Halving of the meniscectomy rate and their costs in Italy: A 15-years period analysis.

PURPOSE: The purpose of this study was to determine the incidence and hospitalization trends of meniscectomy in Italy from 2001 to 2016. A secondary aim was to investigate the economic burden of the disease on the national healthcare system. METHODS: Data were extracted from the Italian Ministry of Health's National Hospital Discharge Reports. Diagnoses are coded according to the ICD-9-CM. Meniscectomy was defined by the following main procedure codes: 806, 8026 and 8145. By dividing the number of annual cases by the size of the adult population reported annually by ISTAT, incidence rates were computed. RESULTS: Overall, 1,454,891 meniscectomies were performed in the study period between 2001 and 2016. The incidence was 178 procedures for every 100,000 Italian inhabitants. The incidence declined from 202 in 2001 to 106 in 2016. Males were the largest portion of patients undergoing surgery (68.2%). The average age of patients was 46.59 ± 15.07. A decreasing trend in length of hospital stay was observed over the study period. The annual average cost per 100,000 inhabitants was EUR 491.219 ± 122.148 with a range from EUR 291,500 ± 79.500 in 2016 to EUR 610,500 ± 166.500 in 2004. CONCLUSION: In Italy, the number of meniscectomies performed in the adult population has almost halved over the study period. Results of the present study in the Italian population seem to reflect how the clinical evidence basis affects surgical technique selection. The economic burden of meniscectomy is relevant in Italy with an estimated expenditure from EUR 181.861.375 to 318.257.406 between 2001 and 2016. LEVEL OF EVIDENCE: Level III.

Performance pathways in elite middle- and long-distance track and field athletes: The influence of a successful youth.

OBJECTIVES: There is limited information on the performance progression of athletics endurance athletes from junior-to-senior status and the determinants of success in adulthood. This study aimed to quantify the youth-to-senior transition rate, the likelihood of success and the relationship between youth and senior performance amongst world-class athletes competing in middle- and long-distance disciplines. DESIGN: Retrospective design examining public data between 2000 and 2019. METHODS: The performances of 4678 international athletes (45.3 % female) were analysed. World's all-time top 50 athletes were identified for U18 and Senior categories (age ≥ 20 years). Youth-to-senior transition rate and transition probabilities were calculated. Correlations between best U18 and Senior performances were determined to assess the stability of the performance. RESULTS: The youth-to-senior transition rate for top U18 athletes was low for males and females (~19 % and 21 %). Nevertheless, the probability of transition to a top senior was ~7 times higher for top U18 athletes than for non-top U18 athletes. The correlations between youth and senior best performances were low-to-high. CONCLUSIONS: Few top U18 athletes maintained top world ranking status during their senior careers. Still, they are more likely to become top senior athletes than those who did not perform at the top level in U18. The association between youth and senior performance is stronger when comparing the same discipline or when athletes competed over longer distances in their senior compared to U18 career. Being a successful youth athlete may represent a small advantage for future success, however, it does not guarantee advancement to the senior top level.

Baseline clinical and MRI risk factors for hamstring reinjury showing the value of performing baseline MRI and delaying return to play: a multicentre, prospective cohort of 330 acute hamstring injuries.

OBJECTIVES: Studies identifying clinical and MRI reinjury risk factors are limited by relatively small sample sizes. This study aimed to examine the association between baseline clinical and MRI findings with the incidence of hamstring reinjuries using a large multicentre dataset. METHODS: We merged data from four prospective studies (three randomised controlled trials and one ongoing prospective case series) from Qatar and the Netherlands. Inclusion criteria included patients with MRI-confirmed acute hamstring injuries (<7 days). We performed multivariable modified Poisson regression analysis to assess the association of baseline clinical and MRI data with hamstring reinjury incidence within 2 months and 12 months of follow-up. RESULTS: 330 and 308 patients were included in 2 months (31 (9%) reinjuries) and 12 months (52 (17%) reinjuries) analyses, respectively. In the 2-month analysis, the presence of discomfort during the active knee extension test was associated with reinjury risk (adjusted risk ratio (ARR) 3.38; 95% CI 1.19 to 9.64). In the 12 months analysis, the time to return to play (RTP) (ARR 0.99; 95% CI 0.97 to 1.00), straight leg raise angle on the injured leg (ARR 0.98; 95% CI 0.96 to 1.00), the presence of discomfort during active knee extension test (ARR 2.52; 95% CI 1.10 to 5.78), the extent of oedema anteroposterior on MRI (ARR 0.74; 95% CI 0.57 to 0.96) and myotendinous junction (MTJ) involvement on MRI (ARR 3.10; 95% CI 1.39 to 6.93) were independently associated with hamstring reinjury. CONCLUSIONS: Two clinical findings (the presence of discomfort during active knee extension test, lower straight leg raise angle on the injured leg), two MRI findings (less anteroposterior oedema, MTJ involvement) and shorter time to RTP were independently associated with increased hamstring reinjury risk. These findings may assist the clinician to identify patients at increased reinjury risk following acute hamstring injury. TRIAL REGISTRATION NUMBERS: NCT01812564; NCT02104258; NL2643; NL55671.018.16.

