Sports Medicine Congress 2014

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1 Danish Association of Sports Medicine and Danish Association of Sports Physiotherapy - Sports Medicine Congress 2014 Treatment and prevention of sports injuries Thursday 30. of Janurary to Saturday 1. of Februrary 2014 Hotel Comwell, Kolding fagforum for idrætsfysioterapi

2 velkommen - Welcome It is my great honour to welcome you to the Danish Sports Medicine Annual Meeting for 2014 organized in collaboration between the Danish Society of Sports Medicine and the Danish Society of Sports Physiotherapy. Again with a lot of effort and commitments, the organizing committee has put together an exciting program, based on a mixture of new and old topics. Distinguish foreign and Danish speakers has been persuaded to come and share their knowledge with us. The focus will not only relate to the standard recreational or top athletes, but we are going to learn more about exercise in relation to different patient situation, such as neurological disorders, cancer, and joint replacements. With four parallel sessions for three days and several workshops, many corners of the sport medicine field will be covered, and I am sure that you will be academically enriched. And not to forget, there will be a good chance during the breaks and the social activities, to achieve new contacts, meet old friends and to visit the sponsors bringing the newest must surely be interesting. Thanks for Comming Lars Blønd, President Danish Society of Sports Medicine It is with great pleasure that I welcome you to our annual Danish Sports Congress. We are pleased to be back again in the beautiful surroundings of Comwell Kolding. The organization committee, which is a collaboration between the Danish Society of Sports Physical Therapy and the Danish Society of Sports Medicine, has put together a versatile program that will keep you busy and alert. As always it is in everybody s interest to be attentive, inquisitive and keep the tone civil as you discuss your points of view with the speakers. During our Get Together Thursday, you will get a chance to meet up with the speakers for a friendly conversation, as well as getting a bite to eat. The social program tops on Friday night with our gala dinner and dance. While taking a break from the scientific program be sure to visit the stands in the corridor. The companies represented at the stands also do a great job of presenting you with the latest in training and treatment. Have a great time Karen Kotila, Chairman Danish Society of Sports Physical Therapy Table of Contents Welcome... 2 Analogic Ultrasound Analogic Ultrasound Scientific program... 3 Prøv vores ultralydsskanner i din klinik. Kontakt os for flere detaljer. Poster walk, talk and dine... 9 PhD Lectures Thursday - Program overview.. 12 Friday - Program overview Saturday - Program overview Abstracts Excellent billedkvalitet Stort 19 skærmbillede Ergonomisk design Intuitiv brugerflade Støjsvag Exhibition Plan BK Medical Danmark Mileparken Herlev T F analogicultrasound.com AD0160-A 2

3 SCIENTIFIC PROGRAM ANNUAL CONGRESS DANISH SPORTS MEDICINE (DIMS and FFI) TREATMENT AND PREVENTION OF SPORTS INJURIES Thursday January 30th 2014 MAIN HALL (Thursday) Thursday, Main Hall, (Opening Lecture) Exercise and health from man to molecule Prof. Bente Klarlund Pedersen, Thursday, Main Hall, (Lecture) Tracking of physical activity which technologies do we have? Measurement of physical activity Lars Bo Andersen, Quantification of home-based exercise adherence using simple technology Michael Skovdal Rathleff, Chair: Bente Klarlund Pedersen Lunch Break Thursday, Main Hall, (DSSAK Symposium) The painful elbow Epicondylitis and tendinoses around the elbow Taco Gosens, Netherlands Other causes of elbow Bo Sanderhoff Olsen, : Training of the painful elbow Kim Lützhøft Chair: Bo Sanderhoff Olsen Thursday, Main Hall, (Lecture) Tendinopathies Prof. Jill Cook, Australia Chair: Christian Couppé Break Thursday, Main Hall, (Symposium) Running injuries can they be prevented? Running, training and shoes a brief history Finn Johannsen, : What s new in running-related research? Marienke Van Middelkoop, Netherlands Risk factors for running-related injuries among novice runners Rasmus Østergaard Nielsen, Footwear, landing impacts and running-related injuries Daniel Theisen, Luxenburg Chair: Finn Johannsen ROOM A (Thursday) Thursday, Room A, (Lecture) Guidelines for physical activity after arthroplasty Lars Nordsletten, Norge Chair: Per Hölmich Lunch Break Thursday, Room A, (Symposium) Middle aged and elderly: nutrients and training in keeping yourself fit Endurance training and metabolic health: a dose-response relationship? Bente Stallknecht, Chair: Low intensity resistance exercise training and nutrition: additive effect on muscle anabolism? Søren Reitelseder, Søren Reitelsederand Jakob Agergaard Thursday, Room A, (Lecture) Effects of strength exercise in cancer patients during chemotherapy Jesper Christensen, Chair: Rie Harboe Nielsen Break Thursday, Room A, (ADD (Anti doping ) - Symposium) Medicine for the athlete or the patient? EPO Jakob Mørkeberg,, ADD GH/IGF-1 Simon Døssing,, ADD Testosterone Cand.scient, PhD Thue Kvorning,, ADD Beta2-agonists/astma medication Morten Hostrup,, ADD Policies and guidelines (WADA, Danish legislation) Lone Hansen,, ADD Chair: Mette Hansen Thursday, Room A, DIMS General Assembly ROOM B (Thursday) Thursday, Room B, (Lecture in Danish) What is the evidence behind neuromuscular electrical stimulation? Nicola Maffiuletti, Schweitz Chair: Dorte Nielsen and Christian Couppé Lunch Break Thursday, Room B, (Symposium in Danish) Brugen af spørgeskemaer i idrætsmedicin Kriterier for valg og udvikling af spørgeskemaer - herunder anbefalinger fra COSMIN og COMET Margreth Grotle, Norge og Michael Krogsgaard, Kriterier for måleegenskaber af spørgeskemaer: responsiveness, sensitivitet og specificitet Margreth Grotle og Michael Krogsgaard Mine konkrete valg af spørgeskemaer til vurdering af fire almindelige lidelser Margreth Grotle og Michael Krogsgaard Diskussion Chair: Kristian Thorborg Thursday, Room B, (Lecture) PROMS hvad findes der og hvad er valideret? Michael Krogsgaard, Chair: Henrik Husted Break Thursday, Room B, (Symposium) Is there an active life after knee alloplasty? 3

