Estimating Maturity Status in Elite Youth Soccer Players: Evaluation of Methods.

PURPOSE: The objective of this study is to evaluate the concordance of predicted maturity status classifications (pre-, circa-, or post-peak height velocity (PHV)) relative to observed age at PHV in youth soccer players. METHODS: Longitudinal height records for 124 male soccer players were extracted from academy records spanning the 2000 to 2022 seasons. Age at PHV for each player was estimated with the Superimposition by Translation and Rotation model. Players were classified as pre-, circa-, or post-PHV using both ±1- and ±0.5-yr criteria to define the circa-PHV interval. Maturity status was estimated with several prediction protocols: maturity offset (Mirwald, Moore-1, Moore-2), maturity ratio (Fransen), and percentage of predicted adult height (PAH%) using the Khamis-Roche and Tanner-Whitehouse 2 equations using several bands: 85% to 96%, 88% to 96%, 88% to 93%, and 90% to 93% for the circa-PHV interval, and visual evaluation of individual growth curves alone or with PAH% based on Khamis-Roche and Tanner-Whitehouse 2. Concordance of maturity status classifications based on complete growth curves and predicted estimates of maturity status was addressed with percentage agreement and Cohen's kappa. RESULTS: Visual evaluation of the growth curves had the highest concordance (≈80%) with maturity status classifications (pre-, circa-, post-PHV) based on longitudinal data for individual players. Predicted maturity offset with the Mirwald, Moore-1, and Fransen equations misclassified about one-third to one-half of the players, whereas concordance based on PAH% varied with the band used, but not with the method of height prediction. CONCLUSIONS: Visual assessment of the individual growth curves by an experienced assessor provides an accurate estimate of maturity status relative to PHV. Maturity offset prediction equations misclassify the majority of players, whereas PAH% provides a reasonably valid alternative.

The combined effects of growth and maturity status on injury risk in an elite football academy.

This study aimed to explore the interaction between growth rate on specific injury incidence and burden on pre-, circa- and post-peak height velocity (PHV) periods. Injury and stature data collected during the 2000-2020 seasons in an elite football academy were retrospectively analysed. Only players with height measurements from childhood until the attainment of adult height were included in the study (N = 84). Growth data were smoothed using a cubic spline to calculate daily growth rate and height. Growth rate was categorised into three groups: fast (> 7.2 cm/year), moderate (3.5-7.2 cm/year) and slow (< 3.5 cm/year). Percentage of observed adult height was used to classify players as pre-PHV (< 88%), circa-PHV (88-95%) or post-PHV (> 95%). Overall and specific injury incidence and burden and rate ratios for comparisons between growth rate groups were calculated on pre-, circa- and post-PHV periods, separately. Overall injury incidence and burden were greater in pre-PHV players with quicker growth rates compared to players growing moderately and slowly. All in all, players with more rapid growth-rates were at higher risk for growth-related injuries in all pre-, circa- and post-PHV periods. Post-PHV, the incidence and burden of joint/ligament injuries were 2.4 and 2.6-times greater in players growing slowly compared to players growing moderately. Practitioners should monitor growth rate and maturity status and consider their interaction to facilitate the design of targeted injury risk reduction strategies.

Lost in transition: Exploring injury risk in academy footballers shifting between the second and first teams.

OBJECTIVES: To compare the injury profiles of football players shifting between second and first teams with those of second- and first-team players, and to examine the opinions of shifting players. DESIGN: Prospective cohort study. METHODS: 170 male players from Athletic Club (second team = 90, shifting = 20, first team = 60) were followed over eight seasons. Injuries and exposure time were recorded following the FIFA consensus, and 18 shifting players answered a seven-item questionnaire on their experience. RESULTS: 35 % shifting players became full-time first-team players, in contrast to only 8 % of second-team players (odds ratio = 6.4, p < 0.01). There were no differences in the overall injury incidence, but the overall burden of injuries was higher in second-team (172 days lost/1000 h) and shifting players (194 days lost/1000 h) compared with first-team players (114 days lost/1000 h, p < 0.01). Shifting players had a higher burden of knee joint/ligament injuries compared with first-team players (137 vs. 18 days lost/1000 h, p < 0.01) and anterior cruciate ligament (ACL) ruptures (122 vs. 10 days lost/1000 h, p < 0.01). There was a trend towards a higher burden of ACL ruptures in shifting players than in second-team players (122 vs. 41 days lost/1000 h, p = 0.07). Shifting players reported constant pressure and better communication with the second-team coaching staff than with the first-team staff. CONCLUSIONS: The high burden of injuries in shifting players, particularly from ACL ruptures, highlights the need for action. Ensuring high-quality communication between second- and first-team staff remains a key challenge.

