Surgical Reconstruction of the Anterior Cruciate Ligament: The Central Quadriceps Tendon as an Alternative Graft Source

*Red numbers
indicate references

INTRODUCTION
Significant advances in surgical reconstruction of the anterior
cruciate ligament (ACL) have been made since Jones’ described
open reconstruction with the central one-third patellar tendon
in 1963.29 Advancements in technology, arthroscopic instrumentation,
and surgical skills have decreased surgical morbidity while improving
functional outcome.5,
23
Continued technological
and surgical improvements in the 1990’s eventually enabled surgeons
to perform ACL reconstructions endoscopically. SIZE=”-2″>3, 4, 19, 23, 24, 37

During the evolution of ACL reconstruction surgery, numerous
graft sources have been described. Currently, the most commonly
utilized tissues for ACL reconstruction are autologous semitendinous/gracilis
tendons (ST-G), central one-third patellar tendon (B-PT-B), and
allograft patellar tendon. >13, 14, 21, 22, 31, 32, 46, 49, 50
Each of these grafts has been touted
to reliably restore knee stability, thereby enabling many patients
to return to pre-injury activity levels. Despite these reports,
complications have been noted with all three types of tendons,
the most frequent being anterior knee pain. SIZE=”-2″>1, 6, 7, 9, 10, 12, 17, 18

Based upon its proven efficacy,
the central 1/3 autologous patellar tendon is considered by a
large number of orthopaedic surgeons to be the graft of choice
in the symptomatic ACL-deficient patient. However, the incidence
of anterior knee pain with the use of this graft has been reported
from 13% to 47%, which diminishes the functional outcome in a
large percentage of individuals. SIZE=”-2″>1, 35, 43-45, 51 Moreover, due to technical factors such as tunnel
angle and graft length, many B-PT-B grafts cannot be secured
at the joint level, resulting in non-anatomic graft fixation.
In an effort to eliminate these problems, other graft sources
have been explored. The ideal ACL graft should result in minimal
or no damage to the patient’s tissues after harvest. It should
enable immediate rigid fixation and reproduce the normal anatomy
of the native ACL. It should also restore normal proprioception
and kinematics to the knee. Although numerous graft sources have
been reported, currently, no graft material, autograft or allograft,
can meet all these requirements.

In an effort to minimize post-surgical
anterior knee pain after ACL reconstruction, the use of semitendinosus/gracilis
tendons has been reported. Advocates of ST-G (hamstrings) point
out that post-operative patellar pain is diminished by virtue
of the patellar mechanism not being violated during graft harvest.
Various authors have reported the incidence of anterior pain
to vary from 3% to 21% following hamstrings ACL reconstruction.<FONT
COLOR=”#ff0000″ SIZE=”-2″>2, 11, 15, 26, 30,
33, 42 However, in the
author’s experience, the use of hamstrings for ACL reconstruction
does not eliminate anterior knee pain in many patients. In addition,
some authors have reported increased tibial translation in females
after ST-G ACL reconstruction. >16

Allograft B-PT-B has been advocated
as an alternative graft source due to the lack of harvest morbidity
and decreased operative time required. SIZE=”-2″>25, 32, 36, 41, 46 However, despite the diminished risk of disease
transmission, opponents of allografts cite reports of prolonged
graft-tunnel healing and intraarticular reactions to some allografts.<FONT
COLOR=”#ff0000″ SIZE=”-2″>28, 40

As a result of the continued
controversy regarding the correct ACL graft source, an alternative
graft has emerged, the central quadriceps tendon (CQT). The central
quadriceps tendon was reported as a graft source as early as
1979 by Marshall et al, however, it did not gain popularity among
surgeons until the 1980’s and 1990’s. SIZE=”-2″> 8, 21, 34, 47 Proponents of the CQT cite it’s greater cross-sectional
area, lower strain at failure, and lower modulus of elasticity
when compared to patellar tendon. SIZE=”-2″>48
Advocates have also cited the lower incidence of patellofemoral
symptoms after CQT graft usage. >20, 31
Our experience at the University of South Alabama Medical Center
is similar, with less then 5% of patients demonstrating postoperative
anterior knee pain symptoms after CQT ACL reconstruction.

The CQT consists of a central
portion of the quadriceps tendon approximately 10-11mm wide.
The graft depth extends 7mm with an average length of approximately
80-90mm. When the graft is harvested as the initial portion of
the surgical procedure, the central portion is obtained without
violation of the suprapatellar pouch or transection of the quadriceps
tendon. This eliminates the need to repair the pouch or tendon
before proceeding with the arthroscopic portion of the procedure.

Initial descriptions of the use of the CQT described harvest
of the tendon without a bone block from the patella.31 Prior
to the development of bioabsorable screws for soft tissue fixation,
such a graft would have required the tendon ends had to be secured
by sutures tied over a post, such a staple, button, or screw.
Several biomechanical studies have demonstrated that such fixation
does not reconstitute the normal isometricity of the ACL, with
increased instability noted as the tibial side is fixed further
away from the articular surface. SIZE=”-2″>27, 38
Consequently, many authors now advocate graft fixation near the
articular surface insertions of the native ACL. SIZE=”-2″>39
When the CQT is being contemplated as a graft source, articular
fixation can be accomplished by harvesting a patellar bone block
and fixing both ends of the graft with bioabsorbable screws near
the surface of the tibia and femur.

SURGICAL TECHNIQUE
After previous studies (radiographs, MRI) and clinical examination
confirm that the ACL is disrupted and causing symptomatic instability,
the patient is brought to the operating room for reconstruction.
The CQT is harvested through a short 2-3 inch incision obliquely
along the lines of the quadriceps mechanism. After delineation
of the quadriceps tendon, a 10mm x 7mm x 85mm graft is harvested,
being careful to not violate the suprapatellar pouch. At the
distal end of the quadriceps tendon a 10mm x 25mm x 8mm bone
plug is harvested from the proximal end of the patella. The patellar
defect can be later filled with cancelleous bone from the tibial
reamings or with allograft chips. The CQT is sized on a back
table to fit through the smallest tunnel that the tendon (not
the bone) will glide through easily; the bone plug is trimmed
to fit accordingly. This usually represents 9-10mm. Two #2 Ethibond
sutures are placed in the patellar bone plug, while two #1 Ethibond
sutures are whipped stitched in the tendon end.

