Effects of Acute Caffeine Ingestion on Cognitive Performance before and after Repeated Small-Sided Games in Professional Soccer Players: A Placebo-Controlled, Randomized Crossover Trial.

Soccer is a team sport that requires players to process a significant amount of information quickly and respond with both speed and accuracy to the ever-changing demands of the game. As such, success in soccer depends not only on physical attributes but also on cognitive abilities such as perception and decision-making. The aim of the current study was to investigate the acute effects of caffeine ingestion on Stroop test performance before and after repeated small-sided games (SSG) in professional soccer players. Twelve professional male soccer players (29 ± 4.1 years; 78.1 ± 7.7 kg body mass) participated in this study. A randomized crossover double-blind placebo-controlled trial was used. Caffeine (5 mg.kg-1) or a placebo was ingested 45 min before a protocol consisting of five 5 min SSG with 1 min rest intervals. A computerized version of the colour Stroop test was completed immediately before and after the exercise protocol. During the Stroop test, words appeared on the computer screen in three different ways: (i) neutral words (neutral condition); (ii) correspondent colour (i.e., "red" painted in red; congruent condition), or; (iii) different colour (i.e., "red" painted in green; incongruent condition). The incongruent condition aimed to cause the interference effect, as the colour and the word did not match. Ratings of perceived exertion (RPE) were assessed after each SSG. RPE increased during the five sets of the SSG protocol (p < 0.001), without differences between the caffeine and placebo trials. The soccer-specific exercise protocol promoted a faster response during the Stroop test (two-way ANOVA main effect for SSG protocol: p < 0.05), with no differences in accuracy (p > 0.05). Caffeine ingestion resulted in slower reaction time during the Stroop test during the congruent and neutral trials but not during the incongruent trial (two-way ANOVA main effect for supplementation: p = 0.009, p = 0.045, and p = 0.071, respectively). Accuracy was lower in the caffeine trial in congruent and incongruent trials (p < 0.05 caffeine vs. placebo both on the pre- and post-SSG protocol). In conclusion, a soccer-specific exercise protocol improved the Stroop test performance in professional soccer players, but acute caffeine ingestion (5 mg.kg-1) was detrimental.

Effect of Caffeine Ingestion on Indirect Markers of Exercise-Induced Muscle Damage: A Systematic Review of Human Trials.

The effect of caffeine on mitigating exercise-induced muscle damage (EIMD) is still poorly understood, but it was hypothesized that caffeine could contribute to decreasing delayed onset muscle soreness, attenuating temporary loss of strength, and reducing circulating levels of blood markers of muscle damage. However, evidence is not conclusive and beneficial effects of caffeine ingestion on EIMD are not always observed. Factors, such as the type of exercise that induces muscle damage, supplementation protocol, and type of marker analyzed contribute to the differences between the studies. To expand knowledge on the role of caffeine supplementation in EIMD, this systematic review aimed to investigate the effect of caffeine supplementation on different markers of muscle damage. Fourteen studies were included, evaluating the effect of caffeine on indirect muscle damage markers, including blood markers (nine studies), pain perception (six studies), and MVC maximal voluntary contraction force (four studies). It was observed in four studies that repeated administration of caffeine between 24 and 72 h after muscle damage can attenuate the perception of pain in magnitudes ranging from 3.9% to 26%. The use of a single dose of caffeine pre-exercise (five studies) or post-exercise (one study) did not alter the circulating blood levels of creatine kinase (CK). Caffeine supplementation appears to attenuate pain perception, but this does not appear to be related to an attenuation of EIMD, per se. Furthermore, the effect of caffeine supplementation after muscle damage on strength recovery remains inconclusive due to the low number of studies found (four studies) and controversial results for both dynamic and isometric strength tests.

The Effect of Acute Caffeine Ingestion on Tactical Performance of Professional Soccer Players.

In soccer, physical, tactical, and decision-making processes are highly important facets of successful performance. Caffeine has well established effects for promoting both physical and cognitive performance, but the translation of such benefits specifically for soccer match play is not well established. This study examined the effects of acute caffeine ingestion on tactical performance during small-sided games (SSG) in professional soccer players. Nineteen soccer players (22 ± 4 years) underwent a randomized, counterbalanced, crossover, double-blind placebo-controlled trial. The protocol consisted of 5 bouts of 5-min SSG with 3 players plus a goalkeeper in each team (3 + GK × 3 + GK) with each SSG separated by 1 min rest intervals. Tactical performance was assessed using the system of tactical assessment in soccer (FUT-SAT). Prior to each experimental trial, participants ingested caffeine (5 mg·kg-1) or a placebo 60 min before the protocol. Overall, caffeine ingestion resulted in an increased ball possession time when compared to the placebo. When the offensive and defensive core principles were analyzed, the results were equivocal. Caffeine resulted in positive effects on some tactical decisions during the protocol, but it was deleterious or promoted no observed effect on other of the core tactical principles. Caffeine ingestion resulted in less offensive (during SSG3) and defensive (SSG 2, SSG3, and SSG4) errors. Caffeine ingestion also resulted in higher total offensive success during SSG 1 and SSG2, but it was detrimental during SSG3. Additionally, total defensive success was lower for the caffeine conditions during SSG 2 and SSG5 when compared to the placebo. In conclusion, caffeine influenced aspects of tactical decisions in soccer, resulting in fewer offensive and defensive errors, although it may be deleterious considering other tactical parameters. Future studies may clarify the effects of caffeine ingestion on specific decision-making parameters in soccer.