4 Chairs: Thursday, Room B, FFI General Assembly Exercise following Total knee replacement Thomas Bandholm, Quadriceps function after TKA Nicola Maffiuletti, Schweitz What to expect following Total knee replacement Anders Troelsen, Per Hölmich and Kristian Thorborg Chair: Predisposing factors in Jumpers knee are there others than loadbearing factors? Jill Cook, Australien The jumping paradox is there anything we can do to prevent the injuries in jumping athletes? Håvard Visnes, Norge From basic to clinical science: New treatments of patellar tendinopathy are there any? Michael Kjaer, Peter Magnusson ROOM C (Thursday) WORKSHOPS Thursday, Room C, (Workshop in Danish) Hvad skal vi gøre ved den skadede løber en praktisk tilgang Rasmus Østergaard Nielsen, Lunch Break Thursday, Room C, (Workshop in Danish) Ultrasound: the shoulder join Skulderleddet (max participants) Jens Olesen and Thoøger Krogh, Thursday, Room C, (Workshop in Danish) Neuromuscular electrical stimulation a demonstration Nicola Maffiuletti, Schweiz Break Thursday, Room C, (Workshop in Danish) Ultrasound: the ankle and foot joints Fodleddet (max participants) Jens Olesen and Thøger Krogh, Friday January 31st 2014 MAIN HALL (Friday) Friday, Main Hall, (ADD Symposium) Doping amongst non-elite athletes in Chair: Fitness doping in is there a problem? Malene Radmer Johannison, The long-term side-effects of doping on the musculoskeletal system Michael Kjær, The Danish model how to fight fitness doping Malene Radmer Johannison, The Norwegian model how to fight fitness doping Anne Thidemann, Mette Hansen Friday, Main Hall, (Mini battle) Mini battle: Weight Training in Children why bother? PRO et CONTRA Chair: Break Niels Wedderkopp, The positive effects of strength training in children Jesper Bencke, The effect of training on CNS plasticity in children Jens Bo Nielsen, Should weight training be avoided in children from a clinical view point: Severe injuries as result of weight training. Niels Wedderkopp, Niels Wedderkopp Friday, Main Hall, (Symposium) Jumper s knee Lunch Break Friday, Main Hall, (Professors lectures) Professor lectures Prof. Bente Stallknecht, PhD lectures A. Neuromuscular exercise prior to total joint arthroplasty in patients with osteoarthritis of the hip or knee. Allan Villadsen, MD, PhD Department of Ortopaedic Surgery, Odense University Hospital B. Experimental and clinical neck pain: studies on training-induced neuroplasticity Bjarne Rittig-Rasmussen, MD, PhD Danish Pain Research Center, Aarhus University Hospital C. Stem Cells derived from adipose tissue and umbilical cord blood for cartilage tissue engineering in schaffold cultures Samir Munir, MD, PhD Department of Ortopaedic Surgery, Hvidovre University Hospital, Copenhagen D. Tendon and skeletal muscle responses to immobilization and rehabilitation in humans: Influence of aging and growth hormone administration Anders Boesen, MD, PhD-stud. Institute of Sports Medicine, Bispebjerg University Hospital, Copenhagen Chair: Peter Magnusson Friday, Main Hall, (Lecture) Work-related shoulder problems Susanne Wulff Svendsen, Chair: Bo Sanderhoff Olsen Break Friday, Main Hall, (Symposium - Oral presentations finalists) Oral presentations for Competition and The Ove Bøje Award Prize lecture Oral Communications from 6 selected abstracts (8 min.), Questions by Panel (2-3 min.) Abstract No 7 Previous knee-injury and low knee function score increase the risk of future knee injury in adolescent female football Clausen MB et al. Arthroscopic Centre Amager, SORC-C, Copenhagen University Hospital Amager- Hvidovre, Abstract No 9 Effect of whey protein hydrolysate supplementation on performance and recovery of top-class runners Hansen M et al. Section of Sport Science, Department of Public Health, Aarhus 4

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6 Iniversity, Aarhus, Abstract. No 12 Primary anterior cruciate ligament reconstruction: Rates of patient acceptable symptom state, treatment failure and associated KOOS scores in Norway Ingelsrud LH et al. Institute of Sports Science and Clinical Biomechanics, University of Southern, Odense, Abstract No 18 Effect of early progressive resistance training compared with home-based exercise after total HIP replacement. A randomised controlled trial Mikkelsen LR et al. Elective Surgery Centre, Silkeborg Regional Hospital, Department of Orthopaedics, Aarhus University Hospital Abstract No 25 High-load strength training improves outcome in patients with plantar fasciitis: A prospective randomised study with 12 months follow-up Rathleff MS et al. Orthopaedic Surgery Research Unit, Aalborg University Hospital Abstract No 26 Patient education with or without exercise therapy for adolescent patellofemoral pain A randomised study among 121 adolescents with 2-year follow-up Rathleff MS et al. HEALTH, Aarhus University,. Orthopaedic Surgery research Unit, Aalborg University Hospital, Chair Panel Presentation of The Ove Bøje Prize Winner followed by a price winner lecture. Chair: Michael Krogsgaard, Friday, Exibition Area Walk, Talk and Wine. Poster Walk and appetizer Friday, ROOM A, (Symposium) Complications related to ACL reconstruction What is a complication free course after ACL reconstruction? Michael Krogsgaard, Can we use NSAIDs postoperatively in ACL reconstruction? Lars Nordsletten, Norge Complications reported to the Danish Patient Insurance the importance of tunnel positioning Michael Krogsgaard, Anatomy of nerves at risk during graft harvest Christian Dippmann, Radiographic, histological, ultra structural and clinical findings after ACL reconstruction using patellar tendon and hamstring tendon auto grafts Martina Åhlén, Sweden Chair: Michael Krogsgaard Friday, ROOM A, (Lecture) Heart adaptations to sport is it good or bad? Mathew Wilson, USA Chair: Hanne Kruuse Rasmussen Break Friday, ROOM A, (Symposium) Simple strength training interventions in treatment and prevention Strength training in prevention and rehabilitation: Describing the drug of choice Thomas Bandholm, Effects of blood flow restricted resistance exercise on skeletal muscle growth and myogenic stem cell activation: Implications for patient rehabilitation Per Aagaard, Chair: Lunch Break Strength training in the prevention of ACL injuries Mette Zebis, Michael Rathleff and Kristian Thorborg Friday, ROOM A, (Symposium in Danish) Den forpustede idrætsudøver teenageren Cardiology Niels H. Andersen, Pulmonology Morten Hostrup, Physical fitness Niels Wedderkopp, Chair: Allan Butans Christensen Friday, ROOM A, (PhD Lectures) PhD lectures E. The effects of strength training or Nordic walking and home exercise in older people with hip osteoarthritis Theresa Bieler, Cand. Scient. San., PhD-stud. Institute of Sports Medicine, Bispebjerg University Hospital, Copenhagen F. Progressive Resistance Training after Radiotherapy in Head and Neck Cancer Patients - the Effect on Lean Body Mass Simon Lønbro M.Sc., PhD Section of Sports Science, Dept. of Public Health, Aarhus University G. Body Composition and Cardiovascular Health in School-aged Children Heidi Klakk, Cand. Scient. San., PhD Centre of Research in Childhood Health (RICH) University of Southern, Odense H. Musculoskeletal Extremity Injuries in School-aged Children Eva Jespersen,Cand. Scient. San, PhD Centre of Research in Childhood health (RICH). Department of Sport Science and Clinical Biomechanics, University of Southern, Odense Chair: Thomas Bandholm Break Friday, Exibition Area Walk, Talk and Wine. Poster Walk and appetizer Friday, ROOM B, (Symposium) Muscle injuries in relation to hamstring and groin Etiology of muscle injuries Kristian Thorborg, Treatment of muscle injuries Gustaaf Reurink, Netherlands Hamstring injuries Jesper Petersen, Groin injuries Per Hölmich, Chairs: Per Hölmich and Kristian Thorborg Friday, ROOM B, (Lecture) Danish female soccer: strategies and challenges Thøger Krogh and Kenneth Heiner-Møller, Break Friday, ROOM B, (Oral presentations) Oral presentations Abstract No 1 The effect of light-load resistance exercise and whey protein supplementation on muscle protein synthesis and amino-acid transporters in elderly Agergaard J et al. Institute of Sports Medicine Copenhagen, Bispebjerg Hospital and Center for Healthy Aging, University of Copenhagen, 6

