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Royal Academy of Medicine in Ireland Section of Biomedical Sciences

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Royal Academy of Medicine in Ireland Section of Biomedical Sciences
  ROYAL ACADEMY OF MEDICINE IN IRELAND SECTION OF BIOMEDICAL SCIENCES Proceedings of Meeting held Thursday & Friday 26th, 27th June, 1997 in University of Limerick. A PILOT STUDY TO ENHANCE THE FLEXIBILITY AND STRENGTH OF ADOLESCENT MALES WITH A MILD LEARNING DIFFICULTY (MLD) C. MacDonncha, A. W. S. Watson. Growth and Development Research Centre, Physical Education and Sports Sciences Department, University of Limerick. Evidence exists to indicate that male adolescents with a MLD have lower levels of flexibility and strength than their mainstream counterparts ~. Numerous studies have established a positive relationship between adequate levels of flexibility, strength and good health 2. Flexibility and strength variables and the changes that occurred following an intervention of 7 weeks were measured in males with a MLD. Subjects were active for 3 h each week on alternate days. Experimental (n=13) and control groups (n=6) were randomly selected from the total male population aged 15-17 yr of a special school (mean IQ 647 SD 10.5). Written informed consent was obtained from the subjects and their parents. Ethical approval was obtained. The following variables were measured: height; weight; grip strength; bench and leg press one-repetition maximum (1RM) and sit-ups (number completed in 30 s); trunk flexion and extension strength (kg); right and left knee flexion and extension strength; trunk extension and flexion range of motion (ROM); shoulder flexion and extension ROM; hip flexion and the sit and reach test. Independent t-test analysis indicated that no significant differences existed between the groups at the commencement of the study. The t-tests for paired samples were used to analyse within group changes during the intervention period. The table below presents the variables which changed significantly (P<0.01) over the 7 week intervention period in the experimental group. The 95 per cent confidence intervals are also illustrated. No confidence intervals are indicated for bench and leg press one-repetition maximum as the maximum score established over 3 trails was taken as the test score. No significant changes other than height (P<0.05) occurred in the control group. Variable Pre-test Post-test 95% Confidence (Mean + SD) (Mean + SD) Interval Height (mm) 1720 + 81 1724 + 80 _+ 4.5 Grip Strength (kg) 33.0 5:6.5 34.8 + 5,9 -+ 8.4 Bench Press 1RM (kg) 53.5 -+ 22.3 65.7 5:21.4 Leg Press 1RM (kg) 60.7 _+ 16.7 73,9 _+ 15.8 Sit-ups (reps) 17.6 _+ 4.6 19.3 + 3.6 -+ 3.4 Hip flexion (degrees) 63.8 -+ 8.4 74,2 5:6.4 -+ 8.1 Sit and Reach (era) 7.2 -+ 6.0 13.7 + 4.6 5:4.6 In conclusion this study provides evidence that a 7 week intervention significantly increased levels of flexibility and strength in male adolescents with a MLD. Referetlces 1. MacDonncha, C., Watson, A. W. S. Health related fitness of individuals with a mild learning difficulty. Ir. J. Med. Sci., 1996; 165: 227-228. 2. In: Bouchard, C., Shephard, R. J., Stephens, T. (eds). Physical activity, fitness and Health. Champaign, III: Human Kinetics. 1987. 51 EFFECT OF EXERCISE AND EXERCISE TRAINING ON CIRCULATING INSULIN-LIKE GROWTH FACTORS AND THEIR BINDING PROTEINS IN HUMAN SUBJECTS P. M. Jakeman, L. J. Welsh. Human Science Research Centre, Department of Physical Education and Sport Sciences, University of Limerick, Ireland. Exercise and exercise training invoke a natural perturbation of glucose homeostasis leading to an improvement in glucose tolerance that cannot be fully explained by an increase in insulin sensitivity. The potential hypoglycaemic action of circulating insulin-like growth factors (IGFs) are 50-100 fold that of insulin but, unlike insulin, IGF bioactivity is moderated by association with plasma binding proteins (IGFBPs). To investigate whether IGFs contribute to exercise-induced improvements in