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Open access

Krzysztof Ficek, Remigiusz Rzepka, Tomasz Orawczyk and Zbigniew Żołnierczyk

Groin Pain in Athletes – Clinical Experience

Dysfunction of lumbo-pelvic area is a common problem in many sports. Due to insufficient data supporting variables predisposing to lumbo-pelvic dysfunction, and a lack of standards in thorough assessment, understanding the overall problem continues to provide clinical complications; and unfortunately, the prognosis is less than promising. Most often this type of non-contact injury in the groin area is seen in dynamic sports involving running, sprinting, and sports performed over longer time periods, where fatigue plays an important role (soccer, rugby, hockey). There have been proposals in identifying most probable factors influencing the occurrence of pelvic overload injury. Among those we can list: muscle strength and balance, training regimen (including warm-up), fatigue, flexibility, body mechanics, sports specific activities, movement technique, previous injury, and psychological state. During clinical assessment by the physician and physiotherapist, many of these risks of injury factors are found. Currently more attention is given to neuromuscular factors that can affect risk of this pathology.

Our clinical experience suggests that poor neuromuscular control and lack of strength may significantly contribute to injury in the lumbo-pelvic and groin area. Certain objective indexes (e.g., hamstrings to quadriceps strength H/Q, stability deficits) can be important indicators of injury risk, as well as guidelines for motor dysfunction recovery.

Open access

Krzysztof Ficek, Tomasz Kamiński, Ewa Wach, Jerzy Cholewiński and Paweł Cięszczyk

Application of Platelet Rich Plasma in Sports Medicine

Any new method of treatment is associated with high expectations for its success, particularly if the therapy is based not only on the premise of achieving a symptomatic effect, but also improving functional quality and repairing structurally damaged tissues. Platelet Rich Plasma (PRP) application was shown to be a successful catalyst in the healing process for a wide variety of conditions in animal and human models. However, its use has been controversial due to many types of the PRP definition, optimal concentration, and modalities of implementation. In the qualification of patients for PRP treatment, not only should medical indications be considered, but also the role of participation in therapy with a physiotherapist supervising physical parameters and techniques used during recovery time. Further study is required in order to define optimal handling procedures of PRP injection. Long-term follow up will reveal if the promise of this substance can be realized and implemented to maximize its potential as a therapeutic remedy.

Open access

Agata Grenda, Agata Leońska-Duniec, Mariusz Kaczmarczyk, Krzysztof Ficek, Paweł Król, Paweł Cięszczyk and Piotr Żmijewski

Abstract

We hypothesized that the ACE ID / ACTN3 R577X genotype combination was associated with sprint and endurance performance. Therefore, the purpose of the present study was to determine the interaction between both ACE ID and ACTN3 R577X polymorphisms and sprint and endurance performance in swimmers. Genomic DNA was extracted from oral epithelial cells using GenElute Mammalian Genomic DNA Miniprep Kit (Sigma, Germany). All samples were genotyped using a real-time poly- merase chain reaction. The ACE I/D and the ACTN3 R577X genotype frequencies met Hardy-Weinberg expectations in both swimmers and controls. When the two swimmer groups, long distance swimmers (LDS) and short distance swimmers (SDS), were compared with control subjects in a single test, a significant association was found only for the ACE polymorphism, but not for ACTN3. Additionally, four ACE/ACTN3 combined genotypes (ID/RX, ID/XX, II/RX and II/XX) were statistically significant for the LDS versus Control comparison, but none for the SDS versus Control comparison. The ACE I/D and the ACTN3 R577X polymorphisms did not show any association with sprint swimming, taken individually or in combination. In spite of numerous previous reports of associations with athletic status or sprint performance in other sports, the ACTN3 R577X polymorphism, in contrast to ACE I/D, was not significantly associated with elite swimming status when considered individually. However, the combined analysis of the two loci suggests that the co-occurrence of the ACE I and ACTN3 X alleles may be beneficial to swimmers who compete in long distance races

