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Wolman R.,Royal National Orthopaedic Hospital | Wolman R.,National Institute of Dance Medicine and Science | Wyon M.A.,Jerwood Center for the Prevention and Treatment of Dance Injuries | Wyon M.A.,University of Wolverhampton | And 9 more authors.
Journal of Science and Medicine in Sport | Year: 2013

Objective: Serum 25-hydroxyvitamin D is produced by the exposure of the skin to sunlight. Therefore athletes who train indoors, such as dancers, are vulnerable to vitamin D deficiency. The purpose of the study was to evaluate the serum 25-hydroxyvitamin D status in UK professional dancers during periods of reduced and increased sunlight exposure (i.e., winter vs. summer), and to assess the impact on bone metabolism and risk of injury. Design: Cohort study. Methods: 19 elite classical ballet dancers (age 26. ±. 8.86. yr; height 1.66 ± 8.84. m; mass 54.3 ± 10.47. kg) were monitored over a 6 month period for 25-hydroxyvitamin D, PTH and blood serum bone turnover markers (CTX and PINP) along with injury data. Repeated measure ANOVA and Wilcoxon and Chi-square analyses were used and significance was set at p≤. 0.05. Results: Significant changes were noted between the winter and summer test dates for 25-hydroxyvitamin D (14.9. ng/ml vs. 23.9. ng/ml; p <. 0.001), PTH (38.7. pg/ml vs. 26.3. pg/ml; p < 0.001) and PINP (89.9. ng/ml vs. 67.6. ng/ml; p < 0.01). The oral contraceptive had a significant effect on serum 25-hydroxyvitamin D, PTH and CTX. Soft tissue injuries were significantly lower in summer compared to winter period (winter = 24, summer = 13; p < 0.05). Conclusions: Professional ballerinas characterized by a high incidence of low serum 25-hydroxyvitamin D levels which improve marginally in the summer. These dancers also demonstrate a higher injury incidence in the winter. Oral contraception seems to increase serum 25-hydroxyvitamin D levels and has a positive effect on bone metabolism. © 2013 Sports Medicine Australia.


Stavropoulos-Kalinoglou A.,University of Wolverhampton | Stavropoulos-Kalinoglou A.,Russells Hall Hospital | Metsios G.S.,University of Wolverhampton | Metsios G.S.,Russells Hall Hospital | And 11 more authors.
International Journal of Obesity | Year: 2010

Objective: To assess whether physical activity, diet or inflammation is a more important determinant of body mass index (BMI) and body fat (BF) in patients with rheumatoid arthritis (RA).Methods: A total of 150 RA patients (102 female) were assessed for BMI and BF. Their habitual physical activity was assessed with the international physical activity questionnaire (IPAQ) and their energy intake with a 3-day food diary. Pro-inflammatory cytokines (interleukins, IL-1 and IL-6, and tumor necrosis factor-α), erythrocyte sedimentation rate, C-reactive protein, disease activity score-28 and physical function (Health Assessment QuestionnaireHAQ) were also measured.Results: BMI correlated inversely with IPAQ (r=0.511, P=0.000) and positively with energy intake (r=0.331, P=0.016) and HAQ (r=0.133, P=0.042). BF correlated inversely with IPAQ (r=0.575, P=0.000) and positively with HAQ (r=0.201, P=0.037). Normal weight patients were more physically active compared with those who were either overweight (P=0.006) or obese (P=0.000). Underweight patients consumed significantly fewer calories compared with other patients (P=0.05 in all cases). Cytokines or HAQ did not differ between weight groups. IPAQ was the sole predictor of obesity, whereas energy intake was the sole predictor of underweight.Conclusions: Inflammation does not seem to influence BMI and BF in RA. As in the general population, high levels of habitual physical activity associate with low BMI and BF in RA. Energy intake is a major determinant of being underweight in those who consume fewer calories. Further research is needed to investigate the suitability of exercise and diet modalities, and their effects on the body composition of RA patients. © 2010 Macmillan Publishers Limited All rights reserved.