glucoregulation this paper describes the IGF and IGFBP response to an exercise challenge in endurance-trained subjects and matched controls. Following cannulation of a superficial arm vein, blood samples were obtained from endurance-trained subjects and matched controls during prolonged exercise on a treadmill ergometer. Plasma samples were analysed for IGF-1, IGFBP-1 and IGFBP-3 (RIA), glucose (glucose oxidase) and insulin (RIA) and corrected for changes in plasma volume (Table I). Rest End of Exercise Control Trained Control Trained (n=4) (n=4) (n=4) (n=4) IGF-I (ng/ml) 162+16 201+17 168+20 179+11 IGF-II (ng/ml) 500-2_47 571+34 552+_74 574+52 IGFBP-I (ng/ml) 4.4+1.0 57+23 v 74_+10 253+_26 *v IGFBP-3 (ng/ml) 55985:185 4706-+311 52405:260 4935-+223 Glucose (mM) 5.14+0.43 5.14-+0.54 4.59 + 0~43 3.89+0.9 Insulin (mUlL) 12.3_+4.5 10.2_+3.5 5.45_+0.46* 3.06_+0.68* Table I. Values are mean + S.D.; Sign. diff.:* from rest; VTrained vs Control, P<0.05 The circulating concentration of IGFs (IGF-I + IGF-II) at rest was 16 per cent higher in the trained subjects at rest and did not change in response to exercise. Exercise training appeared to modify the nature of the association of IGFs with their plasma binding proteins with trained subjects having a 20 per cent lower concentration of the high affinity binding protein, IGFBP-3. and 12 fold higher concentration of the low affinity binding protein, IGFBP-1, than the controls. Exercise induced a slight, but non- significant decrease in circulating [IGFBP-3] and a significant increase in circulating [IGFBP-I] in all subjects. On the basis of these data we propose that both acute exercise and exercise training facilitates the actions of IGFs by modifying the association of IGFs with their binding proteins and thereby the apparent affinity for IGF receptors on the target tissues. Given the high density of receptors for IGF in muscle these modifications in IGF bioactivity may, in part, explain the improved glucoregulation following exercise. Ethical approval was granted for this study. LW is a Wellcome Trust Research Fellow.  52 Royal Academy of Medicine in Ireland THE INCIDENCE AND RISK OF INJURY TO CLUB LEVEL GAELIC FOOTBALL PLAYERS S. McGrath, A. W. S. Watson. Sports Injuries Research Centre, Physical Education and Sports Sciences Department, University of Limerick. Previous research has identified the incidence and risk of injury at inter-county and senior club level hurling players 1. There is an absence of research on injury rates to club level Gaelic football players. The purpose of this study was to determine the incidence of injury and risk of incapacity due to injury, to male club-level Gaelic football players. A retrospective analysis of the period 1 September 1995 to 31 August 1996 was conducted. Data was collected during the month of September 1996. Injury was defined as a mishap occurring during, or as a result of, competition or training that resulted in incapacity to train or compete normally ~. It was hypothesised that there was no significant difference in the incidence of injury and risk of incapacity between club players of different grades. Eighty- seven Gaelic football players from 8 clubs in Cork county, gave written informed consent to participate in the study. Thirty-seven subjects, mean age 21.16 + 3.98 yr, played adult competitive football at junior grade and were categorised as non-elite players, while 50 subjects, mean age 22.14 + 3.58 yr, played at adult senior grade and were categorised as elite players. Subjects completed a questionnaire at an individual interview. Data concerning playing level, playing experience and injuries occurring while participating in the game of Gaelic football were collected from the subjects. Data were analysed with independent sample t-tests using the SPSS for windows package (Version 6.0). Table 1. The incidence of injury per 10,000 h participation. Mean + SD. Incidence of injury per 10,000 h Total Subjects Efite Non-Elite (n--g/) (n=50) (n--37) Mean incidence per 10,0O0 h Participation 51.5+40.5 46.9-&'_39.8 