Open access

Paweł Cięszczyk, Jerzy Eider, Magdalena Ostanek, Aleksandra Arczewska, Agata Leońska-Duniec, Stanisław Sawczyn, Krzysztof Ficek and Krzysztof Krupecki

Association of the ACTN3 R577X Polymorphism in Polish Power-Orientated Athletes

Alpha-actinins are an ancient family of actin-binding proteins that play structural and regulatory roles in cytoskeletal organization. In skeletal muscle, α-actinin-3 protein is an important structural component of the Z disc, where it anchors actin thin filaments, helping to maintain the myofibrillar array. A common nonsense polymorphism in codon 577 of the ACTN3 gene (R577X) results in α-actinin-3 deficiency in XX homozygotes. Based on knowledge about the role of ACTN3 R557X polymorphism in skeletal muscle function, we postulated that the genetic polymorphism of ACTN3 could also improve sprint and power ability.

We compared genotypic and allelic frequencies of the ACTN3 R557X polymorphism in two groups of men of the same Caucasian descent: 158 power-orientated athletes and 254 volunteers not involved in competitive sport.

The genotype distribution in the group of power-oriented athletes showed significant differences (P=0.008) compared to controls. However, among the investigated subgroups of athletes, only the difference of ACTN3 R577X genotype between sprinters and controls reached statistical significance (P=0.041). The frequencies of the ACTN3 577X allele (30.69% vs. 40.35%; P=0.005) were significantly different in all athletes compared to controls. Our results support the hypothesis that the ACTN3 577XX allele may have some beneficial effect on sprintpower performance, because the ACTN3 XX genotype is significantly reduced in Polish power-oriented athletes compared to controls.

This finding seems to be in agreement with previously reported case-control studies. However, ACTN3 polymorphism as a genetic marker for sport talent identification should be interpreted with great caution.

Open access

Robert Nowak, Dorota Kostrzewa-Nowak, Zbigniew Jastrzębski, Aleksandra Zarębska, Krzysztof Ficek and Paweł Cięszczyk

Abstract

Purpose. Hypercholesterolaemia is a highly prevalent condition that has major health- and cost-related implications for the society. Aerobic-type exercise improves lipoprotein-lipid profiles, cardiorespiratory fitness and body composition in healthy young women. Thus, the aim of the study was to assess the impact of 9 weeks of low-high aerobic-type exercise on the lipid profile among young women. Methods. On the basis of the lipid profile, 64 women (median age, 21.8 years; range, 19.0-24.7 years) were divided into two groups: with low (LRH) and intermediate (IRH) risk of developing hypercholesterolaemia. The participants completed a 9-week-long low-high aerobic exercise programme. Before and after the training programme, we determined the lipid profile: triglycerides (TG), total cholesterol (TC), lipoprotein cholesterol: HDL-C and LDL-C, and glucose levels. Selected cardiorespiratory fitness variables and body composition were also determined. Results. It was found that aerobic-type fitness exercise in the IRH group caused statistically significant decreases in TC and TG levels in comparison with baseline values. Significant increase in maximum oxygen uptake and decrease in HDL-C in the LRH group were also observed. Conclusions. Aerobic fitness exercises, a combination of two alternating styles, could influence the blood lipid profile by decreasing plasma TC and TG levels. In non-athlete women, physical activity may be a good tool to prevent cardiovascular diseases.

Open access

Tomasz Chamera, Michał Spieszny, Tomasz Klocek, Dorota Kostrzewa-Nowak, Robert Nowak, Milena Lachowicz, Rafał Buryta, Krzysztof Ficek, Jerzy Eider, Waldemar Moska and Paweł Cięszczyk

Summary

Background: Long-term and intensive physical effort causes metabolic and biochemical adaptations for both athletic and non-athletic objectives. Knowing the importance of aerobic training in football players, the aim of this study was to evaluate changes in the activity of: creatinine kinase (CK), creatine kinase MB (CKMB), lactate dehydrogenase (LDH), ahydroxybutyrate dehydrogenase (HBDH), cholinesterase (ChE) and alkaline phosphatase (ALP) in response to a semi-long distance outdoor run under aerobic conditions among both female and male football players.

