This study investigated the association between spinal alignment, mobility of the hips and the thoracic spine and low back pain in adolescent cross-country skiers. Cohort of 51 elite cross-country skiers from a cross-country skiing high school in Sweden participated in the study. Sagittal spinal alignment, active range of motion in flexion, extension and rotation of the thoracic spine as well as passive and active extension of the hips were measured. The participants also completed a questionnaire regarding training, competition, skiing technique and occurrence of low back pain. A simple linear regression was calculated to predict pain score based on thoraco-lumbar relation, with a significant (P<0.05) regression equation of y=-0.069x+2.280 (standard error of estimate, 0.034). Participants with greater lordosis than kyphosis were more likely to suffer from low back pain than subjects without this offset. Thoracic mobility and passive or active hip extension showed no correlation with low back pain. Sagittal spinal alignment seems to be related with low back pain among young elite cross-country skiers. This study shows that range of motion of the thoracic spine and hips do not have an effect on the prevalence of low back pain in this population.

Adolescents in the industrial world are becoming less physically active and are increasingly adopting a sedentary life-style in front of computers and television screens. OBJECTIVE: to determine self-related health, physical activity, sleeping habits, prevalence of overweight, and body complaints in Australian senior high school students. METHODS: Participants were 466 high school students aged 15-17 years enrolled in academic and vocational programs. A questionnaire was completed at two senior high schools with questions about weight and height, health, physical activity, type of physical activity/sport, intensity, sleeping habits, and possible injuries or complaints during the last three months. RESULTS: Seventy seven percent of the high school students participated in sports on a regular basis. Compared with vocational programs, more males and females in academic programs participated in sports (71% and 80% respectively) (p = .036). Males reported significantly better health than females (p < .0001). 65% of the study group reported body complaints during the last 3 months. A higher number of females than males reported complaints about the back (p = .007) and the hip (p = .05). Good sleep was reported in 82.1% of males and in 76.6% of females. In males, 44.3% were often sleepy in the daytime (females 56.6%, p < .01). CONCLUSIONS: Underweight, physical activity and good sleep are factors with significant positive effect on good health, whereas overweight is a negative factor. Proper sleep habits and higher physical activity levels should be promoted among high school students, and TV viewing time and video game use restricted. Additionally, schools should provide opportunities for young people to participate in a wider range of physical activities that address their individual needs while promoting the health benefits of engaging in regular exercise.

Adolescents are becoming less physically active and are increasingly adopting a sedentary life-style in front of computers and television screens. In this chapter we look at self-related health, physical activity, sleeping habits, the prevalence of overweight and body complaints in two senior high schools with questions about weight and height, health, physical activity, type of physical activity/sport, intensity, sleeping habits and possible injuries or complaints during the last three months. Seventy seven percent % of the high school students participated in sports on a regular basis. In academic programs compared to vocational programs, more males and females in academic programs participated in sports (71% and 80% respectively). Males reported significantly better health than females, but 65% reported body complaints during the last three months. A higher number of females than males reported back and hip complaints. Good sleep was reported in 82.1% of the males (76.6% of the females). In males 44.3% were often sleepy in the daytime (females 56.6%). Underweight, physical activity and good sleep were found to be factors with significant positive effect on good health, whereas overweight was a negative factor. Proper sleep habits and higher physical activity levels should be promoted among high school students and TV viewing time and video game use restricted. Additionally, schools should provide opportunities for young people to participate in a wider range of physical activities that address their individual needs, while promoting the health benefits of engaging in regular exercise.

Adolescents in the industrial world are becoming less physically active and are increasingly adopting a sedentary life-style in front of computers and television screens. OBJECTIVE: to determine self-related health, physical activity, sleeping habits, prevalence of overweight, and body complaints in Australian senior high school students. METHODS: Participants were 466 high school students aged 15-17 years enrolled in academic and vocational programs. A questionnaire was completed at two senior high schools with questions about weight and height, health, physical activity, type of physical activity/sport, intensity, sleeping habits, and possible injuries or complaints during the last three months. RESULTS: Seventy seven percent of the high school students participated in sports on a regular basis. Compared with vocational programs, more males and females in academic programs participated in sports (71% and 80% respectively) (p = .036). Males reported significantly better health than females (p < .0001). 65% of the study group reported body complaints during the last 3 months. A higher number of females than males reported complaints about the back (p = .007) and the hip (p = .05). Good sleep was reported in 82.1% of males and in 76.6% of females. In males, 44.3% were often sleepy in the daytime (females 56.6%, p < .01). CONCLUSIONS: Underweight, physical activity and good sleep are factors with significant positive effect on good health, whereas overweight is a negative factor. Proper sleep habits and higher physical activity levels should be promoted among high school students, and TV viewing time and video game use restricted. Additionally, schools should provide opportunities for young people to participate in a wider range of physical activities that address their individual needs while promoting the health benefits of engaging in regular exercise.