The effects of the first wave of COVID-19 restrictions on physical activity: a longitudinal study from "step into health" program in Qatar.

Introduction: The COVID-19 pandemic led to restrictions that prevented physical activity in public places. This study sought to conduct a comprehensive longitudinal analysis of how lockdown policies in an Arabian Gulf country influenced the patterns of physical activity during first wave. Methods: In a longitudinal study design, members of the ongoing "Step into health" community-based health promotion program who provided valid pedometer data from January to August 2020, covering pre, during and post-covid first wave period met the inclusion criteria. Results: 420 (76.7% men, 13.8% ≤40 years) were included in the study. Overall, significant decline in daily step counts was recorded (-1,130 ± SE302) after the implementation of lockdown policies (p < 0.001). When the restrictions were removed, the steps per day were still lower compared to pre-covid for men (-910 ± SE610, p = 0.017) and among individuals with normal BMI (-1,304 ± SE409, p = 0.004). The lockdown in Qatar did not significantly affect women and individuals with obesity who already had lower daily steps pre-covid. Discussion: The present study confirms immediate decline in daily steps imposed indirectly through the COVID-19 lockdown measures. Participants with higher physical activity levels pre-covid experienced significant decline in step count during and even after restrictions were uplifted.

Influence of Lateralization and Distalization on Joint Function after Primary Reverse Total Shoulder Arthroplasty.

The purpose of this study was to investigate how lateralization shoulder angle (LSA) and distalization shoulder angle (DSA) are related to clinical and kinematic outcomes after reverse total shoulder arthroplasty. Thirty-three patients were evaluated at least six months postoperatively. The Single Assessment Numeric Evaluation (SANE), Constant Murley Score (CMS), Simple Shoulder Test (SST), and Visual Analogue Scale (VAS) were used. Shoulder kinematics was evaluated with a stereophotogrammetric system. LSA and DSA inter-rater reliability was analysed through the interclass correlation coefficient (ICC). Stepwise forward linear regression analysis was conducted between LSA and DSA with clinical scales and kinematic measures, between which a correlation analysis was conducted. The inter-rater reliability for LSA (mean ICC = 0.93) and DSA (mean ICC = 0.97) results were good to excellent. Greater LSA values were associated with higher peaks of internal rotation (p = 0.012, R2 = 0.188) and range of motion (ROM) (p = 0.037, R2 = 0.133). SANE (p = 0.009), CMS (p = 0.031), and SST (0.026) were positively correlated to external rotation, while VAS (p = 0.020) was negatively related. Abduction peaks were positively related to CMS (p = 0.011) and SANE (p = 0.037), as well as abduction ROM (SANE, p = 0.031; CMS, p = 0.014).

Management of radiology services during the 2022 FIFA football (soccer) World Cup.

Diagnostic imaging is the predominant medical service sought for the assessment and staging of musculoskeletal injuries in professional sports events. During the 2022 FIFA Football (soccer) World Cup, a centralized medical care infrastructure was established. This article provides a comprehensive account of the radiological services implemented during this event, encompassing the deployment of equipment and human resources, the structuring of workflows to uphold athlete confidentiality, and initiatives aimed at enhancing communication. Communication channels were refined through radiology consultations held with national teams' health care providers and the adoption of audiovisual reports available in multiple languages, which could be accessed remotely by team physicians. Our established framework can be replicated in international professional football events for seamless integration and efficacy.

Medical services at the FIFA world cup Qatar 2022.

