Sports Medicine Congress 2014

Transcription

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 [email protected] 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. Keyword platelet-rich plasma, PRP, tendinopathy, achilles tendinitis, tennis elbow, jumper s knee, plantar fasciitis. 9 Effect of whey protein hydrolysate supplementation on performance and recovery of top-class runners Hansen M 1, Bangsbo J 2, Jensen J 3, Bibby BM 4, Madsen K 5 1 Section of Sport Science, Department of Public Health, Aarhus University, Aarhus, 2 Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, 3 Department of Physical Performance, Norwegian School of Sport Science, Oslo, Norway 4 Section for Biostatistics, Department of Public Health, Aarhus University, Aarhus, 5 Department of Food and Nutrition and Sport Exercise, University of Gothenburg, Sweden We aimed to examine the effect of whey protein hydrolysate intake before and after each exercise session on endurance performance and 20

21 recovery in elite endurance athletes during a 1-week training camp. Material and Method 18 elite orienteers participated in a randomized controlled intervention trial during a 1-week training camp (13 exercise sessions). Half of the runners (PRO-CHO) ingested a protein drink before (0.3 g kg -1 ) and a protein-carbohydrate drink after (0.3 g protein kg -1 and 1 g carbohydrate kg -1 ) each exercise session. The other half of the group ingested energy and time-matched carbohydrate drinks (CHO). A 4-km run-test with 20 control points was performed before and on the last day of the intervention. Blood and salivary were obtained in the mornings, before and after run-tests and after the last training session. PRO-CHO, and not CHO, improved performance in the 4-km run-test (interaction p<0.05). An increase in serum creatine kinase was observed during the week, which was greater in CHO than PRO-CHO (interaction p<0.01). Lactate dehydrogenase (p<0.001) and cortisol (p=0.057) increased during the week, but the change did not differ significantly between groups. The reduction in sense of performance capacity during the intervention was greater in CHO (p<0.05) than PRO-CHO. Ingestion of whey protein hydrolysate before and after each exercise session improves performance and reduces the increased muscle damage during a strenuous 1-week training camp. The results indicate that protein supplementation in conjunction with each exercise session facilitates the recovery from strenuous training in elite orienteers. 10 DEVELOPMENT AND RELIABILITY OF A METHOD FOR ULTRASOUND-SCANNING OF SUBACROMIAL STRUCTURES IN THE SHOULDER Hougs Kjær B 1, Ellegaard K 2, Wieland I 1, Warming S 1, Juul-Kristensen B 3,4. 1 Musculoskeletal Rehabilitation Research Unit, Department of Physicaland Occupational Therapy, Bispebjerg and Frederiksberg Hospitals, Copenhagen, 2 The Parker Institute, Department of Rheumatology, Copenhagen University Hospital, Frederiksberg, Copenhagen, 3 Research Unit of Musculoskeletal Function and Physiotherapy, Institute of Sports Science and Clinical Biomechanics, University of Southern, Odense M,. 4 Institute of Occupational Therapy, Physiotherapy and Radiography, Bergen University College, Bergen, Norway. There is a lack of diagnostic accuracy in clinical tests for subacromial impingement (SI), why ultrasound may be used as a supplement to clinical tests in order to distinguish between underlying pathologies. However, reliability of the ultrasound method needs to be investigated. The purpose was to establish a standardized ultrasound method of the subacromial structures of the shoulder, and investigate the intra- and interrater reliability of this method. Material and Method The study included development of an ultrasound method and a threephase reliability study of subacromial structures related to impingement. A total of 29 SI and 38 asymptomatic subjects (mean age 38) participated. In two armpositions thickness of the supraspinatus tendon (SUPRA) and the subacromial subdeltoid bursa (SASD) and in one armposition the acromial humeral distance (AHD) were all measured in mm. Further, a dynamic impingement examination (DI) to identify if the tendon and bursa disappeared under the acromion during abduction was graded dichotomously. and Bland and Altman plots of SUPRA, SASD and AHD sizes showed no systematic bias between raters and mean differences of less than 1.0 mm. ICC 2,1 (95%CI) was between (0.59;1.00) for all three measures. For the DI the overall agreement was 91% in both inter- and intraexaminations, and Kappa (95%CI) was 0.82 (0.61; 0.96) and 0.96 (0.85; 1.00), respectively. In conclusion, the method for measuring the current six variables by ultrasound had excellent intra- and interrater reliability. MDC 95 was lowest for intrarater and all values were below 1.06 mm. 11 IDENTIFICATION OF THE FEMORAL ATTACHMENT POINT FOR MEDIAL PATELLOFEMORAL LIGAMENT (MPFL) RECONSTRUCTION WITHOUT THE USE OF FLUOROSCOPY - A CADAVER STUDY Hansen CO, Attrup ML, Hölmich P Sports Orthopaedic Research Center-Copenhagen, Arthroscopic Center Amager, Department of Orthopaedic Surgery, Copenhagen University Hospital, Amager-Hvidovre, Anatomically MPFL reconstruction as suggested by Schöttle is a well established technique. A free gracillis graft is pulled from the patella to the anatomical femoral attachment point for the native MPFL and fixated. A reproducible anatomical and radiographic point for the femoral attachment point has been established in cadaver studies. Incorrect femoral attachment can lead to an unsuccessful result of the surgery. The use of perioperative fluoroscopy to identify the femoral attachment is not always routine. This study evaluate the accuracy of identifing the femoral MPFL attachment without the use of fluoroscopy under standardized conditions. Material and Method Twelve fresh frozen cadaver knees were used. Five experienced surgeons in sports traumatology were asked to dissect and mark the femoral MPFL point with a nail according to the description by Schöttle. Fluoroscopic examination was done, in the true lateral position. The 12 knees with the nail markings were then calibrated into a standard knee size by means of a zooming tool, to correct for differences in sizes of the individual knees. Only 4 of the 12 MPFL markings were placed within a distance from 5 mm. of the anatomical MPFL point. Furthermore there was a trend that the individual surgeons placed their markings within a limited area - even when suboptimal. s This study indicates that the ability to identify the femoral MPFL attachment point without use of fluoroscopy is low. We recommend the use of perioperative fluoroscopy for identification of the femoral attachment point in MPFL reconstruction surgery. 12 PRIMARY ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION: RATES OF PATIENT ACCEPTABLE SYMPTOM STATE, TREATMENT FAILURE AND ASSOCIATED KOOS SCORES IN NORWAY Ingelsrud LH 1, Granan LP 2-4, Engebretsen L 5, Terwee CB 6, Roos EM 1 1 Institute of Sports Science and Clinical Biomechanics, University of Southern, Odense, 2 Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway. 3 Department of Pain Management and Research, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway 4 Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway 5 Department of Orthopaedic Surgery, Oslo University Hospital and Faculty of medicine, Oslo, Norway 6 VU University Medical Center, Department of Epidemiology and Biostatistics, Amsterdam, Netherlands Purpose Determine treatment outcomes as Patient Acceptable Symptom State 21