57.8+41.3 Incidence per 10,000 hTraining 22.95:43.1 25.2.'t:43.8 19.9-242.6 Incidence per 10,000 h Matches 144.6-2152.7 114.5+137.5 185.2_5:164.4 * Significantly different rom elite players (p<0.05) The mean incidence of injury was 51.5 injuries per 10,000 h of participation. Non-elite players had a significantly higher incidence of injury per 10,000 h of competitive matches. No statistical difference existed between the groups in the incidence of injury per 10,000 h of participation or per 10,000 h of training. Table II. The risk of incapacity due to injury (days per 1,000 h participation). Mean + SD. Risk of incapacity Total Subjects Elite Non-Elite (n--~) (n~S0) (n-~7) Days of injury per 1,000 h participation 159.4+280.7 132.9-2255.5 196.4_+_311.8 Hours of participation per day affected 6.3 h 7.5 h 5.1 h The mean risk of incapacity to subjects was 159.4 days per 1,000 h of participation, or one day of injury for every 6.3 h of participation. No statistical difference existed between the groups on the risk of incapacity in training, competition or participation rates. In conclusion, non-elite club level Gaelic football players have a higher incidence of injury during competitive games. But the difference in risk of incapacity between the groups was not statistically significant. Similar prospective and intervention studies are recommended for furthei investigation. References 1. Watson, A. W. S. Sports injuries in the game of hurling: A one-year prospective study. Am. J. Sports Med. 1996; 24 (3): 323-328. 2. Watson, A. W. S. Incidence and nature of sports injuries in Ireland. Analysis of four types of sport. Am. J. Sports Med. 1993; 21 : 137-143. LJ.M.S. January, February, March, 1998 THE RAT PULMONARY CIRCULATION AFTER EXPOSURE TO CHRONIC HYPOXIA AND HYPERCAPNIA: A MORPHOMETRIC STUDY H. Ooi ~, H. R. Brady ~, R, G O'Regan ~, P. McLoughlin ~. ~Department of Medicine, Mater Misericordiae Hospital, Eccles Street, Dublin 7 and 2Department of Physiology, University College Dublin, Earlsfort Terrace, Dublin 2. Chronic hypoxia leads to structural remodelling of the pulmonary vascular bed and sustained pulmonary hypertension. Chronic hypercapnia frequently coexists with hypoxia in chronic obstructive pulmonary disease and is associated with greater elevations of pulmonary arterial pressure than hypoxia alone 1. We examined the effects of hypercapnia on hypoxic vascular remodelling in the rat pulmonary circulation. Male Sprague-Dawley rats (n=7 each group) were maintained for 1 week under conditions of hypoxia (10 per cent 02), hypercapnia (10 per cent CO2), combined hypoxia and hypercapnia (10 per cent 02, I0 per cent CO2) or room air. Average weight of the rats was 311.38g, with no significant difference between the groups. The rats were anaesthetised (sodium pentobarbital 60 mg/kg IP), heparinised and killed by exsanguination. The pulmonary arterial tree was perfused and the lungs fixed with 4 per cent formaldehyde in normal saline. Lung sections were stained and assessed as follows: (i) percentage thick-walled peripheral vessels (percentage TWPV) - percentage of muscular intra-acinar vessels (ii) vessel density - number of vessels per 100 alveoli. The right ventricular free wall and the left ventricle plus septum were weighed separately. Mean percentage TWPV (+SD) in the hypoxic group (15.70+7.13) was significantly greater than in the control group (4.02+2 0; P<0.01, ANOVA). In the combined group, mean percentage TWPV (6.92+3.91) was significantly less than the hypoxic group (p<0.01) but not significantly different from control. Mean vessel density in the hypoxic group (3.95+0.81) was significantly reduced compared to control (5.38+1.05, p<0.05). In the combined group, vessel density (4.10+0.73) was significantly reduced compared to controls (p<0.05) but not significantly different from the hypoxic group. The chronic hypoxic and combined groups sho~ed significant right ventricular hypertrophy comparedto ContrOls (ratio right ventricular to left ventricular weight 0.351+0.037 and 0.339+0.056 