An injury burden heat map of all men's and women's teams of a professional football club over a decade.

The aim was to present a descriptive 10-season summary of injury data from all teams of a professional football club using a heat map approach. Injuries and exposure time were registered according to the FIFA consensus in all men's and women's teams from Athletic Club over 10 seasons. A team-by-injury table was created, showing the incidence, median severity, and burden in each cell. Cells were coloured based on the injury burden value using a green - yellow-red gradient (lowest to highest). The highest overall injury burden was found in the women's 2nd and 1st teams and the men's U(under)17 team (>200 days lost/1000 h). Muscle injury burden demonstrated an increasing pattern with age. Knee joint/ligament injuries, particularly anterior cruciate ligament ruptures, had the highest impact on women's teams, followed by the men's 2nd team. In comparison, ankle joint/ligament injuries had a relatively low injury burden in most teams. Growth-related injuries were the most impactful injuries in the men's U15 and younger teams, and the women's U14 team. In conclusion, epidemiological data on injuries can inform and guide injury management processes. New and improved visualization methods might be important assets when presenting injury data to key decision-makers.

What Are the Load and Wellness of Young Second-Team Football Players When Transitioning to the First Team? A Comparison of 2 Consecutive Preseasons.

PURPOSE: To compare the load and wellness of second-team academy football players during a first-team preseason with those of first-team players and those of their previous second-team preseason. METHODS: Athletic Club's first- (n = 10) and second-team (n = 9) players were prospectively followed during the 2019-20 first- and second-team and 2020-21 first-team preseasons. Weekly external and internal loads and average wellness z-scores (fatigue, sleep quality, muscle soreness, stress, and mood) were compared between preseasons and teams. RESULTS: While training together during the 2020-21 preseason, second-team players performed more decelerations <-3 m/s2 per week than first-team players (moderate effect size). For first-team players, there were only small differences between preseasons in external load, but session rating of perceived exertion was higher (moderate) and stress (moderate) and mood (large) z-scores were worse in 2020-21. For second-team players, more total distance (large), accelerations >3 m/s2 (large), and decelerations <-3 m/s2 (very large) were performed; total loading (moderate) and session rating of perceived exertion (moderate) were higher; and fatigue (very large) and stress (moderate) z-scores were worse during the 2020-21 first-team preseason compared to their previous second-team preseason. CONCLUSIONS: Players transitioning from the second team faced higher external and internal loads, fatigue, and stress during the first-team preseason compared to the previous second-team preseason. Player development and monitoring plans appear necessary to manage the transition from the academy to the first team.

The burden of injuries according to maturity status and timing: A two-decade study with 110 growth curves in an elite football academy.