OBJECTIVE: The Football World Cup is among the biggest sporting events in the world, but data to inform the requirements of medical care for such tournaments are limited. This study describes the athlete and team medical services at the FIFA World Cup Qatar 2022 . METHODS: Three different medical service entities were identified through a needs analysis based on expert advice, team physician interviews and questionnaires prior to the event: 'Team Services' to provide any workforce or equipment needs of the teams, a 'Polyclinic' to manage any acute medical demands, and a 'recovery centre' to improve game readiness throughout the tournament. All services had been set up prior to the tournament and thoroughly tested. RESULTS: Of a total of 832 athletes, ~1300 team delegation and ~130 match officials, 167 individuals including 129 (77%) athletes and 38 (23%) non-athletes were assessed in the polyclinic. For the 129 athletes (median 4 players per team), medical imaging was the most requested service, which peaked during the group phase of the tournament. Most requests were received during normal working hours despite many games finishing late at night. 30 of the 32 participating teams solicited medical services for their players at least once. Three teams made use of the recovery facilities, and 17 teams requested additional medical equipment or clinical assistance. CONCLUSION: Central imaging services was the most used medical resource at the FIFA World Cup Qatar 2022, and over half of teams required additional medical equipment or personnel. These data may inform planning of medical services for similar events in the future.

Imaging-detected sports injuries and imaging-guided interventions in athletes during the 2022 FIFA football (soccer) World Cup.

OBJECTIVE: To describe imaging-detected musculoskeletal injuries and image-guided interventional procedures during the 2022 FIFA football (soccer) World Cup. MATERIALS AND METHODS: Retrospective analysis of all radiologic examinations performed in a central medical facility for athletes was performed by two board certified musculoskeletal radiologists. Data on muscle, tendon, ligament, cartilage, and bone injuries were collected according to imaging modality and body part. RESULTS: A total of 143 radiology examinations in 94 athletes were evaluated at the central medical facility. Magnetic resonance imaging (MRI) was the most utilized modality (67%), followed by radiography (12%), ultrasonography (9%), and computed tomography (4%). Image-guided interventions corresponded to 8% of all radiological examinations. There were 112 injuries described, affecting muscles and tendons (42%), ligaments (25%), cartilage (21%), and bone (12%). Most injured body parts were thigh (27%), foot and ankle (23%), knee (23%), and hip/groin (8%). Most injured players were within the age range of 24-35 years old (71%). CONCLUSION: Imaging was utilized in 11% of players who participated in the 2022 FIFA World Cup in Qatar. MRI was the most utilized modality, and acute muscle tears were the most diagnosed type of injury. Diagnostic imaging played an important role in diagnosing sports-related injuries during the 2022 FIFA World Cup.

Junior to senior transition pathway in Italian Football: The rocky road to the top is not determined by youth national team's selections.

Football is a popular sport, but little is known about the youth-to-senior transition rates in elite players, particularly in large and successful countries. This study aims to investigate the youth-to-senior transition rate in the Italian national football team, both prospectively and retrospectively, and to explore if Relative Age Effects (RAEs) affect this transition. Data from 885 players selected in youth and senior Italian national teams between 2000 and 2021 were included in the study. For each player, the birthdate and the number of selection in Under 16, 17, 19, 21 and senior team was considered. The transition rate was determined by the number of youth players competing in the Senior National team (and vice versa), whilst birth quarter (Q) distributions with a chi-square goodness-of-fit test. Prospectively, the transition rate increased as age increased (i.e., from ~20% in U16 to ~50% in U19). Retrospectively, less than 10-20% of youth players were subsequently selected for the senior team. Data revealed a skewed birth date distribution in all age groups, and the RAEs magnitude decreased when age increased (i.e., ORs for Q1 vs Q4 was ~ 9 in U16 and ~ 1.7 in senior teams). Nevertheless, the RAE magnitude was smaller for successfully transitioned players. In conclusion, most players in the senior team were not previously selected for youth teams suggesting that junior international experience may not be a prerequisite for later success. Moreover, while the birthdate strongly influences the selection of youth national teams, its impact is less evident in the youth-to-senior transition.

Thermoregulatory responses during road races in hot-humid conditions at the 2019 Athletics World Championships.

