Global Alliance for the Promotion of Physical Activity: the Hamburg Declaration

Non-communicable diseases (NCDs), including coronary heart disease, stroke, hypertension, type 2 diabetes, dementia, depression and cancers, are on the rise worldwide and are often associated with a lack of physical activity (PA). Globally, the levels of PA among individuals are below WHO recommendations. A lack of PA can increase morbidity and mortality, worsen the quality of life and increase the economic burden on individuals and society. In response to this trend, numerous organisations came together under one umbrella in Hamburg, Germany, in April 2021 and signed the 'Hamburg Declaration'. This represented an international commitment to take all necessary actions to increase PA and improve the health of individuals to entire communities. Individuals and organisations are working together as the 'Global Alliance for the Promotion of Physical Activity' to drive long-term individual and population-wide behaviour change by collaborating with all stakeholders in the community: active hospitals, physical activity specialists, community services and healthcare providers, all achieving sustainable health goals for their patients/clients. The 'Hamburg Declaration' calls on national and international policymakers to take concrete action to promote daily PA and exercise at a population level and in healthcare settings.

Joint position statement of the International Federation of Sports Medicine (FIMS) and European Federation of Sports Medicine Associations (EFSMA) on the IOC framework on fairness, inclusion and non-discrimination based on gender identity and sex variations

The IOC recently published its framework on fairness, inclusion and non-discrimination based on gender identity and sex variations. This framework is drafted mainly from a human rights perspective, with less consideration for medical/scientific issues. The framework places the onus for gender eligibility and classification entirely on the International Federations (IFs), even though most will not have the capacity to implement the framework. The position of no presumption of advantage is contrary to the 2015 IOC consensus. Implementation of the 2021 framework will be a major challenge for IFs that have already recognised the inclusion of trans and women athletes with differences of sexual development (DSD) using a scientific/medical solution. The potential consequences for sports that need to prioritise fairness or safety could be one of two extremes (1) exclusion of all transgender or DSD athletes on the grounds of advantage or (2) self-identification that essentially equates to no eligibility rules. Exclusion of all transgender or DSD athletes is contrary to the Olympic charter and unlawful in many countries. While having no gender eligibility rules, sport loses its meaning and near-universal support. Athletes should not be under pressure to undergo medical procedures or treatment to meet eligibility criteria. However, if an athlete is fully informed and consents, then it is their free choice to undergo carefully considered or necessary interventions for gender classification for sport to compete fairly and safely in their chosen gender. Free choice is a fundamental human right, but so is the right to fair and safe competition.

Periodontal nitric oxide pathway alteration due to precompetition anxiety in handball players

BACKGROUND

Psychologic and physical stress is known to be related with periodontal disorders. The objective of this study is to investigate salivary and gingival crevicular fluid (GCF) nitric oxide (NO) metabolism and its association with the periodontal reaction to precompetition anxiety in competitive athletes.

METHODS

A total of 18 elite male handball players participated in this study. The anxiety level of participants was determined by using a competitive state anxiety inventory-2 (CSAI-2). Periodontal clinical measurements, saliva, and GCF samples were obtained before the application of the CSAI-2 during the half-season break and just before the league championship match. NO-level, arginase, and NO synthase (NOS) activities were analyzed in saliva samples; NO and basic fibroblast growth factor (FGF-b) levels were analyzed in GCF samples.

RESULTS

The CSAI-2 was significantly different between the two evaluation time points. GCF NO and FGF-b levels increased before the championship match, whereas saliva levels did not change. The plaque index and gingival index (GI) increased at the evaluation just before the championship match. The difference in the GI was statistically significant.

CONCLUSION

The competitive stress of athletes may lead to a gingival/periodontal disturbance accompanied by an altered NO metabolism in saliva and GCF.

Can heart rate values obtained from laboratory and field lactate tests be used interchangeably to prescribe exercise intensity for soccer players?