respectively; controls 0.291+0.04; p<0.05). No significant vascular remodelling or ventricular hypertrophy was found in the hypercapnic group. These results suggest that hypercapnia inhibits hypoxic vascular remodelling. Despite this, combined hypoxia and hypercapnia produced equivalent right ventricular hypertrophy to hypoxia. The underlying mechanisms of these contrasting effects remain to be elucidated. This work has been kindly supported by the Health Research Board. Reference 1. McNee, W. et al. Pathophysiology of cor pulmonale in chronic obstructive pulmonary disease. Am. J. Respir. Crit. Care Med. 1994; 150: 833-852. EFFECTS OF SUPERIOR LARYNGEAL NERVE SECTION ON VENTILATORY CONTROL IN OLD, CONSCIOUS RATS D. Cantillon, A. Bradford. Department of Physiology, Royal College of Surgeons in Ireland, St. Stephen's Green, Dublin 2 We have shown that superior laryngeal nerve (SLN) section affects ventilation during normoxia and hypercapnia in young  Vol. 167 No. 1 (3-6 months old) rats'. Demyelination and axonal degeneration occur in the SLN in old rats z. Therefore, the ventilatory effects of SLN section in old rats may differ from those in young animals. Under ether inhalation, 23-month old Wistar rats were either sham-operated (n=8) or had both SLN cut (n=8). Ventilation was measured by barometric plethysmography in conscious, unrestrained animals breathing air or air containing 3, 6 and 9 per cent CO v Values for minute ventilation (ml/min/100g + SD) were (intact vs. SLN cut) 54.6 + 15.7 vs. 65.1 + 30.3 for air, 67.1 + 22.9 vs. 75.3 + 23.6 for 3 per cent CO v 110.4 + 82.8 vs. 123.9 + 52.1 for 6 per cent CO 2 and 210.4 + 175.4 vs. 284.6 + 100.0 for 9 per cent CO v Although minute ventilation was less following SLN section for all inspired gases, there were no significant differences (ANOVA, p<0.05) in any of these values or in tidal volume or respiratory frequency between intact and SLN-cut groups for all inspired gases. In conclusion, ageing reduces the role of SLN afferents in ventilatory control and this is consistent with the degenerative effects of ageing on SLN structure. Supported by the Royal College of Surgeons in Ireland and the Wellcome Trust References 1. Curran, A. K., O'Halloran, K. D., Bradford, A. Laryngeal sensory deafferentation alters the ventilatory response to inspired CO2. J. lr. Coll. Phys. Surg., 1993: 22(4), 316. 2. Rosenberg, S. I., Malmgren, L. T., Woo, P. Age-related changes in the internal branch of the rat superior laryngeal nerve. Arch. Otolaryngol. Head Neck Surg., 1989: 115, 78-86. Section of Biomedical Sciences 53 Table I. Anthropometric data and rowing experience of elite Irish lightweight oarsmen (n=7). age weight height rowing body fat (yr) (kg) (m) experience (%) (yr) mean 25.57SD5.71 76.93SD 1.43 1.80SD0.06 10.14SD 4.78 8.16SD 1.88 Table 2. Relative peak torque of oarside legs of elite Irish lightweight oarsmen (n--7) Muscle Mean peak torque Mean eak torque group oarside limb nonoarside imb (nm/kg) (nm/kg) Angular vel ~ 60 Quads 3.01 SD 0.22 3.12 SD 0.28** Hams 1.82 SD 0.30 1.70 SD 0.17 180 Quads 2.20 SD 0.08 2.16 SD 0.22 Hams 1.43 SD 0.21 1.33 SD 0.24 **indicates a difference p=0.07 between value in column o left This is a pilot study seeking to compile baseline data for the purposes of training and rehabilitation goals for the future and for Irish rowers and other sports. Difficulties encountered include the small population of Olympic level oarsmen available in Ireland for inclusion in the study. A prospective study would be needed to provide a larger database suitable for the development of effective training and rehabilitation programmes, aimed at the highest level of performance and the prevention of injury. Reference 1. Hagerman, F. C., Staron, R. E. Seasonal variations among physiological variables in elite oarsmen. Can. J. Appl. Sci. 1983; 8(3): 143-148. RELATIONSHIP BETWEEN ISOKINETIC STRENGTH CHARACTERISTICS OF KNEE FLEXORS AND EXTENSORS AND INJURY IN OLYMPIC OARSMEN C, Deacy, M. Garrett. School of Physiotherapy, University College Dublin. Seven Irish Olympic