The purpose of this study was to characterize thermoregulatory and performance responses of elite road-race athletes, while competing in hot, humid, night-time conditions during the 2019 IAAF World Athletic Championships. Male and female athletes, competing in the 20 km racewalk (n = 20 males, 24 females), 50 km racewalk (n = 19 males, 8 females), and marathon (n = 15 males, 22 females) participated. Exposed mean skin (Tsk) and continuous core body (Tc) temperature were recorded with infrared thermography and ingestible telemetry pill, respectively. The range of ambient conditions (recorded roadside) was 29.3°C-32.7°C air temperature, 46%-81% relative humidity, 0.1-1.7 m·s-1 air velocity, and 23.5°C-30.6°C wet bulb globe temperature. Tc increased by 1.5 ± 0.1°C but mean Tsk decreased by 1.5 ± 0.4°C over the duration of the races. Tsk and Tc changed most rapidly at the start of the races and then plateaued, with Tc showing a rapid increase again at the end, in a pattern mirroring pacing. Performance times were between 3% and 20% (mean = 113 ± 6%) longer during the championships compared with the personal best (PB) of athletes. Overall mean performance relative to PB was correlated with the wet-bulb globe temperature (WBGT) of each race (R2 = 0.89), but not with thermophysiological variables (R2 ≤ 0.3). As previously reported in exercise heat stress, in this field study Tc rose with exercise duration, whereas Tsk showed a decline. The latter contradicts the commonly recorded rise and plateau in laboratory studies at similar ambient temperatures but without realistic air movement.NEW & NOTEWORTHY This paper provides a kinetic observation of both core and skin temperatures in 108 elite athletes, during various outdoor competition events, adding to the very limited data so far available in the literature taken during elite competitions. The field skin temperature findings contrast previous laboratory findings, likely due to differences in relative air velocity and its impact on the evaporation of sweat. The rapid rise in skin temperature following cessation of exercise highlights the importance of infrared thermography measurements being taken during motion, not during breaks, when being used as a measurement of skin temperature during exercise.

Don't Throw the Baby Out With the Bathwater: Talent in Swimming Sprinting Events Might Be Hidden at Early Age.

PURPOSE: This study aimed to describe the career performance progression of elite early- and later-success international swimmers competing in sprint events (ie, 50 and 100 m). METHODS: The career performance trajectories of 6003 swimmers (50.9% females; 58,760 unique records) competing in the 4 swimming strokes were evaluated. Swimmers with early and later success were identified. The authors identified the top 50 all-time swimmers competing in junior career who did not reach the top 50 rankings in their senior career, and vice versa, and successful swimmers in both junior and senior career. RESULTS: Early-success swimmers mainly achieved their peak performance before the age of 20 years and approximately 5-6 years before successful senior swimmers or approximately 3-4 years before successful swimmers both in junior and senior careers. The annual performance improvements of later-success swimmers were higher (about 1%-2%) until the age of 20 to 24 years, whereas early-success swimmers showed a performance stagnation at about 16 to 18 years in females and 19 to 20 years in males. CONCLUSIONS: Early-success swimmers who achieved peak performance at a young age were unable to maintain the same level of competitiveness in adulthood as they experienced a plateau in performance from the age of 20 years. The procedure of considering early performances solely for talent identification (and not the current rate of progression) might represent a limited approach for selecting future elite swimmers. Our results indicate that performance progression in the transition toward adult careers might be a strong indicator of performance potential.

Association between thermal responses, medical events, performance, heat acclimation and health status in male and female elite athletes during the 2019 Doha World Athletics Championships.

PURPOSE: To determine associations between thermal responses, medical events, performance, heat acclimation and health status during a World Athletics Championships in hot-humid conditions. METHODS: From 305 marathon and race-walk starters, 83 completed a preparticipation questionnaire on health and acclimation. Core (Tcore; ingestible pill) and skin (Tskin; thermal camera) temperatures were measured in-competition in 56 and 107 athletes, respectively. 70 in-race medical events were analysed retrospectively. Performance (% personal best) and did not finish (DNF) were extracted from official results. RESULTS: Peak Tcore during competition reached 39.6°C±0.6°C (maximum 41.1°C). Tskin decreased from 32.2°C±1.3°C to 31.0°C±1.4°C during the races (p<0.001). Tcore was not related to DNF (25% of starters) or medical events (p≥0.150), whereas Tskin, Tskin rate of decrease and Tcore-to-Tskin gradient were (p≤0.029). A third of the athletes reported symptoms in the 10 days preceding the event, mainly insomnia, diarrhoea and stomach pain, with diarrhoea (9% of athletes) increasing the risk of in-race medical events (71% vs 17%, p<0.001). Athletes (63%) who performed 5-30 days heat acclimation before the competition: ranked better (18±13 vs 28±13, p=0.009), displayed a lower peak Tcore (39.4°C±0.4°C vs 39.8°C±0.7°C, p=0.044) and larger in-race decrease in Tskin (-1.4°C±1.0°C vs -0.9°C±1.2°C, p=0.060), than non-acclimated athletes. Although not significant, they also showed lower DNF (19% vs 30%, p=0.273) and medical events (19% vs 32%, p=0.179). CONCLUSION: Tskin, Tskin rate of decrease and Tcore-to-Tskin gradient were important indicators of heat tolerance. While heat-acclimated athletes ranked better, recent diarrhoea represented a significant risk factor for DNF and in-race medical events.