22 (PASS), Treatment Failure (TF) and associated Knee injury and Osteoarthritis Outcome Score (KOOS) scores following anterior cruciate ligament reconstruction (ACLR). Design 1197 patients were extracted from the Norwegian Knee Ligament Register at three time points: 397 at 6 months, 400 at 12 months and 400 at 24 months postoperatively. Inclusion criteria were unilateral primary surgical reconstruction of the ACL. KOOS was sent to the patients accompanied by TF and PASS anchor questions. Patients had reached a PASS when answering Yes to the PASS question. Of those responding No, those answering Yes to the TF question were considered treatment failures. 744 patients (45% women, mean age 28.7) responded. For all timepoints, 55-66% considered themselves to have reached a PASS and 6-10% considered the treatment to have failed. Ranges of mean KOOS scores at the three follow-up time-points for the patients reaching PASS were: Pain 88-91, Symptoms 82-85, ADL 94-96, Sport/Rec and QOL The patients that considered that the treatment had failed had worse mean KOOS scores (Pain 57-58, Symptoms 54-57, ADL 69-73, Sport/Rec 26-32, QOL 25-31). Half of the patients at six months and about two-thirds at one-two years consider themselves to have achieved an acceptable symptoms state after receiving an ACLR. Mean KOOS scores were reflective of patient s perception about treatment outcome after ACLR. Patients achieving PASS had KOOS scores reflecting no to mild problems while for treatment failures the scores reflected moderate to severe problems. 13 DISTRIBUTION OF DIFFERENT TYPES OF COLLAGEN IN HUMANMUSCLE AND MYOTENDINOUS JUNCTION Jakobsen JR, Knudsen A, Mackey AL, Kjaer M, Krogsgaard MR Department of sportstraumatology M51 and Institute for Sportsmedicine M81, Bispebjerg Hospital, University of Copenhagen,. The force created in skeletal muscles is thought to be transmitted to tendon through a direct pathway from the endings of the myofibrils through the basal membrane to the tendon and through the endo/ perimyium by lateral force transmission, but it is unknown if one of these pathways is dominating. The distribution and amounts of collagens are important for the ability to transmit force. However, the distribution of collagens in human MTJ has never been described. Materials and methods Biopsies were taken from 15 patients and frozen in liquid nitrogen before they were cut on a cryostat and stained immunohistochemically with antibodies against collagen I, III, IV, VI, XII and XIV. The sections were analysed with a fluorescent microscope where the amounts of stained protein were estimated visually on a scale from 0 to 2. Collagen I, III, VI, XII and XIV were abundant in the MTJ ranging on an average score from 1,5-2, whereas Collagen IV had an average score of 1. The human MTJ contains a large number of collagen types, indicating that it is a complex tissue. We found Collagen I, III, VI, XII and XIV to be the most abundant in the endo- and perimysium. 14 CHANGES IN IMMUNOHISTOCHEMICAL MATRIX PROTEIN STAINING IN THE MYOTENDINOUS JUNCTION IN HUMANS FOLLOWING ACUTE AND 4 WEEKS HEAVY RESISTANCE EXERCISE TRAINING Jakobsen JR, Knudsen A, Mackey AL, Kjaer M, Krogsgaard MR Department of sportstraumatology M51 and Institute for Sportsmedicine M81, Bispebjerg Hospital, University of Copenhagen,. Objectives The The myotendinous junction (MTJ) is a common site for straininjuries in athletes, and strengthening of the MTJ by heavy resistance training may reduce the risk of strains. However, the effect of exercise on the MTJ in humans has never been reported. The aim of this study was to describe the immunohistochemical changes in matrix proteins and macrophages in the MTJ and its surrounding tissue (tendon and skeletal muscle) of mm. gracilis and semitendinosus following acute and 4 weeks of heavy resistance training of the hamstrings region. Collagen I and III were abundant at the MTJ and in the endo- and perimysium, and no significant effect of training was detected. Macrophages (CD68+) were detected in the muscle region and the MTJ. A greater density of macrophages was detected in T2 vs T0 in muscle (p<0.05). A trend towards a greater level of Tenascin-C immunoreactivity in muscle was observed in T2 vs T0 (p<0.0979). No other significant differences were found. The increased immunoreactivity of Tenascin-C and macrophages content in muscle after 4 weeks of heavy strength training provides strong support for remodelling of the muscle matrix tissue close to (within 1mm of) the MTJ. Furthermore, given the importance of macrophages in recovery and maintenance of tissue homeostasis, the presence of macrophages in the MTJ is fitting with the remodelling that occurs at this important muscle-tendon interphase. Macrophage activity could potentially influence the mechanical properties of the MTJ and its vulnerability towards strain injury. 15 WALKING AND RUNNING IN PATIENTS WITH HIP DYSPLASIA AND HEALTHY CONTROLS: DOES PERIACETABULAR OSTEOTOMY NORMALISE MOVEMENT? Jacobsen JS 1, Nielsen DB 2, Sørensen H 2, Søballe K 3, Mechlenburg I 3 1 Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, 2 Department of Sports Science, Aarhus University, 3 Department of Orthopaedic Surgery, Aarhus University Hospital, Hip dysplasia can be surgically treated with periacetabular osteotomy (PAO). The aim was to evaluate changes in walking and running in patients with hip dysplasia prior to and 6 and 12 months after PAO, and furthermore to evaluate differences in joint angles and joint moments in movement in the patients compared to healthy controls. Material and Method Joint kinematics and kinetics were recorded using a three-dimensional motion capture system. The pre- and post-operative gait characteristics quantified by the peak hip extension angle and the peak joint moment of hip flexion were compared among 23 patients with hip dysplasia (18 to 53 years). Similarly, this pattern in the patients was compared with 32 controls (18 to 54 years). The peak hip extension angle and the peak joint moment of hip flexion were significantly reduced at baseline between the patients and controls during walking (p=0.021 and p=0.007). The peak joint moment of hip flexion increased at 6 and 12 months after PAO compared with baseline during walking, and 6 months after PAO compared with baseline during running (p<0.02). In running, the improvement did not reach statistical significance after 12 months (p=0.035). In addition, the hip extension angle during walking increased, though not statistically significant (p=0.119), 12 months after PAO. There were no significant differences 22

23 in primary outcome measures between patients and controls after 12 months. Walking and running characteristics were improved after pelvic surgery in patients with symptomatic hip dysplasia. Gait modifications were still present 12 months after PAO. 16 NOT CONVINCING RESULTS AT 2YEARS FOLLOW-UP AFTER TruFit IMPLANTATION FOR FULL THICKNESS CARTILAGE DEFECTS IN THE KNEE Konradsen L, Krogsgaard MR Section for sportstraumatology M51, Bispebjerg University Hospital Purpose To present our short-term experience with an artificial osteochondral scaffold plug as secondary treatment for isolated cartilage defects in the knee. Methods Cohort study: 22 patients treated over a 2 year period. Median patient age 37.5 years (range 24-49). 8 women. 20 medial, and 2 lateral femoral condyle defects. Median defect size 1 cm 2 (range 0.6 to 3). All defects previously debrided or microfractured. 1 plug implanted in 13 cases, 2 in 7, 3 in 1, and 4 in 1 case. KOOS and Tegner scores and standard MRI pre-op, and 1 and 2 years post-op. CT scans 2 years post-op. KOOS scores: Median values in the 5 KOOS domains increased significantly (Wilcoxon s test) from preoperatively to 1 year follow-up (p<0,05 for symptoms and p<0,001 for the other 4 domains), and increased insignificantly from 1 to 2 year follow-up. did not reach values for normal age-matched subjects without knee problems. Tegner score Pre-op: median 2; 2 years post-op: 3 (not significant). Complications 1-2 years post-op: Plugs were removed and bone grafting performed in 3 cases; in one case followed by a MACI procedure. CT scans after 2 years: bone defects were median 80% of the primary plug volume without evidence of trabecular bone ingrowth. MRI based modified MOCART score: 33% after 2 years. KOOS scores improved significantly but were far from normal, and Tegner activity scores remained low for this previously active patient group. CT showed very limited bony tissue fill of the intraosseos part of the plug. Substantial surface deficits were still present in the plug areas 2 years post-op based on an MRI evaluation. In our cohort results were not convincing 2 years after the implantation. TruFit has now been removed from the market. 