Paschalis V.,Institute of Human Performance and Rehabilitation | Paschalis V.,University of Thessaly | Nikolaidis M.G.,Institute of Human Performance and Rehabilitation | Nikolaidis M.G.,University of Thessaly | And 9 more authors.
Journal of Sports Sciences | Year: 2010

In this study, we investigated the effect of eccentric exercise on position sense and reaction angle of the elbow and knee flexors. Twelve males underwent two eccentric exercise sessions involving a randomized crossover design. In the first session participants used their elbow flexors and in the other session their knee flexors. Muscle damage indices, position sense, and joint reaction angle to release of the elbow and knee flexors were measured before, immediately after, and up to 7 days after exercise. Exercise induced greater muscle damage in the elbow flexors than knee flexors. Exercise disturbed position sense of the elbow and knee joint. For both limbs, the participants adopted a more extended position than the reference angle. The elbow and knee joint reaction angles to release increased after exercise for both the elbow and knee flexors. The disturbances in position sense and reaction angle after exercise were greater in the elbow flexors than knee flexors. The elbow flexors remained more accurate and faster than the knee flexors at all time points. These results may be explained by the higher density of muscle spindles and the lower innervation ratio of the elbow flexors compared with the knee flexors, as well as the fact that the arms are more accustomed than the legs to perform fast and accurate movements. © 2010 Taylor & Francis.


Kerasioti E.,University of Thessaly | Stagos D.,University of Thessaly | Jamurtas A.,University of Thessaly | Kiskini A.,University of Thessaly | And 7 more authors.
Food and Chemical Toxicology | Year: 2013

Intense exercise induces increased levels of pro-inflammatory and anti-inflammatory cytokines. Thus, the purpose of this study was to examine the effects of a special cake (consisting of carbohydrate to whey protein 3.5:1) vs. an isocaloric carbohydrate cake on inflammatory markers after exhaustive cycling in humans. Nine subjects received either the experimental or placebo cake in a counterbalanced fashion using a crossover, double-blind, repeated-measures design. They performed one trial involving a 2h exercise on a cycle ergometer at 60-65% VO2max followed by a 4h recovery and then a second trial involving an 1h exercise at 60-65% VO2max which was increased at 95% VO2max. Blood samples were collected pre-exercise, 30min and 4h post-exercise, post-time Trial and 48h post-time Trial. Cakes were consumed immediately post-exercise and every 1h for the next 3h. The results showed that consumption of the experimental cake reduced significantly (p<0.05), 4h post-exercise, the pro-inflammatory protein levels IL-6 and CRP compared to the control group by 50% and 46% respectively. Moreover, in the experimental cake group, the level of the anti-inflammatory cytokine IL-10 was higher by 118%, 4h post-exercise, compared to the control group but not statistically significant. © 2013 Elsevier Ltd.


Stavropoulos-Kalinoglou A.,Dudley Group of Hospitals NHS Trust | Stavropoulos-Kalinoglou A.,University of Birmingham | Metsios G.S.,Dudley Group of Hospitals NHS Trust | Metsios G.S.,University of Wolverhampton | And 5 more authors.
Rheumatology | Year: 2011

Obesity is a major threat for public health and its study has attracted significant attention in the general population, predominantly due to its association with significant metabolic and cardiovascular complications. In RA research, BMI is frequently reported as a demographical variable, but obesity, as such, has received little interest. This is surprising, in view of the clear associations of obesity with other arthritides, particularly OA, but also in view of the now-clear association of RA with increased cardiovascular morbidity and mortality. In this review, we summarize the studies that have looked into obesity in the RA population, evaluate their findings, identify knowledge gaps and propose directions for future research. We also pose a question of high clinical and research significance: is the use of BMI still a valid way of assessing obesity in RA? © The Author 2010. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved.