7 Abstract No 2 Development of a standardised MRI evaluation protocol for athletes with hyp-and/or groin pain Branci S et al. Arthroscopic Center Amager, SOR-C, Copenhagen University Hospital, Amager-Hvidovre,. Department of Radiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Abstract No 3 MRI findings in soccer-players with adductor-related groin pain and asymptomatic controls: A single-blinded study Branci S et al. Arthroscopic Center Amager, SOR-C, Copenhagen University Hospital, Amager-Hvidovre,. Department of Radiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Abstract No 10 Development and reliability of a method for Ultrasound-Scanning of the subacromial structures in the shoulder Hougs Kjær B et al. Musculoskeletal Rehabilitation Research Unit, Department of Physical- and Occupational Therapy, Bispebjerg and Frederiksberg Hospitals, Copenhagen, Abstract No 11 Identification of the femoral attachment point for medial patellofemoral ligament (MPFL) reconstruction without the use of fluoroscopy A cadaver study Hölmich P et al. Sports Orthopaedic Research Center- Copenhagen, Arthroscopic Center Amager, Department of Orthopaedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Abstract No 16 Not convincing results at 2 years follow-up after TruFit implantation for full thickness cartilage defects in the Knee Konradsen L et al. Section for sportstraumatology M51, Bispebjerg University Hospital, Copenhagen, Abstract No 23 ACL injury prevention in handball Time for action Møller M et al. Department of Public Health, Section of Sport Science, Aarhus University, Aarhus, Abstract No 27 Poorer 2 year prognosis of patellofemoral pain versus other types of knee pain: A prospective cohort study among 504 adolescents Rathleff MS et al. HEALTH, Aarhus University,. Orthopaedic Surgery Research Unit, Aalborg University Hospital, Abstract No 29 Clinical presentation and radiological findings of a consecutive series of acute groin injuries in athletes Hölmich P et al. Aspetar Sports Groin PainCenter, Qatar Orthopedic and Sports Medicine Hospital Doha, Qatar. Arthroscopis Center Amager, SORC-C, Copenhagen University Hospital, Amager-Hvidovre, Abstract No 31 Association between maximal hamstring muscle strength and hamstring muscle pre-activity during a movement associated with non-contact ACL injury Sørensen RS et al. Gait Analysis Laboratory, Sec 247, Department of orthopaedic Surgery, Copenhagen University Hospital, Hvidovre, Copenhagen, Abstract No 32 Pain intensity and pain duration is not associated to area of allodynia in patients with plantar fasciitis Aaskov S et al. Kaalunds Orthopaedic Clinic, Aalborg, Chair: Henrik Aagaard Chair: SC joint anatomy, SC joint injury and degenerative conditions, SC jointproblems in sport Taco Gosens, Netherlands Surgical treatment Martin Ratchke, Netherlands Michael Krogsgaard Friday, ROOM B, (SAKS Symposium) Treatment of meniscal lesions Classification of meniscus lesions Michael Krogsgaard, Visualization of meniscal lesions by MRI and ultrasound Morten Boesen Indications for operative treatment (in relation to symptoms, patient age, time since injury and MRI appearance should asymptomatic lesions be operated on?) Rene Verdonk, Belgium Treatment of tears. Reinsertion? Resection? Rasping? (in relation to patient age and type of lesion) Rene Verdonk, Belgium Fixation methods Michael Krogsgaard, Rehabilitation after meniscus reinsertion is there any evidence? Bent Lund Consequence of meniscus injury and future perspectives in treatment Prof. Rene Verdonk, Belgium Chair: Micael Haugegaard Break Friday, ROOM C, (WORKSHOPS) Tendinopathies Jill Cook, Australia Chair: Christian Couppe Friday, ROOM C, (Workshop in Danish) Skulder diagnostik udredning af symptomer Tommy Øhlenschlæger og Rikke Høffner Målgruppe: Yngre læger, fysioterapeuter og almen praktiserende Break Friday, ROOM C, (Workshop in Danish) Steroid injektioner med og uden ultralyd, sådan gør jeg! Finn Johannsen, Lunch Break Friday, ROOM C, (Workshop) Running gait analysis with insoles, minimalistic shoes and normal running shoes Daniel Theisen, Luxemburg and Rasmus Østergaard, Chair: Finn Johannsen Friday, ROOM C, (Workshop) Cardiology in Sports Mathew Wilson, USA and Hanne Kruuse Rasmussen, Chair: Hanne Kruuse Rasmussen Break Friday, Exibition Area Walk, Talk and Wine. Poster Walk and appetizer Lunch Break Friday, ROOM B, (Lecture) The sternoclavicular joint and sport an overview 7

8 Saturday February 1st 2014 MAIN HALL (Saturday) Saturday, Main Hall, (Symposium) Snapping scapula diagnosis, treatment and prognosis Anatomy and biomechanichs of the thoracoscapular junction with special reference to snapping scapula Finn Bojsen-Møller, Diagnostic strategy in relation to snapping scapula Martin Ratchke, Netherlands Rehabilitation strategies for patients with snapping scapula Rikke Høffner Surgical treatment Lars Blønd, of surgical treatment. Strategies when surgery is failing Martin Ratchke, Netherlands Chair: Martin Ratchke Break Saturday, Main Hall, (Symposium) Treatment options for the painful knee in the active, middle aged person to the problem. Epidemiology of knee pain in these athletes and the pathologies involved. Diagnostic strategy Michael Krogsgaard, Non-surgical options: Specific training programs and bracing Ewa Roos, denmark Surgical options: Menisci, cartilage, synovitis, osteoarthritis Rene Verdonk, Belgium Suggestion of a treatment strategy. When is it time to reduce sports activity? Panel Discussion Chairman: Martin Ratchke Saturday, Room A, (Symposium) Weight and exercise - from commitment to obsession Exercise addiction can you get too much of a good thing? Mia Lichtenstein, Physiological consequences of low energy availability Anna Melin, Chair: Mette Hansen Break Saturday, Room A, (PRO et CONTRA debate) Steroid injections PRO et CONTRA debate PRO Finn Johannsen, CONTRA Thøger Krogh, Chair: Tommy Øhlenschlæger Saturday, Room B, (Symposium) Neuromuscular changes after ACL injury Muscular contributions to knee joint stability during weight bearing Daniel Benoit, Canada Adaptations to ACL injury - copers vs non-copers Tine Alkjær, denmark To be announced Rickard Dahan, Sweden Neuromuscular strategies after ACL injury Michael Krogsgaard, Chair: Break Daniel Benoit Saturday, Room B, (Symposium) Training of neurological patients Apoplexia and training Kaare Severinsen, Spinal cord injury and training Finn Biering Sørensen, Exercise and dementia Steen Hasselbalch, Multiple sclerosis and training Ulrik Dalgas, Chair: Ulrik Dalgas ROOM C Saturday, Room C, (Workshops - Instructions) Simple strength training interventions using elastic exercise bands (Instruction) Kristian Thorborg and Mette Zebis, Break Saturday, Room C, (Workshops Case baseret - in Danish) Akutte skader hvem kan spille videre? Morten Skjoldager, Søren Kaalund, Dorte Nielsen, Friday, Exhibition Area Poster Area, Poster walk, talk and wine Abstract No 4 MRI assessment of symphyseal and adductor-related findings in athletes: Intra- and inter-tester reliability of a standardised evaluation protocol Branci S et al. Arthroscopic Center Amager, SOR-C, Copenhagen University Hospital, Amager-Hvidovre,. Department of Radiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Abstract No 5 Relationship between knee kinetic outcome measures in counter movement jumps and self-reported function in ACL reconstructed subjects Brekke AF et al. School of Physiotherapy, University College Zealand,. Orthopaedic Research Unit, Department of Orthopaedics and Traumatology, Odense University Hospital, Institute of Clinical Research, University of Southern Abstract No 6 Muscle protein synthesis during daily living physical activities and normal eating routines Bülow J et al. Institute of Sports Medicine Copenhagen, Department of Orthopaedic Surgery M, Bispebjerg Hospital, and Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Abstract No 8 Platelet-Rich plasma, results of 100 treatments of chronic tendinopathy Hanisch K. Department of Orthopaedic surgery, SVS Esbjerg, Abstract No13 Distribution of different types of Collagen in human muscle and myotendinous junction Jakobsen JR et al. Department of sportstraumatology M51 and Institute of Sports Medicine M81, Bispeberg Hospital, University of Copenhagen, Abstract No 14 Changes in imminohistochemical matrix protein staining in the myotendinous junction in humans following acute and 4 weeks heavy resistance exercise training Jakobsen JR et al. Department of sportstraumatology M51 and Institute of Sports Medicine M81, Bispeberg Hospital, University of Copenhagen, 8