After the stitches are in place
and CQT has been sized, appropriate markings are made to aid
the surgeon during arthroscopic reconstruction. In our use of
the CQT, we place the tendon side in the femoral tunnel, with
the patellar bone block in the tibia. First, a pen mark is made
at the bone-tendon junction. Next, a distance of 35mm is measured
from the CQT-bone junction. This marked area represents the approximate
intraarticular distance of the native ACL. This distance is approximately
30mm in most individuals, however, we allocate an additional
5mm in case the graft slides more proximally in the femoral tunnel.
The distance of the remaining tendon represents the portion of
the tendon that will be pulled into the femoral tunnel (~25mm).
The following calculation is what we use in preparing the CQT
graft for implantation:
85mm {total graft} – 60mm {bone plug + intraarticular
tendon} = 25mm {femoral tunnel}
The graft is set in a moist sponge until later implantation.

After harvest of the CQT, a
routine knee arthroscopy is performed. We routinely perform a
5-7mm lateral notchplasty, along with debridement or repair of
any meniscal lesions. Using a standard tibial guide set at an
angle of 55o, we drill a 9mm tibial tunnel centered 5mm anterior
to the PCL within the footprint of the native ACL. After the
posterior portion of the tibial tunnel has been debrided of all
soft tissue and rasped posteriorly, a 7mm offset endoscopic guide
is placed through the tibial tunnel at the “10:30”
or “1:30” positions on the posterior femoral notch.
A 9-10mm femoral tunnel is reamed to the depth of the previous
calculations (~ 25mm).

After reaming, an eyed Beath
pin (Arthrex, Naples, FL) is placed in the femoral tunnel. Sequential
impaction dilatation of the tibial and femoral bone tunnels is
performed to increase the bone density of the tunnels for bioabsorable
screw placement. After the tunnels are dilated to the size of
the graft (9-10mm), the tendon side of the CQT is brought into
the femoral tunnel. Through the anteromedial or an accessory
anterior portal, a bioabsorable screw of the same diameter as
the femoral tunnel is placed anterior to the graft. Fixation
of the graft is assessed by pulling upon the tibial sutures,while
the knee is put through a range of motion. Tensioning the graft
through several motion cycles diminishes creep within the graft
prior to tibial fixation. After the graft is assessed in extension
for signs of impingement, the knee is placed in 10o-20o of flexion
with 5kg of tension place upon the tibial sutures. The graft
is fixed adjacent to the tibial articular surface with a 10mm
bioabsorable interference screw. The knee is assessed for anterior
tibial translation and the wounds closed with absorbable sutures.
Prior to waking the patient, an intraarticular pain pump is placed
within the knee.

CLINICAL EXPERIENCE
At the University of South Alabama Medical Center, our experience
with CQT spans over 2 years, with nearly 20 cases. To date we
are gathering 2 year follow-up data. 1 patient ruptured his graft
during athletics (collegiate athlete) at 9 months postoperatively.
No patient has reported significant patellofemoral pain and there
have been no ruptures of the quadriceps tendon. All patients
have been happy with their results, indicating that they believe
the procedure improved their quality of life.

Other authors have reported
good results with the CQT. Fulkerson reported excellent results
with the use of the CQT with either endobutton or bioabsorbable
screw fixation.20,
31
Leitman et al reported
on 65 CQT graft cases with a KT-1000 side to side differences
of 2.1mm at 1-2 year follow-up. The authors noted that no patient
had patellofemoral pain and all subjects had returned to their
previous level of activity with no instances of quadriceps tendon
rupture.31

CONCLUSIONS
Individuals with a disrupted anterior cruciate ligament and symptomatic
knee instability often require surgical reconstruction of the
ACL. Over the last several decades, tremendous technological
advances have enabled surgeons to reconstruct the ACL with a
more anatomic and durable graft, while minimizing postoperative
morbidity. As the evolution of ACL graft material continues,
numerous graft choices are available. The central quadriceps
tendon (CQT) is an alternative graft source with biomechanical
properties comparable to or better than a bone-patellar tendon-bone
or double-looped hamstrings graft. In early follow-up studies,
patients undergoing CQT ACL reconstruction have demonstrated
minimal patellofemoral symptoms and excellent clinical function.
The CQT provides another weapon in the orthopaedic surgeon’s
repertoire of surgical graft alternatives to reconstruct the
symptomatic ACL-deficient knee.

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Address correspondence to:
Albert W. Pearsall, IV, MD
Department of Orthopaedic Surgery
University of South Alabama Medical Center
2451 Fillingim Street
Mobile, Alabama 36617
Email: apearsal@usamail.usouthal.edu

2020-06-02T16:16:34-05:00February 13th, 2008|Contemporary Sports Issues, Sports Exercise Science, Sports Management, Sports Studies and Sports Psychology|Comments Off on Surgical Reconstruction of the Anterior Cruciate Ligament: The Central Quadriceps Tendon as an Alternative Graft Source

Sports Equipment and Technology

Introduction

In this Olympic year it is appropriate to consider the roles that sport play in our societies. While the natural focus of attention associated with an Olympiad is on “the elite” of sport, we as administrators in the profession cannot lose sight of the fact that sport is truly an activity for everyone in society. Thus it is also appropriate that the focus of this conference is on sport and social inclusion which is really what SPORT FOR ALL should be all about.

I have been asked to address the topic of the application of technology to sports equipment. This is difficult to do in 30 minutes but I will attempt to provide an overview of how technology is changing the nature of sport. The discussion of the application of technology in the world of sport can be done in two broad areas:

1st Sport specific applications of technology most notably in the area of equipment.
2nd How today’s “technological revolution” can be applied to sport. This will be addressed in terms of how technology can impact broad based participation and promote social inclusion.

When looking at how technology can enhance social inclusion and to expand the base of participation in sport throughout society, it is the second case that is most significant. First, however, I will provide an overview of technology in sport specific applications.

Sport Specific Applications

First of all, when we say technology, what exactly do we mean? There are several definitions from the dictionary, but I picked only two to illustrate the scope and impact of technology on the human race. These are:

1st The application of science or a technical method of achieving an intended purpose.
An even broader definition is:
2nd Technology is the totality of the means employed to provide the objects necessary for human sustenance and comfort.