17 CASE RHABDOMYOLYSIS AFTER INTENSE EXERCISE Larsen C 1, Olesen JL 2, Pfeiffer-Jensen MP 1 1 Dept. of Rheumatology, Aarhus Universityhospital 2 Institute of Sports Medicine, Bispebjerg Hospital Patient case A 35-year old woman acutely hospitalized with edema of the upper limbs, reduced force, severe movement reduction and muscle pain in both upper extremities. Her symptoms started after three days of intense exercise doing kayaking and a lot of pull-ups in crossfit. Her symptoms progressed. No trauma. No known diseases. Elevated Creatine Kinase (> IE/L) and Myoglobin (4.473 µg/l) was seen. She was diagnosed rhabdomyolysis due to the characteristic symptoms and history. The EMG showed myopathy. Muscle biopsy showed metabolic myopathy. Her treatment was rehydration with high urine output. After 6 days of hospitalization her condition and blood work was back to normal. Discussion Rhabdomyolysis is a syndrome, characterized by muscle necrosis. Usually there is a marked elevation of Creatine Kinase (CK) with symptoms as described and myoglobinuria (dark colored urine). The severity ranges from asymptomatic to life threatening with electrolyte imbalances and acute kidney failure. The most common cause to rhabdomyolysis is toxins (alcohol and illicit drugs) and medical drugs. Underlying causes like myopathies and metabolic defects is also a common cause. Subclinical and asymptomatic cases with myoglobinemia, myoglobinuria and elevated serum CK are often seen following physical exertion. Less common is rhabdomyolysis developed by physical exertion. The first case of rhabdomyolysis in crossfit was reported back in May 2005 in USA. The treatment is symptomatic. Intensive rehydration with isotonic NaCl (1-2 l/hour) and high urine output ( ml/hour). Bicarbonate can be used to alkalinize the urine, and loop-diuretics/mannitol can be used to get higher urine outputs. Intensive care and monitoring is necessary. In severe cases dialysis can be necessary. 18 EFFECT OF EARLY PROGRESSIVE RESISTANCE TRAINING COMPARED WITH HOME-BASED EXERCISE AFTER TOTAL HIP REPLACEMENT. - A RANDOMISED CONTROLLED TRIAL Mikkelsen LR, Mechlenburg I, Søballe K, Mikkelsen S, Bandholm T, Petersen MK. Elective Surgery Centre, Silkeborg Regional Hospital, Department of Orthopaedics, Aarhus University Hospital, Physical Medicine & Rehabilitation Research Copenhagen (PMR-C), Department of Physiotherapy, Department of Orthopedic Surgery, Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Department of Physiotherapy- and Occupational Therapy, Aarhus University Hospital, Centre of Research in Rehabilitation (CORIR), Institute of Clinical Medicine, Aarhus University, Muscle strength and physical function deficits persist after total hip replacement (THR). Training effect evidence after THR is lacking. This study investigates the effect of supervised progressive resistance training in early post-thr rehabilitation on muscle strength and functional performance. Material and Method 73 THR patients with preoperative self-assessed disability (HOOS ADL score 67) were randomly assigned to a control group (CG, homebased exercise 7 days/week) or an intervention group (IG, home-based exercise 5 days/week and resistance training of hip and thigh muscles 2 days/week). The IG trained with loads of 10 repetition maximum from week 1 to 10 after THR. Before surgery and after the intervention, performance was evaluated by leg extension power (primary outcome), isometric strength (hip abduction + flexion), sit-to-stand test (STS), stair test and 20 meter walking speed. 62 patients completed the trial (31 in each group). Leg extension power improved significantly in both groups with no between-group difference: IG (baseline-follow up): 0.28 [0.1;0.3] Watt/kg, CG: 0.26 [0.0;0.5] Watt/ kg, p= m walk performance improved more in IG (2.98 [1.8;4.2] sec) than in CG (1.58 [0.8;2.4] sec) (p=0.05). No significant differences were found in stair test; yet, borderline significance (p= ) favoured IG in STS and isometric strength. 7 days/week of home-based exercise was just as effective as 5 days/ week of home-based exercise plus 2 days/week of supervised progressive resistance training in improving leg extension power after THA. For most of the secondary outcomes, trends were in favour of resistance training. ClinicalTrials.gov Identifier: NCT

24 19 ANABOLIC RESPONSE TO RESISTANCE EXERCISE AND WHEY PROTEIN IN PATIENTS WITH RHEUMATOID ARTHRITIS Mikkelsen UR, Andersen MB, Dideriksen KJ, Boesen A, Clausen N, Sørensen IJ, Holm L, Kjær M Institute of Sports Medicine, Department of Orthopedic Surgery M, Bispebjerg Hospital and Center for Healthy Aging, Faculty of Health and Medical Sciences, University of Copenhagen, The chronic inflammatory disease rheumatoid arthritis (RA) is often associated with loss of muscle mass (cachexia). To verify if RA patients display anabolic resistance, this study compared the acute muscle protein synthesis response to resistance exercise and feeding in RA patients (which has not been investigated before) with healthy agematched controls. Methods Thirteen RA patients (age 56(14) years; BMI 25(4) kg/m 2 ; mean (SD)) were compared to 13 healthy controls matched for gender, age, BMI and activity level (CON; age 57(15); BMI 25(5)). Fractional synthesis rate (FSR, %/hr) of muscle myofibrillar protein was measured before, after intake of whey protein (0.5 g/kg lean body mass), and combined with unilateral knee-extensor exercise (8x10 reps, 70% of 1RM). FSR was measured by infusion of the stable isotope-labeled amino acid 13 C 6 -phenylalanine. Plasma levels of C-reactive protein (CRP), IL6 and TNFa were measured using ELISA. are mean (SE). Preliminary results show that FSR of muscle myofibrillar protein in RA patients was not significantly different from CON. Although both groups had low plasma inflammatory markers, CRP was higher in RA patients (2.25(0.50) mg/l) than CON (1.07(0.25) mg/l; p=0.016). Likewise, TNFa tended to be higher in RA (1.16(0.30) pg/ml) than CON (0.64(0.07) pg/ml; p=0.075) but IL6 was not different between groups (RA 2.89(0.68) pg/ml; CON 1.74(0.32) pg/ml; p=0.121). To our surprise, we were unable to detect an anabolic response to whey protein feeding and resistance exercise in RA patients and controls. The RA patients in the present study had only slightly elevated systemic inflammatory markers. 20 CLINICAL EXPERIENCE IS IMPORTANT WHEN ASSESSING VARUS THRUST IN KNEE OSTEOARTHRITIS Bye EK a, Magnussen B a, Skou ST b,c, Mølgaard CM a,d. a Department of Physiotherapy, University College Northern, Aalborg. b Center for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Faculty of Medicine, Aalborg University, 9220 Aalborg, c Orthopaedic Surgery Research Unit, Aalborg University Hospital, 9000 Aalborg, d Department of Occupational- and physiotherapy, Aalborg University Hospital, 9000 Aalborg, Varus thrust at baseline increases the risk of progression of knee osteoarthritis (KOA). However, current methods of determining thrust are expensive or require the assistance of highly experienced clinicians. The aim of the present study was to assess the importance of clinical experience when determining the presence of varus thrust. Material and method Two physiotherapist students and one experienced physiotherapists in evaluating varus thrust assessed videos of 20 KOA patients (mean age: 63.4, 75% women) during treadmill walking for the presence varus thrust (+/- thrust) using a standardized protocol. Kappa statistics were applied to the findings. The agreement between physical therapist students and experienced clinicians in determining varus thrust was moderate (Kappa value of 0.6). Varus thrust assessed during clinical gait observation is influenced by clinical experience, and is not applicable when assessed by those with little or no experience. Since varus thrust is a risk factor for progression of KOA future studies are needed to determine whether other methods can be used to evaluate varus thrust in clinical practice. 