I very much enjoyed reading the Review article [1] by Professor
Noakes and the letter [2] in the same edition of the BJSM July 2008.
As he rightly states measurement of VO2max has several limitations in
determining an athlete's potential. He also pointed out in the letter that
research has shown that 'the rating of perceived exertion (RPE) rises as a
linear function of the duration of...
I very much enjoyed reading the Review article [1] by Professor
Noakes and the letter [2] in the same edition of the BJSM July 2008.
As he rightly states measurement of VO2max has several limitations in
determining an athlete's potential. He also pointed out in the letter that
research has shown that 'the rating of perceived exertion (RPE) rises as a
linear function of the duration of exercise that remains', and
extrapolation from this 'that humans have an exquisite capacity to predict
accurately the duration of exercise they will be able to sustain at any
exercise intensity'.
Would it therefore not be possible to determine an athlete's optimal
running distance by getting them to run on a treadmill for 10 minutes and
asking them to run as fast as possible for imagined distances of 5k, 10k,
40k, etc?
References
1. NOAKES TD. Testing for maximum oxygen consumption has produced a
brainless model of human exercise performance. Br J Sports Med 2008; 42:551-555
2. NOAKES TD. Rating of perceived exertion as a predictor of the duration of exercise that remains until exhaustion. Br J Sports Med 2008; 42:623-624
I read with interest the study by Panics et al on the effect of proprioceptive training on joint position sense (JPS)at the knee. The authors report a significant improvement in JPS in terms of reduction in
mean absolute error after the training.
I have several concerns, however, regarding the methods used by the author to assess JPS. First, looking at Fig 1, one can ask as to how the positioning of...
I read with interest the study by Panics et al on the effect of proprioceptive training on joint position sense (JPS)at the knee. The authors report a significant improvement in JPS in terms of reduction in
mean absolute error after the training.
I have several concerns, however, regarding the methods used by the author to assess JPS. First, looking at Fig 1, one can ask as to how the positioning of the electrogoniometer was properly controlled between sessions and between participants. Reports have shown that even slight change in reference points with regard to anatomical landmarks can lead to substantial error in measurements (see Szulc,et al (2001) Med Sci Monit, 7(2), 312-315).
Second, given that the leg was moved passively by one experimenter, how tactile feedback arising from contact with the skin was controlled? And what about the speed of mobilization? One can easily see the difficulty for accelerating the leg at the reported constant speed (ie., 10 deg/s) at 10 vs 80 deg in the range tested. Such factors, when not properly controlled, can lead to spurious cues influencing participants' ability to report joint angle. It is also not clear to me as to why the intervention group initially displayed poor JPS as compared to control. In the same vein, the range of errors for JPS reported by the authors (8.21 -9.78 deg) is quite at odds with the range reported in previous studies for normal young adults (typically >5 deg, see Barrett et al (1991). J Bone Joint Surg Br, 73-B(1), 53-56.).
I think the issue of measuring the impact of proprioceptive training on proprioception is important for rehabilitation of sport injuries, but we also need to be careful as to how we measure this complex sensation.
To the Editor: In my opinion the negative influence of Nobel Laureate AV Hill on subsequent generations of exercise physiologists is not about the plateau in VO2 or other physiological concepts criticized by Professor Tim Noakes in his article. Hill’s influence is much deeper than that. It is about the fundamental assumption over which the current physiological model of exercise tolerance has been built over the years:
In well-...
To the Editor: In my opinion the negative influence of Nobel Laureate AV Hill on subsequent generations of exercise physiologists is not about the plateau in VO2 or other physiological concepts criticized by Professor Tim Noakes in his article. Hill’s influence is much deeper than that. It is about the fundamental assumption over which the current physiological model of exercise tolerance has been built over the years:
In well-motivated subjects used to physical exertion, exercise is terminated because the subject, due to muscle fatigue, is no longer able to produce the force/power required by the task.