As you can see, there is a lot of latitude when we start talking about how technology affects sport or even more narrowly, sports equipment.

There was a time when technology and equipment had very little impact on sport, even in the Olympics. As you may recall, the athletes who participated in ancient Olympic Games did so in the nude using implements such as discii that were both “off the rack” and shared among the competitors. So it is safe to say in this instance, there was no real advantage that accrued to any participant as a result of the application of “technology” in-so-far as equipment or personal gear was concerned.

But it is equally safe to say that in the Olympics of the modern era, technology applied to sport has played an important role both in training and in competition. This has manifested itself in a variety of ways that range from the creation of new sports, to facilities used to accommodate them, to the equipment used by the athletes in competition to the training support used by teams to prepare the athletes for competition. Moreover, the processes employed in the adoption of technology and technological methods to enhance sport and recreation have accelerated with each successive Olympiad. These advances in technology, as with all other walks of life, have had a marked impact in most aspects of sports. Examples of this impact include:

1st The development of new sports both recreational and competitive.

These changes reflect a natural evolution in sports as well as generational shifts that are more pronounced. In the latter instance, there are new multi-sport competitions such as the “X-Games,” which include events such as mountain biking, in-line roller skating, roller boarding, boogie boarding and snow boarding. The X-Games are, incidently, named after the 15 to 30 year old demographic group called “Generation X” who make up the largest participant group for these sports which have sprung up to compete for sponsorship and media space with older, more established events.

A very good example of this process is the introduction of snow boarding in the Nagano Olympiad. At one time, snow boarding was banned from most ski resorts because of a perceived conflict on the part of resort managers between the snow board enthusiasts and the more traditional skier. This antipathy stemmed from both the free-wheeling way in which the snow boards are used on the slopes and a perceived cultural clash between the two sets of resort patrons. Now most ski resorts could not survive or remain economically viable without the revenue generated by snow boarders.

2nd Which brings us to facility design. The application of technology in sport facility design has yielded real changes in terms of athlete use, spectator comfort and usable life span. Example of these changes include:

Equipment which makes competition judging and compiling results more accurate. Further, technological applications such as photo-finish timing devices tied in with communications technology for in-stadium displays such as scoreboards and broadcasting make the events more enjoyable for the spectators.

Technological changes have resulted in facilities that are more cost efficient to operate resulting in the freeing up of scarce financial resources for programs which would have otherwise been expended for operating costs such as utilities. Among these advances are lighting options that extends the useable hours of facility operation or computerized HVAC controls that gain operating efficiency as well as increasing both athlete and spectator comfort.

And lastly, technological change frequently results in better building finishes that extend the life of the facility, are safer for the participants and are less costly to maintain. Most notable in this area are finishes such as sports flooring and playing surfaces.

There exists, however, a real irony with respect to the application of technology in sport facility design, at least in North America. While on the one hand technological advances allow for a greater life span of the facility through the development of components such as better finishes and surfaces, on the other hand technological changes also drive obsolescence causing facilities to be replaced for economic reasons long before they are worn out. Thus stadia and auditoriums which should last more than 50 years are now being razed and replaced at great cost after only 30 years of service in many cities.

3rd Technology has affected equipment design at all levels; from low level recreational activities to high level competitive sports. We’ve already seen that the application of technology to sports serves a role in creating whole new sports events. The use of technological tools such as Computer Assisted Design (CAD) can also play a role in the enhancement of sport equipment. A good example of this and well known in sailing circles is the story of how America³ won the 1992 Americas Cup, which is probably the most venerable race in among the oldest of sports. Through the application of technology (and a large amount of money) a rookie skipper surprised the veterans and took the prize.

A better example of applied technology in sports is the use of “smart” equipment that incorporates sensors and computers as a part of their function. Most international caliber athletes typically undergo some form of human performance evaluation as a part of their training regimen. This can range from exercise stress testing and cardiovascular assessment to the use of very sophisticated biomechanical analysis using equipment such as the APAS system. Computer technology can even be found in equipment used for the evaluation of strength and conditioning.

4th Equipment construction also benefits from the application of composite materials which reduces weight while yielding increased strength and extended life spans. Composite materials can certainly be found in high level competitive equipment such as bikes, skis, racquets, and other types of gear such kayaks which almost by definition are targeted toward the elite competitor.

But it is also important to note that advances in materials have made sport participation safer and has penetrated down the sports hierarchy to the recreational user, for example, in items such as bike helmets.

5th And lastly, technology is also applied to personal sports gear such as clothing and shoes. A recent, albeit controversial example, is the full body suits used in swimming which streamline the competitor reducing times in a sport where winning or losing is measured in hundredths of a second.

Unfortunately, the use of technology in enhancing sports facilities and equipment is generally an expensive proposition. And because of the expense involved in these applications, the benefits derived at least initially tend to be limited to the upper end of the sports hierarchy. For example, because of cost, changes brought about in sport through the application of technology tend to be available first to elite level athletes and teams. By definition, elite level athletes and sports are exclusive and thus omit the broader base of participants further down the sports hierarchy.

Nonetheless, there is a “trickle down” effect. As more people seek out the “best and newest”, market economies come into play and the cost for equipment brought about or improved through technological innovation declines as distribution is expanded. Unfortunately, this trickle down effect is frequently a process that is measured in years. In the meantime, technological development as applied to sports equipment continues with the next generation of the “newest and the best” being developed. And as before, this new generation of equipment is out of the reach of many sports participants. And so the cycle continues.

This division between the “haves” and the “have nots” is a problem for the profession and it manifests itself in many ways. Consider the following example.

In the United States those professional teams that can afford better facilities and equipment, frequently developed through the application of technology, typically earn more revenue. With a better revenue stream, the team owners can obtain better performers. Better performers yield better team results, which creates more interest by the fans. Increased interest on the part of the fans means an increase in ticket sales and more revenue generated for the team. More revenue means better facilities and players and so too does this cycle continue.

Striking a competitive balance is a real challenge facing the professional leagues in North America. But North America is not alone with this problem. Relative cost related to the application of technology is also a challenge with respect to international sports as well. Wealthier nations, such as those found in Western Europe or the United States, can better afford the training facilities, expensive composite equipment and personal gear required for elite level competition. Thus the benefits of technological advances applied to sports accrue most greatly to those who can afford the price.