lightweight oarsmen were tested in the off season stage of the yr to establish baseline anthropometric (Table I) and kinetic data and to establish the relationship between these data and the subjects' performance including history of injury. Maximum voluntary torque output and endurance of the quadriceps and hamstring muscle groups of the oarside and non oarside legs were tested at speeds of 60~ and 180~ and endurance test speed of 120~ on the Cybex 330 dynamoneter. Statistical tests were concluded on torque values using two-tailed Student.'s t-test. No significant differences were seen in the parameters tested (p<0.05). The possibility of trends were suggested by differences between the absolute (p=0.09) and relative (p=0.07, see Table ll) peak torque values of the quadriceps of the oarside and non- oarside legs at the angular velocity of 60~ and the hamstring/ quadriceps muscle torque ratio at 60~ (p=0.06L No significant differences were seen between the peak toque values of the oarside and non-oarside legs at the angular velocity of 180~ or endurance ratios at 120~ The relative peak torque value of the quadriceps of the Irish rowers at the angular velocity of 180~ was greater than that of the United States rowers tested in 1983. The mean endurance ratio of the quadriceps was greater than that of the hamstring on both legs. No relationship was seen between injury and isokinetie muscle imbalance. THE EFFECT OF LOW INTENSITY LASER THERAPY (LILT) 890NM UPON A RADIATION IMPAIRED WOUND HEALING MODEL IN MURINE SKIN A. S, Lowe*, M. D, Walker z, G. D. Baxter*, G. D. Kennovin 3, M. Leek 3, D. G. Hirst z. Rehabilitation Sciences and Radiation Sciences Research Groups, Schools of Health Sciences ~ and Biomedical Sciences 2, University of Ulster at Jordanstown, N. Ireland and Smith & Nephew Group Research Centre 3, York Science Park, Heslington. Low intensity laser therapy (LILT) has become a popular therapeutic modality for a variety of clinical conditions including the promotion of wound repair. Nevertheless, the evidence base for such application remains sparse, although recent studies have demonstrated a number of quantifiable biological effects of low- intensity laser*'~. In the present study, the effect of low-intensity laser (4J/cm 2) upon a radiation impaired wound model in routine skin was investigated. Male Balb/c mice (n=30; age matched at 12 weeks) were included in the current study and randomly allocated to 3 experimental groups (n=10 each group). In Group 1, mice were left untreated; in Groups 2 and 3 a well-defined area on the dorsum was exposed to 20 Gy (Siemens Stabilipan X-ray machine). Seventy-two h post-irradiation all mice were anaesthetised and a 7mm square area wound made on the dorsum, corresponding in Groups 2 and 3 to the previously irradiated area. All wounds were videotaped alongside a marker scale (3 times weekly) until closure was complete. In Group 3, mice were treated with low-intensity laser irradiation (4J/cm 2) using a 890nm multidiode (n=60) array unit (270Hz; 300mW; Anodyne, Denver, CO, USA). Subsequently, the area of each wound was measured from video using an image analysis system (Fenestra 2.1). Statistical analysis using analysis of variance showed that  54 Royal Academy of Medicine in Ireland LJ.M.S. January, February, March, 1998 prior irradiation with X-ray doses of 20Gy caused a significant (p<0.04) delay in the rate of wound healing by day 9 when compared to the untreated group (at day 9, Group 1; 0.20_+0.05, Group 2; 0.40_+0.03). However, treatment with 4J/cm 2 rradiation had no effect upon the rate of closure in this animal model (at day 9, Group 2; 0.40+0.03, Group 3; 0.405:0.05). These findings provide little evidence of the claimed stimulatory effects of this modality upon wound closure in vivo. References 1. Funk, J. O., Kruse, A., Kirchner, H. J. Cytokine production after helium-neon laser irradiation in cultures of human peripheral blood mononuclear cells. J. Photocbem. Photobiol. 1992; 16: 347-55. 