Hill thought that muscle fatigue during intense whole-body exercise in athletic subjects was caused by “oxygen want and lactic acid in their muscles” (Gandevia, 2000). As correctly pointed out by Dr. Mark Burnley in his letters, since then many more central and peripheral mechanisms of muscle fatigue have been identified (McKenna and Hargreaves, 2008), and some of the conclusions reached by Hill in the early XX century have now been proven wrong. However, the main assumption of Hill’s model has remained unchallenged for many years, and the vast majority of exercise physiologists accept as true the proposition that athletic subjects stop exercise not because of motivational factors but because of muscle fatigue (Sejersted and Sjøgaard, 2000; Allen et al., 2008; Jones et al., 2008). The problem with this fundamental assumption is that it has never been proven valid. Furthermore, available scientific evidence suggests it is very likely to be invalid.
Indeed, in the literature there is plenty of evidence (Millet and Lepers, 2004) suggesting that after exhaustion, despite significant muscle fatigue, maximal voluntary force produced with the locomotor muscles is well above the force required by even maximal intensity aerobic exercise (less than 20% of resting MVC) (Löllgen et al., 1980). These findings do not provide conclusive evidence against Hill’s basic assumption because MVC tests are usually of isolated muscles in isometric conditions, and performed few minutes after exhaustive exercise. Therefore, these MVC tests are not specific to dynamic whole-body exercise, and some recovery of muscle fatigue may occur. However, scientists interested in muscle fatigue of isolated muscles have measured MVC in a specific manner immediately after terminating prolonged isometric contractions to exhaustion, and found very similar results: MVC at exhaustion (about 80% of resting MVC) is well above the force required by the submaximal task (5-30% of resting MVC). Therefore, these scientists have now concluded that the duration of sustained tasks is not necessarily limited by fatigue of the principal muscles (Enoka and Duchateau, 2008). The same may be true for even very high-intensity endurance exercise.
For how long can traditional exercise physiologists live with this elephant in their room? Given that their model of exercise tolerance is based on the assumption that central and/or peripheral muscle fatigue causes exhaustion, why nobody has checked, in more than 80 years, whether this assumption is true or not?
As Richard P. Feynman would certainly agree, the mere presence of muscle fatigue and/or its mechanisms (e.g. falling [PCr] and pH and rising [Pi] and [ADP]) does not prove that muscle fatigue directly limits time to exhaustion during incremental or constant-workload exercise tests.
Samuele M Marcora
REFERENCES
Allen DG, Lamb GD, Westerblad H. Skeletal muscle fatigue: cellular mechanisms. Physiol Rev. 2008; 88: 287-332
Enoka RM, Duchateau J. Muscle fatigue: what, why and how it influences muscle function. J Physiol. 2008; 586: 11-23.
Gandevia SC. Spinal and supraspinal factors in human muscle fatigue. Physiol Rev. 2001; 81: 1725-89.
Jones AM, Wilkerson DP, DiMenna F, Fulford J, Poole DC. Muscle metabolic responses to exercise above and below the "critical power" assessed using 31P-MRS. Am J Physiol Regul Integr Comp Physiol. 2008; 294:R585-93.
Löllgen H, Graham T, Sjogaard G. Muscle metabolites, force, and perceived exertion bicycling at varying pedal rates. Med Sci Sports Exerc. 1980; 12: 345-51.
McKenna MJ, Hargreaves M. Resolving fatigue mechanisms determining exercise performance: integrative physiology at its finest! J Appl Physiol. 2008; 104: 286-7.
Millet GY, Lepers R. Alterations of neuromuscular function after prolonged running, cycling and skiing exercises. Sports Med. 2004; 34: 105-16.
Sejersted OM, Sj�gaard G. Dynamics and consequences of potassium shifts in skeletal muscle and heart during exercise. Physiol Rev. 2000; 80: 1411-81.
