popular particularly in the hom e environment.. However quantification o f exercise intensity is difficult. One p ossible m ethod would b e the use o f heart rate bu t the relationship betw een heart rate (H R ) and oxygen consum ption (VO») during m ini-tram poline exercise is not clear. T h erefore the aim ol the current study was to elucidate the relationship betw een H R and V 0 2 during m ini-tram poline exercise and to com pare the sam e relationship during treadm ill running over a com parable range ol heart rates. A 11 additional aim was to investigate the c f f e c t o f d ie h eigh t o f leg lift at a given; com m only used step rate. Subjects (n =1 7) were m ale Cage range 18-30) and all had undertaken a fam iliarisation session prior to com p letin g th e test. W orldoads 011 the tram poline were 100, 120, 160 and 200 s t e p s / m in with a 15cm leg lift and a final w orkload at 120 stcp s/m in with a 9 0 ‘ leg lift, with pace maintained by m etronom e. 1 lie first w orldoad was m aintained for 5 m ins and all subsequent w orkloads for 3 m ins, will] recordings m ade for analyses in th e last 30 sec ol caeli w orldoad. Five treadm ill w orkloads were selected for each subject to give a sim ilar range o f heart rates to those achieved 011 the niini-trainpoliiie. Im m ediately after the 5th w orkload 011 the treadm ill, subjects continued to exhaustion for determ ination o f p eak V 0 2. T h e relationship betw een V 0 2 and MR 011 tiie treadm ill was linear as d escribed elsew h ere, with tlic equation VOo=20.2HR - 1070, whilst, the equation o f th e relationship betw een V O , and H R for tram poline exercise was exponent.ial (VO..=441 c " " |,IMi') show ing a p ronounced elevation iu H [{prior to an elevation in VO-,. T he m ean V 0 2 w h ilst stepping at 120 ste p s/m in with a leg lift o f 90" was significantly high er than with a leg lift o f 15 cm (2 .1 0 1/inin vs 1.97 1/min, p< 0.001). T h e results o f this study indicate the heart rate is not mi accurate m eth od o f m onitoring c x cr c is c intensity during tram poline e x ercise and that the degree o f leg lift is crucial in prescribin g exercise intensity' during such exercise. SPORTS MEDICINE MARCH 1997 13 R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 2. ) 36 FUSAFUNGINE REDUCES SYMPTOMS OF UPPER RESPIRATORY TRACT INFECTIONS (URTD IN RUNNERS AFTER A 56KM RACE M SchweUiws FACSM, M Kiessig, W Demiaii FACSM, T Noakes FACSM. University o f Cape Town,'South Africa. The effect o f Fusifungine, a topical anti-infjammatoty/anti- bacterial nasal/oral sprav, 011 the incidence ol symptoms of upper respiratory7 tract infections (URTD in the 9 days following, a £>61011 running lt o iI was studied. Male runners (n=96) with a 42km tune of <3hrs, with no history of allergy, and with daily intakes of ■0 < lOOOmg-Vitamin C, ii) < 18mg Beta carotene, and hi) < 400 LU Vitamin E were recruited. Prior to the race, subjects were instructed on the proper use o f the medication (4 spray's into each nostril and the throat 4. times daily) and then randomly allocated to either a group receiving Fusafimgine (F:n=48) or a placebo ( p :n = 48) in a double blind manner. Subjects completed a daily logbook detailing symptoms [runny nose (RN), b l « * ecl nosf all nasal symptoms (N = RN+BN), sore throat (SI ), and all URT symptoms (URTS = RN+BN+ST), in die 2 day's before die race, the first 3 days after, and die 4-9 days after d ie race. AU the symptomatic subjects underwent medical evaluation. Throat swabs and viral gargles for culture were taken. No athlete widi symptoms had a positive bacterial or viral c u l t u r e . The incidence BN KN N ST UR r s F P F P F- P F P F p D ay -2 to -1 Day 0 to 3 Day 4 to 9 to 6 i t T T T T s r 17 6 15 11 3 15 8 19 9+ 17 23 23 21 ' 12 14 22 15 21 17 21 17* 28 33 40 27 inere was a ciecreuweu uiciu*,au ̂ \./»j — - ©---r- (F=1.7%; P=40%: *:p<0.05) in the period Day 0-3 after die race, widi a ’ tendency for the nasal symptoms to be lower (F=9%; P=23%:+:p=0.08) in die same period. In summary' post-race URTS are not o f infective origin (viral or bacterial) and tiieir incidence can be reduced by a topical anti-inflammatory' agent. Hence post­ race URTS are likely the result o f an inflammatoiy and not an infective process. Supported by Servier Laboratories SA (Ply) Ltd. 37 THE EFFECTIVENESS OF A MENTAL SKILLS TRAINING PROGRAMME FOR EASTERN PROVINCE ACADEMY CRICKETERS H Kotras*, L Slogrove* *, G Robertson* and R Stretch * Department o f Psy chology, University o f Port Elizabedi, Soutii Africa * ‘ Department of Human Movement Studies, University o f Port Elizabeth, South Africa ** ‘ Sport Bureau, University o f P o r t Elizabeth, Soudi Africa A major doctrine of Sport Psychology' is that sport performance is strongly determined bv mental skills. This study evaluated die effectiveness o f a mental skills training programme on the sell- reported ‘knowledge of’, ‘importance placed on’ and ‘use ol six mental skills: goal-setting, concentration and attention, arousal and anxiety control, visualization and imagery', confidence, and pre-, during- and post-game activities, i.e., ideal performance state (IPS), in a sample of male cricket academy players (11 = 14). Selected non-academy players formed a comparison group (n - 12). The Academy players participated in a six-week mental skills training programme, which involved one ol die six mental skills each week. During each session the particular skill was defined and explained, as w'ere the principles and implementation that applies to that specific mental skill, followed by a practical exercise, where the players were guided tlirough die application of the skill. The players also completed assessments belore and after die programme. The comparison group members did not participate in die programme, but also completed assessments on two separate occasions. Overall, the results suggest that the programme was instrumental in changing the ‘knowledge ol ratings most consistentiy across die mental skills, but was less consistent in changing die cricketers’ ‘importance placed on’ and ‘use o f’ ratings. Knowing more about: the mental skills and even acknowledging dieir importance in cricket, may not necessary be sufficient in order to lead to enhancement in performance. Therefore, cricketers need to be encouraged to practice using and improving dieir mental skills consistentiy and regularly. It may' prove beneficial to integrate die mental skills witii the physical and technical practice, in order to increase the ‘use o f mental skills in cricket perfoimance. The comparison group did not show any significant increase in any' o f die ratings for any' ol the mental skills, wliicli suggests that it was die programme that was instrumental in changing certain ratings. 38 THE PREVALENCE OF ANABOLIC STEROID USE IN ADOLESCENTS IN SOUTH AFRICA MI Lambert, M Schwellnus, S Tidestad. University o f Cape Town Medical School Twenty-six schools were randomly selected 1 rom all the schools in 2 geographical regions (A and B). A questionnaire was administered to 2912 adolescents (17-19 years) from these schools to determine the prevalence ol anabolic steroid (AS) use and to test their knowledge on AS (assessed by a score obtained in response to 8 questions on AS). Complete data were obtained from 2836 (97.4%) adolescents in the 2 regions (A, n=1361; B, 11=1475). The prevalence o f AS use in all the adolescents was 1.4%. The prevalence o f use was higher in region B (2.2%) compared to region A (0.6%) (p<0.005) and in boys (2.8%) compared to girls (0.07%)(p<0.001). When the group was subdivided, d ie highest prevalence o f AS use occurred in bovs who competed in d ie first team (3.8%). The score (maximum o f 8) obtained by all sports participants in the knowledge Lest (mean ± SD) was low (2.7 ± 1.6). The score was higher in bovs (2.9 + 1.6) than gills (2.3 ± 1.5) (p<0.0o) and sports participants (2.7 ± 1.6) compared to non-participants (2.2 ± 1.6) (p<0.01). In conclusion, this study highlights the problem o f AS use in schoolboy's, show's regional differences in AS use and a poor knowledge o f AS in all the groups. 39 ISOKINETIC STRENGTH TRAINING OF THE QUADRICEPS FEMORIS BY MEANS OF ELECTRICAL STIMULATION iT , Lategan L, Loots J M, Lourens A, Van Wyk GJ, Cilliers PJ. Biokinetics Department, 1 Military Hospital Soudi African Medical Sendees, Pretoria, South Africa The primary aim o f the study was to investigate the strengdiening o f die quadriceps femoris muscle group by means o f an isokinetic NMES training programme. 21 subjects, wdtii an average age ol 22.55 y'ears, participated in the study'. A Cvbex 340 dynamometer w'as used to measure extension torque at O'.s'1 (60" knee flexion), 60, 180 and 240 .s'1 before and after the NMES training period consisting o f 10 sessions. The subjects were divided into groups: Group A (who received isokinetic NMES training) and Group C (who served as a control group). In addition, each individual had a designated “ treatment” and “ control” leg; the “ control” leg served as an extra control for determining the effect o f the isokinetic NMES training programme. Independent and dependent t tests revealed that 10 sessions o f isokinetic NMES training o f die quadriceps femoris, resulted in statistically significant knee extension torque improvements in Group A (for die treatment leg), atO-.s'1 (18.2%), 6 0 \ s’ (20.7%), 180\s' (17.4%), and 240 . s 1 (13.2%), respectively. However, Group As control leg also showed statistically significant improvements o f 2.6 and 2.0% at 0 and 60".s\ respectively. Additionally, Group C s “ treatment” leg showed a significant (p<0.05) improvement in the post-treatment condition o f 6.2%, even though it received 110 NMES treatment. I11 the present study, a safe metiiod ol isokinetic NMES was developed which proved to be viable as a strength training modality for the quadriceps femoris muscle group. The isokinetic NMES training programme at 60\sj resulted in significant improvements in both isometric and isokinetic knee extension torque (p<0.05). 