Kinetic and Kinematic Assessment of the Band-Assisted Countermovement Jump.

ABSTRACT: Fernandes, JFT, Arede, J, Clarke, H, Garcia-Ramos, A, Perez-Castilla, A, Norris, JP, Wilkins, CA, and Dingley, AF. Kinetic and kinematic assessment of the band-assisted countermovement jump. J Strength Cond Res 37(8): 1588-1593, 2023-This study sought to elucidate kinetic and kinematic differences between unloaded and band-assisted countermovement jumps (CMJs). In a randomized order, 20 healthy subjects (mass 84.5 ± 18.6 kg) completed 3 repetitions of CMJs across 3 conditions: unloaded (at body mass), low, and moderate band (8.4 ± 1.9 and 13.3 ± 3.3 kg body mass reduction, respectively). For all repetitions, a force platform and linear position transducer were used to record and calculate kinetic and kinematic data. Body mass was significantly different between the unloaded, low, and moderate band conditions ( p < 0.05). Peak velocity, absolute peak, and mean force and movement duration displayed a trend that was mostly related to the condition (i.e., unloaded > low > moderate) ( p < 0.05). The opposing trend (i.e., moderate > low > unloaded) was generally observed for relative peak and mean force, reactive strength index modified, and flight time ( p < 0.05). No differences were observed for mean velocity, movement duration, and absolute and relative landing forces ( p > 0.05). The use of band assistance during CMJs can alter force, time, and velocity variables. Practitioners should be aware of the potential positive and negative effects of band assistance during CMJs.

Implementation of enhanced recovery after surgery for pancreatoduodenectomy increases the proportion of patients achieving textbook outcome: A retrospective cohort study.

BACKGROUND: Enhanced Recovery After Surgery (ERAS) for patients undergoing pancreatoduodenectomy is associated with reduced length of stay (LOS) and morbidity. However, external validating of the impact is difficult due to the multimodal aspects of ERAS. This study aimed to assess implementation of ERAS for pancreatoduodenectomy with a composite measure of multiple ideal outcome indicators defined as 'textbook outcome' (TBO). METHODS: In a tertiary referral center, 250 patients undergoing pancreatoduodenectomy were included in ERAS (May 2012-January 2017) and compared to a cohort of 125 patients undergoing traditional perioperative management (November 2009-April 2012). TBO was defined as proportion of patients without prolonged LOS, Clavien-Dindo ≥ III complications, postoperative pancreatic fistula, postpancreatectomy hemorrhage, bile leakage, readmissions or 30-day/in-hospital mortality. Additionally, overall treatment costs were calculated and compared using bootstrap independent t-test. RESULTS: The two cohorts were comparable in terms of demographic and surgical details. Implementation of ERAS was associated with reduced median LOS (10 days vs 13 days, p < 0.001) and comparable overall complication rate (62.0% vs 61.6%, p = 0.940) when compared to the traditional management group. In addition, a higher proportion of patients achieved TBO (56.4% vs 44.0%, p = 0.023) when treated according to ERAS principles. Furthermore, ERAS was associated with reduced mean total costs (£18132 vs £19385, p < 0.005). CONCLUSION: Implementation of ERAS for patients undergoing pancreatoduodenectomy is beneficial for both patients and hospitals. ERAS increased the proportion of patients achieving TBO and reduced overall costs. TBO is a potential measure for the evaluation of ERAS.

Implementation of enhanced recovery programme for laparoscopic distal pancreatectomy: feasibility, safety and cost analysis.

BACKGROUND/OBJECTIVES: The adoption of laparoscopy for distal pancreatectomy has proven to substantially improve short-term outcomes. Stress response after major surgery can be further minimized within an enhanced recovery programme (ERP). However, data on the potential benefit of an ERP for laparoscopic distal pancreatectomy are still lacking. The aim was to assess the feasibility, safety and cost of ERP for patients undergoing laparoscopic distal pancreatectomy. METHODS: This is a case-control study from a Tertiary University Hospital. Sixty-six consecutive patients who underwent laparoscopic distal pancreatectomy were analyzed. Twenty-two patients were enrolled for the ERP and compared with previous consecutive 44 patients managed traditionally (1:2 ratio). Operative details, post-operative outcome and cost analysis were compared in the two groups. RESULTS: Patients enrolled in the ERP had similar intraoperative blood loss (median 165 ml vs. 200 ml; p = 0.176), operation time (225 min vs. 210 min; p = 0.633), time to remove naso-gastric tube (1 vs. 1 day; p = 0.081) but significantly shorter time to mobilization (median 1 vs. 2 days; p = 0.0001), start solid diet (2 vs. 3 days; p = 0004), and pass stools (3 vs. 5 days; p = 0.002) compared to the control group. Median length of stay was significantly shorter in the ERP group (3 vs. 6 days; p < 0.0001). No significant difference in readmission or complication rate was observed. Cost analysis was significantly in favor of the ERP group (p = 0.0004). CONCLUSIONS: Implementation of ERP optimizes outcomes for laparoscopic distal pancreatectomy with significant earlier return to normal gut function, reduced length of stay and cost saving.