Allen N.,Birmingham Royal Ballet Company | Allen N.,University of Wolverhampton | Allen N.,National Institute of Dance Medicine and Science | Nevill A.M.,University of Wolverhampton | And 7 more authors.
Clinical Journal of Sport Medicine | Year: 2013

OBJECTIVE:: The aim of this study was to determine whether an intervention with individualized conditioning program based on injury history and functional movement screening would be effective in reducing ballet injury incidence. DESIGN:: Prospective 3-year epidemiological study. SETTING:: Professional ballet company and its in-house medical facility. PARTICIPANTS:: Dancers from a professional ballet company over the 3-year study period. Participant numbers ranged from 52 to 58 (year 1: 52; year 2: 58; year 3: 53). INTERVENTIONS:: The intervention consisted of individual conditioning programs developed using injury history and functional movement screening. Analysis was undertaken of the all dancers who were present in the company during the study period. The significance of change in injuries over a 3-year period was determined using a Poisson distribution model. MAIN OUTCOMES MEASURES:: To determine whether individual conditioning programs resulted in a decrease in injury incidence over the study period. RESULTS:: The injury count reduced significantly in years 2 and 3 (P < 0.001). Injury incidence for male dancers declined from year 1 (in year/1000 h) (4.76/1000 h) to year 2 (2.40/1000 h) and year 3 (2.22/1000 h). For women, a reduction in the injury incidence was observed from year 1 (4.14/1000 h) to year 2 (1.71/1000 h) and year 3 (1.81/1000 h). CONCLUSIONS:: Through prospective injury surveillance, we were able to demonstrate the benefit of individualized conditioning programs based on injury history and functional movement screening in reducing injuries in ballet. CLINICAL RELEVANCE:: The implementation of well-structured injury surveillance programs can impact on injury incidence through its influence on intervention programs. 2013 by Lippincott Williams & Wilkins.


Wyon M.A.,University of Wolverhampton | Wyon M.A.,Jerwood Center for the Prevention and Treatment of Dance Injuries | Wyon M.A.,National Institute of Dance Medicine and Science | Koutedakis Y.,University of Wolverhampton | And 8 more authors.
Journal of Science and Medicine in Sport | Year: 2014

Objectives: Athletes who train indoors during the winter months exhibit low serum 25-hydroxyvitamin D [25(OH)D] concentrations due to a lack of sunlight exposure. This has been linked to impaired exercise performance. The purpose of this study was to assess the effects of oral vitamin D3 supplementation on selected physical fitness and injury parameters in elite ballet dancers. Design: Controlled prospective study. Methods: 24 elite classical ballet dancers (intervention n=17; control n=7) participated in a controlled 4-month oral supplementation of vitamin D3 (2000IU per day). Isometric muscular strength and vertical jump height were measured pre and post intervention. Injury occurrence during the intervention period was also recorded by the in-house medical team. Repeated measures ANOVA and Mann-Whitney-U statistical tests were used and significance was set at p≤0.05. Results: Significant increases were noted for the intervention group for isometric strength (18.7%, p<. 0.01) and vertical jump (7.1%, p<. 0.01). The intervention group also sustained significantly less injuries than the controls during the study period (p<. 0.01). Conclusions: Oral supplementation of vitamin D3 during the winter months has beneficial effects on muscular performance and injury occurrence in elite ballet dancers. © 2013 Sports Medicine Australia.


Kerasioti E.,University of Thessaly | Kiskini A.,University of Thessaly | Veskoukis A.,University of Thessaly | Jamurtas A.,University of Thessaly | And 8 more authors.
Food and Chemical Toxicology | Year: 2012