14 SPORTS MEDICINE MARCH 1997 R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 2. ) 40 THE ENERGY COST OF RUNNING IN FIELD HOCKEY IS GREATER WHEN DRIBBLING A BALL B Lawther and R Carter, Department o f Physiology, Centre for the Study o f Exercise, Nutrition and Muscle Science, University o f the Witwatersrand, Medical School, Johannesburg, South Africa The physiological demands o f field hockey, which employs a unique posture while playing die ball, have mainly been inferred from studying athletes running in the upright posture. In this study, resting pulmonary function was assessed in both die upright and the semi-crouched dribbling posture in eleven male and ten female elite field hockey players. In addition, the players completed a 4 minute run 011 the treadmill at 10,12 and 14 km/hr for the men, and 8, 10 and 12 km/hr ibr the women, whilst both dribbling a 1 >all at the end of a hockey stick and during normal running. The metabolic and ventilatory responses to normal running and to dribbling a hockey ball in the semi-crouched position were evaluated in order to establish the additional physiological strain imposed by this compromised posture. The semi-crouched posture significantiy reduced resting pulmonary' function in both die men and the women (IVC 6.0 ±0 1 .2 vs 6.3 ± 1.21 hi males, and 4.1 ± 0.6 to 4.2 ± 0.6 in females; PEF 11.1 ± 2.2 vs 11.8 ± 2 .7 1/s in males, and 8.7 ± 1.7 vs 9.1 + 1.6 1/s in females; P<0.05). Dribbling increased energy expenditure above levels observed in normal running, for bodi the men and women at each speed (e.g. 52.2 ± 1.9 to 47.6 ± 2.3 1111. kg .n 1 i 11 in males, and 43.9 ± 2.0 vs 39.8 ± 2.3 ml.kg'.min1 in females at die high speed; P<0.001). Heart rate was significandy higher while dribbling at each speed (e.g. 190 ± 6 vs 177 ± 7 beats/min in males, and 189 ± 11 to 178 ± 12 beats/min in females, at the high speed; P<0.001). Minute ventilation was significantly higher while dribbling relative to orthodox running at each speed (e.g. 150 ± 25 vs 107 ± 15 1/min in males, and 109 ± 14 vs 82 ± 13 1/niin in females, at die high speed; P<0.001). Tliis studv has shown that die compromise in pulmonary function detected in the dribbling posture at rest does not impair the physiological performance of hockey players executing dribbling skills on the treadmill. Furthermore, running in the dribbling posture is far more physiologically cosdy dian is orthodox running. The additional strain diat the players experience hi diis peculiar posture must be incorporated in predictions of the energy cost of competitive match-play hockey. 41 MOOD, AND PERFORMANCE OF CRICKETERS DURING AN INTERNATIONAL TOUR PW Macfarlane, University o f Cape Town, Cape Town, South Africa. Objectives: An attempt was made to determine whedier die mood state o f cricketers and the team as a whole could contribute to the extremely variable performance which was noted on previous occasions. Methods: A modified questionnaire based 011 die Profile o f Mood States (POMS) was administered by interview wadi each player individually 011 most mornings o f a six-week cricket tour. Categories assessed were Anxiety, Confusion, Depression, Fatigue, Vigour, Relaxation, Soreness, Homesickness, Boredom and Frustration. Results: Anxiety scores showed short-term trends and were match-related. Higher scores were associated widi better performance. Confusion scores appeared to reflect die state o f leadership and success on tour, radier dian predict performance. Depression scores were also more a result of events dian a predictor. Fatigue was also related to match history. Vigour did not mirror fatigue, but was low 011 rest days. Relaxation scores were higher during rest periods, but also at the end o f one match when performance was lower. Soreness scores did not increase during the tour, but individual variation was evident, d u e ,usually to injury. Flomesick scores showed a rising trend, exacerbated 011 the rest days. Boredom was lowest at the beginning and highest on rest'days. Some individual Frustration scores were very' high at certain times, and the team score was high during a period o f poor performance and prior to another period of |M>or performance. Conclusions: Teams touring abroad Cac.e stresses diat are different from what diey and their management are used to at home. This study highlights some o f the general problems such as rest days and motivation which can be taken into account when planning tours in general. Certain scores o f mood relate more to die result o f events, and need to be taken into account in managing team morale and strategy on a particular tour. Other scores may' predict performance and give early warning o f a dip in form. 42 COMMUNITY BASED CARDIAC REHABILITATION PROGRAMMES - A PILOT PROJECT. N Mars M, Modiilal B* and Stubbs J*. South African Association of Cardiovascular Rehabilitation and Heart Foundation of Southern Africa*. In die South African Indian population over 45 years o f age approximately 50% o f deaths “ from all causes” are due to diseases o f the circulatory system. I11 a large random survey of Durban s hidian population, 48% of people over die age o f 15 years were found to have ECG changes. Coronary heart disease accounts for 24% o f all deaths in the medical wards o f one of Durban’s major hospitals. With increasing intervention surgery and angioplasty' there are a large number of patients who are candidates for cardiac rehabilitation programmes. A review of the rehabilitation programmes hi the Durban Functional Region revealed that diere are about 35 Indians attending. Analysis of the reasons for the low attendance, revealed die following factors: lack of knowledge o f the medical practitioners o f the benefits o f rehabilitation and o f the sendees available, piaetidoners fear o f “ losing’ the patient, family'pressure 011 the patient to not exercise as it is considered dangerous, inappropriate siting and timing of rehabilitation programmes, and the fear o f losing disability grants if rehabilitated. With this in mind, discussions were initiated with the local community leaders in Phoenix. After initial scepticism, a partnership was entered whereby die community would provide facilities, and volunteers to run a tertiary rehabilitation programme. The local doctor’s guild was invited to participate, and although supportive of the idea, tiiey did not offer tiieir time. The volunteers underwent training in CPR, exercise prescription and monitoring, and programme management. General community interest was raised by phone in programmes 011 the community radio, Radio Lotus, and equipment was donated bv the public. The service is free, and tiiere is no budget. All incidental costs such as printing etc have been borne by donation from the local community. The programme has been running for 3 months and is growing. There are requests from other Indian communities to start similar projects in their areas, and project committees are being established. 43 INFRA-RED LASER: AN IN VITRO DOSIMETRY STUDY Mars S, Cliulurgoon A and Mars M. Dept, o f Physiology', University'of Natal Medical School, Durban, Soutii Africa. Low intensity' laser tiierapy is a popular treatment modality used to enhance wotuid healing. A commonly used commercially available low intensity infra-red laser is the superluminous diode based Gallium Aluminium Arsenide laser, 830nm. There is however little scientific evidence to support bodi its efficacy and optimal dosage. The literature on die use o f laser is confounded by a lack o f standardisation o f terminology witii respect to dosage which has been expressed hi terms of power, power density or energy' density'. There are few dosimetry' studies using infra-red laser directly on fibroblasts. The aim o f this pilot study was to investigate the effect o f different doses o f infra-red laser 011 fibroblast activity in cell culture. Human fibroblasts were cultured, and confluent fibroblast cells were trypsiuized and resuspended in culture medium to give a measured cel1 count o f 11 x 10* cells/ml. 100ml o f cell suspension and 200inl o f culture medium were titrated into each well of a 96 well microtiter plate. The plate was then incubated 37'C until confluent. Ten o f die twelve eight well channels were irradiated on three consecutive days at energy densities o f 0.2, 0.4, 0.6, 0,8, 1, .1.5, 2.3, 3, 4 and 5 J.cm 3. Each well was irradiated individually. The two end channels of eight wells each were not irradiated and served as controls. On the day after die last treatment, cell viability was measured using the MTT assay, which is an indicator of mitochondrial enzyme activity'. The optical density o f each well was measured