In the recent article published online (18th April, 2008) Noakes et
al. (2008) present some interesting data detailing lap-times recorded en-
route to world record performances in the one mile run. These data show
that, on average, the times for the second and third laps were
significantly slower than those for the first and last lap. Subsequently,
Noakes et al. (2008) interpret these data as being sup...
In the recent article published online (18th April, 2008) Noakes et
al. (2008) present some interesting data detailing lap-times recorded en-
route to world record performances in the one mile run. These data show
that, on average, the times for the second and third laps were
significantly slower than those for the first and last lap. Subsequently,
Noakes et al. (2008) interpret these data as being supportive of the
Central Governor hypothesis; a complex anticipatory regulatory system in
which running speed is dictated primarily by motor unit recruitment as
determined by a central governor (the brain) (Noakes et al., 2004), rather
than a catastrophe model, in which pacing strategy is dictated by the
development of peripheral fatigue. Indeed, the increase in running speed
(end-spurt) during the final lap is purported to be incompatible with a
model in which pacing strategy is regulated by peripheral fatigue.
However, these data, and their interpretation, raise a number of
interesting questions.
Firstly, the observation that the running pace is reduced
significantly after the first lap might alternatively be interpreted as
indicative of the selection of a sub-optimal pacing strategy i.e. the
anticipatory selection of a running speed that cannot be sustained for the
entire race distance. Another explanation is that the pace of the first
lap is influenced by the tactical requirement for a good position. Indeed,
the impact of the presence of other athletes on the interpretation of the
lap times does not appear to have been considered. In the majority of the
races presented the record-breaking athlete will not have led the race
from the start to the finish, while in many instances pace-makers will
have been employed to dictate a pre-determined pace strategy for a portion
of the race. Thus, the pacing strategy selected by the record breaking
athlete may not be entirely autonomous for portions of the race, and
consequently may not be optimal. The observation that in most instances
the last lap of the race was the fastest might also support this
interpretation. Alternatively, this competitive element may have played a
role in the slower pace during the middle portion of the race, with the
athletes ensuring a ‘reserve’ for the latter portion of the race.
Regardless of the interpretation, it is clear that the competitive
influences on the pacing strategy employed in a race situation should not
be underestimated.
Noakes et al. (2008) also point out that if peripheral fatigue and
the failure of the exercising limb to maintain homeostasis are the factors
determining pacing strategy, then the pace would fall with each successive
lap (with no end-spurt). However, this is precisely the pacing strategy
consistently evident during the 800 m run (Tucker et al., 2006).
Moreover, this pacing strategy is also evident during track cycling in
both the 1 km time trial and 4 km individual pursuit (Corbett, 2008
unpublished observations); events which are less likely to be influenced
by the pacing strategies of other competitors and require the athlete to
complete a set distance in the fastest time possible. In addition, the 4
km individual pursuit is of a comparable duration to the one mile run (~4
min). This might suggest that either the pacing strategy is regulated by
different mechanisms in these events, or that a sub-optimal pacing
strategy is employed in one of these examples. Perhaps the end-spurt is
an example of a sub-optimal pacing strategy?
That a pacing strategy is selected by some central mechanism in
anticipation of an event appears undeniable; experienced athletes do not
commence the mile race at the same speed as a 100 m race. However, the
extent to which the pacing strategy predominating in the mile race (with
the presence of an end-spurt), is optimal, remains unclear.
Jo Corbett
Martin Barwood
References
Noakes, TD, St Clair Gibson, A. Lambert EV. From catastrophe to
complexity: a novel model of integrative central neural regulation of
effort and fatigue during exercise in humans. Br. J. Sports Med.
2004;38:511-14.
Noakes, TD, Lambert, L, Human, R. Which lap is the slowest? An
analysis of 32 world record performances. Br. J. Sports Med. 2008: Apr 18.
[Epub ahead of print].
Tucker, R, Lambert, MI, Noakes, TD. An analysis of pacing strategies
during men’s world-record performances in track athletics. Int. J. Sports
Physiol. Perform. 2006;1:233-45.