9 Abstract No 15 Abstract No 17 Abstract No 19 Abstract No 20 Abstract No 21 Abstract No 22 Abstract No 24 Abstract No 28 Abstract No 30 Abstract No 33 Abstract No 34 Abstract No 35 Walking and running in patients with hip dysplasia and healthy controls: does periacetabular osteotomy normalise movement? Jacobsen JS et al. Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Case Rhabdomyolysis after intense exercise Larsen C et al. Department of Rheumatology, Aarhus Universityhospital Anabolic response to resistance exercise and whey protein in patients with rheumatoid arthritis Mikkelsen UR et al. Institute of Sports Medicine, Department of Orthopaedic Surgery M, Bispebjerg Hospital and Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Clinical experience is important when assessing varus thrust in knee osteoarthritis Mølgaard CM et al. Department of Physiotherapy, University College Northern, Aalborg. Department of Occupational and physiotherapy, Aalborg University Hospital, Aalborg, Intratester reliability of hand-held versus strapmounted dynamometry to assess ankle inversion and eversion strength Mølgaard CM et al. Department of Occupational and Physiotherapy, Aalborg University Hospital. Department of Physiotherapy, University College Northern Potential interaction of experimental knee pain and laterally wedged insoles for knee off-loading during walking Mølgaard CM et al. Department of Occupational and Physiotherapy, Aalborg University Hospital. Center for Sensory-Motor Interaction (SMI) Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg,. Department of Physiotherapy. University College Northern, Aalborg. Visual scapula dyskinesis assessment is inter-observer reproducible Møller M et al. Department of Public Health, Section of Sport Science, Aarhus University, Aarhus, Validation of a new and practical method with stable isotope-labeled milk proteins as tracer for measurement of muscle protein synthesis Reitelseder S et al. Institute of Sports Medicine Copenhagen, Department of Orthopaedic Surgery M, Bispebjerg Hospital, and Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, Good life with arthritis in (GLA:D). Longterm effectiveness and predictors of outcome at 1 year Skou ST et al. Orthopaedic Surgery Research Unit, Aalborg University Hospital,. Department of Health Science and Technology, Centre for Sensory- Motor Interaction, Aalborg University,. Research Unit for Musculoskeletal Function and Physiotherapy, Institute of Sports Science and Clinical Biomechanics, University of Southern, Two narrative interviews describing the influence of a course on the Danish homeless soccerteam Bjerregaard A et al. Metropolitan University College Ultrasonographic measurement of the healthy patellar tendon A study of intra- and intertester reliability Christensen SW et al. Center for Sanse-Motorisk Interaktion (SMI), Institut for Medicin og Sundhedsteknologi, Aalborg Universitet, Aalborg The within and between day reliability of a variety of tests associated with lower limb functional performance Ghulam H et al. Knee Biomechanics and Injury Research Programme, University of Salford, United Kingdom Abstract No 36 Abstract No 37 Abstract No 38 Abstract No 39 Neuromuscular knee joint control in adolescents with and without generalised joint hypermobility during landing in the single leg hop for distance test Junge T et al. Institute of Regional Health Services, University of Southern,. Department of Physiotherapy, University College Lillebaelt, Reproducibility and validity of the Nintendo Wii Balance board for assessment of balance in children Larsen LR et al. University of Southern, Institute of Regional health Services Research, Odense, Comparison of a 12-week partly supervised exercise programme and a self-administered exercise programme for patients newly diagnosed with rheumatoid arthritis Seneca T et al. Department of rheumatology and Department of Physiotherapy and Occupational Therapy Aarhus University Hospital Eccentric hip-adduction strength deficits in soccerplayers with adductor-related groin pain Thorborg K et al. Arthroscopis Centre Amager, Copenhagen University Hospital, Amager, Copenhagen,, Departments of Orthopaedic Surgery and Physical Therapy, Copenhagen University Hospital Hvidovre, Copenhagen, 9

10 PhD Lectures - Abstracts A Experimental and Clinical Neck Pain: Studies on training-induced neuroplasticity Rittig-Rasmussen B., PhD thesis Danish Pain Research Center, Aarhus University Hospital. Training is a key element in the management of neck pain. Yet clinical outcomes are small and improvements are required. Inflammation and pain arising from spinal structures not only affect the involved musculoskeletal structures, but also have a significant impact on the nervous system. These changes have been shown to correlate with the level of injury and functional recovery, and there is thus a need for more knowledge of training-induced neuroplasticity. This thesis investigates the neuroplastic effects of training in experimental and clinical neck pain. We conducted three experimental studies with 162 participants, including pain-free participants, participants exposed to no pain or experimental pain and patients with non-specific neck pain. Transcranial magnetic stimulation and electromyography were used to excite and monitor changes in motor evoked potentials (MEPs) recorded from the corticospinal pathways of the trapezius and thumb muscles. In pain-free participants, neck training significantly increased the corticospinal responsiveness of MEPs from the trapezius muscle for up to 7 days after 20 minutes of training. In participants exposed to experimental pain and concomitant training, the responsiveness was significantly reduced for 7 days. In patients with chronic neck pain, the responsiveness was significantly reduced for 30 minutes, and notably, training did not increase MEPs when compared to participants with no pain. No significant changes were seen in controls or in a within-subject control muscle. These results and the method may prove valuable in the ongoing process of developing more effective training protocols and combinatorial therapies for patients with chronic neck pain. B Tendon and skeletal muscle responses to immobilization and rehabilitation in humans: Influence of aging and growth hormone administration. Anders Ploug Boesen, MD, PhD thesis Institute of Sports Medicine Copenhagen, Bispebjerg Hospital & Center for Healthy Aging, Copenhagen,, The loss of muscle and tendon function during periods of immobilization and recovery from this represents a challenge in clinical medicine. Maintenance of musculo-tendinous function during periods of inactivity, is of vital importance. Therefore possible pharmacological intervention able counteract the loss in connective tissue quality and mass of the musculotendinous tissue during inactivity, or accelerate the effect of rehabilitation in humans, could be preferable. The GH/IGF-1 axis is known to play a central role in the regulation of human collagen turnover in musculotendinous tissue. Although GH supplementation has been shown to have a positive anabolic effect on the musculo-skeletal tissues both in animals and in humans with GH deficiency (GHD), the anabolic effect of GH/IGF- 1 levels on healthy human adults both young and elderly under challenged situation (e.g. inactivity) is less clear, and its interaction with mechanical loading (rehabilitation) remains unexplained. The primary aim of this study was to determine the effect of GH supplementation during immobilization and subsequent re-training on the connective tissue, structural and mechanical properties in human skeletal muscle (quadriceps muscle) and adjacent tendon (patellar tendon) in healthy humans (normal GH/IGF-1 levels) of different age groups (young vs elderly). Young (20-30 years, n=20) and elderly (65-80 years, n=12) were randomly assigned in both age groups to daily recombinant GH (rhgh) (33-50µg/kg/d) or placebo (Plc), and had one leg immobilised for two weeks followed by six weeks of strength training. Cross sectional area (CSA), maximal muscle strength (MVC) and biomechanical properties of m.quadriceps and patellar tendon were determined. Muscle and tendon biopsies were analysed for mrna of collagen (COL-1A1/3A1), insulin-like growth factors (IGF-1Ea/Ec), lysyloxidase (LOX), matrix metalloproteases (MMP-2 and 9), decorin and tenascin-c. Fibril morphology was analysed by transmission electron microscope (TEM) to detect changes in fibril diameter. We found that rhgh supplementation increased circulating GH/IGF-1 levels and stimulated local IGF-1 and collagen mrna expression in musculo-tendinous tissue in young males, whereas in elderly only a significant increase in IGF-1 and collagen mrna expression was seen in the muscle tissue in response to GH supplementation. Moreover, rhgh maintained tendon stiffness following immobilization with further stimulation on tendon size and mechanical properties during six weeks subsequent re-training. In contrast to the effect of GH on tendon properties, skeletal muscle CSA in young males and muscle strength in both age groups was not affected by GH supplementation neither during inactivity nor during rehabilitation, whereas GH supplementation in elderly attenuated muscle loss (CSA) following immobilization and stimulated muscle growth during subsequent re-training. These findings indicate that GH/IGF-1 stimulates collagen expression in both skeletal muscle and tendon and abolishes the normal inactivity related decline in tendon stiffness, and furthermore results in an increased tendon CSA and stiffness during rehabilitation. GH has a matrix stabilizing effect during periods with inactivity and rehabilitation in humans. G Body composition and cardiovascular health in School-aged Children, the Childhood Health, activity and motor performance School study. Heidi Klakk, PhD thesis Centre of Research in Childhood Health (RICH). Department of Sport Science and Clinical Biomechanics, Faculty of Health Sciences, University of Southern, Odense. : Childhood obesity and the associated immediate and future health consequences are of growing concern for public health. Schools are recognized as potentially effective settings for public health initiatives. on effectiveness from earlier school-based studies are not univocal. More research is required on duration and volume of interventions in large-scale cohorts with long term follow up. In 2008 the municipality of Svendborg established sports schools, providing six physical education (PE) lessons per week. The objective of this thesis was to evaluate the effects of that intervention focusing on overweight and obesity and cardiovascular health in school-aged children. Material and Method: A total of 1507 children attending pre-school to the 4 th grade in ten public schools (six intervention and four controls schools) were invited to participate in the CHAMPS study-dk and 1218 (81%) children and their parents accepted. Height, weight, waist circumference, DXA scans, Cardio respiratory fitness (CRF), blood pressure, pubertal stage and fasting blood samples were obtained at baseline (2008) and follow-up (2010). : Intervention did not change mean BMI significantly, but had a significantly beneficial effect on overweight and obesity prevalence. Also a composite risk score and most single risk factors for CVD changed significantly more in favour of children attending intervention schools compared to children attending control schools. : Intervention had beneficial health effects and the children in special need had the largest effect of intervention. Overall, results support that six PE lessons per week at school have the potential to positively affect future public health. H Musculoskeletal Extremity Injuries in School-aged Children Eva Jespersen, PhD thesis, Faculty of Health SciencesCentre of Research in Childhood Health, Department of Sport Science and Clinical Biomechanics, University of Southern 10