PURPOSE: Muscle strength, endurance and range of movement of the cervical spine in a group of Swedish Air Force jet pilots (AF) and in a reference group of conscripts doing their military service (RG) were compared. METHODS: We tested 30 (AF) 24-42 yr and 33 (RG) 19-22 yr. A questionnaire was used to document complaints. Maximum voluntary isometric muscle strength of the flexor and extensor muscles of the cervical spine and sub-maximum isometric endurance in the flexor and extensor muscles were measured. RESULTS: Eleven AF (37%) and four RG (12%) had experienced discomfort in the neck within the previous year. The pilots' flexor and extensor muscle strength (47 Nm and 65 Nm) was superior to that of the conscripts (36 Nm and 59 Nm) (p = 0.0001, p = < 0.05, respectively). However, the RG group had greater isometric endurance in the flexor muscles than AF (p = < 0.05) and greater neck rotation (p = <0.005). There was no difference between the two groups in the other variables. CONCLUSION: Differences between the groups with regard to muscle strength and endurance might depend on variations in work-related physical muscle strain, and/or differences in fiber composition in the muscles, which might be reflected by pilot selection procedures.

PURPOSE: Muscle strength, endurance and range of movement of the cervical spine in a group of Swedish Air Force jet pilots (AF) and in a reference group of conscripts doing their military service (RG) were compared. METHODS: We tested 30 (AF) 24-42 yr and 33 (RG) 19-22 yr. A questionnaire was used to document complaints. Maximum voluntary isometric muscle strength of the flexor and extensor muscles of the cervical spine and sub-maximum isometric endurance in the flexor and extensor muscles were measured. RESULTS: Eleven AF (37%) and four RG (12%) had experienced discomfort in the neck within the previous year. The pilots' flexor and extensor muscle strength (47 Nm and 65 Nm) was superior to that of the conscripts (36 Nm and 59 Nm) (p = 0.0001, p = < 0.05, respectively). However, the RG group had greater isometric endurance in the flexor muscles than AF (p = < 0.05) and greater neck rotation (p = <0.005). There was no difference between the two groups in the other variables. CONCLUSION: Differences between the groups with regard to muscle strength and endurance might depend on variations in work-related physical muscle strain, and/or differences in fiber composition in the muscles, which might be reflected by pilot selection procedures.

The aim of the present investigation was to test the reliability of two sports related functional tests, a speed test (slalom-test) and an agility test (hurdle-test). Eleven athletes aged 11 years (8 boys, 3 girls) participated voluntarily in the study. All subjects completed four different test sessions for both the slalom-test and the hurdle-test using six standard track hurdles placed at 2-m intervals along a 12-m length of track. There were no significant differences between testing sessions for either the slalom-test (P=0.99) or the hurdle-test (P=0.96), showing no systematic variation between test times. The intraclass correlation coefficients were 0.96 and 0.90 respectively, indicating a good reliability. We conclude that the slalom-test and the hurdle-test are reliable sports related functional tests for measuring speed and agility in groups of young athletic individuals.

The aim of the present investigation was to test the reliability of two sports related functional tests, a speed test (slalom-test) and an agility test (hurdle-test). Eleven athletes aged 11 years (8 boys, 3 girls) participated voluntarily in the study. All subjects completed four different test sessions for both the slalom-test and the hurdle-test using six standard track hurdles placed at 2-m intervals along a 12-m length of track. There were no significant differences between testing sessions for either the slalom-test (P=0.99) or the hurdle-test (P=0.96), showing no systematic variation between test times. The intraclass correlation coefficients were 0.96 and 0.90 respectively, indicating a good reliability. We conclude that the slalom-test and the hurdle-test are reliable sports related functional tests for measuring speed and agility in groups of young athletic individuals.