Exercise has been associated with oxidative stress that is correlated with muscle fatigue and reduced exercise performance. The aim of this study was to examine the effects of a special cake (consisting of carbohydrate to whey protein 3.5:1) vs an isocaloric carbohydrate cake on biomarkers of oxidative stress in 9 males after exhaustive cycling. A randomized single-blind cross-over study was completed. They performed one trial involving a 2-h exercise on a cycle ergometer at 60-65% VO2max followed by a 4-h recovery and then a second trial involved an 1-h exercise at 60-65% VO2max which was increased at 95% VO2max (time trial). The subjects received 4 experimental or placebo cakes after the first trial (the first immediately after and then one every hour). Blood samples were collected at eight time intervals: pre-exercise, 30min, 1.5h and 4h post-exercise, post time Trial, 1h, 24h and 48h post time Trial. Thiobarbituric Acid Reactive Substances (TBARS), protein carbonyls, total antioxidant capacity (TAC), catalase and glutathione (GSH) were determined spectrophotometrically. The mean time to exhaustion did not differ upon cake consumption. Consumption of the special cake reduced TBARS significantly, but had no effect on other oxidative stress markers. © 2012 Elsevier Ltd.


Tsarouhas A.,University of Thessaly | Iosifidis M.,Papageorgiou General Hospital | Spyropoulos G.,University of Thessaly | Kotzamitelos D.,University Hospital of Alexandroupolis | And 4 more authors.
Arthroscopy - Journal of Arthroscopic and Related Surgery | Year: 2011

Purpose: To evaluate in vivo the differences in tibial rotation between single- and double-bundle anterior cruciate ligament (ACL)reconstructed knees under combined loading conditions. Methods: An 8-camera optoelectronic system and a force plate were used to collect kinematic and kinetic data from 14 patients with double-bundle ACL reconstruction, 14 patients with single-bundle reconstruction, 12 ACL-deficient subjects, and 12 healthy control individuals while performing 2 tasks. The first included walking, 60°pivoting, and stair ascending, and the second included stair descending, 60°pivoting, and walking. The 2 variables evaluated were the maximum range of internal-external tibial rotation and the maximum knee rotational moment. Results: Tibial rotation angles were not significantly different across the 4 groups (P =.331 and P =.851, respectively) or when side-to-side differences were compared within groups (P =.216 and P =.371, respectively) for the ascending and descending maneuvers, nor were rotational moments among the 4 groups (P =.418 and P =.290, respectively). Similarly, for the descending maneuver, the rotational moments were not significantly different between sides (P =.192). However, for the ascending maneuver, rotational moments of the affected sides were significantly lower by 20.5% and 18.7% compared with their intact counterparts in the single-bundle (P =.015) and double-bundle (P =.05) groups, respectively. Conclusions: High-intensity activities combining stair ascending or descending with pivoting produce similar tibial rotation in single- and double-bundle ACL-reconstructed patients. During such maneuvers, the reconstructed knee may be subjected to significantly lower rotational loads compared with the intact knee. Level of Evidence: Level III, retrospective comparative study. © 2011 Arthroscopy Association of North America.


Kalyva A.,University of Kent | Kalyva A.,Institute of Human Performance and Rehabilitation | Schmidtmann A.,University of Kent | Geeves M.A.,University of Kent
Biochemistry | Year: 2012

Tropomyosin (Tm) is a dimer made of two alpha helical chains associated into a parallel coiled-coil. In mammalian skeletal and cardiac muscle, the Tm is expressed from two separate genes to give the α- and β-Tm isoforms. These associate in vivo to form homo- (α 2) and heterodimers (α•β) with little β 2 normally observed. The proportion of α 2 vs α•β varies across species and across muscle types from almost 100% α 2- to 50% α•β-Tm. The ratio can also vary during development and in disease. The functional significance of the presence of these two isoforms has not been defined because it is difficult to isolate or purify the α•β dimer for functional studies. Here we report an effective method for purifying bacterially expressed Tm as α•β dimers using a cleavable N-terminal tag on one of the two chains. The same method can be used to isolate Tm dimers in which one chain carries a mutation. We go on to show that the α•β dimers differ in key properties (actin affinity, thermal stability) from either the α 2- or β 2-Tm. However, the ability to regulate myosin binding when combined with cardiac troponin appears unaffected. © 2012 American Chemical Society.

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