11 SPORTS MEDICINE CON G R ES S Abstract Background: Physical activity-related injuries have been established as a leading cause of paediatric injuries with high costs for children, parents and society. Previous studies have primarily presented traumatic injuries: the tip of the iceberg phenomenon. There has been a lack of prospective studies on childhood injury epidemiology including overuse injuries. Objectives: To investigate the patterns of musculoskeletal extremity injuries in a cohort of school children using weekly assessments for 2.5 years and to estimate the associations of possible risk factors. Methods: In all, 1259 school children, aged 6-12, were surveyed each week with an automated mobile phone text message asking questions on the presence of musculoskeletal problems. Clinicians assigned to the study diagnosed injuries using ICD-10. Injuries diagnosed in other clinical settings (e.g. emergency departments) were collected in the same period. Physical activity was measured from text messaging and accelerometers. : Weekly rates of injury incidence and prevalence were 1.2% and 4.6% respectively. A total number of 1229 injuries were diagnosed; 180 injuries in upper extremity and 1049 in lower extremity with an overall rate of 1.59 injuries per 1000 physical activity units (95% CI 1.50 to 1.68). Close to twice as many overuse as traumatic extremity injuries were found s and perspectives: This study has added an overall perspective to injury epidemiology in children aged 6 to 12 by using frequent and prospective measures to capture both traumatic and overuse injuries. The generic findings from this heterogenic cohort of school children call for strategies to avoid overuse injuries. Idrætsudøvere over hele verden stoler på Bauerfeinds produkter og kundskaber Vi fortæller gerne hvorfor Besøg vores stand for at opleve Bauerfeinds nyheder indenfor ortoser, indlæg og kompressionsstrømper. Her finder du også vores nyeste studie, der viser at vores bløde SofTec Genu er en hard frame ortose overlegen på flere parametre. Motion is Life: Supporting Athletes+SofTec-Genu_DK_148,5x210+3_ indd 1 12/4/2013 5:04:10 PM MUSKELSTIMULATION & SMERTELINDRING Globus Genesy 600: Globus DiaCare 3500 Pro: Kom og se alle de nye og spændende apparater NY teknologi fra Globus Professionelt apparat l diatermi. Fungerer i resis v og kapaci v modus. Til behandling af smerter samt såvel kroniske som aku e ubalancer i det ostear kulære og muskulære system. Anbefales desuden l behandling af ødemer og hæmatomer i den aku e fase. 4-kanals apparat med 149 programmer - bl.a. det NYE program Ac onnow Elterapi l professionelle samt l hjemmebrug. Til behandling af smerter, muskelopbygning, træning og rehabilitering. Elektronisk muskels mulering (EMS) er blevet anvendt af fysioterapeuter og idrætsfolk i mange år l muskelopbygning, træning og rehabilitering. Grunden er, at man opnår resultatet hur gere, når man anvender EMS i kombina on med den vanlige træning. Man får øget cirkula on og forbedret muskelafslapning. Se det store udvalg af TENS- og muskels mula onsapparater på: Tlf:

12 Thursday January 30th, 2014 Main Hall Exercise and health from man to molecule Bente Klarlund Pedersen, Tracking of physical activity which technologies do we have? Measurement of physical activity Lars Bo Andersen, Quantification of home-based exercise adherence using simple technology Michael Skovdal Rathleff, Room A Lunch break DSSAK symposium: The painful elbow Epicondylitis and tendinoses around the elbow Taco Gosens, Netherlands Other causes of elbow Bo Sanderhoff Olsen, Training of the painful elbow Kim Lützhøft Tendinopathies Jill Cook, Australia Break Running injuries can they be prevented? Running, training and shoes a brief history Finn Johannsen, What s new in running-related research? Marienke Van Middelkoop, Netherlands Risk factors for running-related injuries among novice runners Rasmus Østergaard Nielsen, Footwear, landing impacts and running-related injuries Daniel Theisen, Luxemburg Guidelines for physical activity after arthroplasty Lars Nordsletten, Norge DIMS General Assembly Middle aged and elderly: nutrients and training in keeping yourself fit Endurance training and metabolic health: A dose - response relationship? Bente Stallknecht, Low intensity resistance exercise training and nutrition: additive effect on muscle anabolism? Søren Reitelseder, Effects of strength exercise in cancer patients during chemotherapy Jesper Christensen, ADD (Anti doping ) symposium: Medicine for the athlete or the patient? EPO Jakob Mørkeberg:, GH/IGF-1 Simon Døssing, Testosterone Thue Kvorning, Beta2-agonists/astma medication Morten Hostrup, Policies and guidelines (WADA, Danish legislation) Lone Hansen, Friday January 31st, 2014 Main Hall ADD symposium: Doping amongst non-elite athletes in Fitness doping in is there a problem? Malene Radmer Johannison, The long-term side-effects of doping on the musculoskeletal system Michael Kjær, The Danish model how to fight fitness doping Malene Radmer Johannison, denmark The Norwegian model how to fight fitness doping Anne Thidemann, Mini battle: Weight Training in Children why bother? PRO et CONTRA Niels Wedderkopp, The positive effects of strength training in children Jesper Bencke, The effect of training on CNS plasticity in children Jesper Bo Nielsen, Should weight training be avoided in children from a clinical view point: Severe injuries as result of weight training. Niels Wedderkopp, Room A Complications related to ACL reconstruction What is a complication free course after ACL reconstruction? Michael Krogsgaard, Can we use NSAIDs postopera-tively in ACL reconstruction? Lars Nordsletten, Norge Complications reported to the Danish Patient Insurance the importance of tunnel positioning Michael Krogsgaard, Anatomy of nerves at risk during graft harvest Christian Dippmann, Radiographic, histological, ultrastructural and clinical findings after ACL reconstruction using patellar tendon and hamstring tendon autografts Martina Åhlén, Sweden Heart adaptations to sport is it good or bad? Mathew Wilson, USA 12

13 Thursday January 30th, Room B What is the evidence behind neuromuscular electrical stimulation? Nicola Maffiuletti Room C - Workshops Hvad skal vi gore ved den skadede løber en praktisk tilgang (In Danish) Rasmus Østergaard Nielsen, Lunch break Symposium: Brugen af spørgeskemaer i idrætsmedicin 1. Kriterier for valg og udvikling af spørgeskemaer - herunder anbefalinger fra COSMIN og COMET 2. Kriterier for måleegenskaber af spørgeskemaer: responsiveness, sensitivitet og specificitet 3. Mine konkrete valg af spørgeskemaer til vurdering af fire almindelige lidelser Margreth Grotle, Norge og Michael Krogsgaard, (In Danish) PROMS hvad findes der og hvad er valideret? Michael Krogsgaard, Ultrasound: Skulderleddet (In Danish) Jens Olesen and Thøger krogh, Neuromuscular electrical stimulation - demonstration Nicola Maffiuletti, Schweiz Break Is there an active life after knee alloplasty? Exercise following Total knee replacement Thomas Bandholm, Quadriceps function after TKA Nicola Maffiuletti, Schweitz What to expect following Total knee replacement Anders Troelsen, Ultrasound: Fod leddet (In Danish) Jens Olesen and Thøger Krogh, FFI General Assembly Friday January 31st, 2014 Room B Muscle injuries in relation to hamstring and groin Etiology of muscle injuries Kristian Thorborg, Treatment of muscle injuries Gustaaf Reurink, Netherlands Hamstring injuries Jesper Petersen, Groin injuries Per Hölmich, Room C - Workshops Tendinopathies Jill Cook, Australia Danish female soccer: strategies and challenges Thøger Krogh and Kenneth Heiner-Møller, Skulder diagnostik udredning af symptomer (In Danish) Rikke Høffner og Tommy Øhlenschlæger, 13