We were pleased to see the ‘original article’ by Milne and Shaw (2008) offering advice for those travelling to the Beijing Summer Olympics Games in August later this year in a professional or participatory capacity. The authors are to be complimented on their endeavours to accommodate a comprehensive range of environmental aspects that might
influe...
We were pleased to see the ‘original article’ by Milne and Shaw (2008) offering advice for those travelling to the Beijing Summer Olympics Games in August later this year in a professional or participatory capacity. The authors are to be complimented on their endeavours to accommodate a comprehensive range of environmental aspects that might
influence health and performance. Their experiences in China in particular should be of interest to other groups, especially those hitherto unable to make reconnaissance visits to its competitive venues and training camps to
experience and monitor the challenges to be faced. Besides they are in good time to be of use for devising travel strategies and general advice to be circulated to all athletes selected to participate and their support
staff.
There is one area that we would wish to comment on, the issue of travel fatigue and jet-lag. These problems will be worse for European, frican and American athletes than for those from Australia and New Zealand in view of the difference in time–zone transitions. Furthermore,
some of the advice about dealing with jet-lag should not be based on the previous report of Milne and Fuard (2007) in this journal. The interpretation of anecdotal information, on one individual, was flawed. It is easy to beat an opponent who does not exist and the conditions that
provoke jet-lag may not have applied in the trip they described.
In the original report, a brief account was given about one subject who travelled between Europe and New Zealand and back within a few days. The itinerary focused upon constituted a net zero time-zone transition by
which time body-clock time and local time were desynchronised. The root cause of jet-lag is the desynchronisation that occurs between the
endogenous circadian rhythm and local environmental time. Prior to undertaking the last trip before the critical final game, the athlete would not have been in France long enough to adjust to European time, is unlikely to have experienced anything more severe than mild jet-lag, even if travel fatigue was severe.
The authors made no attempt to measure jet-lag, either subjectively or by means of an appropriate biological marker. Jet-lag is likely to have been minimal by the time of the criterion match since there would have
been limited adjustment before the last 12-hour time-zone transition and hence no need of a further re-adjustment. Besides, there was no valid measure of performance used. Evidence consists of an anecdotal comment that the player’s performance was up to its usual high standard (open
skills) and that he kicked a conversion and three penalty kicks (closed skills). Finally, the cocktail of soporifics that were advocated are not recommended as a panacea for jet-lag in recent reviews (Waterhouse et al.,
2007) or in consensus statements about alleviating jet-lag (Reilly et al., 2007a).
Lastly, the notes about travellers’ diarrhoea and on food are to be welcomed. Whilst the notes are necessarily brief, an appropriate further reference would be that of Reilly et al. (2007b). In this consensus, supported by the International Association of Athletics Federations, more
detailed advice on food and nutrition is given, as is an account of other gastrointestinal problems that travelling athletes face.
Thomas Reilly, Greg Atkinson, Ben Edwards, Jim Waterhouse
Liverpool John Moores University
References Milne C. Fuard MH. Beating jet lag. Br J Sports Med 2007; 41: 401.
Milne CJ. Shaw MTM. Travelling to China for the Beijing 2008 Olympic Games. Br J Sports Med 2008; 42: 321-326.
Reilly T. Atkinson G. Edwards B. et al. Coping with jet lag: a Position Statement for the European College of Sport Science . Europ J Sport Sci 2007a; 7: 1-7.
Reilly T. Waterhouse J. Burke LM. Alonso JM. Nutrition for travel. J Sports Sci 2007b; 25: S125-134.
Waterhouse J. Reilly T. Atkinson G. Edwards B. Jet lag: trends and coping strategies. The Lancet; 2007 ; 369: 1117-1129.
The authors have attempted to suggest that the new Law, that is Law
20.1.(h) in Laws of the game rugby union, 2007 has had an influence on
reducing claim applications to the ACC. It may be so that there were less
claims made within the period of the study but it would be difficult to
link an association with the new Law and the effect it might have on the
neck and back, even if it is performed as is st...
