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Medicina is published by MDPI from Volume 54 Issue 1 (2018). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Lithuanian Medical Association, Lithuanian University of Health Sciences, and Vilnius University.

Medicina, Volume 46, Issue 6 (June 2010) – 10 articles

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Article
Raumenų sutraiškymas ir sutraiškymo sindromas
Medicina 2010, 46(6), 435; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina46060061 - 12 Jun 2010
Cited by 3 | Viewed by 519
Abstract
Raumenų sutraiškymas – tai galūnių ar kūno raumenų pažeidimas (trauminė rabdomiolizė). Sisteminės raumenų sutraiškymo pasekmės: rabdomiolizė, elektrolitų kiekio, šarmų ir rūgščių pusiausvyros pokyčiai, hipovolemija, ūminis inkstų nepakankamumas. Šių raumenų pažeidimų žmonės patiria įvairių nelaimingų įvykių metu: žemės drebėjimai, uraganai, transporto avarijos, karai, namų [...] Read more.
Raumenų sutraiškymas – tai galūnių ar kūno raumenų pažeidimas (trauminė rabdomiolizė). Sisteminės raumenų sutraiškymo pasekmės: rabdomiolizė, elektrolitų kiekio, šarmų ir rūgščių pusiausvyros pokyčiai, hipovolemija, ūminis inkstų nepakankamumas. Šių raumenų pažeidimų žmonės patiria įvairių nelaimingų įvykių metu: žemės drebėjimai, uraganai, transporto avarijos, karai, namų griūtys ir t. t. Šiame straipsnyje aptariama raumenų sutraiškymo sindromo epidemiologija, rizikos veiksniai, patofiziologija (raumeninių skaidulų pažeidimo mechanizmai, išsilaisvinančios iš pažeistų raumenų medžiagos, reperfuzijos pasekmės); klinikiniai požymiai; tyrimų duomenys; diferencinė diagnostika; komplikacijos (ūminis inkstų nepakankamumas, hipovoleminis šokas, hiperkalemija, infekcija, raumenų guolio ankštumo sindromas); gydymas (tinkama rehidracija, vartojami intraveniniai skysčiai, forsuota manitolio šarminė diurezė, hiperkalemijos korekcija, žaizdų priežiūra, hiperbarinė oksigenacija ir kt.); prognozė, mirštamumo rodikliai ir profilaktika (neatidėliotina pagalba gali sumažinti šios patologijos metu tiek sergamumo trukmę, tiek mirštamumą). Full article
Article
Functional state assessment on the dynamics of interparametric concatenations during exercise tests
Medicina 2010, 46(6), 429; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina46060060 - 12 Jun 2010
Cited by 1 | Viewed by 462
Abstract
The aim of this study was to complement an analytical approach by new methodology of data sequences analysis of muscular and cardiovascular indices during the assessments of functional state. The participants of the study were 14 elite Greco-roman wrestlers and they underwent two [...] Read more.
The aim of this study was to complement an analytical approach by new methodology of data sequences analysis of muscular and cardiovascular indices during the assessments of functional state. The participants of the study were 14 elite Greco-roman wrestlers and they underwent two exercise tests 30 squats per 45 s while 12-lead ECG was recorded continuously and 30-s vertical jumps test while the height, contact and flight times of each jump recorded. The parametric interactions parameters and their sequences analysis based on a mathematical method founded upon a matrix theory were applied. The obtained results enabled to identify dynamical changes of the independence of parameters or an opposite phenomenon – interaction. The dynamics of ECG or performance parameters did not allowed to fi nd out the moments of critical changes during the exercising. The dynamics of concatenation between the time of push-off and the height of jumps while performing repeated jumps has a tendency to increase in the values of discriminant and the fl uctuations at some point of jumping task comes on. Analysis of concatenation between ECG or muscle performance parameters allows distinguishing the individual peculiarities which could be in value of discriminant, in time of exercising before the fl uctuations occurs, in character how the body behave as to compensate fatigue. It was concluded that assessment the dynamics of inter-parametric concatenation of physiological parameters based on the data sequences analysis provide a new approach in the field of functional state assessment allowing to reveal features of functional preparedness and fatigability during workloads. Full article
Article
Assessment of functional conditions of basketball and football players during the load by applying the model of integrated evaluation
Medicina 2010, 46(6), 421; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina46060059 - 12 Jun 2010
Cited by 4 | Viewed by 531
Abstract
We consider the human body as an adaptable, complex, and dynamic system capable of organizing itself, though there is none, the only one, factor inside the system capable of doing this job. Making use of the computerized ECG analysis system “Kaunas-load” with parallel [...] Read more.