Nutrition Adequacy Therapeutic Enhancement in the Critically Ill: A Randomized Double-Blind, Placebo-Controlled Trial of the Motilin Receptor Agonist Camicinal (GSK962040): The NUTRIATE Study.

BACKGROUND: Camicinal is a novel, nonmacrolide, motilin receptor agonist that accelerates gastric emptying in critically ill patients with established feed intolerance. The primary question was whether the preemptive administration of camicinal increased the provision of enteral nutrition (EN) to critically ill patients with risk factors that predisposed to feed intolerance. METHODS: This was an international, multicenter, parallel-group, blinded, randomized controlled trial. Patients at risk for feed intolerance, defined as receiving moderate to high doses of vasopressors or opiates, or admitted because of multiple traumatic injuries or with brain injury, received either enteral camicinal 50 mg or placebo daily for a maximum of 7 days, along with EN administered according to a standardized feeding protocol. The primary outcome was the daily adequacy of enteral feed delivered, as assessed by percentage of goal volume (delivered/prescribed × 100) before development of intolerance. RESULTS: Eighty-four patients participated. The administration of camicinal did not result in a statistically significant clinical difference in the daily average percentage goal volume delivered (camicinal vs placebo: 77% [95% confidence interval: 71, 83] vs 68% (58, 78); mean difference 9% [-5, 23]; P = 0.21). Similarly, there were no differences in the percentage goal calories (76% [65, 88] vs 68% [60, 77]) and protein (76% [66, 86] vs 70% [61, 80]) administered, or the incidence of feed intolerance (15% vs 14%). CONCLUSION: The incidence of feed intolerance was low in both groups. In this cohort the preemptive administration of enteral camicinal did not significantly augment the provision of goal EN.

Examination of unplanned 30-day readmissions to a comprehensive cancer hospital.

PURPOSE: The Centers for Medicare and Medicaid Services (CMS), under the Hospitals Readmissions Reductions Program, may withhold regular reimbursements for excessive 30-day readmissions for select diagnoses. Such penalties imply that some readmissions reflect poor clinical decision making or care during the initial hospitalization. We examined factors related to potentially preventable readmissions in CMS patients at a tertiary cancer hospital. METHODS: The medical records of all CMS patients with unplanned readmissions within 30 days of index admission were reviewed over 6 months (October 15, 2011-April 15, 2012). Each readmission was classified as not preventable or potentially preventable. Factors associated with potentially preventable readmissions were sought. RESULTS: Of 2,531 inpatient admissions in CMS patients over 6 months, 185 patients experienced at least one readmission for 282 total readmissions (11%). Median time to readmission was 9 days (range, 0 to 30 days). The most common causes for first readmission were new diagnoses not present at first admission (n = 43, 23%), new or worsening symptoms due to cancer progression (n = 40, 21%) and complications of procedures (n = 25, 13%). There were 38 (21%) initial readmissions classified as potentially preventable. Use of total parenteral nutrition at the time of discharge was associated with potentially preventable readmission (P = .028). CONCLUSION: Most unplanned readmissions to a tertiary cancer hospital are related to progression of disease, new diagnoses, and procedure complications. Minimizing readmissions in complex cancer patients is challenging. Larger multi-institutional datasets are needed to determine a reasonable standard for expected readmission rates.

Effects of sports massage and intermittent cold-water immersion on recovery from matches by basketball players.

The aim of this study was to compare the effects of intermittent cold-water immersion and massage on perceptual and performance markers of recovery by basketball players after competitive matches. Eight men (age 23 ± 3 years; stature 190.5 ± 8.9 cm; body mass 90.3 ± 9.6 kg; body fat 12.8 ± 4.8%) and eight women (age 22 ± 2 years; stature 179.0 ± 8.5 cm; body mass 77.6 ± 9.2 kg; body fat 22.5 ± 6.6%) basketball players participated. Massage, cold-water immersion or control were applied immediately after competitive matches, followed by assessments of perceptual measures of recovery and physical performance, countermovement jump and repeated-sprint ability 24 h after intervention. There was lower perception of fatigue overall and in the legs immediately after the massage and cold-water immersion condition (P < 0.001; η²(P) = 0.91). Furthermore, women had a lower perception of fatigue in cold-water immersion than massage at any testing time (P < 0.001; η²(P) = 0.37). Jump performance was greater after cold-water immersion than the control condition (P = 0.037, η²(P) = 0.37). There was no effect of any of the recovery interventions on repeated-sprint measures (P at best 0.067, η²(P) at best 0.68). The results suggest that both massage and cold-water immersion improve perceptual measures of recovery. Furthermore, cold-water immersion improves jump performance although neither such immersion nor massage had an effect on repeated-sprint ability. This suggests that, overall, cold-water immersion is more useful than massage in the recovery from basketball matches, especially in women.