The authors have attempted to suggest that the new Law, that is Law
20.1.(h) in Laws of the game rugby union, 2007 has had an influence on
reducing claim applications to the ACC. It may be so that there were less
claims made within the period of the study but it would be difficult to
link an association with the new Law and the effect it might have on the
neck and back, even if it is performed as is stated in Law.
The call by
the referee in sequence of 'crouch', 'touch', 'pause', 'engage' allows
time for an impact to occur at engagement. Whist the scrum engagement can
be 'controlled' by the referee it remains the prerogative of the coach to
ensure that scrum is taught and practised as a means of re-starting the
game. It is Argentina whose teaching of the scrum is worthy of imitating.
Basically scrum machines are not used and all scrums are practised live.
This allows for important Laws of Motion and biomechanical principles to
be better appreciated and how well a scrum can be effective.
Furthermore,
paralell alignment after engagement ensures that Law 20.6 (d) is adhered
to by the scrum half who throws the ball in straight.
I read with interest the study by Panics et al on the effect of
proprioceptive training on joint position sense (JPS)at the knee. The
authors report a significant improvement in JPS in terms of reduction in
mean absolute error after the training. I have several concerns, however,
regarding the methods used by the author to assess JPS. First, looking at
Fig 1, one can ask as to how the positioning of t...
I read with interest the study by Panics et al on the effect of
proprioceptive training on joint position sense (JPS)at the knee. The
authors report a significant improvement in JPS in terms of reduction in
mean absolute error after the training. I have several concerns, however,
regarding the methods used by the author to assess JPS. First, looking at
Fig 1, one can ask as to how the positioning of the electrogoniometer was
properly controlled between sessions and between participants. Reports
have shown that even slight change in reference points with regard to
anatomical landmarks can lead to substantial error in measurements (see
Szulc,et al (2001) Med Sci Monit, 7(2), 312-315). Second, given that the
leg was moved passively by one experimenter, how tactile feedback arising
from contact with the skin was controlled? And what about the speed of
mobilization? One can easily see the difficulty for accelerating the leg
at the reported constant speed (ie., 10 deg/s) at 10 vs 80 deg in the
range tested. Such factors, when not properly controlled, can lead to
spurious cues influencing participants' ability to report joint angle. It
is also not clear to me as to why the intervention group initially
displayed poor JPS as compared to control. In the same vein, the range of
errors for JPS reported by the authors (8.21 -9.78 deg) is quite at odds
with the range reported in previous studies for normal young adults
(typically <5 deg, see Barrett et al (1991). J Bone Joint Surg Br, 73-
B(1), 53-56.).
I think the issue of measuring the impact of proprioceptive training on
proprioception is important for rehabilitation of sport injuries, but we
also need to be careful as to how we measure this complex sensation.
Thank you for this contemporary assessment of dietary intake among
the Masai pastoralists. Through the paradigm-shifting lens of a recent
comprehensive summary of the lack of science to implicate saturated fat as
a cause for heart disease [1], and new studies which suggest carbohydrate
to be more worrisome than saturated fat for atherogenesis [2-4], there is
a simple explanation for why the Masai do not develop atheroscle...
Thank you for this contemporary assessment of dietary intake among
the Masai pastoralists. Through the paradigm-shifting lens of a recent
comprehensive summary of the lack of science to implicate saturated fat as
a cause for heart disease [1], and new studies which suggest carbohydrate
to be more worrisome than saturated fat for atherogenesis [2-4], there is
a simple explanation for why the Masai do not develop atherosclerosis
despite consuming a high-fat diet that the authors did not consider: high-fat diets (not containing man-made fats) are not atherogenic.
1. Taubes G. Good Calories, Bad Calories. Knopf Publishing, 2007.
2. Krauss RM et al. Separate effects of reduced carbohydrate intake and
weight loss on atherogenic dyslipidemia. Am J Clin Nutr 2006;83:1025-31.