spectrophotometrically at a wavelengdi o f 595 mil witii a reference wavelength o f 630nm. Analysis o f variance showed a significant difference between fibroblast activity at different doses (P=0.004). Post hoc testing revealed significant differences between die controls and diose cells treated widi the low dose 0.4 J.cm - and die highest dose 5 J.cm 3. Previous studies have not used doses as low as 0.4 J.cm- and increased activity at tiiis dose is a novel finding. The increased activity' at 5 J .c m 3 is hi keeping with other dosimetry studies. The information gained in this study on dose efficacy w ill be used to evaluate a new in vitro model o f wound healing. SPORTS MEDICINE MARCH 1997 15 R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 2. ) 44 THE RISK OF HUMAN IMMUNODEFICIENCY VIRUS (I I I V ) TRANSMISSION IN BOXING KOP M a t s e k e , M P S c h w e l l n u s , S p o i l s Medicine, D e p a r t m e n t o f Physiology, U n iv e r s it y o l C a p e Town HIV disease is a fatal disease that can be transmitted through contact with blood or blood products. Sports participants that engage in contact sports such as boxing, are therefore at risk to acquire the condition. In boxing, the precise risk o f transmis­ sion has not been documented. The risk o f transmission o f FHV in boxing is dependent upon the following four factors: i) die seroprevalence o f HIV infection in boxers, ii) the risk ol an open bleeding wound in a boxing bout, iii) the risk o f contact between the boxers, and iv) the risk o f transmission of.the virus when bleeding wounds make contact. The aim ol this study was to determine the risk o f transmission o f HIV during a boxing bout. Assuming that the risk o f contact between two boxers is 100%, and that the risk o f transmitting the vims when open bleeding wounds make contact is 5% (similar to that o f a needlcstick injury), two studies were designed to firstly determine the sero­ prevalence o f HIV in professional boxers in South Africa, and secondly to calculate the incidence o f open bleeding wounds in professional bouts in South Africa. The nature o f the bleeding wounds was also studied, as well as current precautions that boxers and support staff in and around the ring take. In the first study, medical records, in particular the HTV status, in the year alter compulsory HIV testing was introduced at routine annual medical examination, were obtained from all the professional boxers in South Africa (with approval o f the SA Boxing Board of Control). A total o f 925 boxers were registered, and the HIV pos­ itive prevalence rate was 9%. In the second study, video clips of 30 professional boxing bouts were studied. During each bout, the following data were obtained: the presence o f an open bleed­ ing wound, die type and site o f injury, die amount o f bleeding, contamination bv the blood, and d ie action taken by cornermen. In 14 out o f 30 bouts, an open bleeding wound was sustained by a boxer (46.7%). /Ml the injuries were in the face/head (100%), and most injuries were lacerations (54%), followed by contusions (21%), abrasions (6.5%) and otiiers (18.5%). The amount o f bleeding was classified as mostly present but not flowing (46%), followed by fast flowing and dripping off (25%), slow flowing and not dripping (20%), and no bleeding visible (9%). The blood con­ taminated the following: boxing gloves (31%), towels (26%), skin (19%), ring or railing (10%), cornermen (8%), and referee (3%). Actions taken by cornermen were attempts to stop bleeding (40%), washing with water (27%), wiping but no attempt to stop bleeding (25%), and no action (8%). The risk o f HIV transmis­ sion in South African boxers during one bout was therefore cal­ culated as follows: seroprevalence (0.09) X the risk of an open bleeding wound (0.467) X the risk ol contact (.1) X risk of viial transmission between wounds (0,05) = 0.0021 (1 in 476 bouts). Professional boxing in South Africa therefore carries a signifi­ cant risk o f HIV transmission. Preventative measures to decrease the risk oi l l IV transmission should include education o f boxers and support staff, reducing the risk ol contamination, and appropriate action of contaminated material. 4 5 IMF, EFFECT OF LOW -DOSAGE, LONG-TERM C REATIN E M ONOHYDRATE SUPPLEMENTATION ON T H E PERFORMANCE OF CYCLISTS France M oilcr, Wayne V iljocn, Pauline Nicmvoudt, J a cq u cs Rossomv, D epartm ent Sport S ciences, Technikon Pretoria, Pretoria, South Africa Previous studies on creatine m onohydratc concentrated on the effect o f high-dosage, short-term supplementation on athletic perform ance. T his study exam ined th e effect ofloxv-dosage (3 g /d a v ), long-term (12 w eeks) creatine luonohvdrate supplem entation on b lo o d lactate accumulation, pow er output mid fatigue. Eleven well-trained m ale cyclists perform ed repeated bou ts o f th e 30-second Wingate anaerobic test. Finger-sample m easurem ents for b lood lactate w ere taken at rest and alter each o f the three bou ts o f maximal cy clc ergometry. Peak power output, average pow er output, total work and pow cr-drop w ere com puted. No significant d ifferences were reported for average power output and total work after th e adm inistration period. Creatine supplem entation led to a significant decrease in pow er-drop during all d iree exercise bou ts (pj ̂ = 0,003: P2 0,009: p3 = 0 ,0 2 8 ) and a significant decrease (p = 0,0 0 9 ) in blood lactate accumulation. A significant increase (p = 0,0 9) in mean pow er output w'as recorded during th e last 15 secon d s o f the exercise bouts. We therefore concluded that for well trained cyclists perform ing repeated bouts o f maximal exercise, low dosage loiig-tcm t crcatin c m onoli\diate supplem entation significantly d ccrca se d fatigue and b lo o d lactate accumulation. Funding: P PL. (Ptv) Ltd. 4 6 ELECTROMYOGRAPHY AND SERUM ELECTROLYTES DURING RECOVERY FROM E X E R C IS E A S SO C IAT E D MUSCLE CRAMPING (EAMC). J Nicol, M P S chw ellnus, T D Noakes, M R C /U C T Bionergctics o f E xercisc R esearch Unit Univ. of C ape Town, RSA. T h e anil o f this study was to relate baseline integrated surfacc clectrom vograpliic (BIEM G) activity mid serum electrolyte concentraUons (SEC) to clinical recovery in runners with EAMC. Subjects were runners presenting with acute severe (unable to walk) EAMC after a 06 lan race (E, n =11). Controls for d ie SEC (Cl, n = 11) were runners m atched for age, gender and linishing tim e who com pleted the o 6kni race without EAMC. Controls for the BIEMG (C2, n = 7) were runners with no EAMC after a 35 km run. BIEMG was recorded i) in the affected muscle (quadriceps (Q), gastrocnemius (G )) of the subjects in the E group on adm ission O'o) and after recovery (60 minutes later) (T60) during periods w hen th e runners w ere not experiencing a spontaneous m uscle contraction (BIEMG) and ii) in the C2 group in the Q an d G m uscles attci the 35 km run (To) and 60 m inutes later (T60). EMG data w ere expressed as % change in BIEMG f l o to T60). T he % decrease (mean (SD )) 0 0 vs 'W 0 ) in BIEMG for the E group (52 (2 5)) was significantly greater (p <0.05) than the C2 group (12 (47)). T he results o f blood sam ples collected for measuring SEC (m niol/1) on admission (To) and 60 minutes later f 160) in d ie E and C groups are dcp icted in Table 1. Table 1 : Serum electrolyte concentrations ((m ean (SO)) during recovery from EAMC Na+(minol/l) Ka+(nimol/l) Ca++(minol/l) Mg++(nmiol/l) la : C l group To: E group 1 6 0: C l group 160: E group 142(3) 142(2) 141(3)** 140(3) 4 .7 (0 .4 ) 4 .3 (0 .5 )* 4 .4 (0 .0 5 )* * 4 .2 (0 .4 ) 2 .3(0.1) 2 .3 (0 .1 ) 2.1 (0.3 ) 2 .2(0.1 ) 0 .7(0.1) 0.7(0.1) 0 .7(0.1) 0.8( 0.1 ) * p<0.05, E vs C l group at To: **p < 0 .05, To vs T 60 for C l group Til esc' results indicate that i) runners with EAMC have greater BIEMG activity than control runners during the next race period ii) d ecreases in BIEMG activity are associated with recovery from EAMC, iii) there is no relationship between SEC and cither recovery from EAMC o f BIEMG and iv) that differences ill serum K+ and N+ between E and C l are not o f clinical significance. Supported by the Sports M edicine Research Fund o f the University o f Cape Town. 4 7 SERUM ELECTROLYTE CONCENTRATIONS AND HYDRATION STATUS IN RUNNERS WITH EXERCISE ASSOCIATED MUSCLE CRAMPING (EAMC) J N icol, M P S ch w e lln u s, T D N oak es, S p orts M e d icin e , M R C /U C T B ion erg ctics o f E xercise R csearcli Unit University o f C ape Town, RSA. T he aim o f this study was to determ ine w hether acute EAMC in distance limners is related to changes in scrum electrolyte concentrations (SEC) and hvdration status (FIS). A coh ort o f runners (N=44) participating in a 5 6 kni race all w idi a history o f EAMC were recruited. Body weight was measured and blood sam ples for blood glucose (BG), SEC, serum osmolalitv (O sm ), Haemoglobin and hacm atociit w ere collcctcd from all the limners 30 mill before the race (Tb) and im mediately oil completion o f the race (To). Samples for SEC and Osm were also collcctcd 60 lnin f ! 6 0 ) after the race. T he cohort was divided into a group o f runners (C, n=21) who suffered from EAMC during the race, and a group with no EAMC (N, 11=23). Bodi groups had similar [(m ean (S D )j age (years) [N:42(8), C :37(8)l, pre-race BW (kg) [N :73(8). C :7 8 (ll)l,' and race finishing tim es (m ill) [N:304(36), C:309(41).