Injuries have a negative impact on the development of football players. Maturation is a potential risk factor for football injuries but available data on this topic provide limited evidence due to methodological shortcomings. The aim of this study was to describe the injury burden of male academy football players according to growth curve-derived maturity status and timing. Injury and growth data were collected from 2000 to 2020. Longitudinal height records for 110 individual players were fitted with the Super-Imposition by Translation and Rotation model to estimate age at peak height velocity (PHV). Players were clustered according to maturity status (pre-, circa-, post-PHV, or adults) and timing (early, on-time, late maturers). Overall and specific injury burdens (days lost/player-season) and rate ratios for comparisons between groups were calculated. Overall injury burden increased with advanced maturity status; pre-PHV players had 3.2-, 3.7-, and 5.5-times lower burden compared with circa-PHV, post-PHV, and adult players, respectively. Growth-related injuries were more burdensome circa-PHV, while muscle and joint/ligament injuries had a higher impact post-PHV and in adults. Further, in the pre-PHV period, late maturers showed lower burden of overall, growth-related, anterior inferior iliac spine osteochondrosis, and knee joint/ligament injuries compared with on-time maturers. In adult players, however, injuries were less burdensome for early maturers than on-time and late maturers. In addition, joint/ligament injuries of adult late maturers were 4.5-times more burdensome than those of early maturers. Therefore, monitoring maturity seems crucial to define each player's maturation profile and facilitate design of targeted injury prevention programmes.Highlights Injury burden is significantly lower in football players at pre-peak height velocity (PHV). Growth-related injuries are most burdensome circa-PHV, while muscle and joint/ligament injuries are more burdensome post-PHV and especially in adults.Before PHV, growth-related and knee joint/ligament injuries have lower burden in players who mature late than those who mature on-time. Adult late maturers have greater burden of overall and joint/ligament injuries than early maturers.Football academies should regularly assess the maturity status and timing of young football players, as the impact of injuries varies with maturation status and timing.Management of the maturity-related injury risk profile, in combination with other relevant factors (training load, neuromuscular and biomechanical factors, physiotherapy, coaching, communication, psychosocial factors …), might help improve the success of player development programmes and protect the health of young football players.

Relationship between strength training and shoulder pain in male and female water polo players.

The objective of this study was to assess the effect of two different strength-training methods on both male and female water polo players' performance and shoulder pain. The players were randomly allocated to a maximum strength (MS: 14 males, 8 females) or power strength (PS: 13 males, 8 females) training group. Before and after the intervention, we assessed player's anthropometric characteristics, shoulder internal and external rotation strength, hand grip strength, upper body strength, countermovement jump height, throwing velocity, swimming speed, shoulder pain on a visual analogue scale (VAS), wellness, and rate of perceived exertion per session. We observed no significant improvement (P<0.05) in specific skills but enhancement in hand grip strength in male players. In female players in the MS group, throwing speed and bench press weight decreased significantly (P<0.05). Shoulder external rotation strength at 240°/sec in male MS group players and shoulder external rotation strength at 60°/sec in female PS group players decreased significantly (P<0.05). In addition, from the first to the last week, shoulder pain increased significantly (P<0.05) in all players. Inverse correlations (P<0.05) were found between VAS and shoulder rotation strength in males in the PS group, and between wellness and shoulder internal rotation strength in men in the MS group and women in the PS group. We found that both MS and PS training did not enhance performance and increased shoulder pain in male and female water polo players.

Injuries are negatively associated with player progression in an elite football academy.

BACKGROUND: The aim was to investigate the association of injuries with male football player continuity, progression and chances of reaching the First team in an elite academy. METHODS: Injuries and exposure time were prospectively recorded, following the FIFA guidelines, over 6 seasons (2011-2017) in Under (U)12, U14, U16, U19, 2nd/3rd team and First team players from the same professional football club. RESULTS: U19 and 2nd/3rd team players progressing to the next level had a lower injury burden and higher match availability compared to players that did not progress. Injury burden was lower in players progressing from U12 to U14. All players progressing from the 2nd/3rd teams to the First team had a match availability higher than 84% and did not suffer an anterior cruciate ligament (ACL) rupture or an injury requiring over 200 (+200) days to return to play. In U19 and 2nd/3rd team players, injuries requiring +100 and +200 days to return to play, ACL ruptures and groin pain, but not hamstring and ankle ligament injuries, were associated with lower odds of continuing in the academy each season. CONCLUSION: Injuries were negatively associated with player progression, and injury prevention and return-to-play strategies should be a priority for football academies.

Relative skeletal maturity status affects injury burden in U14 elite academy football players.