The point is that the application of technology to sports equipment is by no means universal and is, at best, unevenly applied. And solving this problem is very difficult because of the inherent conflicts of interests between the various stake-holders or constituencies in sports. Among the stake holders are the fans who are the consumers of the sport product. The people who pay to see sport competitions, whether it be the individual fan or media companies, want the excitement of high scoring contests or record setting performances. Athletes and participants want the recognition that accompanies victory and the setting of records. Regulators such as the national and international sport governing bodies similarly are motivated to gain the best possible competitive advantage for their teams and athletes. Equipment manufacturers want to recoup their investment in research and product development.

Thus, at least at the upper end of the sports hierarchy, there is a natural pressure among all of these constituencies toward the ever more efficient and costly facilities and equipment. This process continues to increase the gap between those who can afford to acquire the “latest and the best” and those who cannot. It is very important, however, this natural tendency toward a division between the “haves” and “have nots” be controlled in the best interests of the sports profession.

This is simply because central to the philosophy of sport is the concept that on any given day, every athlete participating in a competition has a chance to emerge victorious. It is this idea of competitiveness that keeps fans returning to the stadium and buying tickets, the revenue from which supports the athletes and the teams. Should the fans believe that too great an advantage has accrued to one competitor or another, their interest will diminished to the detriment of all. This is why drug abuse by athletes brings such severe penalties from sports regulators and why fans tend to lose interest in a given sport when the “best team that money can buy” consistently wins the championship.

The challenge then for sports administrators is to insure that too great an advantage does not accrue too greatly to one team or another through the application of technology for better equipment or facilities. Those who are in a position to develop rules with respect to the use of sports equipment or to fund equipment or facility acquisitions for economically disadvantaged teams through the administration of grants need to bear in mind the fundamental principle of parity in competition.

So the question arises, what technology is available and can be applied toward leveling the playing field for all? What equipment can promote social inclusion with respect to sport? Interestingly enough, the answer to that question lies within what most people think of in terms of “technology” itself.

The Technological Revolution

We are living in the midst of one of those very unusual occurrences that come along every few generations. What has been occurring over the past few decades is a fundamental paradigm shift that is moving society as a whole from the age of industry to the age of information. The currency in this new society that is being formed is called IT – information technology. IT is simply the tools and methods used for the identification, organization and manipulation of facts that we call data. IT has become the engine that is driving all sectors of today’s economy be it industry, government, education or indeed, sports.

The most important piece of equipment that lies at the heart of the whole IT process is the computer. The computer and the software that it runs is an essential element in the new societal paradigm and it is a key to success for the modern sports administrator. It is THE piece of equipment that allows the sports administrator to maximize the return on scarce resources whether this is people, facilities and equipment or finances. In turn, it is also perhaps the single most important tool to insure the extended reach of sport and recreational programming and with it, the whole idea of inclusion in these activities of the greatest number of participants.

Just as money has been the currency and a source of power in the old paradigm, information is the currency and a source of power in the new paradigm. No where is the old saying “that knowledge is power” more true than in a society where information or data is what drives the economy. The secret to managing knowledge and information is in the development and maintenance of databases.

A data base is nothing more than an organized collection of common records that can be searched, accessed and modified. Database software is very widespread as most standard office computer software packages will typically have a simple database program in addition to word processing, spreadsheet and presentation applications.

There is, however, a far more powerful and useful kind of database for sport managers than the one that comes in the standard software suite. This most powerful of data management tools is called a relational database. Very simply, a relational database is a data management system that stores information in a series of tables e.g. rows and columns of data. When the operator conducts a search, a relational database allows the individual to match data from one table with data from a second to produce a third table or a report. So for example, if you are a manager conducting a complex sports competition, the details of which have been entered into a relational database, the event manager can retrieve the time for a scheduled event from one table, a roster that has the names of qualified referees who can officiate the event from another table, their availability from a third table and produce a report that lists all of the personnel who can undertake the officiating task. The same type of event management software can assist the sports manager with a myriad of other tasks ranging from facility scheduling, equipment set up and knock-down, or even ordering soft drinks for the concession stand.

If one of the goals of the sports manager is social inclusion, and I submit to you that it should be, then the computer and the data base software that it contains within it are one of the key tools available to them to help them to reach this goal. That this is the case can be seen by the kinds of sport program information that can be contained within these databases aside from the event management sample just cited:

  1. Athlete or team rosters to include demographic information such as name, sex, age, contact information such as addresses and phone numbers and so on. Other parts of the database can contain details on medical conditions, performance history, or other participation characteristics of the athletes.
  2. There are databases that can assist coaches organize scouting reports of the opposition as well as conditioning and preparation activities for their own athletes.
  3. Rosters of volunteers such as officials, drivers, timekeepers, or medical staff. Aside from the similar demographic details, a database of this type might also contain information about availability and reliability, e.g. do they actually show up when they volunteer?
  4. Donors or potential donors whether this be for money or in-kind services. Here too will be demographic information but also other kinds of details as to the source of their motivation or affiliation, frequency of participation and so on.
  5. While the foregoing are examples of useful data with respect to programming, databases are also essential for administrative information. Examples here include equipment and inventory lists, facility maintenance software packages, marketing information such as ticket sales, accounting and business records, employee directories and the list could go on and on.

Once entered, data can be easily manipulated. More importantly, databases can and should be updated to record changes. Bear in mind that the passage of time presents a more comprehensive picture of most activities and the ability of record change and make sense of them is essential for long term survival. Further, there is nothing so constant as change and a well thought out and maintained data base is a great way to record those changes and their implications to the organization.

There are a couple of keys to remember when considering the acquisition of this kind of software:

1st System capacity which addresses the hardware questions. Bear in mind that a relational data base can consume huge amounts of memory capacity.
2nd The degree of accuracy required with the application is an issue. Standard vendor prepared packages typically operate on the basis of the lowest common denominator which usually means that only about 80% of most organization’s needs are met with an off-the-shelf product. So the sport administrator is left with the choice of adapting organizational operating procedures to the software to some degree or writing their own programs. The latter can be hugely time consuming and very expensive. Generally, the more specific modification required for a software product, the more expensive the product becomes and the more difficult it will be to accommodate software upgrades from the vendor.
3rd Lastly, one needs to consider user capabilities. The adoption of information technology and procedures usually means extensive training of the staff.