|. Runners with EAMC were treated onlv with rest, passive stretching and oral fluids,and all had recovered by 'W0. SEC (m m ol/1) B GOm nol/l), OSM (m osni/1) and hydration status (calculated as % change in BW (% BWC) and % changc in piasnia volume (%PVC) w'cre com pared in the C and N groups using ANOVA G ab le 1). Table 1. B lood glucose and scrum electrolytes in th e N and C group at Tb, To and T60. BG \ra+ K+ Ca++ Mg++ Osm Ta:N 6 .1 ( 1 .1 ) 13 9(2) 4 .4 (0 .4 ) 2 .2(0.1 ) 0.8(0.1 ) 282(4) Tb:C 6 .3(3.1) 139(2) 4 .5 (0 .4 ) 2 .2(0.1 ) 0.8(0.1 ) 28 4(5) Ta2:N 6 .5(2.0) 14 2(2) 4 .7 (0 .5 ) 2 .3(0.1) 0.7(0.1) 28 4(10 ) Ta:C 6 .8( 1 .9) 14 0(3) 4 .9 (0 .6) 2 .3(0.2) 0.7(0.1) 28 0(16 ) T60:N 6.5 (1.0 ) 142(2) 4 .6 (0 .5 ) 2 .2( 0.2) 0.7(0.1) 183(8) T 60:C 6 .3(1.0) 140(2) 4 .7 (0 .5 ) 2 .2( 0.3) 0.8(0.1 ) 28 4(7) T here were no significant differences in the SEC, BG, Osm and IIS between th e C (% BWC: - 2.9 (1.3), %PVC: 0.2 (6 .3 )) and the N (%BWC : - 3 .6 (1.2), % PVC : 0.7 (8.6)) group. T he results o f this study refute the hypothesis that EAMC is associated with changes in SEC and HS. Supported by the Sports M cd icin c Research Fund o f the University' o f Cape Town. 16 SPORTS MEDICINE MARCH 1997 R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 2. ) 48 PSETJDOEPHEDRINE IS WITHOUT ERGOGENIC EFFECTS DURING PROLONGED EXERCISE H Gillies, WE Demian, TD Noakes*, P Smith, A Evans, G Gabriels. University o f Cape Town Medical School. This study was designed to measure whether a single dose o f 120 mg pseudoephedrine ingested 120 minutes before exercise influences performance during 1 hour o f high intensity exercise. The effects of exercise on urinary excretion o f the drug were also studied. Ten healthy male cyclists were tested on two occasions, separated by at least 7 days, using a randomly .assigned, double-blind, placebo controlled, crossover design. Exercise performance was tested during a 40 tan trial on laboratory cycle ergometer and skeletal muscle function was measured during isometric contractions. On a third occasion, subjects ingested 120 mg pseudoephedrine but did not exercise (Control = C). Pseudoephedrine did not influence either time trial performance (58.1 ± 1 .4 vs 58.7 ± 1.0 mill; Mean ± SEM: drug (D) vs placebo (P) or isometric muscle function. Urinary pseudoephedrine concentrations (114.3 ± 27,2 vs 35.4 ± 13.1 ug/ml; p < 0.5) were significantly increased one hour after exercise (D vs C). Peak plasma pseudoephedrine concentrations (p < 0.05) but not time taken to reach peak plasma concentrations nor the area under the plasma pseudoephedrine concentration vs time curve was significantly increased in the total group with exercise (D vs C). In three subjects, plasma pseudoephedrine concentrations were not influenced by exercise. Only these subjects showed increased urinary pseudoephedrine excretion during exercise. We conclude that, a single therapeutic dose o f pseudoephedrine did not have a measurable ergogenic effect during high intensity exercise o f 1 hour duration. But plasma drug concentrations and urinary excretion were altered by exercise. These findings have practical relevance to doping control ivgu la I ions in international sporting competitions. 50 RATE OF PI ASM A LACTATE CLEARANCE DURING PASSIVE RECOVERY FROM HIGH INTENSITY E X P O S E Tanya Oosthuyse and Roderick Carter, Department o f Physiology, University o f the Witwatersrand Johannesburg, South Africa. An athlete’s ability to repeatedly perform at high intensities during intermittent exercise could b e related to accelerated plasma lactate removal during the recovery phase. We determined the rate o f plasma lactate disappearance during passive recovery after an incremental exercise test to exhaustion on a bicycle ergometer in live trained and five untrained male subjects. Venous blood samples were taken during exercise and recover)' at set intervals for the analysis o f plasma lactate concentration. The endurance fitness of the subjects was characterised from die work load at the lactate turn point (LIP) and classified as maximum turn point power out (MTP) in Wkff '. The mean MTP o f the trained group was 3.92 ± 1.8 W k g1 and 2 .1 ± 0.51 \Y. kg for the untrained subjects. From the exponential curve of percentage ol peak plasma lactatc vs time during passive recovery we determined die rate o f lactate clearance at 5min, lOmin and at die equivalent lactate concentration to diat found at the LTE We also determined the time taken to clear 30% and 50% o f peak lactate concentrations, and die time to return to LTP concentration in recover)'. Using Spearman rank correlation, no significant relationships were demonstrated between the recovery parameters measured from die curve and endurance fitness (rs, spanning an interval of -0.042 to -0.31). Our study shows that, after exercise at equivalent relative maximal work loads, trained subjects do not have an improved ability to remove plasma lactate during passive recovery. We propose that this physiological response may be a consequence o f the decrease in blood and muscle pi I and die rise in circulating catecholamine concentration during high intensity' exercise. Also, d ie low muscular energy demand during passive recover)' decreases to drive to remove lactate for use as a fuel substrate. Many studies have shown that training enhances the rate o f lactate removal. However, we found diat training confers no adv antage to the rate of lactate removal while recovering passively from exhaustive 49 INSTITUTIONAL REVIEW BOARDS AND SCIENTIFIC PROGRESS Steve Olivier. University o f Ziduland, KwaDlangezwa, Soudi Africa. Research into the limits o f human performance has become a growth industry, and critical to investigators is a readily available supply o f subjects. However, history attests that free scientific inquiry and social stability have often been at odds. Particularly when research (and the freedom to conduct it) impinges on the perceived rights o f individuals or groups, a sense o f alarm grows even iu societies that have traditionally given free rein to such activities. As a result, there have been, and continue to be, numerous demands for the regulation o f research with injurious or invasive potential. Growing acceptance of ethical principles such as autonomy, as well as public reaction to past abuses, has led to die establishment o f Institutional Review Boards (IRBs). This paper examines the structure, function, and effectiveness o f IRBS, and specifically focuses on the notion that the institutionalisation o f these committees has created a growing bureaucracy that retards scientific progress bv reducing creative nonconformity. The paper evaluates the argument that not only is ethical review endangering valuable research oil human beings, but that it is also endangering the very ethic that is needed to govern such research. Future strategies and possible solutions are explored, and the paper concludes that die imperfections o f the concept shoidd not lead to the ethical review process being discarded. 51 THE EPIDEMIOLOGY OF INJURIES IN SOUTH AFRICAN SENIOR SCHOOL SOCCER PLAYERS J Ramatliesele, MP Scliwelhius, Sports Medicine, Department o f Physiology, University o f Cape Town Tlie auii of this study was to document the epidemiology of injuries sustained by Soutii African senior school soccer players. Subjects for the study were selected from all die senior schools (n=20) in Tembisa (Gauteng, Soutii Africa). A cohort o f 227 senior school soccer players, representing all die players in die Tembisa schools, was followed over one playing season. All prac­ tice and match hours were recorded and specific injury report forms w'ere completed by all the coaches. All injured plavers were then referred to the principle investigator (JR) for detailed examination to document injuries. Factors such as pre-season training, warm-up, stretching, playing surface, environmental factors, and the use o f protective equipment was also recorded, hi this study, 63% of all the players sustained an injur)' during die season (seasonal incidence). The overall incidence of injuries was 9.04/1000 hours o f play. The incidence of injuries in match­ es was. 274 times higher than hi practices. More dian half (57%) o f the injuries were classified as moderate severity. The highest incidence of injury per player position was in goalkeepers (13.7/1000 horn’s play). The low'er extremity accounted for most injuries (88.8%), widi the ankle (42.4%) and the loiee (27.1%) mostly affected. The type o f injur)' was mostly a ligamentous sprain (68%), followed by musculotendinous strains (15.8%). Tliere were only two joint dislocations, and no fractures. All die participants in this study played on grav'd pitches and on no occasion a first aid kit was available. The majority of players were not aware o f appropriate stretching, warm-up, and strap­ ping techniques that can be used to prevent injuries. None o f die players engaged in any form o f pre-season training. In only two of the schools (10%) the soccer coaches had any formal training with coaching certification. Although the injury rate in senior school soccer players in tiiis study is only slightiy higher dian that reported by others, it is clear that scientifically based mea­ sures o f in jury prevention (pre-season training, warm-up, stretch­ ing, and