Maturation progresses at different times and at different rates between individuals. Thus, differences in maturity status exist among players in the same chronological age-based category, especially in U14 players. The purpose of this prospective study was to describe injury burden according to the relative skeletal maturity status in U14 elite academy football players. From 2011 to 2020, injuries and individual exposure (training and match) were prospectively recorded in 183 male U14 players. Skeletal age (SA) was assessed using the Tanner-Whitehouse 2 method. Relative skeletal maturity status [SA minus chronological age (CA)] was classified as follows: early (SA-CA > 0.5), on-time (SA-CA ± 0.5), and late (SA-CA < -0.5). Overall and specific injury burden (days lost/1000 h) and rate ratios for comparisons between groups were calculated. Overall injury burden was 2.8 times higher (3.6 times in training) in early maturers compared with late maturers. Growth-related injuries were the most burdensome injuries in all three groups, but significant differences were not found between groups. Muscle injuries were 4 times more burdensome in early maturers compared with on-time and late maturers. Besides, joint/ligament injuries were 7 and 12 times less burdensome in late maturers than in on-time and late maturers, respectively. Significant differences between groups in overall and specific injury burden were not found in matches. Our results showed different injury patterns in U14 early, on-time, and late maturers. Hence, monitoring maturity seems crucial to detect potential injuries that cause the greatest disruption, and facilitate design of targeted injury prevention programs.

Injury risk is greater in physically mature versus biologically younger male soccer players from academies in different countries.

OBJECTIVES: To investigate if maturity status was associated with injury risk in male academy soccer players. DESIGN: Prospective cohort surveillance study. SETTING: Professional soccer academies. PARTICIPANTS: 501 players (aged 9-23 years) from eight academies in England, Spain, Uruguay and Brazil. MAIN OUTCOME MEASURES: Players were grouped by maturity offset as pre-peak height velocity (PHV), circa-PHV, post-PHV or adult. Injury prevalence proportion (IPP) and days missed were recorded for one season per player, with training/match exposure recorded in a sub-sample (n = 166). RESULTS: IPP for all injuries combined increased with advancing maturity, with circa-PHV (p = 0.032), post-PHV (p < 0.001) and adult (p < 0.001) higher than pre-PHV. IPP was higher in post-PHV and adult than pre-PHV for non-contact (p = 0.001 and p = 0.012), soft-tissue (both p < 0.001), non-contact soft-tissue (p < 0.001 and p = 0.005), muscle (both p < 0.001), thigh (both p < 0.001), ankle (p = 0.035 and p = 0.007) and hamstring injuries (p = 0.041 and p = 0.017). Ligament/tendon IPP was greater in adult versus pre-PHV (p = 0.002). IPP for growth-related injuries was lower in post-PHV than pre-PHV (p = 0.039). Injury incidence rates (n = 166) exhibited similar patterns to IPP in the full cohort. CONCLUSIONS: Injury patterns were similar between post-PHV and adult academy players but, crucially, relatively more of these groups suffered injuries compared to pre- and circa-PHV (except growth-related injuries).

Playing Position and the Injury Incidence Rate in Male Academy Soccer Players.