2. Baxter, G. D., Walsh, D. M., Allen, J. M., Lowe, A. S., Bell, A. J. Effects of low intensity infrared laser irradiation upon conduction in the human median nerve in vivo. Exp. Physiol. 1994; 79: 227-234. POSTURE AND BODY MECHANICS OF YOUTHS OF DIFFERENT SOCIAL GROUP AND RESPONSE TO INTERVENTION A. W. S. Watson. Sports Injuries Research Centre, University of Limerick. Fifteen aspects of posture were assessed in 59 schoolboys attending 2 schools in Ireland using a procedure previously described' and shown to be reliable. Knowledge of posture and the interest of the pupil and his parents in posture were assessed by means of a questionnaire. An intervention designed to improve posture was organised for subjects who wished to participate. Following this the subject's posture was re-assessed. The results of the study are shown in the table below. Subjects of Subjects of Social Groups Social Groups Variable I and 2 4 and 5 (High Social Groups) (Low Social Groups) Number of subjects 32 27 Age of subjects (years) 16.7i-0.6 16.5i-0.8 Number of subjects with good posture 20 9 Mean posture score of subjects 58.4_+.5.3 52.4+38 Number of subjects who had significant 2 7 posture defects Number of subjects with parents who took 21 5 an interest in their posture Score on test of knowledge about posture 7.5+2.3 4.8+_3.8 Subjects who stated that they were 30 20 interested in the posture assessment ' Subjects who stated that they intended o 24 20 carry out posture correction exercises Subjects who attended for reassessment of 22 10 their posture Number of subjects whose posture 20 8 improved following exercise programme The results of the study indicate that pupils from social groups 1 and 2 had fewer posture defects than pupils from social groups 4 and 5. Both they and their parents took a greater interest in their posture and they were also more likely to complete an intervention programme designed to improve their posture. Reference 1. Watson, A. W. S. Physical fitness and athletic performance (second edition). Longmans, London, 1995. ANALYSIS OF EIGHTEEN MEASURES OF FLEXIBILITY IN ACTIVE YOUNG ADULTS C. MacDonncha, A. W. S. Watson. University of Limerick. It is generally accepted that flexibility (joint range of motion) is an important component of physical fitness. However, the methods available for its assessment are problematical. The human body contains a large number of joints and most are capable of several different kinds of motion. Yet the "sit-and- reach" test, or a measurement of hip and spinal flexion taken when the subject is standing, are the only measurement of flexibility commonly employed in the physical fitness assessment of athletes. Other flexibility measurements are possible using goniometers or flexiometers but such instruments are difficult to use, have poor reproducibility when used as part of a fitness assessment, and are seldom seen outside the setting of clinical practice. The purpose of the present investigation was to measure 18 different aspects of flexibility in a group of 28 male and female sports science students in an attempt to determine if such measurements provided unique information concerning the flexibility of the subjects. Descriptive statistics of the data were computed and male and female subjects ~were compared. Unpaired t-tests indicated that the female subjects obtained higher scores on 5 of the 18 measurements (27.8 per cent) but that the differences were not statistically significant on the other 13 measures. A zero-order correlation matrix of the 18 flexibility measurements provided 289 correlations of which only 51 (17.6 per cent) were significantly different from zero. This result indicates a high degree of specificity of the individual flexibility measurements and suggests that a single measurement is unlikely to be an adequate indication of the overall flexibility of an individual. The results further suggest that a factor analysis should be undertaken in order to identify the individual measurement most representative of the overall flexibility of the athlete. GOOD FLEXIBILITY DOES NOT PROTECT FROM INJURY IN PLAYERS OF