stra|>ping) need to be implemented in these schools. In addition, proper sports and first-aid facilities should be provid­ ed , and coaches should receive formal training. SPORTS MEDICINE MARCH 1997 17 R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 2. ) 52 THE EFFECT OF ENDURANCE TRAINING ON HYPOTHALAMIC 5-HYDROXYTRYPTAMINE (5-HT) RECEPTOR FUNCTION K Scheepers, M Lambert, J du Buisson, T Noakes and W Dermaii, University o f Cape Town and Sports Science Institute o f South Africa. Previous studies indicate that the serotonergic nervous system plays an inhibitory role in the central control o f fatigue during prolonged exercise. Researchers have also demonstrated a down-regulation o f 5-HT receptor function in elite endurance trained subjects, compared to sedentary controls. This study examines the effect o f endurance exercise training on 5-HT receptor function in 7 recreational athletes (T) who underwent training and improved their 5 km time, and 6 sedentary' controls (C). Prior to, and after a 5 month exercise training programme, subjects underwent a 12 hour fast and baseline blood sample w as drawn for determination o f serum prolactin concentration [Pr]. Subjects then ingested 60mg o f Buspirone, a partial 5-HT la receptor agonist. Serial blood samples for [Pr] were drawn every' 30 minutes for a period o f 4 hours. The [Pr] response to Buspirone challenge was determined, thus providing an indication ol' 5-HT receptor sensitivity. Average AUC [Pr] concentration before training were similar in T compared to C (915±316 vs 700±258 Iu.min/L). After training [Pr] in the T group tended to increase to 1141.6±316 Iu.min/L (p<0.1) hi contrast to [Pr] in C w'hich remained the same (748+117 lu.min/L). Peak [Pr] concentration w'as higher in T than in C both before (742.2±409 Iu.m in/L vs 535.8±289.9 Iu.min/L) and after (842.6±439 Iu.m in/L vs 504.5±87.4 Iu/1) the intervention. Conclusion: This study shows i) there is a trend tow'ards an up-regulation o f hypothalamic 5-HT receptor function after training in recreational endtuance athletes; ii) differences seem to occur in the response o f the serotonergic svstem to endurance training in elite, com pared with recreational athletes. 53 ABNORMAL PATTERNS OF KNEE MEDIO-LATERAL DEVIATION (MLD) ARE ASSOCIATED WITH PATELLOFEMORAL PAIN (PFP) IN CYCLISTS J Milligan, M Schw'ellnus FACSM, TD Noakes FACSM. Sports Medicine, UCT The aetiology o f PFP in cyclists is not w'ell understood. The aim o f this study was to document the relationship betw'een PFP and abnormal patterns o f knee movement during cy cling. Eighteen cyclists w'ere recruited and eight (E,n=8) fulfilled the diagnostic criteria for PFP in 12 knees (bilateral pain in 4 subjects) (KP,n=12). Tw elve controls (C,n=12) w'ere pain free in 24 knees (KC,n=24). Subjects in the E and C groups had similar age (vears) [mean (SD)J [E,27(9)); C, 29(9)], height (cm) [E, 179(8); C,184(5)], and body weight (kg) IE,75(9); C,80(5)]. Using high speed two-dimensional video analysis, reflective markers placed on the knees o f all the subjects w'ere filmed during cycling (>20 revs). Subjects used tlieir own cycling shoes and bicycles w'hich w'ere mounted on rollers. The movement o f the reflective markers was plotted on a screen, digitised and measured. The patterns oi knee movement [normal linear (NL), deviated oval (DO), deviated figure o f eight (DF), deviated combined (DO+DF)] and the average medio-lateral deviation (MLD) o f the knees was recorded. Prior to the study, the repeatability o f this technique w'as established (r=0.93). The frequency o f patterns o f knee deviation in the KP and KC groups is depicted in Table 1. Table 1: Frequency o f patterns o f deviation o f tlie k nee in the KP and d ie KC knees NL DO+DF DO DF KP (n=12) 0 /1 2 * 1 2 /1 2 * 8 /1 2 * 4 /1 2 KC (n=24) 1 7 /2 4 7 /2 4 6 /2 4 1 /2 4 *: Significantly d ifferent between KP and KC (p ,0.0 0 1 ) The MT P [mean (SD)1 (mm) o f the KP [14(5)] was greater than in the KC group [8(3)] (p<0.001). This study show's that PFP in cyclists is associated with non-linear patterns o f knee movement and excessive MLD o f the knee. Correcting uon- linear patterns and decreasing the MLD may be important in the management o f PFP in cyclists. Supported by tlie Sports Medicine Research Fimd o f the University' o f Cape Tow'n. 54 CORRECTING LOWER LIMB KINEMATICS DECREASES PATELLOFEMORAL PAIN (PFP) IN CYCLISTS E Van Zyl, M Schw'ellnus FACSM, TD Noakes FACSM. University' o f Cape Town. In cyclists with PI'I! abnormal oval (O) or Figure-of-8 (F) patterns of knee movement during d ie downstroke in cycling resulting in excessive medio-lateral deviation (MLD), have previously been documented using 2D video analysis. Using 5 different methods [5mm medial forefoot w'edge (MW), 5mm lateral forefoot w'edge (LW), 5' internal foot rotation (IR), 5" external foot rotation (ER), a raised saddle (RS=110% previous height)], correction of abnormal knee movement (MLD> 10mm) w'as tested in 15 cy'clists (32 ± 9 y'ears, mean ± SD) (0=12; F=9). A significant reduction in MLD (mm; mean ± SD) wras achieved-by' MW (18 ± 8; p<0.0001) and RS (19 ± 9; p<0.0005) but not by LW, IR, or ER. Once corrected to tlie most linear pattern using the niost effective method o f correction (lowest MLD), all 15 cyclists performed a 30m in (3X10niin) cycling test at predetermined w'ork loads (125W, 180W, 200W) after 3 training periods (T1 = 4 w'eeks training with no correction, T2 = 4 w'eeks training w'ith correction, T3= 4 w'eeks training with correction removed). During each test, pain experienced w'as plotted every minute using a visual analogue scale (VAS: 0-10; 0 = no pain, 10= unbearable pain). Total pain (TP) (pain units) was calculated as the area under the pain vs time graph. TP (mean ± SD) was decreased after the T2 period (19 ± 23), compared to after tlie T1 (42±40) or the T3 (34 ± 42) period (p<0.0004). Cyclists also recorded daily pain (VAS: 0-10) during training in each 4 w'eek period (T l, T2, and T3). Pain/training ride/day (PPD) was calculated for Tt, T2, and T3. PPD (mean ± SD) w'as decreased during T2 (1.4 ± 1.2), compared to T l (3.0 ± 1.7) or T3 (2.2 ± 1.5)(p<0.002). In conclusion, i) cyclists with PFP exhibiting excessive MLD o f the downstroke can be corrected to a more linear pattern using minor biomechanical modification, and ii) once corrected, PFP during cycling decreases. Supported by the Sports Medicine Research Fund o f the University o f Cape Tow'n. 55 POST MATCH ECG CHANGES IN VETERAN SQUASH PLAYERS - IS IT A PROBLEM? Sibbald H, Weston A, Naidoo DP, and Mars M. Depts. o f Physiology', and Medicine, University' o f Natal Medical School, Durban, Soutii Africa. Veteran’s squash has a large following in South Africa. Participation in high intensity' sports by competitors over tlie age o f 45 years is considered potentially hazardous, and squash is considered to have a relatively high risk o f associated sudden death during or following play'. In a study by'- Northcote, 7/21 subjects in a group aged 23 - 43 y'ears, showed significant electrocardiograph (ECG) changes in the hotu after play. The aim o f this pilot study was to determine the frequency o f post match ECG changes in squash players over the age o f 45 years, who participate in league squash. Eighteen volunteers were studied. Their ages ranged from 45 to 54 (mean 49 ± 3 yrs). Resting ECG’s were obtained before play'. During match play, heart rate was recorded using heart rate monitors. On completion o f the match, subjects w'ere immediately fitted w'ith Holter monitors and their ECG’s recorded for the hour after play. The data .from the Holter monitors were downloaded by an independent technician and read by a cardiologist, blinded to the study. The matches were play ed at an average o f 87% o f predicted maximum heart rate (P1MHR), w'ith an average o f 44 % o f match play occurring at above 90 % o f PMHR. Tlie mean maximal heart rate achieved dtuing play' w'as 169 ± 14 b/m in (99% o f PMHR). ANOVA show'ed no difference between intensity o f games, there w'as how'ever a significant difference betw'een the hardest and the easiest game. (P< 0.0001) No abnormalities w'ere noted in the resting or post match ECG’S. This study confirms that veteran squash play'ers play' at a high intensity. Tlie failure to demonstrate post game ECG changes may be due to the sample size, but it may' also suggest that those who continue to participate actively' in veteran’s squash have selected themselves out as a relatively low' risk group on the basis of having had no warning symptoms o f cardiac problems. Further studies are required to compare exercise stress test ECG’s w'ith post match ECG changes. 