Soccer scores a health hat trick for hypertensive men

Playing soccer (football) could be the best way for people with high blood pressure, known as hypertension, to improve their fitness, normalise their blood pressure and reduce their risk of stroke. Research from Universities of Exeter and Copenhagen, and Gentofte University Hospital in Denmark, published today (Monday 15 October 2012) in the journal Medicine and Science in Sports and Exercise, suggests that soccer training prevents cardiovascular disease in middle-aged men with hypertension and is more effective than healthy lifestyle advice currently prescribed by GPs.

After six months of soccer training, three out of four men in this study had blood pressure within the normal, healthy range.

Almost one third of British men have hypertension, which increases the risk of cardiovascular diseases including stroke and coronary artery disease. It has long been known that physical exercise can reduce blood pressure in patients with hypertension, but until now little evidence is available on which form of exercise is most effective.

The research team recruited 33 men aged between 33 and 54 with mild to moderate hypertension. They randomly divided them in two groups: one took part in two hour-long soccer training sessions a week while the other received usual care by a GP including advice about the importance of physical activity and a healthy diet, together with control blood pressure measurements. The effects on exercise capacity, maximal oxygen uptake, body fat and blood pressure, were monitored after three months and at the end of the six-month trial.

For the soccer-playing group, average mean blood pressure was reduced by 10 mmHg, while the reduction was only 5 mmHg in the control group receiving the usual GP advice. For the football group, maximal oxygen uptake and maximal exercise capacity was improved by10 per cent, resting heart rate decreased by eight beats per minute and body fat mass dropped by an average of two kilograms. No significant changes to these health measures were observed in the control group.

The men who had taken part in soccer training were also found to be less physically strained during moderate intensity exercise. When taking part in activities such as cycling, they had markedly lower heart rates and elevated fat burning.

Lead researcher Professor Peter Krustrup of the University of Exeter said: "Playing soccer scores a hat trick for men with hypertension: it reduces blood pressure, improves fitness and burns fat. Only two hour-long football training sessions a week for six months caused a remarkable 13/8 mmHg in arterial blood pressure, with three out of four participants normalising their blood pressure during the study period.

"The soccer training also boosted the aerobic fitness and resulted in marked improvements in both maximal and moderate exercise capacity. Playing football made it easier for previously untrained men to train even harder, and also make it easier for them to cope with everyday life activities such as cycling, walking upstairs, shopping and lawn mowing."

Professor Peter Krustrup concludes "Although our previous research has highlighted the many health benefits of playing soccer, this is the first evidence that soccer may contribute fundamentally to prevention of cardiovascular disease in hypertensive men."

Senior cardiologist from Gentofte University Hospital in Denmark, Peter Riis Hansen, also emphasised that evidence suggests that the decrease in blood pressure after football training lead to a considerable reduction in the risk of stroke, myocardial infarction and death. "He said: Our results are very exciting and we are now trying to understand the findings in more depth, for example by investigating the effects of playing football on the heart's structure and function.

"Recent studies from our research group have also shown positive effects of football training on the blood pressure and heart in premenopausal women with normal blood pressure and we are now aiming to test the effects of football in women with hypertension."

England World Cup wins and losses linked to 30 percent rise in domestic violence

Domestic violence rates rose by an average of 30 percent each time England won or lost their games during the 2010 World Cup, but draws had little impact on the statistics.

Those are the key findings of research carried out by statistician Professor Allan Brimicombe and BBC News journalist Rebecca Cafe and published in the October issue of Significance, the magazine of The Royal Statistical Society and the American Statistical Association.

As a consequence of this and previous research, Professor Brimicombe believes there is a strong case for schools to educate pupils of the dangers of domestic violence, event organisers should promote initiatives that tackle domestic violence and that police forces should prepare themselves for peaks in domestic violence around major sporting events.

"Domestic violence is widespread, accounting for 15 percent of all violent crimes and 35 percent of murders in the UK," explains Professor Brimicombe, from the Centre for Geo-Information Studies at the University of East London.

"It is a crime that is estimated to affect some 30 percent of women and 17 percent of men at some point in their lives."

The researchers based their findings on statistics provided by 33 of the 39 police forces in England, which between them cover 77 percent of the country's population.

The data, for the period covering the 2010 World Cup and the same period in 2009, was obtained under the Freedom of Information Act 2000, which enables members of the public to request official information from public bodies.

The figures showed that when England drew 1-1 against the USA, domestic violence fell by 1.9 percent and when England drew 0-0 against Algeria it rose by 0.1 percent.

However when England won its game against Slovenia 1-0, domestic violence rose by 27.7 percent. And England's exit from the World Cup, after losing 4-1 to Germany, was accompanied by a 31.5 percent rise in domestic violence.

The research aimed to test the validity of an analysis carried out by the Home Office that showed that domestic violence had risen during the 2006 World Cup. "Major sporting events do not cause domestic violence, as perpetrators are responsible for their actions," said the analysis, "but the levels of alcohol consumption linked to the highly charged emotional nature of those events seems to increase the prevalence of such incidents."

Professor Brimicombe concludes that the Home Office findings were right in some respects but fell short in their analysis in other respects.

Professor Brimicombe explains: "Our research shows that increased levels of domestic violence are associated with national football matches, but only if there is a definite win or lose result. The failing of the earlier Home Office analysis was that it ignored the outcome of the match, which as we have seen is crucial.

"The percentage differences that we found are so great that we believe we have established a strong case for linking wins and losses, but not draws, to increased domestic violence.

"I hope that the findings will encourage improved education around the links between major sporting events and peaks in domestic violence and greater awareness of the risk.



"And I would applaud initiatives like the recent beer mat campaign highlighting the dangers of domestic violence, run by the London Borough of Newham and Metropolitan Police during the 2012 Olympics."

Physical therapy, not a knee brace, aids in ACL recovery

Wearing a knee brace following anterior cruciate ligament (ACL) surgery has no effect on a person’s recovery. However, strength, range-of- motion, and functionality exercises provide significant benefits, and other new therapies may show promise.

In a new literature review recently published in the Journal of Bone and Joint Surgery (JBJS), a team of orthopaedic surgeons reviewed 29 studies regarding treatment following reconstructive ACL surgery. They found that physical therapy, begun shortly after surgery, can bring about very good outcomes for patients. Bracing, though, did not seem to improve results.

The ACL runs through the middle of the knee joint and helps to stabilize it. While the ACL can be injured through impact, it is most commonly strained or torn during non-contact injuries when a person:
- Suddenly changes direction
- Stops abruptly
- Lands incorrectly after a jump

These injuries often require reconstructive surgery, with post-surgical rehabilitative therapy. These therapies usually focus on improving the patient’s strength, range of motion, and function, and also may include some balance exercises.

Other findings include:
Physical therapy should begin early, ideally within a few days after surgery.
Therapies focusing on proprioception (awareness of movement of one’s body) may have benefits; however, the extent of their efficacy requires further research.
Balance therapies also may be promising.
Neuromuscular therapies are not harmful, but their benefits are in doubt and require more study. Neuromuscular therapies should be used to support other physical therapies, not in place of them.
Accelerated rehabilitation also does not appear to be harmful, but should be studied further.
No vitamins or other supplements have been proven to have any effect on ACL healing.

“The most important thing for ACL surgery patients is to start physical therapy early and rigorously,” says Rick W. Wright, MD, professor and co-chief of the sports medicine department at the Washington University Department of Orthopaedic Surgery, St, Louis, Mo. "It can be difficult at first, but it’s worth it in terms of returning to sports and other activities.”