We consider the human body as an adaptable, complex, and dynamic system capable of organizing itself, though there is none, the only one, factor inside the system capable of doing this job. Making use of the computerized ECG analysis system “Kaunas-load” with parallel registration of ECG carrying out body motor characteristics, ABP, or other processes characterizing hemodynamics enable one to reveal and evaluate the synergistic aspects of essential systems of the human body what particularly extends the possibilities of functional diagnostics. The aim of the study was to determine the features of alterations in the functional condition of basketball and football players and nonathletes during the bicycle ergometry test by applying the model of evaluation of the functional condition of the human body. Material and methods. The study population consisted of 266 healthy athletes and nonathletes. Groups of male basketball players, male football players, male nonathletes, female basketball players, and female nonathletes were studied. A computerized ECG analysis system “Kaunas-load” that is capable of both registering and analyzing the power developed by the subject and 12-lead ECG synchronically were used for evaluating the functional condition of the CVS. The subject did a computer-based bicycle ergometry test. The following ECG parameters at rest and throughout the load – HR, JT interval, and the deduced JT/RR ratio index that reflects the condition between regulatory and supplying systems – were evaluated. After measuring ABP, the pulse amplitude (S–D) was evaluated. The pulse blood pressure ratio amplitude (S–D)/S that depicts the connection between the periphery and regulatory systems was also evaluated. Speeds of changes in physiological parameters during physical load were evaluated too.
Results
. Heart rate and JT/RR ratio of athletes at the rest and during load were lower, and JT interval of rest was longer and became shorter more slowly during load, compared to that of healthy nonathletes. The pulse arterial blood pressure amplitude of men at rest and during load was higher than that of women. The pulse ABP amplitude of athletes was higher than that of nonathletes. The relative pulse ABP amplitude in the state of rest in the groups of men was higher than in groups of women. The relative pulse amplitude of female basketball players at rest and during load was higher than that of female nonathletes. Significant differences in the dynamics of speed of changes in HR, the pulse ABP amplitude, and the relative pulse ABP amplitude of male and female basketball players, male football players, as well as male and female nonathletes were observed.
Conclusions. The newly deduced parameters, namely, speeds of changes in the parameters with changes in the phase of the load reflect very well peculiarities of functional condition of the human body during bicycle ergometry test. The sum total of those newly deduced parameters and customary parameters reveals new functional peculiarities of the human body. Full article
Article
Agility assessment in female futsal and soccer players
Medicina 2010, 46(6), 415; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina46060058 - 12 Jun 2010
Cited by 31 | Viewed by 1212
Abstract
Agility is the player’s capability to perform rapid whole-body movement with change of velocity or direction in response to a stimulus. The aims of this study were as follows: 1) to assess the reliability of a reactive visual stimuli agility field test (RVS-T); [...] Read more.
Agility is the player’s capability to perform rapid whole-body movement with change of velocity or direction in response to a stimulus. The aims of this study were as follows: 1) to assess the reliability of a reactive visual stimuli agility field test (RVS-T); and 2) to evaluate differences in RVS-T and planned (PVS-T) agility performances between female soccer and futsal players.
Material and methods
. Sixty-six female players belonging to Italian teams of regional level were recruited to the study. The experimental apparatus consisted of four lighted spherical visual stimuli connected to a computer able to randomly generate three different sequences. Differences between RVS-T and PVS-T performances were calculated to evaluate the decision-making time (DMT) of players.
Results. The intraclass reliability coeffi cient for RVS-T was 0.80. Significant (P<0.05) differences emerged only for RVS-T (futsal, 17.3±0.5 s; soccer, 18.8±1.1 s) and DMT (futsal, 2.6±0.6 s; soccer, 4.1±1.2 s), whereas similar performances between groups resulted for PVS-T (futsal, 14.7±0.6 s; soccer, 14.6±0.6 s).
Conclusions
. The RVS-T proved to be a reliable tool to evaluate agility in field conditions. Futsal players showed better RVS-T and DMT performances with respect to soccer counterparts, probably due to the higher velocity of actions and faster decision-making of their sport. The lack of difference in PVS-T performances confi rms the importance to evaluate agility capabilities of players in both planned and reactive conditions. Full article
Article
Capturing complex human behaviors in representative sports contexts with a single camera
Medicina 2010, 46(6), 408; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina46060057 - 12 Jun 2010
Cited by 55 | Viewed by 1110
Abstract
Background and objective. In the last years, several motion analysis methods have been developed without considering representative contexts for sports performance. The purpose of this paper was to explain and underscore a straightforward method to measure human behavior in these contexts.