Tanner-Whitehouse and Modified Bayley-Pinneau Adult Height Predictions in Elite Youth Soccer Players from the Middle East.

PURPOSE: To provide the first scrutiny of adult height prediction protocols based on automated Greulich-Pyle and Tanner-Whitehouse (TW) skeletal ages applied to elite youth soccer players from the Middle East. METHODS: We examined the application of modified Bayley-Pinneau (BoneXpert®), TW-II, and TW-III protocols using mixed-longitudinal data available for 103 subjects (chronological age range, 19.4 to 27.9 yr) previously enrolled as academy student-athletes (annual screening range, one to six visits). Random-effects generalized additive models quantified the presence of systematic mean differences between actual versus predicted adult height. Effects were deemed practically equivalent based on the location of the confidence interval (95% CI) against a realistic difference value of Δ = ± 1 cm. Each model pooled residual standard deviation described the actual precision of height predictions and was used to calculate a 95% prediction interval. RESULTS: The BoneXpert® method overpredicted adult height systematically at chronological ages in the range of approximately 13.5 to 14.5 yr (95% CI range, -1.9 to -1 cm) and Greulich-Pyle skeletal ages between 13.5 and 15 yr (95% CI range, -3.1 to -1 cm). Effects based on TW-II were practically equivalent across the chronological and skeletal age measurement ranges, with this protocol yielding adult height predictions with a precision (standard deviation) of approximately ±2.6 cm. The mean TW-III effects indicated systematic adult height overpredictions until the attainment of 14.5 and 15 yr of chronological age (95% CI range, -3.8 to -1.1 cm) and TW-III skeletal age (95% CI range: -5.2 to -2.3 cm), respectively. CONCLUSIONS: Tanner-Whitehouse-II adult height prediction method provided more consistent estimates and can be considered the method of choice for talent development purposes in youth soccer players from the Middle East.

Weight Loss in Patients Waiting for Total Hip Arthroplasty: Fiber-Enriched High Carbohydrate Diet Improves Hip Function and Decreases Pain before Surgery.

The impact of obesity on clinical outcomes following joint replacement procedures is resounding. Therefore, multiple strategies to achieve a substantial weight loss before surgery are needed in obese patients. The aim of the study was to test the effect of a fiber-enriched high carbohydrate (FEHC) diet on the reduction in body weight and pain in elderly obese patients undergoing total hip arthroplasty (THA). Sixty-one candidates for THA were included in our study. Prior to the procedure, the participants have been randomly assigned to a 3-month diet intervention (FEHC diet or free diet). Anthropometric measures and food questionnaires were collected at the enrollment and after 3 months. The Oxford Hip Score (OHS), the Hip disability and Osteoarthritis Outcome Score (HOOS) and the Western Ontario McMaster Universities OA Index (WOMAC) were administered at baseline and before surgery. A statistically significant variation of weight was found in the FEHC diet group (-3.7 kg, -4.4--2.5) compared to the control group (-0.2 kg; -1.4-1.7; p < 0.0001), as well as significant improvements in the OHS (p < 0.0001), the HOOS (p < 0.0001) and the WOMAC (p < 0.0001) questionnaires. According to the results of the study, the FEHC diet in obese patients undergoing THA might help weight loss and improve related anthropometric parameters as well as hip function and pain.

Preparing athletes and staff for the first "pandemic" Olympic Games.

Severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) is the virus causing Coronavirus disease 2019 (COVID-19). Since the World Health Organization declared the outbreak of pandemic on March 11, 2020, cases have been increasing around the World with more than 3-million deaths recorded and a daily number of COVID-19 cases 20 times higher than when the Olympics were postponed, at the time of writing. Governments adopted various lockdown measures forcing isolation for many weeks/months depending on the evolution of the disease in each country. The rapid transmission of the disease forced the Tokyo 2020 Olympics to be postponed for one year. Travel restrictions, quarantine requirements and isolation have been the norm for many athletes in preparation for the Olympic Games. Also, due to the measures put in place to reduce the spread of the disease, sporting facilities have been closed and competitions cancelled forcing athletes and their staff to find alternative solutions to maintain performance and continue preparing for the Olympics. This unique challenge is affecting the whole World, and while vaccination programs start to be deployed, in a few months the world will see the first Olympic Games' edition during a pandemic. The aim of this special paper was to consider the various challenges posed by the COVID pandemic and to provide information for coaching support staff to improve the preparation for Tokyo Olympics as well as consider the possible performance implications of this unique Olympic edition.

Being a top swimmer during the early career is not a prerequisite for success: A study on sprinter strokes.

OBJECTIVES: To quantify the junior-to-senior successful transition rate in sprint swimming events in elite European performers. DESIGN: Retrospective analysis of publicly available competition data collected between 2004 and 2019. METHODS: The yearly performance of 6631 European swimmers (females = 41.8% of the sample) competing in 50 and 100 m freestyle, backstroke, breaststroke, and butterfly were included in the analysis. The junior-to-senior transition rate was determined as the number of elite junior athletes who maintained their elite status in adulthood. To investigate how the definition of elite may affect the calculation of the transition rate, we operationally defined elite athletes as those ranked in the all-time top 10, 25, 50, and 100 in their category. We also calculated the correlation between junior and senior performances. RESULTS: The average transition rates ranged, depending on the age of reference, from 10 to 26% in males and from 23 to 33% in females. The transition rate for the top 100 junior swimmers was greater than that for the top 10 swimmers. In general, swimmers who swam 50 m showed a slightly lower transition rate compared with those that swam 100 m. Depending on the age of reference, low-to-moderate correlations were observed between junior and senior peak performances. CONCLUSIONS: Most elite junior athletes did not maintain the elite level in adulthood. Except for athletes in the last year of the junior category (18 years for males and 17 years for females), junior performances were poorly correlated with senior performances.

Elite Junior Throwers Unlikely to Remain at the Top Level in the Senior Category.

PURPOSE: This study investigated (1) the transition rate of elite world-class throwers, (2) the age of peak performance in either elite junior and/or elite senior athletes, and (3) if relative age effect (RAE) influences the chance of being considered elite in junior and/or senior category. METHODS: The career performance trajectories of 5108 throwers (49.9% females) were extracted from the World Athletics database. The authors identified throwers who had reached the elite level (operationally defined as the World all-time top 50 ranked for each age category) in either junior and/or senior category and calculated the junior-to-senior transition rate. The age of peak performance and the RAE were also investigated. RESULTS: The transition rate at 16 and 18 years of age was 6% and 12% in males and 16% and 24% in females, respectively. Furthermore, elite senior throwers reached their personal best later in life than elite junior throwers. The athletes of both genders considered elite in the junior category showed a large RAE. Interestingly, male athletes who reached the elite level in senior category also showed appreciable RAE. CONCLUSIONS: Only a few of the athletes who reach the top 50 in the world at 16 or 18 years of age manage to become elite senior athletes, underlining that success at the beginning of an athletic career does not predict success in the athlete's senior career. Moreover, data suggest that being relatively older may confer a benefit across the whole career of male throwers.

An objective description of routine sleep habits in elite youth football players from the Middle-East.

BACKGROUND AND STUDY OBJECTIVES: Adequate sleep is essential to support preparation and recovery processes for training and competition in athletes. A limited number of studies have examined whether adolescents from the Middle-East meet the minimum age-specific recommendations ranging from 8 to 9 h of night sleep based on objective measurements. This study aimed to provide an objective description of routine sleep habits in elite youth football players from the Middle-East. METHODS: Using wrist-worn actigraphy, we examined objective measures of sleep over a 14-day surveillance period from fifty-nine, male, Middle-Eastern elite youth football players (age range: 12.1 to 16 years). RESULTS: The observed median sleep duration was approximately 5.5 to 6 h during weekdays and 6.5 to 7.5 h over weekend days. Sleep intermissions resulting in two or more periods of sleep accounted for 8% and 17% of the data during weekdays and weekends, respectively. CONCLUSIONS: For the first time, we reported an objective quantification of sleep measures indicating that elite youth athletes from the Middle-East do not meet the age-specific sleep recommendations. Integration of sleep tracking into the routine training monitoring process can be valuable to inform decisions relevant to the adoption of potential multidisciplinary interventions to address sleep insufficiency and disorders in youth athletes.