21 INTRATESTER RELIABILITY OF HAND-HELD VERSUS STRAP-MOUNTED DYNAMOMETRY TO ASSESS ANKLE INVERSION AND EVERSION STRENGTH McGirr KA 1, Kennedy TSR 1, Mølgaard CM 2,3, Rathleff MS 1 Orthopaedic Surgery Research Unit, Aalborg University Hospital Department of Occupational and Physiotherapy, Aalborg University Hospital Department of Physiotherapy, University College Northern Ankle inversion and eversion strength is important in clinical situations, such as assessment of ankle sprain risk and rehabilitation after ankle sprain. The objective of this study was to investigate the intrarater reliability and agreement, and the concurrent validity of hand-held dynamometry (HHD) versus strap-mounted dynamometry (SMD), in assessing ankle eversion and inversion strength. Material and Method The study was an intrarater and concurrent validity study, with 25 healthy individuals. Three standardised make and break tests were performed for ankle eversion and inversion with both HHD and SMD by a male rater with limited experience. Tests were repeated after a restperiod. Reliability was calculated using intraclass correlation coefficients (ICC 2.1) and Limits of Agreement in percentage of mean strength (LoA%). Concurrent validity was measured with Pearson correlation coefficient and paired t-test. ICC for the make tests ranged from and with LoA% from % and % for HHD and SMD respectively. The SMD break test had slightly better reliability and agreement compared with HHD (ICC versus and LoA% % versus % for HHD and SMD respectively). Subjects had 17.6% higher strength during the inversion make test using HHD compared to SMD, otherwise no systematic differences were observed. The correlation between the two methods ranged from r= , p<0.0001, but was significantly lower for the eversion break test (r=0.22, p=0.30). This research suggests that a rater with limited experience can achieve reliable strength testing of inversion and eversion with both HHD and SMD. 22 Potential INTERACTION OF experimental KNEE pain And LATERALLY wedged INSoles FOR KNEE OFF- LOADING DURING WALKING. Mølgaard CM, a,b,c Graven-Nielsen T, b Simonsen O, d Kersting UG b a Department of Occupational and Physiotherapy Aalborg University Hospital, Aalborg, b Center for Sensory-Motor Interaction (SMI), Department of Health 24

25 Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, c Department of physiotherapy, University College Northern, Aalborg d Orthopaedic Division, North Region, Aalborg University Hospital, Aalborg, Laterally wedged insoles are one the gait modifications potentially slowing down progression of medial knee osteoarthritis. Clinical studies have, however found large individual differences in the biomechanical effect and an insufficient pain effect. To better understand if and how pain mediates mechanical changes during gait, the current study investigated how acute experimental knee pain change the mechanical effect of laterally wedged insoles in healthy subjects during walking. Material and Methods A full 3D gait analysis was carried out for twelve healthy individuals with a ten degree laterally wedged insole before and during experimental knee pain. The study was a cross-over design and data were collected with both a neutral and wedged insole with experimental pain/saline injections into in Hoffas fat pad and a control situation. Peak knee adduction moment (KAM1) was the primary outcome. A three factor repeated ANOVA was used to evaluate the relationship between the factors wedge, day, time. Experimental muscle pain did not affect generation or attenuation of KAM1 with lateral wedges. While frontal plane mechanics relatively unaffected by pain sagittal plane knee extension moment increased with laterally wedging (P=0.008), whereas late knee flexion moment was reduced with knee pain (P=0.04). It is concluded that the effect of laterally wedged insoles and attenuation of knee adduction moment during walking are independent of knee pain. The present study does provide some evidence that knee pain decrease sagittal plane mechanics, whereas lateral wedges have the opposite effect and increase knee extension moment. This should be further addressed in future clinical studies. 23 ACL injury prevention in handball - Time for action! Møller M (1), Zebis MK (2), Attermann J (3), Myklebust G (4), Wedderkopp N (5) (1) Department of Public Health, Section of Sport Science, Aarhus University, Aarhus, (2) Arthroscopic Centre Amager & Gait Analysis Laboratory, Copenhagen University Hospital, Copenhagen, (3) Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, (4) Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway (5) Institute of Regional Health Services Research and Center for Research in Childhood Health, IOB, University of Southern, Odense, Handball players are at high risk of sustaining ACL injuries. In 2005, the Danish Handball Federation initiated a nationwide campaign ( Knokl for dit knæ ) including a program aiming to improve information and prevent knee injuries shown to be efficacious in Norwegian handball. Purpose: To evaluate whether the campaign and preventive program has been successfully implemented in Danish handball. Material and method An delivered survey was completed by 333 senior (74 female, 53 male), U18 (53 female, 39 male) and U16 (87 female, 27 male) Danish handball players during the 2010/2011 season. The two following questions were asked: Are you aware of the campaign Knokl for dit knæ? If yes: Do you use the exercises from the campaign Knokl for dit knæ in your training? 35% of the players were aware of the campaign, and 12% used the prevention program in their training, 16% of the female handball players and 5% of the male handball players used the prevention program. Among the adolescent handball players, 35% of U16 players and 32% of U18 players were aware of the campaign and 16% and 9%, respectively, used the program in their training. Awareness of the Knokl for dit knæ program is not pervasive amongst Danish handball players, and implementation of this program is poor. Future research needs to be conducted to understand and address the barriers to program awareness and uptake amongst Danish handball players, in order to fulfill the promise it has shown as an injury prevention strategy. 24 Visual Scapula dyskinesis assessment is interobserver reproducible Povlsen SB (1), Attermann J (2), Myklebust G (3), Wedderkopp N (4), Ranvik AM (1), Sørensen H (5), Lind M (6), Møller M (5) (1) VIA University College, Aarhus, (2) Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, (3) Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway (4) Institute of Regional Health Services Research and Center for Research in Childhood Health, IOB, University of Southern, Odense, (5) Department of Public Health, Section of Sport Science, Aarhus University, Aarhus, (6) Department of Orthopaedics, Aarhus University Hospital, Aarhus, Previous studies have found moderate inter-observer reproducibility using a scapular dyskinesis test (SDT) among collegiate athletes. No studies have examined the inter-observer reproducibility for the SDT in a well-defined group of young athletes. Purpose: To examine the inter-observer reproducibility for the SDT in youth handball players. Material and Method In total, 86 U-16 and U-18 handball players with no present or previous shoulder pain (35 girls, 51 boys) were tested with the SDT by two trained physiotherapist students at two separate test stations. The participants performed 5 repetitions of bilateral weighted (Girls: 2 kg, boys: 3 kg) shoulder flexion and frontal plane abduction. Primary outcome was dyskinesis, defined as normal, subtle or obvious, using operational definitions based on abduction and flexion movement rated individually for the dominant and non-dominant arm. Inter-observer reproducibility was analyzed for the dominant and nondominant arm using weighted kappa statistics. A weighted kappa of 0.73 (sd 0.09) and 0.75 (sd 0.09) was found for the non-dominant arm and dominant arm, respectively. Total agreement of obvious dyskinesis was found among 29% of the players for the nondominant arm, and 23% for the dominant arm. In general, there was a high agreement, when categorizing into normal or obvious scapula dyskinesis (range 80-97%), but low agreement when categorizing the scapula as subtle (range 46-48%). In this present study we found a substantial acceptable kappa in both dominant and non-dominant arm in a sample of youth handball players, which is a higher inter-observer reproducibility than previously reported. 25