GAELIC FOOTBALL, SOCCER, RUGBY AND HURLING. A. W. S. Watson. Department of Physical Education and Sports Science & Sports Injuries Research Centre, University of Limerick. The subjects were 66 Irish males between the ages of 18 and 27 who played 1 or more of the following sports: soccer, rugby, Gaelic football, hurling. All competed at county or good-club level and were involved in training or matches on at least three days per week during the playing season. All gave informed consent to participation in the study. At the start of the investigation each subject produced a record of his previous injuries and undertook assessments of the following:- height and body weight, body fat content, estimated from 6 skinfold thicknesses, 15 aspects of posture and body mechar~ics, certain fitness v-ariables, and certain clinical parameters. Injuries sustained over the following 24 months were recorded, as were the number of days in hospital, days off sport and days of restricted activity. The following 6 aspects of flexibility were measured as described elsewhere~: spinal forward flexion, hip abduction when the subject's knees were fully flexed, hip flexion with the subject's knees fully extended, ankle dorsi-flexion, hip hyper-extension, shoulder hyper-extension with the arms horizontal. During the course of the investigation the following injuries were recorded: back injury (25 cases), strain of groin (14), strain of hamstrings (10), strain of calf (14), strain of quads (12), strain of arm or shoulder (6), knee injury (25), shin splints (21), ankle injury (45). Possible relationships between the 6 measures of flexibility and the incidence of the above injuries  Vol. 167 No. 1 was carried out using unpaired t-tests (for two-group comparisons) and analysis of variance when there were more than 2 groups. In none of the analyses was a significant relationship between flexibility and injury found. Thus the present results do not support the popular supposition that good flexibility protects the athlete from sports injury. Reference 1. Watson, A. W. S. Physical fitness and athletic performance (second edition). Longmans, London, 1995. ECCENTRIC EXERCISE AND DELAYED ONSET MUSCLE SORENESS (DOMS): A COMPARISON OF FREE WEIGHTS AND AN ISOKINETIC DYNAMOMETER AS METHODS OF INDUCTION J. Robinson 2, I. D. HilP, J. M. Allen 2, G. D. Baxter t. Rehabilitation Sciences Research Group, ~School of Health Sciences and 2Faculty of Science Research Graduate School, University of Ulster, Jordanstown BT37 OQB, Northern Ireland. Delayed onset muscle soreness (DOMS) is a common form of muscle pain and dysfunction associated with unaccustomed exercise or, in particular, eccentric exercise I. Use of isokinetic dynamometers and free-weights are 2 methodologies commonly employed for the laboratory induction of delayed onset muscle soreness (DOMS) 2. The aim of the present study was to assess the comparative inducement efficacy of these in producing DOMS. In the current study, for which ethical approval was obtained, healthy human volunteers (n = 16; 8 males, 8 females) were recruited, and allocated to 1 of 2 groups: (1) i sokinetic eccentric exercise or (2) free-weights eccentric exercise. DOMS was induced in the non-dominant elbow flexors in both groups by a series of eccentric contractions to exhaustion. This was achieved in group 1 by each subject performing maximum voluntary eccentric contractions on a Biodex isokinetic dynamometer and in group 2 by using subjects' (concentric) one repetition maximum and free weights. The measurements performed to provide an index of inducement efficacy were: range of movement (elbow resting angle: RANG; universal goniometer): pain (visual analogue scale: VAS; McGill pain questionnaire: 9 PQ), mechanical pain threshold (pressure algometer) and force deficits (maximal voluntary isometric contraction: Biodex isokinetic dynamometer). All measurements were taken prior to DOMS induction on the first day and repeated on subsequent days over a 5 day period. Standardized difference scores were used as the basis for