Hydration and cooling in elite athletes: relationship with performance, body mass loss and body temperatures during the Doha 2019 IAAF World Athletics Championships.

PURPOSE: To characterise hydration, cooling, body mass loss, and core (Tcore) and skin (Tsk) temperatures during World Athletics Championships in hot-humid conditions. METHODS: Marathon and race-walk (20 km and 50 km) athletes (n=83, 36 women) completed a pre-race questionnaire. Pre-race and post-race body weight (n=74), Tcore (n=56) and Tsk (n=49; thermography) were measured. RESULTS: Most athletes (93%) had a pre-planned drinking strategy (electrolytes (83%), carbohydrates (81%)) while ice slurry was less common (11%; p<0.001). More men than women relied on electrolytes and carbohydrates (91%-93% vs 67%-72%, p≤0.029). Drinking strategies were based on personal experience (91%) rather than external sources (p<0.001). Most athletes (80%) planned pre-cooling (ice vests (53%), cold towels (45%), neck collars (21%) and ice slurry (21%)) and/or mid-cooling (93%; head/face dousing (65%) and cold water ingestion (52%)). Menthol usage was negligible (1%-2%). Pre-race Tcore was lower in athletes using ice vests (37.5°C±0.4°C vs 37.8°C±0.3°C, p=0.024). Tcore (pre-race 37.7°C±0.3°C, post-race 39.6°C±0.6°C) was independent of event, ranking or performance (p≥0.225). Pre-race Tsk was correlated with faster race completion (r=0.32, p=0.046) and was higher in non-finishers (did not finish (DNF); 33.8°C±0.9°C vs 32.6°C±1.4°C, p=0.017). Body mass loss was higher in men than women (-2.8±1.5% vs -1.3±1.6%, p<0.001), although not associated with performance. CONCLUSION: Most athletes' hydration strategies were pre-planned based on personal experience. Ice vests were the most adopted pre-cooling strategy and the only one minimising Tcore, suggesting that event organisers should be cognisant of logistics (ie, freezers). Dehydration was moderate and unrelated to performance. Pre-race Tsk was related to performance and DNF, suggesting that Tsk modulation should be incorporated into pre-race strategies.

Development in Adolescent Middle-Distance Athletes: A Study of Training Loadings, Physical Qualities, and Competition Performance.

ABSTRACT: Jones, TW, Shillabeer, BC, Ryu, JH, and Cardinale, M. Development in adolescent middle-distance athletes: a study of training loadings, physical qualities, and competition performance. J Strength Cond Res 35(12S): S103-S110, 2021-The purpose of this study was to examine changes in running performance and physical qualities related to middle-distance performance over a training season. The study also examined relationships between training loading and changes in physical qualities as assessed by laboratory and field measures. Relationships between laboratory and field measures were also analyzed. This was a 9-month observational study of 10 highly trained adolescent middle-distance athletes. Training intensity distribution was similar over the observational period, whereas accumulated and mean distance and training time and accumulated load varied monthly. Statistically significant (p < 0.05) and large effect sizes (Cohen's d) (>0.80) were observed for improvements in: body mass (5.6%), 600-m (4.6%), 1,200-m (8.7%), and 1,800-m (6.1%) time trial performance, critical speed (7.1%), V̇o2max (5.5%), running economy (10.1%), vertical stiffness (2.6%), reactive index (3.8%), and countermovement jump power output relative to body mass (7.9%). Improvements in 1,800 m TT performance were correlated with increases in V̇o2max (r = 0.810, p = 0.015) and critical speed (r = 0.918, p = 0.001). Increases in V̇o2max and critical speed were also correlated (r = 0.895, p = 0.003). Data presented here indicate that improvements in critical speed may be reflective of changes in aerobic capacity in adolescent middle-distance athletes.