Objectives: To determine if measurements of static lower limb alignment are related to lower limb injury in recreational runners. Methods: Static lower limb alignment was prospectively measured in 87 recreational runners. They were observed for the following six months for any running related musculoskeletal injuries of the lower limb. Injuries were defined according to six types: R1, R2, and R3 injuries caused a reduction in running mileage for one day, two to seven days, or more than seven days respectively; S1, S2, and S3 injuries caused stoppage of running for one day, two to seven days, or more than seven days respectively. Results: At least one lower limb injury was suffered by 79% of the runners during the observation period. When the data for all runners were pooled, 95% confidence intervals calculated for the differences in the measurements of lower limb alignment between the injured and non-injured runners suggested that there were no differences. However, when only runners diagnosed with patellofemoral pain syndrome (n = 6) were compared with non-injured runners, differences were found in right ankle dorsiflexion (0.3 to 6.1), right knee genu varum (20.9 to 20.3), and left forefoot varus (20.5 to 20.4). Conclusions: In recreational runners, there is no evidence that static biomechanical alignment measurements of the lower limbs are related to lower limb injury except patellofemoral pain syndrome. However, the effect of static lower limb alignment may be injury specific. R unning is a popular form of recreational exercise in Canada, with an estimated 31% of Canadians running or jogging for physical fitness.1 Analysis of prospective and retrospective survey studies and cohort studies of recreational and competitive runners reveals a yearly incidence of injuries in runners of 24-85%. 3Risk factors for injury in any sport may be categorically divided into extrinsic or intrinsic. Static alignment measurements of leg length discrepancy (.1 cm), femoral neck anteversion, knee genu varum, valgum and recurvatum, excessive Q angle, patella alta, tibial torsion, increased ankle dorsiflexion, and excessive subtalar and forefoot varus have been proposed as potential intrinsic risk factors for running injury. [4][5][6][7][8] In contrast with these observations, other studies did not find any association between running injury and measures of static lower limb alignment. 9-11Given the lack of agreement in the literature, the purpose of this study was to examine the relation between static measurements of lower limb alignment and the incidence of lower limb running injury in a prospective cohort study of recreational runners. METHODSThe study was reviewed and approved by the University of Calgary Conjoint Health Research Ethics Board. A total of 153 recreational runners (82 men and 71 women) were recruited through poster advertisements placed at the University of Calgary, local running shoe stores, YMCAs, YWCAs, and other fitness facilities. The inclusion criteria were age greater than 18, running more than 20 km/wee...

Footwear and running style can influence knee angular impulse, and the appropriate manipulation of these variables may play a preventive role for patients who are predisposed to patellofemoral pain.

Objective. The purposes of this study were 1) to quantify the proteoglycan 4 (PRG4) and hyaluronan (HA) content in synovial fluid (SF) from normal donors and from patients with chronic osteoarthritis (OA) and 2) to assess the cartilage boundary-lubricating ability of PRG4-deficient OA SF as compared to that of normal SF, with and without supplementation with PRG4 and/or HA.Methods. OA SF was aspirated from the knee joints of patients with symptomatic chronic knee OA prior to therapeutic injection. PRG4 concentrations were measured using a custom sandwich enzyme-linked immunosorbent assay (ELISA), and HA concentrations were measured using a commercially available ELISA. The molecular weight distribution of HA was measured by agarose gel electrophoresis. The cartilage boundarylubricating ability of PRG4-deficient OA SF, PRG4-deficient OA SF supplemented with PRG4 and/or HA, and normal SF was assessed using a cartilage-oncartilage friction test. Two friction coefficients ( ) were calculated: static ( static, Neq ) and kinetic (< kinetic, Neq >) (where N eq represents equilibrium axial load and angle brackets indicate that the value is an average).Results. The mean ؎ SEM PRG4 concentration in normal SF was 287.1 ؎ 31.8 g/ml. OA SF samples deficient in PRG4 (146.5 ؎ 28.2 g/ml) as compared to normal were identified and selected for lubrication testing. The HA concentration in PRG4-deficient OA SF (mean ؎ SEM 0.73 ؎ 0.08 mg/ml) was not significantly different from that in normal SF (0.54 ؎ 0.09 mg/ml). In PRG4-deficient OA SF, the molecular weight distribution of HA was shifted toward the lower range. The cartilage boundary-lubricating ability of PRG4-deficient OA SF was significantly diminished as compared to normal (mean ؎ SEM < kinetic, Neq > ‫؍‬ 0.043 ؎ 0.008 versus 0.025 ؎ 0.002; P < 0.05) and was restored when supplemented with PRG4 (< kinetic, Neq > ‫؍‬ 0.023 ؎ 0.003; P < 0.05). Conclusion.These results indicate that some OA SF may have decreased PRG4 levels and diminished cartilage boundary-lubricating ability as compared to normal SF and that PRG4 supplementation can restore normal cartilage boundary lubrication function to these OA SF.

Dietary supplementation is a common practice in athletes with a desire to enhance performance, training, exercise recovery, and health. Supplementation habits of elite athletes in western Canada have been documented, but research is lacking on supplement use by athletes across Canada. The purpose of this descriptive study was to evaluate the dietary supplementation practices and perspectives of high-performance Canadian athletes affiliated with each of the country's eight Canadian Sport Centres. Dietitians administered a validated survey to 440 athletes (63% women, 37% men; M=19.99±5.20 yr) representing 34 sports who predominantly trained≥16 hr/wk, most competing in "power" based sports. Within the previous 6 months, 87% declared having taken≥3 dietary supplements, with sports drinks, multivitamin and mineral preparations, carbohydrate sports bars, protein powder, and meal-replacement products the most prevalent supplements reported. Primary sources of information on supplementation, supplementation justification, and preferred means of supplementation education were identified. Fifty-nine percent reported awareness of current World Anti-Doping Agency legislation, and 83% subjectively believed they were in compliance with such anti-doping regulations. It was concluded that supplementation rates are not declining in Canada, current advisors on supplementation for this athletic population are not credible, and sports medicine physicians and dietitians need to consider proactive strategies to improve their influence on supplementation practices in these elite athletes.

The effects of a self-supervised home exercise program and a physiotherapist-supervised exercise program on motor symptoms in Parkinson's disease (PD) patients were compared in a prospective single-blinded clinical trial. Nineteen subjects (6 women, 13 men; mean age, 65 +/- 8 years) with Hoehn and Yahr Stages 2 to 3 were recruited. Subjects were self-selected into an 8-week exercise program that was self-supervised (HOME group) or physiotherapist-supervised (PT group). The primary outcome measurement was the Unified Parkinson's Disease Rating Scale (UPDRS) Motor subsection score (UPDRSm). The secondary outcome measurements were the Berg Balance Scale, Timed Up and Go Test, UPDRS Total score, and the Activities-specific Balance Confidence Scale. All outcomes were assessed at baseline and at 8 and 16 weeks after the start of the study. The investigators were blinded to the subject treatment group. Bonferroni-corrected paired Student's t test was used to evaluate the change in the UPDRSm from baseline to 8 weeks. Ninety-five percent confidence intervals (CI) were calculated for the change in the secondary outcome measurements from baseline to 8 weeks. There was statistically significant and equal decrease in the UPDRSm from baseline to 8 weeks in both treatment groups. There was no difference in the 95% CI in the change of the secondary outcome measurements. A self-supervised exercise program was found to have similar effectiveness as a physiotherapist-supervised exercise program in improving motor symptoms in PD patients. This finding is important in the counseling of PD patients regarding adjunctive treatment of motor symptoms of PD with exercise.