As great as databases are for effective sport program management, the real power of technology comes when we tie the individual machines together through the medium of a network. This is truly a case where there are synergies created; where the sum is greater the individual parts e.g. 2 + 2 = 6. A computer network simply is the hardware required to connect two or more machines together in such a manner as to allow the sharing of data and other resources.

When I speak of resources, for example, a network can have any number of computers sharing a very good quality printer instead of a using a bunch of stand alone mediocre printers. Proper presentation of the organization’s message is very important for effective marketing and image. Another example of a shared resource is that the network can be driven by a powerful server which can substantially increase computing speed and effectiveness throughout an organization. Most importantly, particularly where relational databases are employed, a network allows the users to share information which is typically stored on a server.

Most larger enterprises, either commercial or sports, use computer networks to link together their operatives. All of the permeations and configurations available to the sports administrator are clearly beyond the scope of this presentation except to note that the most common configuration of these kinds of networks are of the client -server variety. This type of network is where a main server houses most of the information and data base files and the individual operatives access the server through their desktop terminals or workstations which are called clients.

It is important to note that computer networks need not be limited to a single site or facility. Wide Area Networks (WANs) can link together sports administrators located throughout a country. For example, all of the local offices of a national sports body such as the Football Association can be linked whether they be located in Recife or Rio, Brasilia or Belem. All of the administrators so linked can share rosters, performance data, programming information and communicate with each other cheaply and efficiently through the medium of e-mail.

The computer network most familiar to the public is the internet. And the most familiar part of the internet to most people is the World – Wide – Web also known simply as “the Web”.

While the internet has been around for decades going all the way back to ARPAnet in the 1960s, the Web is a comparatively new innovation first introduced in the mid 1990s. It is a medium which presents information in text, audio and graphics, with the latter being both still or animated, in a simple hyper-text computer language readable by a browser. This medium has simply exploded and today there are more than 3.6 million web addresses called Uniform Resource Locators (URLs), many with hundreds of individual pages on their sites. Additional applications for thousands of URLs are received virtually every week. Of these millions of Websites, more than 50% of them are located in the United States but this will eventually change with time. I should note that while much of the data used in this presentation originates from the U.S. Much of what I say is applicable to other nations to a greater or lesser degree already and if not now, then it will certainly be applicable to them at some point in the future. The changes being wrought in society by IT or its brother CT – communications technology – are not confined to any one country and will eventually effect us all.

All the ways in which the Web has changed society are almost too numerous to mention. Suffice to say it has become an extremely important medium of communication and its importance will only continue to grow in the future. For example, USA Today which is the closest thing a national newspaper in America, gets more than three million visits per day. Some 60% of these visits are to its sports pages. Further, there are virtually no professional sports teams in the United States that do not have a Website and most are linked together through networks of Websites coordinated through the various league offices. Just how tight are these linkages is driven in part by agreements between the league teams on activities such as revenue sharing for media broadcasting and merchandise sales among others.

The Web is currently used by professional sports teams in ways that the developers of this technology never envisioned. For example, there are no English language radio broadcasts in Montreal for the Montreal Expos professional baseball team. Fans wanting hear the play-by-play in English can only do so by calling up the team’s Website and listen to it coming across as an audio feed. Another example of how deeply the internet has penetrated professional sports is how some pro hockey teams now require their players to have e-mail addresses as a means to interact with both the team administration and their fans.

These examples lie at the heart of how the internet will affect sports in the future: through the changing of the way that the sports fan will consume the product. Where once sport marketing did not extend much beyond putting out a sign saying “Game Today”, now sports teams must have well developed and extensive Websites to market effectively to their consumers. The trend in this regard is also clear. What will emerge is networks of teams and users bound together by a common interest and driven in part by advances in communications technology.

A good example of this is trend is that of Worldsport.com. This internet presence has succeeded in tying together all 88 members of the General Association of International Sport Federations which represent all of the sports played in the Olympics. Worldsport.com not only hosts the federations individual Webpages, but also provides general technological support through activities such as promotional information and marketing, administrative information for athletes and administrators in secure areas of their sites, educational programming such as certification, logistical support such as a global e – mail communication system and the list could go on and on.

These developments are not limited to the upper end of the sports hierarchy. Compared to the extremely high cost of traditional television broadcast, the comparatively low cost of this technology will bring to sports fans events that could never before be seen broadcast on traditional media. A simple example of how this can occur is an annual sailboat race across the Gulf of Mexico from Mobile to Tampico. Last summer the skipper of a local boat participating in the event took photos with a digital camera of the race activities and the participants every four hours and uplinked them by a satellite phone to his own Website. Thus friends in the community, or anyone else in the world who stumbled into the Web address, could participate in this event as they never could before. Sports events of a distinctly local flavor without the mass appeal that make them economical for television broadcast can so be distributed to anyone with an interest. The Web is not constrained by the limited availability of broadcast channels and high production costs. And while bandwidth is currently an issue for the web, this will resolve itself in the near future with the introduction of broadband technologies.

I’d like to start bringing this discussion to a close with the topic on which we started: sports equipment. I think it appropriate to discuss how the Web will change the sale and distribution of sporting goods. We have already noted that the relative cost for sports equipment can be an issue for the profession, particularly in terms of inclusion by a great number of participants. E-commerce through the internet can play a key role in containing costs for sports equipment as illustrated by the following example.

In the traditional model of manufacture and distribution through a sporting goods store, a tennis racquet which cost $40 to manufacture could be marked up as much as 134% to $94 as it moves through various wholesalers and retailers in the distribution chain to a tennis player. With an e-commerce arrangement whereby the manufacturer can reach the player directly, the mark-up in distribution can be reduced to as little as 20% resulting in a sale price to the end user of $48. The more middle men in a distribution chain, the greater the benefit derived to the end user from using e-commerce distribution. Japan is a classic case in the application of this scenario. Japanese consumers have historically suffered extremely high prices for most consumer products because of a distribution system that has had many layers of middle men in the distribution channel. In Japan today this is changing such that even individual farmers are going on-line with their own websites to sell their produce directly to the consumer, an activity that is empowering both the farmer and the consumer.