14 Break Jumper s knee Predisposing factors in Jumpers knee are there others than loadbearing factors? Jill Cook, Australia The jumping paradox is there anything we can do to prevent the injuries in jumping athletes? Håvard Visnes, Norge From basic to clinical science: New treatments of patellar tendinopathy are there any? Michael Kjaer, Lunch break OBS tidspunkt Professor lectures Bente Stallknecht, Simple strength training interventions in treatment and prevention Strength training in prevention and rehabilitation: Describing the drug of choice Thomas Bandholm, Effects of blood flow restricted resistance exercise on skeletal muscle growth and myogenic stem cell activation: Implications for patient rehabilitation Per Aagaard, Strength training in the prevention of ACL injuries Mette Zebis, OBS tidspunkt PhD lectures A: Allan Villadsen, MD, PhD Department of Ortopaedic Surgery, Odense University Hospital B: Bjarne Ritting-Rasmussen, MD, PhD Danish Pain Research Center, Aarhus University Hospital Den forpustede idrætsudøver teenageren Cardiology Niels H Andersen, Pulmonology Morten Hostrup, Physical fitness Niels Wedderkopp, C: Samir Munir, MD, PhD Department of Ortopaedic Surgery, Hvidovre University Hospital, Copenhagen D: Anders Boesen, MD, PhD-stud. Institute of Sports Medicine, Bispebjerg University Hospital, Copenhagen Work-related shoulder problems Susanne Wulff Svendsen, PhD lectures E: Theresa Bieler, Cand. Scient. San., PhD-stud. Institute of Sports Medicine, Bispebjerg University Hospital, Copenhagen F: Simon Lønbro M.Sc., PhD Section of Sports Science, Dept. of Public Health, Aarhus University G: Heidi Klakk, Cand. Scient. San., PhD. Centre of Research in Childhood Health (RICH) University of Southern, Odense H: Eva Jespersen,Cand. Scient. San, PhD. Centre of Research in Childhood health (RICH). Department of Sport Science and Clinical Biomechanics, University of Southern, Odense Break Oral presentations Competition Abstracts no Prize lecture Ove Bøje 14

15 Break Oral presentations Abstracts no.: Steroid injektioner med og uden ultralyd, sådan gør jeg (In Danish) Finn Johannsen, Lunch break The Sterno-Clavicular joint and sport an overview SC joint anatomy, SC joint injury and degenerative conditions, SC joint problems in sports. Taco Gosens, Netherlands Surgical treatment Martin Ratchke, Netherlands OBS TIDSPUNKT: Kl SAKS symposium: Treatment of meniscal lesions Classification of meniscus lesions Michael Krogsgaard, Visualization of meniscal lesions by MRI and ultrasound To be announcedindications for operative treatment (in relation to symptoms, patient age, time since injury and MRI appearance should asymptomatic lesions be operated on?) Rene Verdonk, Belgium Treatment of tears. Reinsertion? Resection? Rasping? (in relation to patient age and type of lesion) Rene Verdonk, Belgium Fixation methods Michael Krogsgaard, Rehabilitation after meniscus reinsertion is there any evidence? To be announced Consequence of meniscus injury and future perspectives in treatment Rene Verdonk, Belgium Running gait analysis with insoles, minimalistic shoes and normal running shoes Daniel Theisen, Luxemburg Rasmus Østergaard, Cardiology in Sports Mathew Wilson, USA and Hanne Kruuse Rasmussen, Break

16 Poster walk walk, talk and wine Gala Dinner and Party Saturday February 1st, 2014 Main Hall Snapping scapula diagnosis, treatment and prognosis Anatomy and biomechanichs of the thoracoscapular junction with special reference to snapping scapula Finn Bojsen-Møller, Diagnostic strategy in relation to snapping scapula Martin Ratchke, Netherlands Rehabilitation strategies for patients with snapping scapula Rikke Høffner, Surgical treatment Lars Blønd, of surgical treatment. Strategies when surgery is failing Martin Ratchke, Netherlands Room A Weight and exercise - from commitment to obsession Exercise addiction can you get too much of a good thing? Mia Lichtenstein, Physiological consequences of low energy availability Anna Melin, Break Treatment options for the painful knee in the active, middle aged person to the problem. E pidemiology of knee pain in these athletes and the pathologies involved. Diagnostic strategy Michael Krogsgaard, Non-surgical options: Specific training programs and bracing Ewa Roos, Surgical options: Menisci, cartilage, synovitis, osteoarthritis Rene Verdonk, Bekgiums Suggestion of a treatment strategy. When is it time to reduce sports activity? Panel Discussion Mini battle: PRO et CONTRA Steroid injections PRO - Finn Johannsen CONTRA - Thøger Krogh Duolith SD1 >>Ultra<< Kombineret Chokbølge RSW+FSW samt indbygget UL Scanner med power doppler Behandler alle former for kronisk tendinopati og enthesopathic. Myofascial triggerpunkt terapi. Tel Hælspore Plantar fasciit Akillessenesmerter og senetilhæftninger Skinnebenssmerter / Shin splint Springerknæ / Jumper s knee / Patellar tendinopati Løberknæ / Runner s knee Osgood Slatter Trochanterbursit Trochantertendinose Musearm Tennisalbue / lateral epicondylit Supraspinatus tenoperiost tendinopati Hold i nakken / Cervicalgi Spændingshovedpine Hold i lænden / Lumbago M.fl. Se mere på 16

17 Poster walk walk, talk and wine Gala Dinner and Party Saturday February 1st, 2014 Room B Neuromuscular changes after ACL injury Muscular contributions to knee joint stability during weight bearing Daniel Benoit, Canada Adaptations to ACL injury - copers vs non-copers Tine Alkjær, To be announced Rickard Dahan, Sweden Neuromuscular strategies after ACL injury Michael Krogsgaard, Room C - Workshops Simple strength training interventions using elastic exercise bands (instruction) Kristian Thorborg and Mette Zebis, Break Training of neurological patients Apoplexia and training Kaare Severinsen, Spinal cord injury and training Fin Biering Sørensen, Exercise and dementia Steen Hasselbalch, Multiple sclerosis and training Ulrik Dalgas, Akutte skader hvem kan spille videre? (Case baseret) in Danish Morten Skjoldager Søren Kaalund Dorte Nielsen 17