26 25 High-load strength training improves outcome in patients with plantar fasciitis: a prospective randomised study with 12 months follow-up Rathleff MS 1, Mølgaard CM 2, Fredberg U 3, Kaalund S 4, Andersen KB 3, Olesen JL 5,6. 1: Orthopaedic Surgery Research Unit, Aalborg University Hospital 2: Department of Occupational and Physiotherapy Aalborg University Hospital 3: Diagnostic Centre, Silkeborg Regional Hospital 4: Kaalunds Klinik, (private/public orthopaedic clinic), Aalborg 5: Department of Rheumatology, Aalborg University Hospital 6: Institute of Sports Medicine Copenhagen, Copenhagen University Hospital, Bispebjerg, The latest review advocate for plantar fascia specific stretching and shoe inserts as first line treatment of Plantar Fasciitis (PF). However high-load strength training have shown promising results on other degenerative tendon disorders and may yield higher treatment effect compared to plantar-specific stretching. The purpose of this study was to investigate the effectiveness of shoe insert and plantar fascia specific stretching versus shoe inserts and high-load strength training in patients with PF. Material and method 48 patients with ultrasonography verified PF were randomised to shoe inserts and daily plantar specific stretching (the stretch-group) or shoe inserts and high-load strength training (the strength-group) performed every second day. High load strength training consisted of unilateral heel-raises where a towel was inserted under the toes to utilise the windlass mechanism to cause high tensile forces to the plantar fascia. Primary outcome was the Foot Function Index (FFI) at 3 months. Additional follow-ups were performed at 1, 6 and 12 months. At 3 month, the strength-group had a 29 points lower FFI (95%CI: 6-52) compared to the stretch-group. At 1, 6 and 12 months the strength-group had a non-significant 5-7 points lower FFI. At 12 months the FFI were 22 (95%CI: 9-36) points in strength-group and 16 (95%CI: 0-32) points in the stretch-group. High-load strength training may aid in a quicker reduction in pain and improvements in function compared to plantar fascia stretching alone. However long-term outcome at 12 months shows no significant benefit of high load strength training. 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 1,2, Roos EM 3, Olesen JL 4,5, Rasmussen S 2 1: Health, Aarhus University,. 2: Orthopaedic Surgery Research Unit, Aalborg University Hospital, 3: Research Unit for Musculoskeletal Function and Physiotherapy, Institute of Sports Science and Clinical Biomechanics, University of Southern, 4: Department of Rheumatology, Aalborg University Hospital, 5: Institute of Sports Medicine Copenhagen, Copenhagen University Hospital, Bispebjerg, The prevalence of Patellofemoral Pain (PFP) among adolescents is 7% and is associated with long-lasting pain and disability. Patient education and exercise therapy are commonly used treatments but no studies have investigated the effect of these interventions in adolescents. The purpose of this trial was to investigate the effectiveness of patient education with or without the addition of exercise therapy among adolescents with PFP. Material and method 121 adolescents with PFP, aged years, were recruited from a population-based cohort of adolescents attending four different high schools. Adolescents were cluster-randomized (on school-level) to either patient education or patient education and exercise therapy. Patient education covered self-management of pain and information on PFP. Exercise therapy consisted of supervised exercises at school premises three times per week for three months and instructions on home-based exercises. Primary outcome was self-reported recovery (7-point Likert scale) at 12 months. Additional follow-ups were done at 3-, 6-, and 24 months. Follow-up rate was 91% at 12 months. Adolescents randomised to patient education and exercise therapy were more likely to be recovered at 12 months, (odds ratio (OR), 1.73, 95%CI: , Number needed to treat (NNT): 11). Similar results were observed at 3 and 6 months (OR: 1.88 and 1.43) while the effect was further increased at 24 months (OR: 2.52, NNT: 3). In adolescent PFP, the addition of exercise therapy was more effective than patient education alone. The effect was apparent already at 3 months and further increased up until 2 years. 27 Poorer 2-year prognosis of patellofemoral pain versus other types of knee pain: a prospective cohort study among 504 adolescents Rathleff MS 1,2, Rathleff CR 2, Olesen JL 3,4, Rasmussen S 2, Roos EM 5 1: HEALTH, Aarhus University, 2: Orthopaedic Surgery Research Unit, Aalborg University Hospital, 3: Department of Rheumatology, Aalborg University Hospital, 4: Institute of Sports Medicine Copenhagen, Copenhagen University Hospital, Bispebjerg, 5: Institute of Sports Science and Clinical Biomechanics, University of Southern, The prevalence of knee pain among year olds is 30% and patellofemoral pain (PFP) is the most common knee conditions with an insidious onset. Adolescent knee pain is considered self-limiting with a low long-term persistence, although no studies have been conducted to confirm this assumption. The purpose of this study was to investigate the 2-year persistence of knee pain among adolescents and to investigate if adolescents with PFP have a higher risk of persistent knee pain compared to other types of knee pain. Material and method The design was a prospective population-based cohort study. In 2011, adolescents between years from Aalborg, answered an online questionnaire on musculoskeletal pain. 504 reported knee pain and 153 were diagnosed with PFP. After 2 years, adolescents who reported knee pain in 2011 were contacted again. Primary outcome at follow-up was the proportion of adolescents with knee pain during the last week. At 2-year follow-up, 378 (75.0%) adolescents completed the questionnaire. 55.9% (95%CI: %) reported knee pain. Adolescents diagnosed with PFP at baseline had 25.6% (95%CI: %) higher risk of knee pain at 2-year follow-up compared to other types of knee pain. After 2 years, more than 55% reported knee pain during the last week. Adolescents with PFP had a higher risk of knee pain at 2-year follow-up 26

27 compared to adolescents with other types of knee pain. These results do not support the assumption that adolescent knee pain is self-limiting and has a low long-term persistence. 28 VALIDATION OF A NEW AND PRACTICAL METHOD WITH STABLE ISOTOPE-LABELED MILK PROTEINS AS TRACER FOR MEASUREMENT OF MUSCLE PROTEIN SYNTHESIS Reitelseder S, Bülow J, Agergaard J, Kjaer M, Holm L 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, Muscle protein synthesis (MPS) can be measured by use of stable isotope-labeled amino acids, which usually are given intravenously at a constant infusion rate for several hours. This procedure is hardly applicable in daily living settings. Therefore, aim of this study was to validate MPS measurements based on a tracer protocol with intrinsically stable isotope-labeled milk proteins given solely in oral boluses together with normal diet and different levels of physical activity. 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). Venous blood and muscle biopsies were collected. Plasma [1-13 C]leucine enrichment increased within the first 30 min after first intake and were stable around 4% tracer to tracee ratio (TTR) throughout the 10-h FSR period in all groups. Muscle free [1-13 C]leucine enrichment was equally high at first and second biopsy (2% TTR). Muscle FSR were for IA, DA, and SE 0.065± %/h, 0.077± %/h, and 0.081± %/h, respectively (means±se). A sufficient enrichment of free leucine in plasma and muscle was achieved by this tracer protocol, and, therefore, the prerequisites for calculating FSR was fulfilled with the tracer coming solely from oral intake of proteins. 29 CLINICAL PRESENTATION AND RADIOLOGICAL FINDINGS OF A CONSECUTIVE SERIES OF ACUTE GROIN INJURIES IN ATHLETES. Serner A 1,2, Tol J 1, Weir A 1, Jomaah N 1, Whiteley R 1, Robinson M 1, Thorborg K 1,2, Hölmich P 1,2. 