E-commerce is well on its way to becoming a force in the world economy as it serves to remove barriers both natural and artificial. The barriers that will vanish include those of time and space as well as national borders both physical and ideological. That this will occur is underscored by the fact that this year e-commerce will employ more than 2 million people and create a turnover in excess of $500 billion. By next year, the turn over is expected to pass $1 trillion.

While this is all well and good, in closing I would like to note a problem similar to that mentioned earlier with respect to the application of technology to sports equipment. Very simply, technological tools are expensive which has resulted in what we call in the United States the Digital Divide. In the U.S., 56% of American adults, 106 million users representing 47% of American households, are connected to the internet and are on-line. These users are largely from the upper and middle class and have the financial wherewithal to purchase computers and internet services. It is a matter of great concern that the very people who stand to benefit the most from economies to be realized through communications technology as outlined earlier in my discussion on e-commerce are the ones least able to afford it. It is the economically disadvantaged that are currently being left out of the IT revolution.

This Digital Divide also transcends national borders. While 56% of American adults are connected to the internet, only 4% of the global population can make that claim. Some areas, Africa for example, are totally disconnected and can only be considered disadvantaged as a result. Herein lies the challenge for the future.

In conclusion, the application of IT to sports management has dramatically changed the way that we do business. Thinking through how we can use this kind of equipment and these tools greatly enhances outcomes. The bottom line is that these IT tools are rapidly becoming a necessity for the sports administrator at whatever level in the sports heirarchy they are working. They are a powerful force for social inclusion in sport and recreational activity and for the profession as a whole.

Thank you.

 


Paper Presented at the
International Seminar for Sport and Social Inclusion
Sao Paulo, Brasil
26-29 June 2000

 

Sponsored by
SESCO
and
COB Brasil, UNESCO, F.I.S.p.T, FICTS, Sport For All and
University of Sao Paulo – School of Physical Education and Sport


 

Address correspondence to:
Dr. T.J. Rosandich, VP of Development
United States Sports Academy
One Academy Drive
Daphne, AL 36526
(334) 626-3303
Email: tjrosand@ussa-sport.ussa.edu

2013-11-27T16:30:16-06:00February 13th, 2008|Contemporary Sports Issues, Sports Exercise Science, Sports Facilities, Sports Management|Comments Off on Sports Equipment and Technology

Music in Sport and Exercise: Theory and Practice

This article has been inspired
by six years of doctoral research in which I found that the “right”
music can have a very positive impact on sport and exercise performance.
I am grateful to the Academy for cultivating my interest in the
area of psychophysical responses to music during my master’s
programme in 1991/92. I am also pleased to be invited to share
my findings with you, the coaches and fitness professionals.

How Does Music Aid Athletic
Performance?

A review of this area (Karageorghis & Terry, 1997) based
on a meta-analytic study I conducted at the Academy, revealed
four main ways which music may aid performance in sport and exercise.
First, during submaximal repetitive exercise such as running,
music can narrow a performer’s attention and as a consequence,
divert attention away from sensations of fatigue. This is a technique
which many marathon runners and triathletes refer to as dissociation,
i.e., focusing on stimuli unrelated to the task such as the surroundings
or conducting mental arithmetic. Effective dissociation tends
to promote a positive mood state through the avoidance of thoughts
that relate to the fatigue component of mood.

Second, music alters arousal levels and can therefore be used as a form of stimulant prior
to competition or as a sedative to calm over-anxious athletes
(see Karageorghis, Drew, & Terry, 1996). One of the interventions
I often use involves the production of audio cassettes containing
stimulative music combined with verbal suggestions as a psych-up
strategy. Similarly, I use sedative music as a backdrop for relaxation
techniques that are administered via verbal instruction.

Third, music is beneficial
as a result of the similarities between rhythm and human movement;
hence, the synchronization of music with exercise consistently
demonstrates increased levels of work output among exercise participants
(see Karageorghis & Terry, 1997, for review). Fourth, in
relation to the previous point, the rhythmical qualities of music
also emulate patterns of physical skills; therefore, music can
enhance the acquisition of motor skills and create a better learning
environment. There is evidence from both gymnastics and swimming
in support of this (Chen, 1985; Jernberg, 1981).

Selecting the “Right”
Music

Our recent work (Karageorghis, Terry, & Lane, 1997) indicates
that there are four key factors that influence the motivational
qualities of music. First, owing to the fact that people have
an underlying predisposition to react to rhythmical stimuli,
the Rhythmic Response to the music is the most salient factor.
Second, the melodic and harmonic aspects of music shape the listener’s
interpretation and influence mood state. I refer to this factor
as Musicality. Third, the Cultural Impact of music will influence
the listener’s response through socio-cultural upbringing and
previous exposure to music. Fourth, the Association factor which
relates to the extra-musical associations evoked by music, i.e.,
sound can promote sounds that inspire physical activity. The
Rhythmic Response and Musicality factors are internal to the
composition of music, whereas the Cultural Impact and Association
factors are external to the music relating to personal interpretation
of music (see Figure 1). Our research shows that the internal
factors are more important in predicting how a person will respond
to a piece of music than the external factors.

We have developed and validated a questionnaire to rate the motivational qualities of music which
is called the Brunel Music Rating Inventory (BMRI: Karageorghis
et al., 1997). For a piece of music to truly inspire the listener,
it must have strong rhythmic qualities that match the activity
at hand and also a tempo which matches the predicted heart rate.
The melody and harmony of the music should promote a positive
mood state; that is, they should energize the listener and increase
vigor. The music should also stem from the listener’s socio-cultural
background and comply with their preferences. Finally, it is
ideal that for the music to be associated with physical activity
either through the lyrics, e.g., Work Your Body!, or its association
with other media such as film or TV. A classic example of such
a track would be Survivor’s “Eye of the Tiger”, which
was a theme from the Rocky series.

There are three additional
considerations when selecting music: a) Variety in the music
tends to maintain athletes’ interest in the activity; b) the
volume of the music should not be obscured by the noise of the
exercise environment; and c) if synchronizing music with exercise,
the tempo must concur with the preferred work rate. For example,
if you are swimming using the breast stroke at a rate of 100
strokes per minute, it would be sensible to use music playing
at 100 beats per minute (bpm). Alternatively, breast stroking
at a rate of 60 strokes per minute a tempo of 120 bpm can be
used as the swimmer can take one stroke every two beats.