AIM: Children and adolescents in the industrial world are becoming less

physically active and are adopting a sedentary lifestyle in front of computers

and TV. The aim of the present investigation was to determine self-related

health, physical activity, prevalence of overweight and body complaints in

high school students in Norway, and to compare students in academic

programs with those in vocational programs. METHODS: Seven hundred and

two high school students aged 16-19 years were included in the study. A

questionnaire was completed in three high schools and included questions

about weight and height, health, physical activity, type of physical

activity/sport, intensity, possible injuries or complaints during the last three

months. RESULTS: Twenty three percent of the students suffers from

overweight/obesity are at risk of being overweight. Males reported better

health than females (P<0.02). Sixty-six percent of the study group reported

body complaints during the last three months, a higher number of females

than males (P=0.001). Students in vocational programs reported poorer selfrelated

health than those in academic programs and the males reported

better self-related health generally than females. Furthermore, there were a

higher level of prevalence of overweight students in vocational programs

than academic programs (P=0.039). CONCLUSION: It is important to make it

easy for school children and adolescents to do physical activity at school and

during leisure time in order to prevent overweight and obesity as well as

chronic diseases later in life.

AIM: Children and adolescents in the industrial world are becoming less

physically active and are adopting a sedentary lifestyle in front of computers

and TV. The aim of the present investigation was to determine self-related

health, physical activity, prevalence of overweight and body complaints in

high school students in Norway, and to compare students in academic

programs with those in vocational programs. METHODS: Seven hundred and

two high school students aged 16-19 years were included in the study. A

questionnaire was completed in three high schools and included questions

about weight and height, health, physical activity, type of physical

activity/sport, intensity, possible injuries or complaints during the last three

months. RESULTS: Twenty three percent of the students suffers from

overweight/obesity are at risk of being overweight. Males reported better

health than females (P<0.02). Sixty-six percent of the study group reported

body complaints during the last three months, a higher number of females

than males (P=0.001). Students in vocational programs reported poorer selfrelated

health than those in academic programs and the males reported

better self-related health generally than females. Furthermore, there were a

higher level of prevalence of overweight students in vocational programs

than academic programs (P=0.039). CONCLUSION: It is important to make it

easy for school children and adolescents to do physical activity at school and

during leisure time in order to prevent overweight and obesity as well as

chronic diseases later in life.

The aim of this investigation was to study self-related health, physical activity and level of exertion, as well as body complaints in Swedish high school students. A total of 993 high school students aged 16–19 years participated in the study. A questionnaire was completed at school and included questions about self-related health, physical activity behavior, type of physical activity/sport, intensity, duration, possible injuries or complaints, and absence from physical training at school, during the last 3 months. The results showed that 26% of the high school students participated in sports on a regular basis. Males reported significantly better health than females (p < 0.0005). A significantly higher number of females participated in physical activities at a lower level of effort (p < 0.0005) and a higher number of males trained at a higher level of effort (p < 0.005). Sixty-one percent reported body pain during the last 3 months, representing a higher number of females than males (p = 0.03). A higher number of females than males reported complaints from the back (p = 0.002), the knees (p = 0.015), the neck (p = 0.001), and the hip (p = 0.015). Females with body complaints reported poorer health than those without complaints. There was a correlation between poor self-related health and a lower level of physical effort (0.219; p < 0.001). The results showed that the prevalence of musculoskeletal symptoms was high in this population and demonstrated a certain association with self-related health. Therefore, it is important to make it easy for adolescents to perform physical activity at school and during their leisure time in order to prevent chronic diseases.

The aim of this investigation was to study self-related health, physical activity and level of exertion, as well as body complaints in Swedish high school students. A total of 993 high school students aged 16–19 years participated in the study. A questionnaire was completed at school and included questions about self-related health, physical activity behavior, type of physical activity/sport, intensity, duration, possible injuries or complaints, and absence from physical training at school, during the last 3 months. The results showed that 26% of the high school students participated in sports on a regular basis. Males reported significantly better health than females (p < 0.0005). A significantly higher number of females participated in physical activities at a lower level of effort (p < 0.0005) and a higher number of males trained at a higher level of effort (p < 0.005). Sixty-one percent reported body pain during the last 3 months, representing a higher number of females than males (p = 0.03). A higher number of females than males reported complaints from the back (p = 0.002), the knees (p = 0.015), the neck (p = 0.001), and the hip (p = 0.015). Females with body complaints reported poorer health than those without complaints. There was a correlation between poor self-related health and a lower level of physical effort (0.219; p < 0.001). The results showed that the prevalence of musculoskeletal symptoms was high in this population and demonstrated a certain association with self-related health. Therefore, it is important to make it easy for adolescents to perform physical activity at school and during their leisure time in order to prevent chronic diseases.