Methods: Sixteen participants aged 21.9±2 years (women) and 18.4±0.5 years (men), all of them voluntarily recruited football players, took part in an outdoor run, the women covering a distance of 7.4±0.3 km while men covered a distance of 10.7±1.0 km. Plasma activities of the studied enzymes were determined using an appropriate diagnostic assay kit.

Results: Our results indicate that total LDH activity could be a useful tool in evaluating physical fitness among athletes. We simultaneously established that ChE could not be a marker useful in assessing metabolic response to physical effort in athletes. Moreover, our results suggest that post-effort changes in ALP activity might be used to estimate early symptoms of certain vitamin deficiencies in an athlete’s diet.

Conclusions: We confirmed that the assessment of activity of selected traditional diagnostic enzymatic markers provides information about muscle state after physical effort.

Open access

Piotr Król, Andrzej Franek, Jacek Durmała, Edward Błaszczak, Krzysztof Ficek, Barbara Król, Ewa Detko, Bartosz Wnuk, Lidia Białek and Jakub Taradaj

Abstract

The purpose of this article was to evaluate and compare the efficacy of radial and focused shock wave therapies applied to treat tennis elbow. Patients with tennis elbow were randomized into two comparative groups: focused shock wave therapy (FSWT; n=25) and radial shock wave therapy (RSWT; n=25). Subjects in the FSWT and RSWT groups were applied with a focused shock wave (3 sessions, 2000 shocks, 4 Hz, 0.2 mJ/mm2) and a radial shock wave (3 sessions, 2000 + 2000 shocks, 8 Hz, 2.5 bar), respectively. The primary study endpoints were pain relief and functional improvement (muscle strength) one week after therapy. The secondary endpoint consisted of the results of the follow-up observation (3, 6 and 12 weeks after the study). Successive measurements showed that the amount of pain patients felt decreased in both groups. At the same time grip strength as well as strength of wrist extensors and flexors of the affected extremity improved significantly. Both focused and radial shock wave therapies can comparably and gradually reduce pain in subjects with tennis elbow. This process is accompanied by steadily improved strength of the affected extremity.

Open access

Dominika Maciejewska, Małgorzata Michalczyk, Maja Czerwińska-Rogowska, Marcin Banaszczak, Karina Ryterska, Karolina Jakubczyk, Jakub Piotrwski, Joanna Hołowko, Arleta Drozd, Paweł Wysokińki, Krzysztof Ficek, Krzysztof Wilk, Anna Lubkowska, Paweł Cięszczyk, Jerzy Bertrand and Ewa Stachowska

Abstract

The aim of the study was to investigate the efficacy of 6 week Mediterranean diet or 30% calorie restriction on the fatty acid profile and eicosanoids (hydroxyoctadecadienoi acids and hydroxyeicosatetraenoic acids) concentration. Furthermore, basic biochemical variables such as insulin, glucose, HOMA-IR, and a lipid profile were estimated. The study enrolled 94 Caucasian former athletes aged 20-42, with body height of 179 ± 16.00 cm and body mass of 89.26 ± 13.25 kg who had not been active for at least 5 years. The subjects were randomly assigned to one of the three intervention groups: CR group – the 30% calorie restriction (n = 32), MD group - the Mediterranean diet (n = 34), and C group - a control group (n = 28). The pattern of nutrition was analysed before and after the experiment using the 72 h food diaries. In order to evaluate the effect of diet intervention, the following variables were measured: anthropometrics, basic biochemical variables (insulin, fasting glucose, HOMA-IR, lipid profile), fatty acids and their blood derivatives profiles. The CR group showed significantly lower levels of several biochemical variables, i.e., BMI, total cholesterol LDL, TG, total lipids, insulin and HOMA – IR (p < 0.05). Subjects consuming the MD diet significantly decreased their BMI and reduced the level of total lipids (p < 0.05). We did not find any significant changes in the C group. The analysis of the fatty acid profile revealed that the CR group had a significantly decreased EPA level (p < 0.05). The MD group showed a significantly increased level of the DHA (p < 0.05) and improvement in the omega - 3 index (p < 0.05). Subjects following the MD also showed significantly lower concentrations of 15 - hydroxyicosatetraenoic acid (15-HETE). We did not observe any significant differences between the CR and C groups. Within short time, calorie restriction helps to improve lipid variables and insulin resistance. The MD diet seems to be more advantageous in the decrease of inflammation, but does not improve basic biochemical variables. We can conclude that calorie restriction can be a good choice for former athletes, although EPA and DHA supplementation is needed.