Material
[...] Read more.
Background and objective. In the last years, several motion analysis methods have been developed without considering representative contexts for sports performance. The purpose of this paper was to explain and underscore a straightforward method to measure human behavior in these contexts.
Material and methods
. Procedures combining manual video tracking (with TACTO device) and bidimensional reconstruction (through direct linear transformation) using a single camera were used in order to capture kinematic data required to compute collective variable(s) and control parameter(s). These procedures were applied to a 1vs1 association football task as an illustrative subphase of team sports and will be presented in a tutorial fashion.
Results
. Preliminary analysis of distance and velocity data identified a collective variable (difference between the distance of the attacker and the defender to a target defensive area) and two nested control parameters (interpersonal distance and relative velocity).
Conclusions
. Findings demonstrated that the complementary use of TACTO software and direct linear transformation permit to capture and reconstruct complex human actions in their context in a low dimensional space (information reduction). Full article
Article
Development and validation of a notational system to study the offensive process in football
Medicina 2010, 46(6), 401; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina46060056 - 12 Jun 2010
Cited by 29 | Viewed by 853
Abstract
The most striking change within football development is the application of science to its problems and in particular the use of increasingly sophisticated technology that, supported by scientifi c data, allows us to establish a “code of reading” the reality of the game. [...] Read more.
The most striking change within football development is the application of science to its problems and in particular the use of increasingly sophisticated technology that, supported by scientifi c data, allows us to establish a “code of reading” the reality of the game. Therefore, this study describes the process of the development and validation of an ad hoc system of categorization, which allows the different methods of offensive game in football and the interaction to be analyzed. Therefore, through an exploratory phase of the study, we identified 10 vertebrate criteria and the respective behaviors observed for each of these criteria. We heard a panel of five experts with the purpose of a content validation. The resulting instrument is characterized by a combination of fi eld formats and systems of categories. The reliability of the instrument was calculated by the intraobserver agreement, and values above 0.95 for all criteria were achieved. Two FC Barcelona games were coded and analyzed, which allowed the detection of various Tpatterns. The results show that the instrument serves the purpose for which it was developed and can provide important information for the understanding of game interaction in football. Full article
Article
Linear and nonlinear heart rate dynamics in elderly inpatients. Relations with comorbidity and depression
Medicina 2010, 46(6), 393; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina46060055 - 12 Jun 2010
Cited by 12 | Viewed by 501
Abstract
Background. Hospitalization processes are known to increase depressive symptoms arising among elderly population. Meanwhile, dysregulation of cardiac autonomic function has been suggested to link depression and cardiovascular mortality. In this context, analysis of heart rate variability (HRV) is emerging as a powerful [...] Read more.
Background. Hospitalization processes are known to increase depressive symptoms arising among elderly population. Meanwhile, dysregulation of cardiac autonomic function has been suggested to link depression and cardiovascular mortality. In this context, analysis of heart rate variability (HRV) is emerging as a powerful mortality risk stratifier clinical tool. The purpose of the study was to examine the relationship among HRV, depression, and comorbidity risk among an elderly inpatient population.
Material and methods. Twenty-six subjects (aged 78±9 years) were recruited from the Short- Term Stay Unit at the Hospital General de Alicante. Before joining a Physical Activity Program aimed to prevent functional impairment and after medical selection and written consent, inpatients were tested for heart rate variability, Yesavage Geriatric Depression Scale, and Charlson comorbidity index score.
Results
. Men compared to women showed a signifi cantly larger CCI score. Short-term scaling exponent (α1), derived from detrended fl uctuation analysis, showed a negative correlation with Charlson comorbidity index. Conversely, a positive correlation was found between sample entropy (SampEn) and Yesavage Scale.
Conclusions
. On the one hand, fractal analysis of HRV confirms to be useful as a risk stratifier tool. On the other hand, SampEn is proposed to be reflecting a non-neurally generated complexity when accompanied with low values of α1. Accordingly, in this regime, it would be indicative of a paradoxical gradual reduction in cardiac autonomic control, accentuated with the severity of depressive symptoms. Full article
Article
Motor control theories and their applications
Medicina 2010, 46(6), 382; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina46060054 - 12 Jun 2010
Cited by 96 | Viewed by 3149
Abstract
We describe several infl uential hypotheses in the field of motor control including the equilibrium-point (referent confi guration) hypothesis, the uncontrolled manifold hypothesis, and the idea of synergies based on the principle of motor abundance. The equilibrium-point hypothesis is based on the idea [...] Read more.