CONTEXT: Whether playing position influences injury in male academy soccer players (ASPs) is unclear. OBJECTIVE: To determine if playing position was associated with injury in ASPs. DESIGN: Descriptive epidemiology study. SETTING: English, Spanish, Uruguayan, and Brazilian soccer academies. PATIENTS OR OTHER PARTICIPANTS: A total of 369 ASPs from the under-14 to under-23 age groups, classified as post-peak height velocity using maturity offset, and grouped as goalkeepers, lateral defenders, central defenders, lateral midfielders, central midfielders, or forwards. MAIN OUTCOME MEASURE(S): Injuries were recorded prospectively over 1 season. Injury prevalence proportion (IPP), days missed, and injury incidence rate (IIR, injuries/1000 training or match hours, n = 116) were analyzed according to playing position. RESULTS: No association with playing position was observed for any injury type or location regarding IPP (P ≥ .089) or days missed (P ≥ .235). The IIR was higher in central defenders than in lateral defenders for general (9.30 versus 4.18 injuries/1000 h, P = .009), soft tissue (5.14 versus 1.95 injuries/1000 h, P = .026), and ligament or tendon injuries (2.69 versus 0.56 injuries/1000 h, P = .040). The central versus lateral or forward positions were not associated with IPP (P ≥ .051) or days missed (P ≥ .083), but general IIR was greater in the central position than the lateral or forward positions (8.67 versus 6.12 injuries/1000 h, P = .047). CONCLUSIONS: Academy soccer players' playing positions were not associated with IPP or days missed, but the higher general, soft tissue, and ligament or tendon IIRs in central defenders suggest that this position warrants specific attention regarding injury-prevention strategies. These novel findings highlight the importance of considering training or match exposure when investigating the influence of playing position on injury in ASPs.

Effects of Massage and Cold Water Immersion After an Exhaustive Run on Running Economy and Biomechanics: A Randomized Controlled Trial.

ABSTRACT: Duñabeitia, I, Arrieta, H, Rodriguez-Larrad, A, Gil, J, Esain, I, Gil, SM, Irazusta, J, and Bidaurrazaga-Letona, I. Effects of massage and cold water immersion after an exhaustive run on running economy and biomechanics: A randomized controlled trial. J Strength Cond Res 36(1): 149-155, 2022-This study compares the effects of 2 common recovery interventions performed shortly after an exhausting interval running session on running economy (RE) and biomechanics. Forty-eight well-trained male runners performed an exhaustive interval running protocol and an incremental treadmill test 24 hours later at 3 speeds: 12, 14, and 16 km·h-1. Subjects randomly received either massage, cold water immersion (CWI), or passive rest (control). Runners repeated the treadmill test 48 hours after the first test. A two-way mixed analysis of variance was performed comparing groups and testing times. The massage group had significantly better recovery than the control group at 14 km·h-1 in RE (p < 0.05; η2 = 0.176) and greater stride height and angle changes at 16 km·h-1 (p < 0.05; η2 = 0.166 and p < 0.05; η2 = 0.208, respectively). No differences were observed between the CWI and control groups. The massage group had greater stride height and angle changes at 16 km·h-1 than the CWI group (p < 0.05; η2 = 0.139 and p < 0.05; η2 = 0.168, respectively). Moreover, differences in magnitude suggested moderate effects on RE (η2 = 0.076) and swing time (η2 = 0.110). These results suggest that massage intervention promotes faster recovery of RE and running biomechanics than CWI or passive rest.

The genetic association with injury risk in male academy soccer players depends on maturity status.

It is currently unknown if injury risk is associated with genetic variation in academy soccer players (ASP). We investigated whether nine candidate single nucleotide polymorphisms were associated (individually and in combination) with injury in ASP at different stages of maturation. Saliva samples and one season's injury records were collected from 402 Caucasian male ASP from England, Spain, Uruguay, and Brazil, whose maturity status was defined as pre- or post-peak height velocity (PHV). Pre-PHV COL5A1 rs12722 CC homozygotes had relatively higher prevalence of any musculoskeletal soft tissue (22.4% vs. 3.0%, p = 0.018) and ligament (18.8% vs. 11.8%, p = 0.029) injury than T-allele carriers, while VEGFA rs2010963 CC homozygotes had greater risk of ligament/tendon injury than G-allele carriers. Post-PHV IL6 rs1800795 CC homozygotes had a relatively higher prevalence of any (67.6% vs. 40.6%, p = 0.003) and muscle (38.2% vs. 19.2%, p = 0.013) injuries than G-allele carriers. Relatively more post-PHV EMILIN1 rs2289360 CC homozygotes suffered any injury than CT and TT genotypes (56.4% vs. 40.3% and 32.8%, p = 0.007), while the "protective" EMILIN1 TT genotype was more frequent in post- than pre-PHV ASP (22.3 vs. 10.0%, p = 0.008). Regardless of maturity status, T-alleles of ACTN3 rs1815739 and EMILIN1 rs2289360 were associated with greater absence following ankle injury, while the MMP3 rs679620 T-allele and MYLK rs28497577 GT genotype were associated with greater absence following knee injury. The combination of injury-associated genotypes was greater in injured vs. non-injured ASP. This study is the first to demonstrate that a genetic association exists with injury prevalence in ASP, which differs according to maturity status.