1) Aspetar Sports Groin Pain Center, Qatar Orthopedic and Sports Medicine Hospital, Doha, Qatar 2) Arthroscopic Center Amager, SORC-C, Copenhagen University Hospital, Amager-Hvidovre, High quality prospective studies on injury mechanisms, distribution of muscles involved and radiological grading of acute groin injuries are lacking. The objective of this study was to describe these parameters in a prospective cohort of athletes. Material and Method 72 male adult athletes presenting with acute groin pain, within 7 days of injury occurrence were prospectively studied (Aug Oct. 2013). All patients underwent a standardized history, clinical examination, magnetic resonance imaging and/or ultra sound. A clinical entity approach was used to classify all the injuries, and a radiological grading system was used to define the severity in 4 grades. The primary sport was football (61%), and the most common injury mechanism was kicking (36%), followed by stretch situations (21%), change of direction (19%), and sprinting (10%). Sixty percent (43/72) of injuries occurred in the dominant leg. Adductor-related injuries were most frequent (63%), followed by iliopsoas-related injuries (15%) and proximal rectus femoris injuries (15%). Sartorius injuries accounted for 4%, and abdominal-related injuries (3%). Twelve (17%) athletes presented with multiple injuries, with a combination of adductor and abdominal injuries in 9 (75%) of these cases. A total of 14 (19%) grade 0 injuries, 25 (35%) grade I, 26 (36%) grade II, and 7 (10%) grade III injuries were recorded. The most common acute groin injuries are adductor-related, with the kicking action as the most common mechanism. The majority (81%) of the injuries had visible radiological findings (grade I, II or III). 30 GOOD LIFE WITH ARTHRITIS IN DENMARK (GLA:D). LONG-TERM EFFECTIVENESS AND PREDICTORS OF OUTCOME AT 1 YEAR Skou ST 1,2,3, Simonsen ME 1, Roos EM 3 1: Orthopaedic Surgery Research Unit, Aalborg University Hospital, 2: Department of Health Science and Technology, Centre for Sensory- Motor Interaction, Aalborg University, 3: Research Unit for Musculoskeletal Function and Physiotherapy, Institute of Sports Science and Clinical Biomechanics, University of Southern, Long-term effectiveness represents a major challenge in non-surgical osteoarthritis (OA) management. Identifying predictors of long-term effectiveness could benefit treatment outcome. The purpose of this study was to: 1) determine effectiveness from patient education and supervised neuromuscular exercise at 1 year; and 2) evaluate if changes in and absolute values of function and self-efficacy immediately following treatment were predictors of improvement in pain. Material and Method Pain (VAS 0-100) was assessed at baseline, immediately after intervention (3 months) and at the long-term follow-up (1 year). Change in pain from baseline to 1 year was the dependent variable in a univariate regression analysis with changes from baseline to 3 months and absolute results after 3 months in physical performance (30-second chair stand test) and self-efficacy, respectively, as the independent variables. 82 patients treated in a physiotherapy clinic with knee and/or hip OA (68 women; mean age (SD) 62.5 (7.2); mean baseline pain intensity (SD) 43.0 (18.7)) were included. Improvements in pain immediately after treatment (-12.7 mm, P<0.001) was maintained after 1 year (-10.5 mm, P<0.001). Changes in self-efficacy (Beta= 0.369; Adjusted R 2 =0.12), absolute 30-second chair stand test (Beta= 0.251; Adjusted R 2 =0.05) and absolute self-efficacy score (Beta= 0.492; Adjusted R 2 =0.23) at 3 months were significant predictors of 1 year improvement in pain (p<0.05). The effect from patient education and supervised neuromuscular exercise was maintained at 1 year. Immediate treatment results, especially in terms of self-efficacy, predicted long-term pain relief. Patients with a good treatment outcome directly following GLA:D treatment can expect long-lasting effects. 27

28 31 Association between maximal hamstring muscle strength and hamstring muscle pre-activity during a movement associated with non-contact ACL injury Sørensen RS, Bencke J, Thorborg K, Bandholm T, Hölmich P, Andersen LL, Myklebust G, Gliese B, Lauridsen HB, Aagaard P, Zebis MK Gait Analysis Laboratory, sec. 247, Dep. of Orthopaedic Surgery, Copenhagen University Hospital at Hvidovre, Reduced hamstring pre-activity during side-cutting may predispose for non-contact ACL injury. During the last decade resistance training of the lower limb muscles has become an integral part of ACL injury prevention in e.g. soccer and handball. However, it is not known whether a strong hamstring (ACL-agonist) musculature is associated with a high level of hamstring muscle pre-activity during high risk movements such as side-cutting. The purpose of this study was to examine the relationship between hamstring muscle pre-activity recorded during a standardized sidecutting maneuver and maximal isometric hamstring muscle strength. Material and Methods Eighty-five female athletes (17 ± 1 yrs) were screened for neuromuscular pre-activity in medial (ST) and lateral (BF) hamstring muscle during a sidecutting maneuver. Maximal hamstring muscle strength [N/kg BW] (MVC) was measured in a static dynamometer. Neuromuscular activity calculated as average EMG amplitude obtained during side-cutting in the 10 ms interval prior to initial contact (IC) was normalized to peak EMG amplitude obtained during MVC. The correlation between % EMG pre-activity (mean of ST and BF) and MVC was evaluated by Spearman rank correlation analysis. The correlation coefficient (r s ) between hamstring pre-landing EMG activity and MVC was (P=0.319). No direct association was observed between preparatory hamstring muscle activity and MVC. This indicates that high muscle strength may not per se translate into high levels of muscle pre-activity during movements like the sidecutting maneuver. Thus, other exercise modalities (i.e. neuromuscular training) are needed to optimize hamstring muscle pre-activity during movements associated with noncontact ACL injury. 32 Pain intensity and pain duration is not associated to area of allodynia in patients with plantar fasciitis Aaskov S 1, Rathleff MS 2, Kaalund, S 1 1.Kaalunds Orthopaedic Clinic, Aalborg 2. Orthopaedic Surgery Research Unit, Aalborg Hospital - Aarhus University Hospital, Plantar Fasciitis (PF) is a common cause of heel pain in adults. Tissue injury associated with PF may lead to sensitisation of peripheral nociceptors and hence increase the area of allodynia. The purpose of this pilot study was to investigate if pain duration and pain intensity is associated to an increased area of allodynia in patients with PF. Material and methods 23 patients with PF verified by ultrasonography were included, (9 men, average BMI 27.3±4.6). A trained physiotherapist palpated the heel to determine the area of allodynia. The area of allodynia was marked with soft pen and transferred onto a piece of paper. Afterwards the area of allodynia was measured in cm2. Pain was measured by subscore pain on the Foot Function Index (FFI-pain). Spearman Rank correlation was used to test the association between area of allodynia, FFI-pain and pain duration. Mean pain score was 45.0 (±14.4). Average pain duration was 8.2 months (±3.6months). The average thickness of the plantar fascia was 6.8mm (±1.7mm). All 23 patients reported pain on the medial tuber calcanei however three patients also reported pain at the central part of the heel. There were no association between area of allodynia and FFIpain (r=-0.31, p=0.24) or area of allodynia and pain duration (r=-0.39, p=0.14). s The typical patient with PF reports pain on the medial tuber calcanei and have a long pain duration and high FFI pain score. We found no association between pain duration, pain intensity and area of allodynia. 