18 ABSTRACTS ANNUAL CONGRESS DANISH SPORTS MEDICINE (DIMS-FFI) 1 THE EFFECT OF LIGHT-LOAD RESISTANCE EXERCISE AND WHEY PROTEIN SUPPLEMENTATION ON MUSCLE PROTEIN SYNTHESIS AND AMINO-ACID TRANSPORTERS IN ELDERLY Agergaard J 1,2, Bülow J 1, Jensen JK 1, Reitelseder S 1, Schjerling P 1, Drummond MJ 2, Kjær M 1, Holm L 1 1 Institute of Sports Medicine Copenhagen, Bispebjerg Hospital and Center for Healthy Aging, University of Copenhagen, 2 Department of Physical Therapy, University of Utah, Salt Lake City, USA In this study we tested how light-load resistance exercise (LL-RE) affects skeletal muscle protein synthesis (FSR) and amino-acid transporter (AAT) protein expression as a way to counteract anabolic resistance and age related loss of muscle mass. Materials and Methods Untrained healthy men (age: +65 yrs) were subjected to 13 hours supine rest. After 2½ hours of rest, unilateral LL-RE was conducted and consisted of knee-extensions (10 sets, 36 repetitions) at 15% 1RM. Hereafter, the subjects were randomized to oral intake of Placebo (4g maltodextrin/hour) (n=10), Pro-C (4g whey protein/hour) (n=10) or Pro-2 (28g whey protein at 0 hours and 12g whey protein at 7 hours post exercise) (n=10). Quadriceps muscle biopsies were taken at 0, 3, 7 and 10 hours post exercise from both resting and exercised leg. Myofibrillar- FSR and membrane protein expression of select AATs were analyzed from the biopsies. LL-RE increased myofibrillar-fsr compared to the resting leg in all groups (p<0.05). An increase in AAT protein expression was only observed when LL-RE was followed by whey protein intake. Specifically, Pro-C increased LAT1, PAT1 (p<0.05) and a tendency towards increased SNAT2 protein expression (p<0.1), Pro-2 only increased PAT1 protein expression (p<0.05). We conclude that myofibrillar-fsr increased in response to LL-RE, irrespective of feeding in older adults, whereas AAT protein expression only increased when LL-RE was combined with whey protein intake. This points towards LL-RE with protein-intake as a strategy to prevent anabolic-resistance and counteract age related loss of muscle-mass. 2 DEVELOPMENT OF A STANDARDISED MRI EVALUATION PROTOCOL FOR ATHELETES WITH HIP- AND/OR GROIN PAIN Sonia Branci,(1,2) Kristian Thorborg,(1) Birthe Højlund Bech,(2) Mikael Boesen,(3) Erland Magnussen (4), Michel Court-Payen,(5) Michael Bachmann Nielsen,(2) Per Hölmich(1,6) (1) Arthroscopic Center Amager, SORC-C, Copenhagen University Hospital, Amager-Hvidovre, (2) Department of Radiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, (3) Department of Radiology, Frederiksberg Hospital, and Parker Institute, University of Copenhagen, Copenhagen, (4) Department of Radiology, Hvidovre Hospital, Copenhagen University Hospital, Hvidovre, (5) Department of Diagnostic Imaging, Gildhøj Private Hospital, University of Copenhagen, Copenhagen, (6) Aspetar Sports Groin Pain Center, Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar To compare and reproduce MRI findings in published studies on pathological findings in athletes with hip and/or groin pain, images should be assessed according to a standardised MRI evaluation protocol, but such a protocol does not exist currently The aim of our study was to develop a detailed MRI evaluation protocol that enables evaluation of pathological changes related to the pubic symphysis, the pubic bones, and the adductor muscle insertions. Material and methods 86 male subjects representing a mixed group of symptomatic and asymptomatic soccer players, and asymptomatic non-soccer playing athletes were recruited. They all underwent standardised 3 Tesla MRI scans of the pelvis. Three musculoskeletal radiologists developed a list of specific MRI findings for the evaluation protocol, based on previously published studies on MRI findings in longstanding athletic hip and groin pain, and based on their own personal experience with assessing MRI scans of athletes with hip and/or groin pain. The MRI Evaluation protocol consisted of 11 specific MRI findings, each defined by precise radiological criteria and MR sequences that should be used to evaluate their presence or absence. All MRI findings were illustrated with representative images in a pictorial atlas. This is the first time a study presents a well-defined standardised MRI evaluation protocol for athletes with long-standing hip and/or groin pain. The next step consists in assessing its intra- and interobserver reproducibility when used by radiologists with a general sports radiology background. 3 MRI FINDINGS IN SOCCER-PLAYERS WITH ADDUCTOR- RELATED GROIN PAIN AND ASYMPTOMATIC CONTROLS: A SINGLE-BLINDED STUDY Sonia Branci,(1,2) Kristian Thorborg,(1) Birthe Højlund Bech,(2) Mikael Boesen,(3) Michael Bachmann Nielsen,(2) Per Hölmich(1,4) (1) Arthroscopic Center Amager, SORC-C Copenhagen University Hospital, Amager-Hvidovre Hospital, (2) Department of Radiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, (3) Department of Radiology, Frederiksberg Hospital, and Parker Institute, University of Copenhagen, Copenhagen, (4) Aspetar Sports Groin Pain Center, Qatar Orthopaedic and Sports Medicine Hospital, Doha, Qatar Adductor-related pain is one of the most common complaints in male soccer, and despite an increasing MRI evaluation of athletic groin pain, the clinical significance of MRI findings is largely unknown. Our primary and secondary aims were to evaluate 1) whether MRI findings are associated with adductor- related pain in soccer players, and 2) to assess MRI findings in asymptomatic soccer players and non-soccerplaying controls. Material and methods This cross-sectional study included 28 male soccer players with adductor-related pain, 17 male asymptomatic soccer players, and 20 male asymptomatic non-soccer playing athletes, matched for age and athletic activity. Participants underwent identical standardised clinical examination, and MRI scans (3 Tesla) of the pelvis performed by a 18

19 blinded observer. Images were consensus rated by three radiologists blinded to clinical information according to a standardised MRI evaluation protocol. The association between clinical adductor-related findings and pathological MRI findings was investigated by calculating chi square statistics (Fisher s exact test) and Odds Ratios (including 95% confidence intervals). Symptomatic players had significantly higher grades of pubic bone marrow oedema (BMO) than asymptomatic players (p=0.027). However, up to 71% of asymptomatic soccer players displayed different positive MRI findings, with significantly higher odds for BMO, adductor tendinopathy, and degenerative changes than non-soccer playing athletes (p<0.01). Adductor-related pain in soccer players is associated with higher grades of pubic BMO at MRI. However, positive MRI findings are frequent in asymptomatic players, and significantly more so than in asymptomatic non-soccer players (p<0.01), suggesting that these changes may be associated with soccer-play itself rather than actual symptoms. 4 MRI ASSESSMENT OF SYMPHYSEAL AND ADDUCTOR- RELATED FINDINGS IN ATHELETES: INTRA-AND INTER- TESTER RELIABILITY OF A STANDARDISED EVALUATION PROTOCOL Sonia Branci,(1,2) Kristian Thorborg,(1) Birthe Højlund Bech,(2) Mikael Boesen,(3) Erland Magnussen (4), Michel Court-Payen,(5) Michael Bachmann Nielsen,(2) Per Hölmich(1,6) (1) Arthroscopic Center Amager, SORC-C, Copenhagen University Hospital, Amager-Hvidovre, (2) Department of Radiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, (3) Department of Radiology, Frederiksberg Hospital, and Parker Institute, University of Copenhagen, Copenhagen, (4) Department of Radiology, Hvidovre Hospital, Copenhagen University Hospital, Hvidovre, (5) Department of Diagnostic Imaging, Gildhøj Private Hospital, University of Copenhagen, Copenhagen, (6) Aspetar Sports Groin Pain Center, Qatar Orthopedic and Sports Medicine Hospital, Doha, Qatar A detailed standardised MRI Evaluation protocol for athletes with longstanding hip and/or groin pain is not available in the literature. As such a protocol is needed we have developed one. It consists of 11 specific MRI findings, defined according to precise radiological criteria and MR sequences, and illustrated with representative images in a pictorial atlas. The aim of our study was to assess the intra- and interobserver agreement between radiologists representative of a general sports medicine radiological setting, when using this MRI evaluation protocol. Material and methods 86 male subjects (symptomatic and asymptomatic soccer players and non soccer players) were recruited. They underwent identical 3 Tesla MRI scans of the pelvis. Two external blinded experienced musculoskeletal radiologists were instructed individually during two separate sessions of 2-4 hours each to use the protocol and pictorial atlas. Each radiologist subsequently rated all 86 MRI scans independently. One radiologist evaluated all scans once, the other twice with two months interval. Unweighted Cohen kappa statistics were used to determine intra- and interobserver agreement: κ > 0.81 almost perfect, substantial, moderate, fair, slight, and < 0.00 poor. The main findings were (i) substantial intraobserver and moderate interobserver agreement in rating pubic bone marrow oedema, (ii) substantial to moderate intraobserver and moderate to fair interobserver agreement for most other MRI findings, (iii) slight intraobserver and poor interobserver agreement for adductor longus tendinopathy. Our results confirm that MRI investigation of athletes with hip and/ or groin pain requires further development and testing of standardised detailed assessment protocols. 5 Relationship between knee kinetic outcome measures in counter movement jumps and self-reported function in ACL reconstructed subjects Brekke AF 1,2, Nielsen DB 2, Holsgaard-Larsen A 2 1 School of physiotherapy, University College Zealand, 2 Orthopaedic Research Unit, Department of Orthopaedics and Traumatology, Odense University Hospital, Institute of Clinical Research, University of Southern Altered loading pattern of the medial aspect of the knee has been associated with the development of knee osteoarthritis (OA). Anterior cruciate ligament (ACL) injuries are associated with early-onset OA with associated pain, functional limitations, and decreased quality of life. However, specific knee loading pattern of the medial aspect has not been investigated during different jump-tasks in ACL-reconstructed patients. The purpose was to investigate potential kinetic differences between the ACL-reconstructed and contralateral knee during bilateral and unilateral vertical jumping, and to investigate potential associations between selfreported knee function and kinetics. Material and method 23 ACL-reconstructed men 27.2±7.5 years, all hamstring autografts, 27±7 months post-surgery. Bilateral and unilateral counter movement jumps (CMJ) was measured by a 6 camera Vicon-MX03 camera and two AMTI OR6-7 force-plates. Three kinetic outcomes related to the medial aspect of the knee were calculated: Peak knee adduction moment (P-KAM), KAM impulse (I-KAM) and the Total reaction moment (TRM) of the knee calculated by root mean square of the sagittal, frontal and transverse knee joint moments. All participants completed the Knee injury and Osteoarthritis Outcome Score (KOOS) questionnaire. Significant difference between the reconstructed and contralateral knee in CMJ was found in: TRM-bilateral (10.8%, p<0.05), TRM-unilateral (8.7%, p<0.05), P-KAM-bilateral (26.9%, p<0.05) and P-KAMunilateral (17.1%, p<0.05). A weak, yet significant association was only found between I-KAM bilateral and KOOS-symptoms (r 2 =0.18, p<0.05). Decreased medial load on ACL reconstructed knees was observed during unilateral and bilateral CMJ. A weak association between kinetic outcomes and KOOS indicates poor functional/clinical relevance. 6 MUSCLE PROTEIN SYNTHESIS DURING DAILY LIVING PHYSICAL ACTIVITIES AND NORMAL EATING ROUTINES Bülow J, Agergaard J, Kjaer M, Holm L, Reitelseder S Institute of Sports Medicine Copenhagen, Department of Orthopedic Surgery M, Bispebjerg Hospital, and Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, The impact of daily living physical activities such as cycling and walking is to a large extent unknown when it comes to muscle protein synthesis (MPS). However, the potential impact of these light intensity activities is highly relevant, particularly in an elder population. Therefore, the aim of this study was to evaluate effects of daily physical activities on MPS as compared to inactivity and heavy resistance exercise. 19