3. Mozaffarian D et al. Dietary fats, carbohydrate, and progression of
coronary atherosclerosis in postmenopausal women. Am J Clin Nutr
2004;60:1102-3.
4.Volek JS et al. Dietary carbohydrate restriction induces a unique
metabolic state positively affecting atherogenic dyslipidemia, fatty acid
partitioning, and metabolic syndrome. Prog Lipid Res 2008;Mar 15 (Epub
ahead of print]
Utter nonsense. The study laughably considers WG , Ranji, Jardine
& Larwood to have been failures, whilst Reg Simpson, Peter
Richardson & Bob Barber – batsmen who all averaged in the mid 30s -
were bizarrely thought of as successes.
The flaw was in the chosen criteria for success ( 25 Tests). Far
fewer Test matches were played years ago thus those born in the 1900s -
who died,...
Utter nonsense. The study laughably considers WG , Ranji, Jardine
& Larwood to have been failures, whilst Reg Simpson, Peter
Richardson & Bob Barber – batsmen who all averaged in the mid 30s -
were bizarrely thought of as successes.
The flaw was in the chosen criteria for success ( 25 Tests). Far
fewer Test matches were played years ago thus those born in the 1900s -
who died, on average, 10 years younger than their 20th Century
counterparts - are categorised, virtually en masse, as failures. So, of
course successful ( ie modern day) cricketers live longer than
unsuccessful ( Victorian) players.
That aside, cricketers that play 25 Tests should live slightly longer
as England don’t select dead players. Colin Blythe in 19 Tests took 100
wickets at 18 – what a failure - but was killed in the war, aged 38.
Admittedly he’d retired but he still had time to reach the 25 benchmark -
Wilfrid Rhodes played until he was 52 . The correct conclusion should
have been ‘Cricketers that live longer play more Tests’.
We have read with great interest the article by Silva et al and
acknowledge their innovating and pioneering work in the field of shoulder
dyskinesia. Their research uncovered a greater dynamic reduction in
subacromial space in tennis players with shoulder dyskinesia (19.3 mm),
compared to tennis players without shoulder dyskinesia (13.8 mm). The
authors claim there would be an average difference in dy...
We have read with great interest the article by Silva et al and
acknowledge their innovating and pioneering work in the field of shoulder
dyskinesia. Their research uncovered a greater dynamic reduction in
subacromial space in tennis players with shoulder dyskinesia (19.3 mm),
compared to tennis players without shoulder dyskinesia (13.8 mm). The
authors claim there would be an average difference in dynamic reduction of
5.2 mm between these groups. It is improbable to have a 19.3 mm reduction
in subacromial space, considering the fact that the largest subacromial
space in normal individuals is 17 mm.[1] Most likely, some error has
occurred and these values should be divided by a factor ten. In a study by
Herbert et al a reduction in subacromial space of approximately 2 mm was
found between zero and 70 degrees abduction.[2] Values of 1.93 and 1.38 mm
instead of 19.3 and 13.8 mm seem therefore more realistic. This implies
that the average difference in reduction between shoulders with and
without dyskinesia should be 0.52 mm in stead of 5.2 mm.
We question the fact whether ultrasonographic measurement of the
subacromial space is accurate enough to detect such a small difference.
Preliminary results from our own study addressing the issue of
reproducibility of ultrasonographic measurement of the subacromial space,
indicate that an experienced radiologist is capable of reaching an
accuracy of approximately 1 mm (figure 1). This implies that the
difference of 0.52 mm in dynamic reduction falls within the measurement
error of ultrasonographic measurement of the subacromial space. So, even
though Silva et al found a statistically significant difference in dynamic
reduction in subacromial space in shoulders with and without dyskinesia,
the clinical consequence remains unclear. Additional research is therefore
necessary to investigate the clinical use for this promising new
technique.
Figure 1: Bland-Altman-Plot showing difference between measurements plotted against their average for ultrasonograhic measurement of the acromiohumeral distance at zero degrees abduction (cm).