33 TWO NARRATIVE INTERVIEWS DESCRIBING THE INFLUENCE OF A COURSE ON THE DANISH HOMELESS SOCCERTEAM Forfatter navne: Bjerregaard A, Pedersen CT Institution: Metropolitan University College In society today there is an increased attention how to construct health- and sportsinterventions for marginalised-groups. The term marginalized is defined as individuals living a life which falls outside the common perception of what a good life is. With this paper we seek knowledge to obtain an understanding on how two marginalised-people have experienced to be a part of the project Ombold and how their participation has affected their lives in which can be applicable for other health projects. Material and method: A qualitative study based on two semi-structured interviews from Ombold. The interviews are analysed through a modified version of systematic text condensation described by Malterud. Furthermore, the material is discussed on the basis of the theories of Self Efficacy and Social Capital developed by Bandura and Putnam. : The results are presented as narratives. A quotes from one of the players. My mind was empty, I was only thinking of drugs. I did not have much faith in the future. But when I played football, I didn t have to do drugs. It changed my way of thinking about myself. If I could handle football, I could handle everything else in life. : Both players have through the course of Ombold increased their Self Efficacy either Social Capital. This has a positive effect on their health behaviour and quality of life. For both football players hashaddiction was eider reduced or completely stopped. They have become more tolerant towards others and able to control their temper. 34 ULTRASONOGRAPHIC MEASUREMENT OF THE HEALTHY PATELLAR TENDON A STUDY OF INTRA- AND INTERT- ESTER RELIABILITY Christensen SW a, Skjoldager M b, Mølbak S c, Jørgensen H c, Olesen J d, Skou ST a,e. a Center for Sanse-Motorisk Interaktion (SMI), Institut for Medicin og Sundhedsteknologi, Aalborg Universitet, 9220 Aalborg b Arkadens Fysioterapi, 9000 Aalborg c University College Nordjylland, 9000 Aalborg. d Reumatologisk Afdeling, Aalborg Universitetshospital, 9000 e Aalborg Ortopædkirurgisk Forskningsenhed, AalborgUniversitetshospital, 9000 Aalborg 28

29 Musculoskeletal ultrasonographic measurement (USM) is used to diagnose patellar tendinopathy on a daily basis in a clinical setting. However, USM is operator dependent, which is why the reliability is important, when a tendon is investigated several times. Previous studies have only measured patellar tendon thickness at a few measurement points, which does not resemble daily clinical practice, where the whole tendon is scanned. This study aimed at investigating intra- and intertester reliability of USM of patellar tendon thickness at several different measurement points. Method A standardised USM protocol with 16 measurement points at the patellar tendon was used. Two examiners with 9 and 4 years of experience investigated 12 healthy participants. The patellar tendon was scanned bilaterally, both longitudinal and transversal. Reliability was calculated using interclass correlation coefficient (ICC) and Bland Altman s 95% limits of agreement (LOA). Intratester reliability showed an average ICC (range) for examiner one of 0.84 ( ) and for examiner two of 0.88 ( ). 15 of the 16 points showed ICC values above 0.7 for both examiners. LOA% (range) for examiner one was 22.5% (14.8%-38.6%) and for examiner two 20.9% (0.0%-35.0%). Intertester reliability showed an average ICC (range) of 0.70 ( ) and average LOA% (range) of 27% ( %). 8 of the 16 points showed ICC values above 0.70 and an average LOA% of 19.2% (14.7%-27.3%) This study found a low to very high intratester and intertester reliability at the different measurement sites. Reliability seems dependent on which site tendon thickness is measured. Keywords Patellar tendon, musculoskeletal, ultrasound imaging, reliability 35 THE WITHIN AND BTWEEN DAY RELIABILITY OF A VARIETY OF TESTS ASSOCIATED WITH LOVER LIMB FUNCTIONAL PERFORMANCE Ghulam H, Herrington L, Comfort P, Jones R Knee Biomechanics and Injury Research Programme, University of Salford, Salford, United Kingdom Background There is limited literature exploring the within and between day reliability of the five tests: hop tests, knee valgus angle tests, balance tests, force tests, and isokinetic muscle testing. These tests may help to investigate the causes which may lead to lower limb injury especially ACL injuries. These individual tests potentially form critical elements in the performance of hop tests, before examining these relationships the reliability of each of the individual tests needs to be established. Therefore, the aim of this study is to investigate the reliability of these tests. Objective To assess the within and between day reliability of five different tests: hop tests, knee valgus angle tests using 2D camera, balance tests using force plate (FP), force tests using Ballistic Measurement System (BMS), and isokinetic muscle testing using BiodexSystem. Design A reliability study. Participants 12 recreational athletes, 8males and 4 females, were recruited (age ± 3.05 years; height 1.7 ± 6.47 m; and mass ± kg). Interventions In this study, there are five different tests have been taken on both legs individually: Hop tests: there are two different tests under hop tests which are: hop for distance test and cross over hop test. Knee valgus angle tests: there are two different tests under knee valgus angle tests which are: hop for distance test and squat test. Balance tests: there are three different tests under balance tests which are: straight leg balance test, bent leg balance test, and hop for distance balance test. Force tests:there are four different tests under force tests which are: squat jump, countermovement jump, ten jumps, and isometric pull. Isokinetic muscle strength tests:in this test there are four different muscle strength tests which are: quadriceps muscle test, hamstring muscle test, ankle plantar flexor muscles test, and hip extensor muscles test. Main Outcome Measurements Hop tests: from the above mentioned tests we measured the maximum point reached by the subjects when hopping. Knee valgus angle tests: from the above mentioned tests we measured the angle of knee valgus when reaching the maximum knee flexion position. Balance tests: from the above mentioned tests we measured the postural sway of the subjects throughout two tests which are: straight leg and bent leg tests. While time to stability was measured during hop land test. Force tests: from the above mentioned tests we measured six different variables which are: maximum rate of force development (RFD), peak force, peak power, peak velocity, time to peak force, and time to peak power. Isokinetic muscle strength tests: from the above mentioned tests we measured three different variables which are: peak torque, peak torque to body weight, and the work to body weight. All of the muscle strength tests have been applied in both concentric and eccentric muscle actions. and conclusion In this study we can clearly see that there are substantial to excellent reliably findings in the most of the tests during Within-day and Betweendays trials. However, there are fair to moderate reliability data has been found in both time to peak force and time to peak power while measuring the force during isometric pull test only when testing both legs individually. 36 NEUROMUSCULAR KNEE JOINT CONTROL IN ADOLESCENTS WITH AND WITHOUT GENERALISED JOINT HYPERMOBILITY DURING LANDING IN THE SINGLE LEG HOP FOR DISTANCE TEST 1, 2 Junge T, 3, 4 Juul-Kristensen B, 3 Bloch Thorlund J, 3 Søgaard K, 1, 5 Wedderkopp N 1 Institute of Regional Health Services, University of Southern, 2 Department of Physiotherapy, University College Lillebaelt, 3 Department of Sports Science and Clinical Biomechanics, University of Southern, 4 Institute of Occupational Therapy, Physiotherapy and Radiography, Bergen University College, Bergen, Norway 5 Spine Centre of Southern, SLB-Middelfart, Knee injuries often occur due to biomechanical factors such as knee joint laxity. Knee hypermobility is frequent in individuals with Generalised Joint Hypermobility (GJH) and has been proposed as intrinsic risk factor for knee injuries in adults and adolescents. To potentially compensate for reduced passive joint stability, adequate neuromuscular knee joint control is required before and during loading. The objective was to investigate differences in knee neuromuscular pre and post activation landing patterns in adolescents with GJH and without GJH (NGJH) in the Single leg Hop for Distance (SLHD) test. Material and Method Fifty-four adolescents (10-15 years), 25 with GJH and 29 with NGJH participated. GJH inclusion criteria were Beighton score 5/9 and 29