Pituitary Society Delphi Survey: An international perspective on endocrine management of patients undergoing transsphenoidal surgery for pituitary adenomas.

PURPOSE: In adults and children, transsphenoidal surgery (TSS) represents the cornerstone of management for most large or functioning sellar lesions with the exception of prolactinomas. Endocrine evaluation and management are an essential part of perioperative care. However, the details of endocrine assessment and care are not universally agreed upon. METHODS: To build consensus on the endocrine evaluation and management of adults undergoing TSS, a Delphi process was used. Thirty-five statements were developed by the Pituitary Society's Education Committee. Fifty-five pituitary endocrinologists, all members of the Pituitary Society, were invited to participate in two Delphi rounds and rate their extent of agreement with statements pertaining to perioperative endocrine evaluation and management, using a Likert-type scale. Anonymized data on the proportion of panelists' agreeing with each item were summarized. A list of items that achieved consensus, based on predefined criteria, was tabulated. RESULTS: Strong consensus (≥ 80% of panelists rating their agreement as 6-7 on a scale from 1 to 7) was achieved for 68.6% (24/35) items. If less strict agreement criteria were applied (ratings 5-7 on the Likert-type scale), consensus was achieved for 88% (31/35) items. CONCLUSIONS: We achieved consensus on a large majority of items pertaining to perioperative endocrine evaluation and management using a Delphi process. This provides an international real-world clinical perspective from an expert group and facilitates a framework for future guideline development. Some of the items for which consensus was not reached, including the assessment of immediate postoperative remission in acromegaly or Cushing's disease, represent areas where further research is needed.

The relative age effect in young athletes: A countywide analysis of 9-14-year-old participants in all competitive sports.

The relative age effect (RAE) has primarily been investigated in male athletes involved in popular sports and high-level competitions. However, occurrence of RAE in other types of sports at the grassroots level, particularly in female athletes, is less well-studied. Thus, we examined the RAE in a large cohort of young athletes who participated in all competitive sports in Bizkaia, Spain, according to gender and specificity of the sport. The birth dates of 38,381 participants (65.1% males and 34.9% females) aged 9-14 years old in 37 competitive sports were analyzed. Birth dates were divided into four birth-quarters and compared to those of all children born in the same period using a χ2 goodness-of-fit test and standardized residuals. The effect size Cramer's V was measured, and odds ratio and 95% confidence intervals were calculated to determine the odds of athletes born in January playing in the highest leagues. In the total sample, in boys RAE was evident in football, but only in higher-competition leagues (p<0.001, large effect size). In girls, RAE was evident in the most popular team sports: basketball (p<0.001, large effect size in basketball 1st league), handball and football (p<0.05, both small effect sizes). Players born in January were 3.23- and 2.89-times more likely to play in the 1st leagues than those born in December, for boys (football) and girls (basketball) respectively. In the overall analysis and in the remaining sports, presence of RAE was negligible. Therefore, the date of birth does not seem to be a constraint to participating in most sports in Bizkaia. The potential mechanisms for RAE are multifactorial and complex, yet a combination of factors, such as the popularity of a sport and the depth of competition, physicality and social influences may be involved. We discuss these mechanisms and potential measures to mitigate RAE.