18 SPORTS MEDICINE MARCH 1997 R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 2. ) 56 CARDIAC PERFORMANCE IN VETERAN SQUASH PLAYERS AND RUNNERS DURING A ROUTINE STRESS ECG, SQUASH AND RUNNING A St Clair Gibson, J Perold, GA Watermeyer, JA Hawley, MI Lambert, TD Noakes. Exercise Science Unit, University o f Cape Town, Cape Town, SA. The aim o f the study was to assess the relationship between cardiovascular performance in a routine stress ECG and during field testing in veteran squash players and runners. Ten veteran league squash players (LSP), 10 social squash players (SSP), 10 league runners (LR), 10 social runners (SR) and 10 sedentary individuals (SED) were recruited for the study. AH subjects filled in a lifestyle questionnaire, underwent a complete medical examination and performed a routine stress electrocardiogram (ECG). The sport playing groups subsequently underwent heart rate monitoring during their specific sport activity on two separate occasions. There were no differences in age, stature and medical history between the groups. The SED group had a significantly higher percentage body fat (p < 0.05), mass (p < 0.01) and resting heart rate (p < 0.01) than the LR group. Although there were no significant differences between the mean heart rate attained during the field test and the maximal heart rate attained during the ECG test, a highly significant difference occurred between the maximal heart rate attained in the field and maximal heart rate attained during the ECG test for all groups (p <0.01). The maximal heart rate during routine exercise is significantly higher than that attained dtuing a routine stress-ECG test. This finding was not sport specific or related to level o f competitiveness o f sports participants. Caution thus should be exercised when advising patients to exercise freely on the basis o f a routine stress-ECG. 57 THE ENERGY EXPENDITURE OF A NON-CONTACT BOXING TRAINING SESSION COMPARED TO SUBMAXTMAL TREADMILL RUNNING A St Clair Gibson, B Bellinger, A Oelofse, R Oelofse, MI Lambert. UCT Exercise Science Unit, University o f Cape Town, Cape Town, SA The aim o f this study was to determine the energy expenditure o f a one hour non-contact boxing training session and to compare these results to the energy expenditure o f a more conventional recreational activity such as running. Eight healthy males, accustomed to non-contact boxing training, were recruited for the study. Subjects underwent 3 tests; (i) A boxing training session in (lie laboratory during which energy' expenditure was m easured continuously using indirect calorimetry' (BOXL), (ii) A boxing training session in a boxing studio during which heart rate was measured continuously' (BOXS), and (iii) an incremental running test on the treadmill during which energy' expenditure was measured continuously. The energy expenditure during 60 minutes o f BOXL ranged between 2519 and 3079 k j (2821 ±190 k j). Seven o f the 8 subjects had higher heart rates during BOXL compared to BOXS, suggesting that the subjects exercised at a slightly' higher intensity during BOXL, possibly because o f the “ one oil one” supervision. The average running speed on the treadmill at which the subjects had a similar energy expenditure was 9.2±0.8km .hr1. 58 THE HEART RATE RESPONSE OF CRICKFT UMPtwpq TO ON-FIELD EVENTS ^ R,Stretch*, J Tyler** and S Bassett*** * Sport Bureau, University' o f Port Elizabeth ** Department o f Statistics, University' o f Fort Hare *** Department o f Human Movement Studies, University' o f Fort Hare This study assessed die differences between the heart rate responses, recorded every 15 seconds, o f 6 provincial and 4 international umpires to on-field events during limited-overs cricket matches. Specific on-field events including appeals, the umpires resulting decisions and any' other tasks the umpire had to make such as calling a no-ball or a wide, w'ere recorded. The results show'ed that the international umpires (IU) rated the on­ field decisions as less stressliil than the provincial umpires (FU), who showed a far greater variance with regard to LBW, catch, run-out and wide-balf decisions. Tachycardia occurred before the match resulting in a high mean (±SD) heart rate (IU - 102.0 ± 13.9 beats m i n P U - 97.5 ± 11.1 beats m in1), corresponding to approximately 60% o f estimated maximal heart rate. Similar mean heart rates for the first innings (IU. -101.5 ±12.5 beats min PU - 99.7 ± 13.5 beats m in') and second innings (IU - 99.5 ± 8.9 beats m in 1; PU - 100.2 ± 10.1 beats m in') w'ere found. Differences (D = -0.7 beats m in') betw'een the heart rate o f IU and PU prior to the match (102.0 ± 13.9 beats m in') and the first session (101.3 ±12.0 beats m in1) o f the first innings w'as significantly less (p < 0.05) than the corresponding difference (D = 7.5 beats m ill1) prior to (95.3 ± 10.7 beats min'1) and during the first session (102.8 ± 9.9 beats min'1) o f the second innings. A significant difference (IU-D = 0.0 beats m ill‘; PU D = -6.0 beats m in1; p < 0.05) occurred between the difference between the mean heart rate for the second (IU - 97.0 ± 6-7 beats m i n P U - 101.2 ± 9.2 beats min ‘) and the third (IU - 97.0 ± 5.2 beats min ■; PU - 95.2 ± 11.4 beats min'1) sessions o f the second innings, illustrating greater variation for the inexperienced umpires. The PU show'ed greater, although non-significant, variations to an appeal at the time o f the decision, 15s post decision and 30s post decision, with both tachycardia and bradycardia occurring. Heart rate data o f an IU during an international hat-trick (three wickets in three balls) show'ed anticipatory tachycardia. It can be concluded that the heart rate response o f the umpires to on-field events indicate that they are under tremendous psychological pressure, with international umpires, although umpiring at a higher level, better able to handle these pressures. 59 AN ANALYSIS OF THE HR-VO,, RELATIONSHIP DURING FREE-RANGE EXERCISE IN THE LABORATORY. E Terblanche and JA Wessels. Department o f Medical Physiology, University o f Stellenbosch, PO Box 19063, Tygerberg, Cape Town. Laboratory estimates of heart rate are often used bv coaches and athletes to identify' field training intensities. This approach, how'ever, assumes that the relationship between heart rate (HR) and oxygen consumption (V02) remains constant under all conditions. It has been shown that representation o f fiefd performances during laboratory testing cannot necessarily depend on this assumption, simply because the mode o f exercise appear to be the same.1 It was the aim o f this study to determine the HR- V0o relationship for different modes o f free-range cycling in the laboratory. Fifteen cyclists (fit and unfit) between the ages of 18 and 26 volunteered to participate in the study. They' performed a 30 km time trial (TT) on a computer controlled cycle ergometer, using a laboratory' simulation o f field cycling. During this test the cyclist could select and change (lie gear ratio and pedal frequency at will. Both HR and V0o w'ere monitored continuously' and diese results w'ere compared to the cyclist’s physiological responses during a progressive, incremental exercise test to exhaustion. Although there was a linear relationship betw'een HR and V02 during simulated field cycling and the maximal exercise test, there were significant differences in the intercepts (102 ± SEM 6.6 b/m in vs 66 ± SEM 3.7 b/min; p = 0.009) and slopes (0.02 ± SEM 0.002 re 0.03 ± SEM 0.003; p = 0.01) o f die 30 km TT and progressive, incremental exercise tests. These results indicate that standard laboratory exercise tests underestimate the “ normal w'orking limits” o f cyclists during free-range cycling and that extrapolation of laboratory results to field exercise should be done with caution. (1 ) Kenny GP et al. A comparative analysis o f physiological resjx>nses at submaximal workloads during different laboratory simulations o f field cycling. Eur J Appl Phys 1995; 71: 409 - 415. SPORTS MEDICINE MARCH 1997 19 R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 2. ) 60 EFFECT OF PROPHYLACTIC DOSE OF FLURBIPROFEN ON MUSCLE DAMAGE AND CARDIOVASCULAR VARIABLES DURING SUBMAXIMAL EXERCISE. Terblanche S, Noakes TD and Lambert Ml Bioenergetics o f Exercise Research Unit, Sport Science Institute o f South Africa, Cape Town, South Africa. Aim: To determine the effect of an prophylactic dose of flurbiprofen on muscfe damage, soreness and cardiovascular variables during submaximal exercise in recreational athletes. Methods: 19 Male recreational athletes (age 28 ± 12 years; X ± SD) were recruited for the study. Subjects underwent a V0onlax and peak treadmill running speed (PTRS) test three days before the first submaximal test and 72 hours after tlie induction o f delayed onset o f muscle soreness (DOMS). Twelve hours before the submaximal test and every 12 hours thereafter until the end o f the experiment, the subjects placed patches with 40mg o f flurbiprofen (TransAct; n = 10), or identical patches without drug (Placebo; n = 9), on tlieir quadriceps muscles. Subjects ran for 15 minutes at 75% PTRS during which cardiovascular variables were measured and blood was collected. Thereafter DOMS was induced by a series o f eccentric muscle contractions. The submaximal test was repeated 24 and 48 hours after DOMS was induced. Results: Pain, assessed subjectively, increased Similarly in both groups. Pain, measured with a pressure probe, was significantly higher in Placebo than TransAct at 24 and 48 hours after the induction of DOMS (p < 0.03). Blood CK activity increased similarly in both groups (p < 0.05). WCC (p < 0.03), neutrophil % (p<0.04) and lymphocyte % (p < 0.03) were significantly increased in tlie Placebo group, 2.5 hours after DOMS. Blood lactate concentration was significantly higher in Placebo after the 15 minutes submaximal test compared to TransAct, even before the induction o f DOMS (p < 0.05). Serum cortisol concentration was not different throughout the experiment. Tlie relative perceived exertion (RPE) during tlie submaximal test was higher in the Placebo group after 48 hours (2.0 ± 1.8 vs 1.0 ± 1.3; p < 0.05). The average heart rate increased significantly more in the Placebo group during the submaximal test compared to the TransAct group (5.1 ± .7 vs 0.3 ± 2.3 beats.m in1; p < 0.