Music and Flow State
Our most recent research (Karageorghis & Terry, 1998) has
revealed an interesting link between music and the attainment
of flow state during aerobic dance exercise. Flow involves an
altered state of awareness during physical activity in which
the mind and body function on “auto-pilot” with minimal
conscious effort. Some coaches refer to this as being “in
the zone”; it is an almost trance-like or hypnotic state.
Flow has been associated with optimal psychological state and
represents complete enjoyment of and immersion in physical activity.
Our study involved 1,231 aerobic dance participants who were
asked to rate the motivational qualities of the music used during
a class on completion of their workout using the BMRI. They also
rated flow using the Flow State Scale, a 36 item questionnaire
developed by Jackson and Marsh (1996). The results revealed a
very significant association between ratings of music and ratings
of flow. We concluded that music may have a considerable effect
on enjoyment levels during exercise an selecting the “right”
music may be a key factor in maintaining adherence to exercise.

Conclusion
Music is an often untapped source of both motivation and inspiration
for sport and exercise participants. One important point to remember
is that musical preference is very personal indeed; that is the
reason for which I have avoided suggesting which music you should
prescribe for your athletes and exercise participants. That is
entirely your decision. However, you should now be aware of some
factors that make listening to music more rewarding in sport
and exercise settings. Happy listening!

Dr. Costas Karageorghis is
a BASES accredited scientific support and research sport and
exercise psychologist. He is a member of the British Olympic
Association Psychology Advisory Group and lectures in sport psychology
at Brunel University’s Department of Sport Sciences. Further,
Dr. Karageorghis is an alumnus of the USSA MSS program and acts
as the United Kingdom academic representative. E-mail: costas.karageorghis@brunel.ac.uk

2013-11-27T17:36:10-06:00February 11th, 2008|Sports Exercise Science, Sports Studies and Sports Psychology|Comments Off on Music in Sport and Exercise: Theory and Practice

You Go Girl ! The Link Between Girls’ Positive Self-Esteem and Sports

Positive self-esteem is a favorable perception of one’s self, or, how happy you are with just being you. In general, feelings of self-esteem contribute to a person’s self-worth, confidence and competence. These feelings of worthiness, assurance and proficiency can influence a person’s life in regard to personal aspirations, motivation, achievement potential and relationships (Melpomene Institute, 1996). A person’s self-esteem is affected by and formed from a variety of circumstances in life, some of which are:

  • degree of parental expectations, encouragement and influence
  • degree of peer expectations, encouragement and influence
  • involvement in making of decisions
  • development of talents, hobbies or interests
  • influence and importance of role models
  • extent of emphasis on body image
  • experiences and interactions during education
  • participation in physical activity and/or sports (Kopecky, 1992)

 

Many studies have been done to investigate the self-esteem of young girls and have concluded that as girls move from grade school to high school, their self-esteem levels drop (Feldman & Elliott, 1990; Gilligan, Lyons & Hammer, 1990; How Schools Shortchange Girls, 1992). For example, one study found that 69% of grade school boys and 60% of grade school girls responded that they were “happy the way I am”. The same study found 46% of high school boys and only 29% of high schools girls reported being “happy the way I am”. Overall, girls self-esteem dropped at a rate three times that of boys. Feelings of low self-esteem in adolescence are one contributing factor that increases the likelihood of a young girl dropping out of school or becoming pregnant. The low self-esteem seen in girls does not disappear with maturity; girls with low self-esteem often grow to be women with low self-esteem. Low levels of self-esteem are linked to increased rates of depression, substance abuse, suicide and eating disorders in both adolescents and adults (How Schools Shortchange Girls, 1992; Melpomene Institute, 1996).

What can be done about the decrease in self-esteem? What can girls do to maintain their self-esteem as they mature? To answer these questions, it is important to look at what boys are doing differently from girls as both groups move from grade school to high school. One important difference to consider is the rate of sports participation among boys and girls. As girls move from grade school to high school, they drop-out of sports at a rate six times higher than boys (Women’s Sports Foundation, 1998). Could the lower rate of sports participation among girls be linked to a lower self-esteem? In order to answer the question, it is essential to consider two factors: what contributes to the development of self-esteem and the benefits of sport participation.

For girls living in the 1990s, self-esteem is linked to both physical attractiveness and physical competence. Prior to the 1990s, however, the main factor contributing to a girls’ self-esteem was physical attractiveness (Nelson, 1994). Coupling self-esteem to both competence and beauty is a step in the right direction, although it’s still unfortunate that girls place so much importance on physical attractiveness as it relates to their happiness. Recognizing that young girls often compare themselves to unrealistic standards of beauty can help parents better understand, guide and influence their children (Nelson, 1994; Women’s Sports Foundation, 1998). In attempting to de-emphasize the importance their daughters place on beauty and emphasize the importance of physical competence, parents may find it helpful to utilize the benefits of participation in sport.

Participating in sport is one way that girls can develop physical competence. Girls learn to appreciate their bodies for what they can do, instead of the perceived appearance by oneself or by others. In a sport environment girls learn to control their bodies and to rely on acquired physical skills. Partaking in sport also helps girls trust and rely on themselves and teammates while working toward common goals. In a sense, participation in sport allows each girl to become her own personal cheerleader – cheering on her physical self and what might be possible; not just standing on the sidelines, or in the bleachers, cheering others on (Nelson, 1994). Involvement in athletics provides lessons in teamwork and leadership, the development of citizenship, and community involvement. Membership in sport also offers girls a greater pool of adult role models from where they can draw guidance and support (Melpomene Institute, 1996; Murtaugh, 1988). Additionally, girls find new friends in the sport setting. For girls, this sense of friendship is essential, being liked by other girls is sometimes more important than having others see them as smart or independent (Feldman & Elliott, 1990).

 

A study published by the Women’s Sport Foundation on over 30,000 girls compared athletes to non-athletes.