Cerebral palsy (CP) is the most common disorder of movement and posture in children. The disorder results from a non-progressive brain lesion occurring in the fetal or infant brain. Children with CP have challenges with movement, posture, and mobility that last a life time. Few studies describe physical activity and health among adolescents with CP. Aim: The aim of this study was to describe self-related health, physical activity, and body complaints among adolescents with CP in Sweden. Methods: A questionnaire was answered by 64 adolescents with CP, with 143 adolescents without disabilities serving as controls. Results: Adolescents with CP reported their general health to be better than adolescents without disabilities (p = .001). Adolescents with CP participated less than adolescents without disabilities in sport during recreation time (p = .009). About 19% of adolescents with CP were never or seldom physically active, compared with 8% in the control group (p = .025). A total of 50% of adolescents with CP reported musculoskeletal complaints during the last three months, compared with 69.5% in the control group. There was a correlation between musculoskeletal complaints and self-related health in adolescents with CP (p = .015) but not in the controls. Conclusion: Adolescents with CP reported their general health to be good. Adolescents with CP were less physically active than adolescents without disabilities. There was a correlation between musculoskeletal complaints and self-related health among adolescents with CP. Further research is needed to determine the cause of the low physical activity among adolescents with CP and also to determine the relationship between musculoskeletal complaints and physical activity.

Purpose. The aim of this study was to evaluate the 2-year outcome of a multidisciplinary rehabilitation programme for working-age people, regarding sick leave and mental health. Method. The test persons consisted of 40 women and 20 men (mean age 46.8 +/- SD 7.9) with musculoskeletal disorders, mainly neck and back pain. The rehabilitation programme was individually adapted and consisted of physical activity in several forms, relaxation, theoretical and practical education and individual guidance. Before, during and after the programme all participants were evaluated with the Global Self-Efficacy Index, Hospital Anxiety and Depression Scale, and stress test. Results. At the 2-year follow-up full-time sick leave had decreased by 37% (p < 0.0001) in the women, and by 25% (p < 0.05) in the men. Both women and men showed an increased quality of life (QoL) and decreased anxiety, depression and self-experienced stress at the 2-year follow-up compared with the start of the rehabilitation programme. Conclusions. The most important conclusion was that the effects of the rehabilitation programme persisted for up to 2 years. At 2 years the majority of the participants were still physically active, their QoL was increased, and most participants had returned to work.

Aim. The purpose of this study was to compare physical health, physical activity and location for possible symptoms in high school students with cross-country skiers of the same age from ski high schools. Another aim was to study back pain with regards to influence on skiing.Methods. The subjects studied were: 92% (n=120) of all Swedish cross-country skiers at ski high schools and 68% (n=993) of regular high school students from the North part of Sweden answered a reliable questionnaire (r=1) with regards to health, physical activity and location of possible symptoms/injuries during the last 3 months. Furthermore, the skiers answered questions on possible ski related back pain.Results. All skiers were active also in other sports compared with 26% of the controls and at considerably higher levels of physical effort than the controls; 92% of the skiers and 76% of the controls described themselves as healthy, meaning "very good" or "good" (P=0.0001); 55% of the skiers and 64% of the controls reported recent symptoms (P=0.06); 47% of the skiers reported previous or present complaints of back pain, mainly low back pain, which could be relieved by changing body position from a flexed to a more extended one while skiing, and 77% reported their back pain to disappear during rest.Conclusion. These results show the need for encouraging regular high school students to participate in sport. It also shows the importance of introducing preventative strategies regarding back pain to long-distance cross-country skiers, who are exposed to a prolonged flexed position of their back.