(In). Neither V02„„„ nor PTRS differed between groups through the experiment. Conclusions: These data show that prophylactic treatment with TransAct before tlie induction o f muscle damage reduces the severity o f DOMS. We want to thank Boots Pharmaceuticals for their financial assistance. 61 MORPHOLOGY AND INTRINSIC INJURY RISK IN SCHOOLBOY RUGBY HJ van Heerden, Department Human Movement Science, University o f Zululand, RSA Thus far epidem iological research has exposed typical extrinsic injury risks o f rugby. However, well controlled studies on potential risks that are intrinsic to the individual have been absent. This study thus focussed on morphology as an intrinsic aetiological risk factor in schoolboy rugliv injuries. A well- defined population o f high school rugby players (N=105) aged 13-17 years were monitored utilizing a prospective injury surveillance design with an injur)' being defined as either requiring medical referral or causing a loss ol at least seven days from participation. Risk factors were subsequently identified by ANOVA, contrasting preparticipation morphological profiles o f in jured players with those o f tlie non­ injured controls. Results for injured vs lion-injured players indicated a significantly (p<0,05) greater stature (176,8 ± 8,6 vs 172,0 ± 8,7 cm); body mass (69,7 ± 11,3 vs 63,9 ± 12,6 kg); lean body mass (60,0 ± 9,7 vs 52,3 ± 9,6 kg); and a lower body fat (13,9 ± 3,1 vs 17,9 ± 6,6%), respectively. Individual somatotype component variations in endomorphy (2,4 ± 0,9 vs 2,9 ± 1,5); mesomorphy (4,8 ± 1,0 vs 4,9 ± 1,2); and ectomorphy (3,2 ± 1,0 vs 3,2 ± 1,4) did not differ significantly (p>0,05). Iii conclusion the data suggests that morphological superiority among high school rugby players appears to predispose rather than preclude from injury' whilst somatotype is independent from injury' risk. 62 MUSCULAR “ FITNESS” AND INTRINSIC INJURY RISK IN SCHOOLBOY RUGBY EJ van Heerden, Department Human Movement Science, University o f Zululand, RSA. Thus far epidem iological research has exposed typical extrinsic injury risks o f rugby. However, well controlled studies on potentitd risks that are intrinsic to the individual have been absent. This study thus focused on musculoskeletal “ fitness” as an intrinsic aetiological risk factor in schoolboy rugby injuries. A well-delined population o f high school rugby players (N.105) aged 13-17 years were monitored utilizing a prospective Injury surveillance design with ail injury being defined as either requiring medical referral or causing a loss o f at least seven days from participation. Risk factors were subsequently identified by ANOVA, contrasting preparticipation musculoskeletal fitness profiles o f injured players with those o f tlie non-injured controls. Results for injured vs non-injured players indicated a significantly (p<0,05) greater mean grip strength (70,5 ± 8,5 vs 64,9 ± 9,9 kg/kg:p<0,01); muscle power (15,3 ± 1,0 vs .1.4,3 ± 1,4W/ltg:p<0,001); and running agility (6,9 ± 0,4 vs 7,1 ± 0,4 sec:p<0,001). Gross range o f motion variations in the shoulders (2,4 ± 0,3 vs 2,5 ± 0,3) did not differ significantly (p>0,05), but gross low-back/hamstring flexibility scores (3,5 ± 1,2 vs 2,9 ± 1,1) were significantly higher (p<0,05) among the exposed (injured) group. In conclusion tlie data suggests that superior musculoskeletal fitness among high school rugby players appears to predispose rather than preclude from injury. 63 THE EFFECT OF UPPER RESPIRATORY T R A C T INFECTION (URTI) ON EXERCISE PERFORMANCE IN DISTANCE RUNNERS D Viljoen*, MP Schw'ellnus FACSM*, TD Noakes FACSM*, M Coetzee#. * Sports M edicine, Department o f Physiology, University o f Cape Town, ♦Department o f Human Movement Sciencc, University o f Zululand. Runners suffering from URTI who return to full activity after the post infection period frequently complain o f a decrease in performance. There are no scientific data to indicate whether i) there is a true decrease in performance, or ii) if such a decrease in performance is due to the effects of detraining or the infection. The aim o f this study was to determine the effects o f URTI on exercise performance during recovery in distance runners. Five distance runners were studied over four months. At the time o f recruitment, all runners underwent a medical assessment and baseline tests consisting of: i) run­ ning performance (VOo peak in m l/kg/m in), ii) total treadmill time (mill), iii) quadriceps muscle strength (peak torque iu Nm) and iv) quadriceps muscle endurance (total work, Joules) were performed. All the subjects continued tlieir normal train­ ing program until thev developed an URTI which was diag­ nosed clinically using a grading system (0 to +++) for symp­ toms (sore throat, headache, blocked nose, painful chest, cough, sore eyes, muscle pains) and signs (temperature, con­ junctivitis, pharyngitis, rhinitis, otitis media, rlionchii, wheeze). Treatment consisted only o f medication for sympto­ matic relief. The runners were followed up regularly until recovery (defined as free from any symptoms or signs o f URTI). Recover)' time was variable (min=5 days, max=13 days, mean=7.8). Following sickness (S), all tlie performance tests were repeated on days 0 (SO), 2 (S2), 4 (S4), and 6 (S6). Runners returned to normal training for 4 months after which they underwent a period o f voluntary detraining (D) for the same period as the URTI. Performance testing was repeated on days 0 (DO), 2 (D2), 4 (D4) and 6 (D6). All parameters were compared during S and D days. There was a significantly lower VOo peak (m l/ltg/inin) [mean(SD)] [SO=53(8), DO=59(7).| (p=0.026), and longer treadmill time (min) [SO=5.2(2.5), DO=6.8(2.2)] (p=0.03) at SO compared to DO. There was a sig­ nificantly lower V 0 2 peak [S2=54(7)), D2=58(7)J (p=0.04) at S2 compared to D2. There was no significant difference in muscle strength, or endurance at any time in S and D. In con­ clusion, runners recovering from URTI appear to have a decrease in running performance but not muscle strength or muscle endurance which is not only due to detraining. However, this additional effect is temporary and lasts for 2-4 days after clinical symptoms have disappeared. 20 SPORTS MEDICINE MARCH 1997 R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 2. ) 64. THE TREATMENT OF PLANTAR FASCHTIS AND ACHILLES TENDONITIS BY MAINTAINING ANKLE DORSTFT EXTON USING A NIGHT SPLINT DA Viljoen, BSc, MBChB, DA. Richards Bay, SouLh Africa. Plantar fasciitis and achilles tendonitis are the most prevalent of lower limb injuries experienced by runners, and are notoriously resistant to conventional forms if treatment. An orthotie device which maintains ankle dorsiflexion and thus tension within the plantar fascii or achilles tendon (hiring sleep is thought to promote tissue healing at a functional length. The purpose o f this study was to optimise the design o f a locally' manufactured anterior fitting orthotie device and to determine the efficacy o f its use in treatment o f these chronic repetitive strain injuries. The optimum angles o f the device, were found to be 20" dorsiflexion and 15" forefoot valgus. Distance runners with plantar fasciitis (n=19) and achilles tendonitis (n=f 5) o f Grade 3 or 4 severity of, on average, 16 months duration were admitted to the study. All had received various forms o f medication, physiotherapy or both during this time. File control groups, who had lower limb injuries o f equal duration and severity were treated with a placebo orthotie and non-steroidal anti-inflammatory drugs (NSAIDs). For the 14 day study period the subjects were required to wear the orthotie during the night, to refrain from training and the use o f any other therapy. On days 0, 7 and 14 die severity o f pain experienced on arising was recorded on a scale o f 1 to 10. The presence o f pain on palpation and the extent o f tissue swelling were determined by the researcher on the same davs. The results show that in both groups who used the night splint, there was a significant reduction (p< 0.001) in the pain experienced on arising on both days 7 and 14. Moreover, 36.8% o f those with plantar fasciitis and 49.7% with achilles tendonitis were able to walk pain free by day 14. However, most still experienced pain on palpation o f the injured site and more than half o f those with achilles tendonitis continued to exhibit marked tissue swelling on Day 14. In both control groups there was no decrease in the degree o f pain experienced on rising, nor in the presence o f pain on palpation, by the end o f the study period. The results suggest that the use o f an anterior fitting night splint significantly aids recovery from chronic repetitive strain injuries o f the lower limb. 65 RECOVERY TECHNIQUES: A COMPARISON OF REST, STRETCHING AND MASSAGE. Viranna N and Mars M. Dept, o f Physiology, University o f Natal Medical School, Durban, South Africa. Rapid and adequate recovery from exercise facilitates subsequent performance and reduces the associated symptoms o f tiredness, fatigue and lethargy. This study compares the effects o f three