Open access

Marta Stępień-Słodkowska, Krzysztof Ficek, Mariusz Kaczmarczyk, Agnieszka Maciejewska-Karłowska, Marek Sawczuk, Agata Leońska-Duniec, Miłosz Stępiński, Paweł Ziętek, Paweł Król, Monika Chudecka and Paweł Cięszczyk

Abstract

The purpose of this study was to examine the association of the BstUI RFLP C/T (rs 12722) and DpnII RFLP C/T (rs 13946) COL5A1 polymorphisms, individually and as haplotypes, with anterior cruciate ligament ruptures in recreational skiers. Subjects were 138 male recreational skiers with surgically diagnosed primary anterior cruciate ligament ruptures. The control group consisted of 183 apparently healthy male recreational skiers, who were without any self-reported history of ligament or tendon injury. DNA was extracted from buccal cells donated by the subjects and genotyping was carried out using real-time PCR. The genotype distributions for both polymorphisms met Hardy- Weinberg expectations in both groups. There were no significant differences in genotype distribution of allele frequencies of COL5A1 BstUI RFLP C/T and COL5A1 DpnII RFLP C/T polymorphisms between the ACL rupture and control groups. The T-T (BstUI RFLP T, DpnII RFLP T) haplotype was the most common (55.6%). The haplotype T-C was not present in any of the subjects. There was an underrepresentation tendency of the C-T haplotype in the study group compared to controls under recessive mode of inheritance. Higher frequency of the COL5A1 BstUI RFLP C/T and COL5A1DpnII RFLP C/T polymorphisms haplotype is associated with reduced risk of anterior cruciate ligament injury in a group of apparently healthy male recreational skiers.

Open access

Ewelina Lulińska-Kuklik, Masouda Rahim, Daria Domańska-Senderowska, Krzysztof Ficek, Monika Michałowska-Sawczyn, Waldemar Moska, Mariusz Kaczmarczyk, Michał Brzeziański, Ewa Brzeziańska-Lasota, Paweł Cięszczyk and Alison V. September

Abstract

Collagen alpha-1(V) chain, encoded by the COL5A1 gene, plays a crucial role in abundant fibrillar collagens supporting many tissues in the body containing type I collagen and appears to regulate the association between heterotypic fibers composed of both type I and type V collagen occurring among others in muscles, tendons and ligaments. Taking this fact into consideration we decided to examine the association between COL5A1 rs12722 and rs13946 polymorphisms, individually and as inferred haplotypes, with anterior cruciate ligament rupture risk (ACLR) in professional soccer players. A total of 134 male professional soccer players with surgically diagnosed primary anterior cruciate ligament ruptures and 211 apparently healthy male professional soccer players, who were without any self-reported history of ligament or tendon injury, were included in the study. Both the cases and the healthy controls were recruited from the same soccer teams, of a similar age category, and had a comparable level of exposure to anterior cruciate ligament injury. Genomic DNA was extracted from oral epithelial cells using GenElute Mammalian Genomic DNA MiniprepKit. All samples were genotyped for the rs12722 and rs13946 polymorphisms using a Rotor-Gene realtime polymerase chain reaction. Statistically significant differences in the genotype frequencies for the COL5A1 rs13946 polymorphisms in dominant modes of inheritance occurred (p = 0.039). Statistically significant differences were documented only in the dominant model under the representation tendency of the C-C haplotype in the ACLR group compared to controls (p = 0.038). Our results suggest that variation in the COL5A1 gene may be one of the non-modifiable factors associated with the ACL injury in professional soccer players. The C-C rs12722-rs13946 haplotype provides a protective effect against the ACL tear.