This study was undertaken to investigate the relationship between blood lactate concentration ([La]) and heart rate (HR) values obtained during treadmill and field tests at fixed velocities with respect to interchangeability of results to be used in exercise prescription. A total of 22 male soccer players participated in the study. Each player performed exercise tests on a motorized treadmill and in the field with 3-min runs and 30 s allowed for blood sampling. During both tests, velocities at the first, second, and third stages were 8, 10, and 12 km x hr(-1), respectively. Velocity was then increased by 1 km x hr(-1) every 3 min until exhaustion. During the field test, players ran on artificial turf on a 120-m hexagonal track marked with cones placed 20 m apart. Running velocity was controlled by means of audio signals. Blood samples were analyzed immediately with an automated lactate analyzer. HR was monitored continuously at 5-s intervals. Data were analyzed with Student's paired t tests to look for differences between treadmill and field data. Coefficients of variation and Blan-Altman plots assessed agreement of HR and blood [La] values between the 2 tests. Although running velocities corresponding to a fixed blood [La] of 4 mmol L-1 showed significant differences between treadmill and field tests (15.9+/-0.9 vs 14.1+/-0.7 km x h(-1), respectively) (P<.01), no significant difference between HR values was noted (190+/-7 vs 187+/-7, field vs laboratory, respectively). Overall, the mean intermeasurement coefficient of variation was 4.8% (+/-0.9%) for HR. Although the lowest coefficient of variation (2.4%) was found, fairly wide differences between individual field and laboratory HR values at velocities corresponding to fixed blood [La] of 4 mmol.L(-1) cast doubt on the interchangeability of tests.

Effects of hypertonic dextrose on injured rat skeletal muscles

OBJECTIVE

Histological examination of proliferative therapy effects on the healing process of muscular injury.

METHODS

We performed this study between March and August 2002 at Ankara University, School of Medicine, Laboratory of Animal Experiments, Ankara, Turkey. We used an experimental animal model by conducting a standardized cut injury of the gastrocnemius muscle in 30 adult male albino rats, which we divided into 2 groups; proliferative therapy group and control group. We evaluated the injured rat muscles by light microscopy on the fifth, eight, and twelfth day of injury.

RESULTS

The muscular regeneration process began at day 5 in both the control and proliferative therapy groups. The proliferative therapy group revealed a prominent inflammatory reaction, fibroblast migration, and necrosis with accompanying regeneration and excessive connective tissue formation.

CONCLUSION

We cannot consider proliferative therapy an appropriate treatment modality for muscular injuries, unless there is evidence of normal muscle physiology and biomechanics post traumatically.

Effects of anterior tibial displacement on the proprioceptive functions of soccer players` knee joints

OBJECTIVE

To investigate the effects of joint laxity on proprioceptive functions of the knee joints of soccer players.

METHODS

In this study, we measured anterior tibial displacements and thresholds to detect the knee joint passive motion of 20 healthy soccer players (18.1+/-1.6 years of age). We performed all the measurements in Autumn 2000 in Ankara, Turkey. We applied the Mann-Whitney U test to analyze the relationship between the anterior tibial displacement and threshold to detect the passive motion (TDPM).

RESULTS

There were no statistically significant differences between the TDPM values of the knee joints with insignificant laxity differences at different angles, and direction of motion (p>0.05). At 45 degrees of knee flexion and externally directed motion, we found the TDPM of looser knees to be significantly greater (p<0.05).

CONCLUSION

Increased knee laxities without any clinical pathologic findings, have negative effects on knee joint proprioception. This is possibly due to the overuse degeneration of the anterior cruciate ligaments, which are the main stabilizers of knee joints.

Comprehensive isokinetic knee measurements and quadriceps tendon evaluations in footballers for assessing functional performance

OBJECTIVES

To ascertain whether detailed isokinetic knee muscle testing reflects the results of other functional measurements in footballers and to look for any correlations between quadriceps tendon thickness and knee strength.

METHODS

Ultrasonographic evaluation of the quadriceps tendon (Hitachi EUB-405), isokinetic knee testing (Biodex System 3), and sprint measurements using telemetric photoelectric cells (Chronometre Prosport ESC TX02) were carried out on 29 elite footballers. Jumping capacity was evaluated using Bosco's jumping mat (Ergojump). Anaerobic fitness was assessed by auricular capillary blood lactate measurements (YSI Model 1500 Sport Lactate Analyzer).

RESULTS

Quadriceps tendon thickness correlated positively with jumping and sprint measurements and negatively with extensor and flexor strength. However, these correlations did not reach statistical significance. There were significant correlations between knee extensor strength at 60 degrees /s and jumping or sprint measurements and between the extension acceleration values of both knees during isokinetic tests at 240 degrees /s and the sprint measurements. No significant correlation was found between the fatigue ratio values of both knees at 240 degrees /s and the calculated fatigue ratios from the sprint measurements.

CONCLUSIONS

Apart from a few variables which correlated with the performance tests, the isokinetic studies did not fully predict the various functional measurements. Neither was there any relation between the quadriceps tendon measurements and the knee strength values nor with the functional performance.