recover)' techniques, rest, stretching and massage in delaying fatigue during repeated bouts o f dynamic exercise, and investigates the relative effects o f rest, massage and stretching on delayed onset muscle soreness. Method: 18 male subjects were randomly allocated to one o f six groups. Subjects performed 5 repetitions o f as many heel raises as possible in 45 seconds. Each repetition was followed by a recovery' technique used for the three minutes between repetitions. This was repeated weekly, until each group had had all three recovery' techniques. A fatigue index was calculated from the decline in the number o f repetitions from stage 1 to 5 and this was expressed as a percentage. Muscle soreness ratings were assessed at 12 - 36 hours after each session. An orthogonal 6 x 3 Latin square design was used to take into account possible training effect and the possible influence on the outcome o f the sequence in which the recovery techniques were used. Results: Based on the fatigue index, significantly more fatigue was shown when rest was the recover)' technique (P< 0.0001). There was no difference noted between stretching and massage. Massage however associated with significantly less muscle soreness than stretching (P < 0.000 1). Conclusions: Rest was shown to be the least effective recover)' technique. While massage and stretching were shown to be equally beneficial in reducing fatigue, massage may be superior to stretching, as it is associated with less muscle soreness than stretching. Further studies are required to confirm these observations using different m odes and intensities o f exercise. 66 SKELETAL MUSCLE ENZYME ACTIVITIES IN AFRICAN DISTANCE RUNNERS Weston AR, Karamizrak O, Durandt J, Smith A, Noakes TD, Myburgli KII, Department o f Physiology, University of Cape Town, South Africa. African athletes dominate distance running internationally and in South Africa but to date only one study has investigated t he skeletal muscle enzyme profile in these. The aim o f the current study was to measure enzyme activity in the vastus lateralis muscle o f African 10 km runners in comparison to Caucasian 10 km runners and sedentary controls. All subjects were seasoned runners (age range 18 - 35 yrs). 5 African and 7 Caucasians consented to undergo two exercise tests and a muscle biopsy. Runners completed a V02miLX incremental treadmill test and on a separate day a fatigue resistance running test at four sequential high intensity workloads. On a separate day a muscle biopsy was performed. One portion was immediately frozen in liquid No for later enzyme assay's and the other embedded for later histochemistry. Citrate synthase (CS) and phospliofruetokinase (PFK) were assayed in duplicate spectrophotometrically in all subjects, whilst 3-hydroxyl-CoA dehydrogenase (3-HAD) hexokinase (HK) and carnitine palmityl transferase (CPT) were assayed in 7 subjects when sufficient tissue allowed. Routine liistochemistry was undertaken to determine skeletal muscle fibre type. African runners were able to exercise for 21% longer at the same percentage o f their peak treadmill speed (p< 0.01). At submaximal worldoads, die African runners had a lower [Lactate] and this was related to time to fatigue (r = -0. 63, p < 0. 05). CS activity was liigher in die African runners (27.9 ± 7.2 re 18.6 ± 2.1 inmol/g ww/min, p < 0.01) and limners were liigher than sedentary controls. 3-HAD activity was also higher in the Africans (23.9 ± 4.7 vs 15.5 ± 5.1 nimol/g ww/min). PFK, HK and CPT were not different. CS activity was correlated with time to fatigue during die high intensity running test (r = 0.70, p< 0.05) and [Lactate] during the running test (r = -0.73, p <0.01). The findings o f the current study suggest diat the African distance runners studied had advantageous skeletal muscle enzyme activities for endurance performance, and diat this activity is related to accumulation o f lactate in the plasma and dieir subsequent ability to sustain exercise at a high relative intensity. The origin o f tiiis advantageous enzyme profile is not elucidated. SPORTS MEDICINE MARCH 1997 21 R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 2. ) REFERENCES A lii 11 13 j\nderson R 21 A n d erso n SJ 1 B C o n sta n ce 2 8 B a s s e tt S 5 8 B a s so n ( J I Beira B 2 B ellin ger B 5 7 B en gu X 13 B o sto n V 3 B ranfield A S 4 Bridgev B 3 0 B n ntm an A J 5 B u x S 2 2 C P arry 2 8 .2 9 ('a id er S 14 C arter R 5 .6 .7 A 0 .5 0 ('h a n tler I 7 C h utu rgoon yl 2 2 .4 3 C olem an K L 8 ,9 Coolc I 10 C ron s L 12 D en n is S 14. 2 5 D erm an E H ' 13. 44 Milligan J 5 3 M itchell G 5 M oller F 4 5 M othilal B 3 6 X a id o o D P 5 5 X ieo l J 46. 4 7 X ieuivoudt P 45 X o a k e s TD 8. 9. 14. 21. 25. 33. 3 4 . 36. 46. 47. 48. 52. 53. 54. 56. 60. 6 6 O 'S b a u g b n essy K 3 0 O elo fse R 5 7 O livier S 49 O o s lb u g s e T 5 0 O tto H' 13 Palm er G 2 5 PeroUl J 5 6 P e ters E M 21 R aine R 9 K am atliesele J R 51 R o b ertso n G 3 7 R o sso tn r J 45 R o u x S 19 S ch eep ers K 5 2 Schw artz P 13 Schw ellnus M P 13. 14. 28. 29. 30. 31. 32. 36. 38. 44. 46. 47. 51. 53. 54. 6 3 Sibbakl H 5 5 Slogrove L 3 7 Smith 8 Sm ith I> 4 8 St Clair G ibson . 1 14. 34. 56. 5 7 St Claire Sm ith O’ 9 S tretch R 18. 37. 5 8 Stubbs J 3 6 Terblancbe E 5 9 T erblanche S 6 0 Theron A T 21 T itlesla d S 3 8 Tow bridge T 2 7 Trichard C 14 T y le r ,I 5 8 I an H eerden IIJ til. 6 2 Van Wgk G J 3 9 I an Zyl E 54 I iljoen D 63. 64 Viljoen IV 45 I iranna X 6 5 W aterm eyer G A 5 6 W essels J A 5 9 W eston A 22. 35. 55. 6 6 Z am brasis M 14 22 SPORTS MEDICINE MARCH 1996 R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 2. ) MSAIWAJWI cm vs BA Tired of Hotels? In the heart o f Camps Bay this beautiful villa invites you to share its panoramic sea & mountain views. Treat yourself & your overseas visitors to the privilege & luxury o f this outstanding villa in an exceptionally quiet street above the Bay Hotel. Sundowners can be waiting on ice for your arrival. Simply relax and enjoy watching the sun setting over the sea. Introduce your visitors to a traditional South African braai or order the menu o f your choice to be delivered to you at Msangasanga. SPECIAL CORPORATE OFFER Upstairs & downstairs each w ith o w n lounge, dining room + kitchen Downstairs: 2 bedroom s (both en suite) sleeps 4 • R800 pd. Upstairs: 3 bedroom s (3 baths 2 en suite) sleeps 6 • R1200 pd. or 5 Bedrooms (5 baths 4 en suite) • R2000 pd. • Villa serviced daily • Secure parking for 4 cars • Phone + fax facilities • Braai facilities • Swimming pool • Laundry service • 10 min to Waterfront • Catering services available • Close to beach, shops & theatre For further information: Tel: 27 - (0)11 442-9759 • Fax: 27 - (0)11 880-7898 I R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 2. ) Physiotherapists converge on Cape Town Cape Town will host two important international congresses during April 1997. The first is the International Congress of the South African Society of Physiotherapy, from 31 March to 3 April, and the second is the Congress of the International Private Practitioners’ Association. The IPPA is a division of the World Confederation for Physical Therapy. More than 300 physiotherapists will attend tlie SASP Congress, coming from countries as far afield as Finland, America, Zimbabwe, Canada and Australia. Several countries in Europe are represent­ ed. Contributors from fourteen countries will present papers on physiotherapy research. Community physiotherapy services are strongly represented in research papers by the 43 South African contributors, which also cover a wide variety of interests ranging from fetal movement studies to the causes of falling in the elderly. Cape Town is a fitting venue for the congresses, as the South African Society of Physiotherapy (SASP) has its origins hi a group who met in Cape Town in 1921 to form an association. The SASP itself was established in 1925 and is a fotmder member of the World Confederation for Physical Therapy. Cape Town is bidding to host the 14th Congress of the World Confederation in 2003. The theme of the Congress is Physiotherapy in Progress and the main fields covered are education, research, quality assurance, community physiotherapy, neurological rehabilitation and orthopaedic manipulative therapy. Tlie organisers have been fortunate in attracting five internationally renowned keynote speakers. David Butler of the University of South Australia will speak in the field of orthopaedic manipulative therapy, which relates to conditions of the vertebral column and joints. Patricia Davies, the author of several well-lmown books, is the guest speaker on neurological reha­ bilitation. Professor Ruth Grant, of the University of South Australia, and Professor Katherine Shepard of Temple University, Philadelphia, will speak on key issues in education and research respectively. The Royal Netherlands Association for Physiotherapy has sponsored the fifth keynote speaker, Joost van Eijkeren, as part of a twinning programme between themselves and the SASP which is committed to promoting quality assurance programmes in physiotherapy. For further information please contact Sally Elliott: Tel: (0 2 1 ) 406-6381 Fax: (0 2 1 ) 44 8-62 63 Email: sally ©medicine, uct. ac.za 24 SPORTS MEDICINE MARCH 1997 R ep ro du ce d by S ab in et G at ew ay u nd er li ce nc e gr an te d by th e P ub lis he r (d at ed 2 01 2. )