statistical analysis (ANOVA with corrected post hoc Fisher and Scheffe tests as appropriate) to assess cumulative inducement effects. One-way ANOVA tests showed consistent significant difference in all measurements except those of maximal isometric contraction, e.g. RANG day 5. p<0:043; isokinetics group 1: decrease in RANG = -5.63+2.35; free-weights group 2: increase in RANG = -23.13+7.52; mean + S.E.M.). This indicates there is a more acute resting angle of the elbow after eccentric exercise with the biceps brachii using free-weights. Given these results, free-weights eccentric exercise would appear to produce a different degree of DOMS when compared with isokinetic eccentric exercise although the reason for this remains to be elucidated. The authors acknowledge support from the European Social Fund. Section of Biomedical Sciences 55 References 1. Armstrong, R. B. Mechanisms of exercise-induced delayed onset muscular soreness: a brief review. Med. Sci. Sports Exerc., 1984; 16: 529-538. 2. Croisier, J. L., Camus, G., Deby-Dupont, G., Bertand, F., Lhermerout, C., Crierlard, J. M., Juchmes-Ferir, A., Deby, C., Albert, A., Lamy, M. Myocellular enzyme leakage, polymorphonuclear neutrophil activation and delayed onset muscle soreness induced by isokinetic exercise. Arch. Physiol. Biochem. 1996: 104(3): 322-329. A PILOT STUDY OF STEROID INJECTION VERSUS HEEL ORTHOSIS IN THE MANAGEMENT OF PLANTAR FASCIITIS A. J. Black ~, S. Hughes 2, G. D. Baxter l, A. L. BelP. ~Rehabilitation Sciences Research Group, Schools of Health Sciences, University of Ulster and 2Rheumatology Unit, Greenpark Healthcare Trust, School of Clinical Medicine, The Queen's University of Belfast. Heel pain is a common cause of difficulty in walking and is most often related to plantar fasciitis. Little attention has been given to formal evaluation of treatment modalities, including local steroid injection. The study was approved by Queens ethical committee, and designed to investigate the effectiveness of local steroid injection (20mg trimcinolone, with 2 ml of 2 per cent lignocaine) with a pair of orthoses (Viscoheel Sofspot, Bauerfeind UK, Aldershot) in the treatment of plantar fasciitis over a 3 month period. Seventeen patients over 16 yr of age, with symtomatic plantar fasciitis were randomly allocated to one of the 2 treatment groups to receive either steroid injection or orthoses. Pain was assessed at the start of the trial and at monthly reviews using MPQ (pain questionnaire) and a 10 cm visual analogue scale. Tenderness was also assessed using a 4 point scale. Results were analysed using non parametric methods. Of the 17 patients who were recruited, 3 withdrew, leaving 14 patients with 21 episodes of plantar fasciitis (7 bilateral). Each treatment group showed a statistically significant reduction after 3 months compared to baseline; the mean improvement was 33 per cent within the steroid group (p<0.01) and 61.6 per cent within the orthotic group (p<0.005). While such differences were not statistically significant between groups, there was a trend towards greater improvement in the heel orthosis group (p=0.056). The effect of steroid treatment appeared to wear off towards the end of 3 months, while there was progressive response in those treated with orthoses. Tenderness scores were not significant between treatment groups. Heel orthosis may be a more cost effective method for treating plantar fasciitis than local steroid injections. We are currently carrying out a double-blinded double-placebo comparison of the 2 treatments and a larger number of patients over a 6 month study period. A STUDY OF THE ACTIVITY OF LOWER LEG MUSCLES DURING THE GAIT CYCLE USING SURFACE ELECTROMYOGRAPHY (EMG) G. Orr l, S. McDonagh l, G. D. Baxter ~, R. Baker 2. Rehabilitation Sciences Research Group, School of Health Sciences, University of Ulster at Jordanstown and 2Gait Analysis Laboratory, Musgrave Park Hospital, Greenpark Healthcare Trust, Belfast. Surface electromyography (EMG) equipment was used to
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