20 Material and method 24 elderly (70±1 y) men were recruited and randomly assigned to one of three groups: inactivity (IA), daily activities (DA), or strength exercise (SE). The study protocol simulated a normal daily eating routine containing carbohydrates, fat, and [1-13 C]leucine-labeled whey and caseinate as the primary protein source. Regular ingestion of labeled protein served to prime (whey), and continue (caseinate) the tracer enrichment for determination muscle protein fractional synthesis rates (FSR). Physical activities were monitored and venous blood and muscle biopsies collected. Total physical activity was highest in DA compared to IA and SE. Regular meal and protein ingestion increased leucine and phenylalanine plasma concentrations in all groups throughout the 10-h FSR measurement period. Muscle protein FSR were for IA, DA, and SE 0.065± %/h, 0.077± %/h, and 0.081± %/h, respectively (means±se, one-way ANOVA P=0.199). Under these applied settings it was not possible to detect significant differences in MPS between the inactivity, daily activities, and strength exercise interventions. The whole meal feeding protocol might attenuate differences typically seen between inactivity and strength exercise. 7 previous knee-injury and LOW KNEE function score increase the risk of future knee injury in adolescent female football Tang L (1), Clausen MB (1,9), Zebis MK (2), Krustrup P (3,4), Hölmich P (1), Wedderkopp N (5), Andersen LL (6), Christensen KB (7), Møller M (8), Thorborg K (1) (1) Arthroscopic Centre Amager, SORC-C, Copenhagen University Hospital, Amager-Hvidovre, (2) Gait Analysis Laboratory, Copenhagen University Hospital, Hvidovre, (3) Department of Nutrition, Exercise and Sports (NEXS), Section of Human Physiology, Copenhagen Centre for Team Sport and Health, University of Copenhagen, Copenhagen, (4) Sport and Health Sciences, College of Life and Environmental Sciences, St. Luke s Campus, University of Exeter, Exeter, United Kingdom (5) Sport Medicine Clinic, Orthopaedic dep. Hospital of Lillebaelt, Institute of Regional Health Service Research and Center for Research in Childhood Health, IOB, University of Southern, (6) National Research Centre for the Working Environment, (7) Department of Biostatistics, University of Copenhagen, (8) Department of Public Health, Section of Sport Science, Aarhus University, Aarhus, (9) School of Physiotherapy, Institute of Rehabilitation and Nutrition, Faculty of Health and Technology, Metropolitan University College, Copenhagen, Knee-injuries are common in adolescent female football. Severe kneeinjuries can cause persistent symptoms, potentially forcing female players to retire from contact sport. Previous knee-injury is recognized as a risk factor for future knee-injuries in adult football, but no such evidence exists regarding adolescent female football. The primary aim of this study was to investigate the risk of sustaining future knee-injury in relation to previous knee-injuries. Secondly, low Knee Osteaoarthritis Outcome Score (KOOS) was investigated as a potential risk factor for future knee injuries. Material and Method A population based sample of 326 girls (15-18 years) without kneeinjury at baseline, participating in a Danish Football Association series during the spring 2012 season, was included. Self-reported data on previous knee-injury and knee function score (KOOS) were collected at baseline. Football-injuries and football-exposures were reported weekly by answers to standardised text-message questions followed by individual injury-interviews. A priori, previous knee-injury and low knee function score (< 80 points) were chosen as independent variables of interest in the primary and secondary risk-factor analyses. Result 29 players sustained 34 time-loss knee-injuries. Adjusted for match/ total ratio and playing-level, baseline report of previous knee-injury significantly increased the risk of time-loss knee-injury (RR: %CI ; p<0.001). Low baseline-score in three KOOS subscales (ADL, Sport/rec and QOL) significantly increased the risk of time-loss knee-injury (RR: 2-5, p= ). Previous knee-injury and KOOS subscale scores lower than 80 points in ADL, Sport/rec and QOL significantly increases the risk of sustaining a knee-injury in adolescent female football players. 8 PLATELET-RICH PLASMA, RESULTS OF 100 TREATMENTS OF CHRONIKC TENDINOPATHY Klaus Hanisch Ortopædkirurgisk afdeling, SVS Esbjerg, Danmark Background Chronic tendinopathy in the lateral elbow, the patella tendon, the achilles tendon and in plantar fasciit are still a challenge. Previous studies have suggested platelet-rich plasma (PRP) to be an effective therapy option. Purpose To evaluate effects of PRP to patients with chronic tendinopathy. Study design Cohort-study. Methods Between January 2012 and October chronic patients with failed conservative treatment got ultrasound assisted with PRP with follow up after 8 weeks. The pain score (VAS), the DASH score for tennis elbow and the VISA score for achilles tendinopathy was compared. Of 33 patients with achilles tendinopathy, 24 patients reported improvement in pain and VISA scores. 6 patients had no benefit of the injection. 13 patients with plantar fasciitis had more the 25% reduction of pain on VAS, 4 didn t. 6 patients with chronic patella tendinopathy had positive response, and one had not. In tennis elbows 34 patients reported pain relieves and reduction on DASH scores, 14 didn t. In the total of 101 patients at 8 weeks follow up 76 had significant pain reduction after PRP injection. 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