We describe several infl uential hypotheses in the field of motor control including the equilibrium-point (referent confi guration) hypothesis, the uncontrolled manifold hypothesis, and the idea of synergies based on the principle of motor abundance. The equilibrium-point hypothesis is based on the idea of control with thresholds for activation of neuronal pools; it provides a framework for analysis of both voluntary and involuntary movements. In particular, control of a single muscle can be adequately described with changes in the threshold of motor unit recruitment during slow muscle stretch (threshold of the tonic stretch reflex). Unlike the ideas of internal models, the equilibrium-point hypothesis does not assume neural computations of mechanical variables. The uncontrolled manifold hypothesis is based on the dynamic system approach to movements; it offers a toolbox to analyze synergic changes within redundant sets of elements related to stabilization of potentially important performance variables. The referent confi guration hypothesis and the principle of abundance can be naturally combined into a single coherent scheme of control of multi-element systems. A body of experimental data on healthy persons and patients with movement disorders are reviewed in support of the mentioned hypotheses. In particular, movement disorders associated with spasticity are considered as consequences of an impaired ability to shift threshold of the tonic stretch reflex within the whole normal range. Technical details and applications of the mentioned hypo theses to studies of motor learning are described. We view the mentioned hypotheses as the most promising ones in the field of motor control, based on a solid physical and neurophysiological foundation. Full article
Article
A dynamic systems approach to bimanual coordination in stroke: implications for rehabilitation and research
Medicina 2010, 46(6), 374; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina46060053 - 12 Jun 2010
Cited by 6 | Viewed by 577
Abstract
During the last 30 years, the dynamic systems approach to coordination patterns contributed to shed new lights on the principles governing interlimb coordination, its dynamics, and its neural basis, predominantly in healthy people. In the present paper, we aim to show how these [...] Read more.
During the last 30 years, the dynamic systems approach to coordination patterns contributed to shed new lights on the principles governing interlimb coordination, its dynamics, and its neural basis, predominantly in healthy people. In the present paper, we aim to show how these concepts could provide a theoretical and a methodological framework to address bimanual coordination dysfunction and rehabilitation in stroke patients. Compared to conventional approaches to research and rehabilitation in stroke, the one proposed in this paper is original since it seeks to assess and improve the impaired limb through (and in) coordination tasks. We concretely envisage a number of implications of the “dynamic systems” view to understand the behavioral consequences of intrinsic asymmetries (due to central nervous system injury) on bimanual dynamics in stroke and to identify how to exploit the central nervous system plasticity and self-organizing properties for recovering more adaptive coordinated movements. We conclude that more interest should be accorded to bimanual coordination assessment and rehabilitation in stroke. In this respect, the dynamical systems approach provides interesting insights and valuable tools. Experimental and clinical studies are still needed in order to elaborate fi rm and founded guidelines for therapy. Full article
Review
Exploiting system fluctuations. Differential training in physical prevention and rehabilitation programs for health and exercise
Medicina 2010, 46(6), 365; https://0-doi-org.brum.beds.ac.uk/10.3390/medicina46060052 - 12 Jun 2010
Cited by 34 | Viewed by 888
Abstract
Background. Traditional causal modeling of health interventions tends to be linear in nature and lacks multidisciplinarity. Consequently, strategies for exercise prescription in health maintenance are typically group based and focused on the role of a common optimal health status template toward which [...] Read more.
Background. Traditional causal modeling of health interventions tends to be linear in nature and lacks multidisciplinarity. Consequently, strategies for exercise prescription in health maintenance are typically group based and focused on the role of a common optimal health status template toward which all individuals should aspire.
Materials and methods. In this paper, we discuss inherent weaknesses of traditional methods and introduce an approach exercise training based on neurobiological system variability. The significance of neurobiological system variability in differential learning and training was highlighted.
Results
. Our theoretical analysis revealed differential training as a method by which neurobiological system variability could be harnessed to facilitate health benefi ts of exercise training. It was observed that this approach emphasizes the importance of using individualized programs in rehabilitation and exercise, rather than group-based strategies to exercise prescription.
Conclusion
. Research is needed on potential benefits of differential training as an approach to physical rehabilitation and exercise prescription that could counteract psychological and physical effects of disease and illness in subelite populations. For example, enhancing the complexity and variability of movement patterns in exercise prescription programs might alleviate effects of depression in nonathletic populations and physical effects of repetitive strain injuries experienced by athletes in elite and developing sport programs. Full article
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