References
1. Azzoni, R.; Cabitza, P.; and Parrini, M.: Sonographic evaluation
of subacromial space. Ultrasonics 2004; 42(1-9): 683-7.
2. Hebert, L. J.; Moffet, H.; Dufour, M.; and Moisan, C.:
Acromiohumeral distance in a seated position in persons with impingement
syndrome. J Magn Reson Imaging 2003; 18(1): 72-9.
Dear Editor
I very much enjoyed reading the Review article [1] by Professor Noakes and the letter [2] in the same edition of the BJSM July 2008.
As he rightly states measurement of VO2max has several limitations in determining an athlete's potential. He also pointed out in the letter that research has shown that 'the rating of perceived exertion (RPE) rises as a linear function of the duration of...
Dear Editor
I read with interest the study by Panics et al on the effect of proprioceptive training on joint position sense (JPS)at the knee. The authors report a significant improvement in JPS in terms of reduction in mean absolute error after the training.
I have several concerns, however, regarding the methods used by the author to assess JPS. First, looking at Fig 1, one can ask as to how the positioning of...
To the Editor: In my opinion the negative influence of Nobel Laureate AV Hill on subsequent generations of exercise physiologists is not about the plateau in VO2 or other physiological concepts criticized by Professor Tim Noakes in his article. Hill’s influence is much deeper than that. It is about the fundamental assumption over which the current physiological model of exercise tolerance has been built over the years: In well-...
Dear Editor,
In the recent article published online (18th April, 2008) Noakes et al. (2008) present some interesting data detailing lap-times recorded en- route to world record performances in the one mile run. These data show that, on average, the times for the second and third laps were significantly slower than those for the first and last lap. Subsequently, Noakes et al. (2008) interpret these data as being sup...
Dear Editor,
Travel fatigue and jet-lag are not synonyms
We were pleased to see the ‘original article’ by Milne and Shaw (2008) offering advice for those travelling to the Beijing Summer Olympics Games in August later this year in a professional or participatory capacity. The authors are to be complimented on their endeavours to accommodate a comprehensive range of environmental aspects that might influe...
Dear Editor
The authors have attempted to suggest that the new Law, that is Law 20.1.(h) in Laws of the game rugby union, 2007 has had an influence on reducing claim applications to the ACC. It may be so that there were less claims made within the period of the study but it would be difficult to link an association with the new Law and the effect it might have on the neck and back, even if it is performed as is st...
Dear editor
I read with interest the study by Panics et al on the effect of proprioceptive training on joint position sense (JPS)at the knee. The authors report a significant improvement in JPS in terms of reduction in mean absolute error after the training. I have several concerns, however, regarding the methods used by the author to assess JPS. First, looking at Fig 1, one can ask as to how the positioning of t...
Thank you for this contemporary assessment of dietary intake among the Masai pastoralists. Through the paradigm-shifting lens of a recent comprehensive summary of the lack of science to implicate saturated fat as a cause for heart disease [1], and new studies which suggest carbohydrate to be more worrisome than saturated fat for atherogenesis [2-4], there is a simple explanation for why the Masai do not develop atheroscle...
Dear Editor
Utter nonsense. The study laughably considers WG , Ranji, Jardine & Larwood to have been failures, whilst Reg Simpson, Peter Richardson & Bob Barber – batsmen who all averaged in the mid 30s - were bizarrely thought of as successes.
The flaw was in the chosen criteria for success ( 25 Tests). Far fewer Test matches were played years ago thus those born in the 1900s - who died,...
Dear Editor
We have read with great interest the article by Silva et al and acknowledge their innovating and pioneering work in the field of shoulder dyskinesia. Their research uncovered a greater dynamic reduction in subacromial space in tennis players with shoulder dyskinesia (19.3 mm), compared to tennis players without shoulder dyskinesia (13.8 mm). The authors claim there would be an average difference in dy...
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