30 hypermobility of at least one knee, and no current pain in the lower extremities. EMG of Vastus Medialis (VM), Vastus Lateralis (VL), Biceps Femoris (BF), Semitendinosus (ST), Gastrocnemius Medialis (GM) and Lateralis (GL) of the most hypermobile knee for the GJH group was used to determine pre- and post impact activation levels in %MVE during landing in the SLHD. GJH pre activated ST 30% less compared with NGJH (22.1 (±12.6) vs 31.4 (±16.6.), p=0.02) ms before landing. Conversely, GJH had 28% higher GM pre activation than NGJH (32.5 (±14.8) vs 23.2 (±15.6), p=0.02). There was no difference in the SLHD test (p=0.67). s Lower ST and higher GM pre activation levels were found in adolescents with GJH and knee hypermobility compared with NGJH. The latter could be a compensatory strategy to enhance joint stability. 37 REPRODUCIBILITY AND VALIDITY OF THE NINTENDO WII BALANCE BOARD FOR ASSESSMENT OF BALANCE IN CHILDREN Larsen 1 LR, Jørgensen 2 MG, Junge 1 T, Juul-Kristensen 3, 5 B, Wedderkopp 1, 4 N 1 University of Southern, Institute of Regional Health Services Research, Winsloewparken 19,3, 5000 Odense C, 2 Department of Geriatrics, Aalborg University Hospital, Hobrovej 18-22, 9000 Aalborg, 3 University of Southern, Institute of Sports Science and Clinical Biomechanics, Campusvej 55, 5230 Odense M, 4 Sports Medicine Clinic, Orthopaedic Dep. Hospital of Lillebaelt Middelfart and Vejle, 5 Bergen University College, Institute of Occupational Therapy, Physiotherapy and Radiography, Department of Health Sciences, Bergen, Norway Good balance control is an important ability in relation to coping with daily activities, and avoiding sport injuries. The use of force platforms to assess balance control, as Centre Of Pressure path Length (COPL) is well known in laboratory settings. It is, however, often difficult to operate, economic costs are high, and feasibility is low. It has been proposed, that balance measures from the low-cost Nintendo Wii board (NWB), is both reproducible and comparable with balance measures obtained from laboratory force platforms, when measuring adults. This has not been investigated in a population of children. The purpose was to investigate (1) the reproducibility of the NWB and a laboratory force platform (AMTI), and (2) to explore the concurrent validity of the NWB compared to the AMTI in a population of children. Method Fifty-four participants, aged years old, from the CHAMPS-II Study DK, performed four different balance tests on NWB and AMTI: Bilateral stance with eyes open (1), unilateral stance on both dominant (2) and non-dominant leg (3) with eyes open, and bilateral stance with eyes closed (4). To assess reproducibility participants had a two-hour break between sessions. Concordance Correlation Coefficient (CCC) for the reproducibility analysis of the NWB was For the AMTI the CCC was Analysis of the concurrent validity resulted in CCC between The NWB has excellent reproducibility in a population of children during four static balance tests. Concurrent validity was excellent in three of four tests, moderate in the fourth test. 38 COMPARISON OF A 12-WEEK PARTLY SUPERVISED EXERCISE PROGRAMME AND A SELF-ADMINISTERED EXERCISE PROGRAMME FOR PATIENTS NEWLY DIAGNOSED WITH RHEUMAOTID ARTHRITIS Seneca T, Hauge EM, Maribo T Department of Rheumatology and Department of Physiotherapy and Occupational Therapy Aarhus University Hospital There is a need for establishing the proper framework and level for exercise programmes for patients with newly diagnosed Rheumatoid Arthritis (RA). The aim of this study was to compare the effect of a partly supervised and a self-administered intensive training programme in patients with newly diagnosed RA. Materials and Methods Fifty-two patients with newly diagnosed RA were randomised to receive either a 6-week supervised exercise programme followed by a 6-week self-administered exercise programme (group 1) or a 12-week self-administered exercise programme (group 2). The endpoints were changes in muscle strength (kg), physical fitness (V O2max in ml/kg/min.), pain perception (NRS), Health Assessment Questionnaire (HAQ-DI), in Short Form 36 health survey questionnaire (SF36v2) and in Fearavoidance Beliefs Questionnaire (FABQ). Thirty-six patients completed the study. Following the 12-week exercise programme changes in muscle strength between groups were significantly different in trunk extensors (p<0.001), but not in legs (p=0.18) shoulders (p=0.17) and trunk flexors (p=0.18), physical fitness (p=0.16) and pain perception (p=0.26). There were no significant chances between groups measured by HAQ-DI, SF36v2 and FABQ (p=0.97, 0.80/0.09 and 0.92). Within-groups changes were significant in muscle strength in legs (p<0.001 and <0.001), shoulders (p<0.001 and <0.001), trunk extensors (p<0.001 and 0.001) and trunk flexors (p<0.001 and <0.001), as well as in physical fitness (p=0.003 and 0.018). Group 1 had significant changes in pain perception (p=0.03 and 0.93). A partly supervised exercise programme seems not to be more effective compared with a self-administered exercise programme. 39 ECCENTRIC HIP-ADDUCTION STRENGTH DEFICITS IN SOCCER-PLAYERS WITH ADDUCTOR-RELATED GROIN PAIN Thorborg K 1, Branci S1, Nielsen MP 1, Tang L 1, Nielsen MB 2, Hölmich P 1 1 Arthroscopic Centre Amager, Copenhagen University Hospital, Amager, Copenhagen, Departments of Orthopaedic Surgery and Physical Therapy, Copenhagen University Hospital, Hvidovre, Copenhagen,. 2 Section of Ultrasound, Radiology Department, Rigshospitalet, Copenhagen University Hospital, Adductor- related pain is the most common clinical finding in soccerplayers with groin pain, and can be a longstanding problem affecting their physical function and performance. Hip adductor weakness has been suggested to be associated with this clinical entity, but this has never been investigated. The purpose was to investigate whether isometric and eccentric hip adduction strength are decreased in soccerplayers with adductor-related groin pain compared with asymptomatic soccer-controls. Material and method 28 soccer-players with adductor-related groin pain were included in a single-blinded, cross-sectional study. The dominant legs of 21 soccerplayers with adductor-related groin pain ( 4 weeks duration) were 30

31 compared with the dominant legs of 16 asymptomatic soccer-players (controls) in a cross-sectional design. The mean age of the symptomatic players was 24.5±2.5 years and the mean age of the controls was 22.9±2.4 years. Isometric and eccentric hip strength were assessed with a hand-held dynamometer, using reliable test-procedures, and a blinded assessor. Eccentric hip adduction strength was 21% lower in soccer-players with adductor-related groin pain in the dominant leg (n=21) compared to controls (n=16), namely 2.45±0.49 Nm/kg versus 3.12±0.43 Nm/ kg, respectively, p< No other strength differences were observed between symptomatic players and controls for the dominant leg (p= ). These results were confirmed by similar findings in the nondominant leg (n=18) between symptomatic players and controls (p= 0.001). Large eccentric hip adduction strength deficits were found in soccerplayers with adductor- related groin pain compared with asymptomatic players, while no isometric strength deficits were observed between the groups. Ultralydsscannere Secma tilbyder et bredt udvalg af ultralydsscannere som er velegnet til muskuloskeletal ultralydsscaning. På alle vores Sonosite produkter tilbyder vi 5 års garanti på både apparatet og transducerne. Vi tilbyder et omfattende uddannelsesprogram, og arbejder tæt sammen med de førende udbydere af kurser. Vi anbefaler hjemmesiden for yderligere information. Få en demonstration Vi kommer gerne forbi din klinik og demonstrerer mulighederne med én eller flere af vores ultralydsscannere. Kontakt os på [email protected] eller ring på og book en demonstration i din klinik. Læs mere på: IceBand køle- og kompressionsbandage Køling med medicinsk godkendelse (CE MD Class 1) OPLEV DEN UTROLIGE K-LASER CUBE4 PÅ VORES STAND Bruger dine patienter køling så ofte som de bør? Bandagen er godkendt til anvendelse DIREKTE på huden. Linvatec Tel IceBand annons Dk 1312.indd :38:19

32 EXHIBITION PLAN ANNUAL CONGRESS DANISH SPORTS MEDICINE (DIMS-FFI) 1 Protesekompagniet MAIN HALL Biomet Maribo Medico Sahva 5.Proterapi 6 Arthrocare 7 Smith & Nephew 8 BK-medical 9 Fitpartner 10 Exorlive 11 Clinical Innovation 12 Stryker 13 Sportspharma COFFEE Simonsen og Weel DJO Nordic Eickemeyer 17 ConMed/Linvatce 18 Chiroform 19 Secma ROOM B ROOM C COFFEE COFFEE ROOM A Bauerfeind Arthrex 32