The study stated that athletes were more likely than non-athletes to:

  • score well on achievement tests
  • feel “popular” among one’s peers
  • be involved in other extracurricular activities
  • graduate from high school (three times more likely)
  • attend college and obtain a bachelor’s degree
  • stay involved in sport as an adult
  • aspire to community involvement
  • not become involved with drugs (92% less likely)
  • not become pregnant (80% less likely)

(Women’s Sports Foundation, 1998).

 

It is important that parents realize the many contributions participation in sport can make to young girls’ development. The positive aspects of sport can help girls maintain their self-esteem as they make the difficult transition from grade school to high school.

References

Feldman, S. & Elliott, G. (Eds.). (1990). At the threshold: the developing adolescent. Cambridge, MA: Harvard University Press.

Gilligan, C., Lyons, L., & Hammer, T. (Eds.). (1990). Making connections: The relational worlds of adolescent girls at Emma Willard School. Cambridge, MA: Harvard University Press.

How Schools Shortchange Girls – The AAUW Report. (1992). New York, NY: Marlowe & Company.

Kopecky, G. (1992). The age of self-doubt. Working Mother, July, 46-49.

Murtaugh, M. (1988). Achievement outside the classroom: The role of nonacademic activities in the lives of high school students. Anthropology and Education Quarterly, 19, 383-395.

Melpomene Institute. (1996). Melpomene Institute packet -Girls, physical activity and self-esteem. St. Paul, MN.

Nelson, M.B. (1994). The stronger women get, the more men love football – sexism and the American culture of sports. New York, New York: Avon Books.

Women’s Sports Foundation. (1998). Eisenhower Park, East Meadow, New York.

2017-08-07T15:37:24-05:00February 11th, 2008|Contemporary Sports Issues, Sports Coaching, Sports Exercise Science, Sports Management, Sports Studies and Sports Psychology, Women and Sports|Comments Off on You Go Girl ! The Link Between Girls’ Positive Self-Esteem and Sports

Analysis of Selected Physical and Performance Attributes of the United States Olympic Team Handball Players: Preliminary Study

During the Spring of 1995, prior to the Olympic Games in Atlanta, the United States Team Handball team and coaches came to the United States Sports Academy in Daphne, AL for testing. Dr. Thomas P. Rosandich, president of the U.S. Team Handball Federation, and the president of the United States Sports Academy hosted the testing at the Alabama campus. Testing of the athletes consisted of laboratory tests of maximum oxygen uptake, computerized strength measures, blood tests, etc., and a battery of field tests that included assessments of physical characteristics, and physical performance components. This paper reports the results of the field test battery.
Skills test batteries have been used in physical education and in sport to assess various components of the skills of players. These assessments served the teacher and coach to determine a player’s level of ability, or their progress, weaknesses and strengths. These test batteries for sports performance usually dealt with the physical fitness components like strength and endurance, or the motor skills components, like speed, agility, power, or accuracy.

Batteries of tests for team handball have not been developed in the United States. The purpose of this investigation was to construct a team handball test battery that would be reflective of the skills, abilities, physical fitness components and anthropometric factors that contribute to high levels of performance, and to establish a database of performances by the National Team Handball players. Additional purposes for developing the test included using the test to screen potential players at the National level, to provide teachers in the schools and colleges with tests that are inexpensive and easy to administer, and to provide self-administered tests that would train the athletes to improve their performance in team handball.

Methods
Subjects
The United States National Handball team came to the United States Sports Academy in Daphne, Alabama for testing in June of 1995 prior to the Atlanta Olympic Games. There were 20 players in attendance. Their ages ranged from 22.01 to 31.73 years with an average age of 26.69 years (sd = 2.94).

Test Selection and Procedures
The coaches and this investigator discussed the test items and agreed that they were relevant to the sport. The test items included:

  1. Anthropometric measurements: height, weight, hand breadth, arm length, and arm span
  2. Hand grip strength
  3. Running speed: 20 m dash
  4. Vertical jump: take-off of dominant leg with one step, non-dominant leg with one step, and both legs
  5. Accuracy throw: a 7 m throw at a automobile tire hanging vertically from the goal. 2 points for shots through the center, 1 point for hitting the tire but not passing through the center. The player had 10 throws.
  6. 50 m dribble test: Five cones are placed in a straight line with 5m between each cone. Player runs 25m, passing each cone alternately on the right and left sides, then goes completely around the last cone and returns to the start line alternating as before. The ball is dribbled once per cone.
  7. Jump and throw test: A volleyball net 2.44 m high placed 7 m from the goal with a tire hanging vertically from the top of the goal. The bottom of the tire rested on the floor. The player had 10 throws. Two points were awarded for hitting the tire or passing through the center and 1 point for passing through the goal mouth.
  8. Endurance test: Four tires are placed on the corners of a basketball court that has the dimensions of 15.24 m by 25.61 m. The player runs diagonally on the first leg, then along the short side, then diagonally again, and then returns to the start. This constitutes one lap. The runner runs 10 laps for a total of 900m; 90 m per lap.

Results
The results of the anthropometric testing are shown in table 1. The data for the skills tests are shown in tables 2 and 3. The mean vertical jump for the dominant leg was 54.03 cm (21.27 in), the non-dominant leg was 46.72 cm (18.39 in), and for both legs was 62.15 cm (24.47 in). This is higher than vertical jumps of 52.8 cm (20.8 in) for professional soccer players (Raven, Gettman, Pollock, & Cooper, 1976), 53.3 cm (21 in) for college basketball players (Noble & Maresh, 1979), but less than 67.0 cm (26.4) for elite men volleyball players (Gladden & Colaccino, 1978). Olympic men’s volleyball players were tested doing the vertical jump with a 4-step approach, as in a spike approach and averaged 94.2 cm (37.1 in). This approach run was estimated to add 10.2 to 15.4 cm (4 to 6 in) higher than the standing position vertical jump off of both legs (McGown et al., 1990). The maximum height reached when the player took off from the dominant leg was 3 m (9 feet, 10.1 in), the non-dominant leg was 2.92 m (9 feet, 7 in), and both legs was 3.08 m (10 feet, 1.26 in).

2013-11-27T17:48:39-06:00February 11th, 2008|Sports Coaching, Sports Exercise Science, Sports Management, Sports Studies and Sports Psychology|Comments Off on Analysis of Selected Physical and Performance Attributes of the United States Olympic Team Handball Players: Preliminary Study
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