Aim. The purpose of this study was to compare physical health, physical activity and location for possible symptoms in high school students with cross-country skiers of the same age from ski high schools. Another aim was to study back pain with regards to influence on skiing.Methods. The subjects studied were: 92% (n=120) of all Swedish cross-country skiers at ski high schools and 68% (n=993) of regular high school students from the North part of Sweden answered a reliable questionnaire (r=1) with regards to health, physical activity and location of possible symptoms/injuries during the last 3 months. Furthermore, the skiers answered questions on possible ski related back pain.Results. All skiers were active also in other sports compared with 26% of the controls and at considerably higher levels of physical effort than the controls; 92% of the skiers and 76% of the controls described themselves as healthy, meaning "very good" or "good" (P=0.0001); 55% of the skiers and 64% of the controls reported recent symptoms (P=0.06); 47% of the skiers reported previous or present complaints of back pain, mainly low back pain, which could be relieved by changing body position from a flexed to a more extended one while skiing, and 77% reported their back pain to disappear during rest.Conclusion. These results show the need for encouraging regular high school students to participate in sport. It also shows the importance of introducing preventative strategies regarding back pain to long-distance cross-country skiers, who are exposed to a prolonged flexed position of their back.

Objectives To evaluate possible changes in spinal curvature over a period of 5 years of an elite cross-country skiing squad, and to study whether there are any differences in this respect between individuals who report low back pain and those how do not. Participants Fifteen young cross-country skiers (M age=13.6±0.9) participated voluntarily throughout the entire study period. Main outcome measures Debrunner's kyphometer was used for measuring the difference between thoracic kyphosis and lumbar lordosis of the spine. All subjects also answered a questionnaire including questions about ski-related low back pain, the amount of ski training, and participation in other sports. Results The results at the end of the 5-year period comprise data from 15 skiers (M age=18.5±0.9 years). The relationship between thoracic kyphosis and lumbar lordosis increased from 3.5° to 13.1°, respectively (p=0.0001). Of the 15 elite cross-country skiers, seven reported low back pain at the 5-year examination. At the 5-year follow-up, skiers with low back pain showed significantly higher relationship between thoracic kyphosis and lumbar lordosis than did those skiers without low back pain, 18.2° and 10.5°, respectively (p=0.035). Of the eight elite cross-country skiers without low back pain, seven were also involved in other sports (p=0.005). Conclusions Based on these findings, our advice is that adolescent cross-country skiers also should participate in other physical activities besides cross-country skiing.

Objectives To evaluate possible changes in spinal curvature over a period of 5 years of an elite cross-country skiing squad, and to study whether there are any differences in this respect between individuals who report low back pain and those how do not. Participants Fifteen young cross-country skiers (M age=13.6±0.9) participated voluntarily throughout the entire study period. Main outcome measures Debrunner's kyphometer was used for measuring the difference between thoracic kyphosis and lumbar lordosis of the spine. All subjects also answered a questionnaire including questions about ski-related low back pain, the amount of ski training, and participation in other sports. Results The results at the end of the 5-year period comprise data from 15 skiers (M age=18.5±0.9 years). The relationship between thoracic kyphosis and lumbar lordosis increased from 3.5° to 13.1°, respectively (p=0.0001). Of the 15 elite cross-country skiers, seven reported low back pain at the 5-year examination. At the 5-year follow-up, skiers with low back pain showed significantly higher relationship between thoracic kyphosis and lumbar lordosis than did those skiers without low back pain, 18.2° and 10.5°, respectively (p=0.035). Of the eight elite cross-country skiers without low back pain, seven were also involved in other sports (p=0.005). Conclusions Based on these findings, our advice is that adolescent cross-country skiers also should participate in other physical activities besides cross-country skiing.

The extent and depth of traumatic brain injury (TBI) remains a major determining factor together with the type of structural insult and its location, whether mild, moderate or severe, as well as the distribution and magnitude of inflammation and loss of cerebrovascular integrity, and the eventual efficacy of intervention. The influence of exercise intervention in TBI is multiple, ranging from anti-apoptotic effects to the augmentation of neuroplasticity. Physical exercise diminishes cerebral inflammation by elevating factors and agents involved in immunomodulatory function, and buttresses glial cell, cerebrovascular, and blood-brain barrier intactness. It provides unique non-pharmacologic intervention that incorporate different physical activity regimes, whether dynamic or static, endurance or resistance. Physical training regimes ought necessarily to be adapted to the specific demands of diagnosis, type and degree of injury and prognosis for individuals who have suffered TBI. © 2012 John Wiley & Sons A/S.