Pituitary society guidance: pituitary disease management and patient care recommendations during the COVID-19 pandemic-an international perspective.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the viral strain that has caused the coronavirus disease 2019 (COVID-19) pandemic, has presented healthcare systems around the world with an unprecedented challenge. In locations with significant rates of viral transmission, social distancing measures and enforced 'lockdowns' are the new 'norm' as governments try to prevent healthcare services from being overwhelmed. However, with these measures have come important challenges for the delivery of existing services for other diseases and conditions. The clinical care of patients with pituitary disorders typically involves a multidisciplinary team, working in concert to deliver timely, often complex, disease investigation and management, including pituitary surgery. COVID-19 has brought about major disruption to such services, limiting access to care and opportunities for testing (both laboratory and radiological), and dramatically reducing the ability to safely undertake transsphenoidal surgery. In the absence of clinical trials to guide management of patients with pituitary disease during the COVID-19 pandemic, herein the Professional Education Committee of the Pituitary Society proposes guidance for continued safe management and care of this population.

An injury audit in high-level male youth soccer players from English, Spanish, Uruguayan and Brazilian academies.

OBJECTIVES: To identify the most common injury types/locations in high-level male youth soccer players (YSP). DESIGN: Prospective cohort surveillance study. SETTING: Professional soccer club academies. PARTICIPANTS: Six hundred and twenty-four high-level male YSP [Under 9 (U9) to U23 year-old age groups] from academies in England, Spain, Uruguay and Brazil. MAIN OUTCOME MEASURES: Injury type, location and severity were recorded during one season. Injury severity was compared between age groups, while injury type and location were compared between nations. RESULTS: Four hundred and forty-three training or match injuries were recorded, giving an injury rate of 0.71 per player. Non-contact injuries were most common (58.5%), with most (44.2%) resolved between 8 and 28 days. Most injuries (75.4%) occurred in the lower limbs, with muscle (29.6%) the most commonly injured tissue. U14 and U16 suffered a greater number of severe injuries relative to U12 and U19/U20/U23/Reserves. Tendon injury rate was higher in Brazil vs. Spain (p < 0.05), with low back/sacrum/pelvis injury rate highest in Spain (p < 0.05). CONCLUSIONS: The proportion of severe injuries in U14 and U16 suggests YSP injury risk is maturation-dependent. Minimal differences in type and location between high-level YSP from four different countries suggest injury rates in this population are geographically similar.

Exercise cessation in active older adults: Effects on inflammatory markers and adiponectin.

AIM: To evaluate the effects of 3 months of exercise cessation in physically active older individuals on inflammatory biomarkers and adiponectin, and examine any association modifications in physical functioning. METHODS: We evaluated the effects of exercise cessation in 49 physically active older adults on inflammatory biomarkers, adiponectin and physical functioning. Participants (38 women, 11 men) were aged >65 years old and had attended a 9-month supervised exercise program. After 3 months of exercise cessation, we measured anthropometry, physical activity, strength, balance, endurance exercise, cholesterol, triglycerides, C-reactive protein, glucose, glycosylated hemoglobin A1c, interleukin-6 and adiponectin levels. RESULTS: Adiponectin was positively correlated with high-density lipoprotein and negatively correlated with triglyceride levels after exercise cessation. Higher adiponectin levels were correlated with worse dynamic balance, endurance exercise and lower limb strength (men only), which might be explained by the adiponectin resistance hypothesis. CONCLUSIONS: Adiponectin therefore might be a promising biomarker of physical dysfunction in older adults, although further research is necessary to understand the mechanisms involved in its double-sided effects. Geriatr Gerontol Int 2020; 20: 494-499.

The impact of physical exercise on cognitive and affective functions and serum levels of brain-derived neurotrophic factor in nursing home residents: A randomized controlled trial.

OBJECTIVES: To determine the effects of a multicomponent physical exercise program on cognitive and affective functioning among nursing home residents and to clarify whether there are any changes in serum levels of brain-derived neurotrophic factor (BDNF) among participants. STUDY DESIGN: This was a single-blind randomized controlled trial in ten nursing homes in Gipuzkoa, Spain. The study included 112 men and women. Participants in the control group engaged in routine activities while those in the intervention group participated in a six-month individualized, progressive, multicomponent physical exercise program focused on strength, balance, and walking. MAIN OUTCOME MEASURES: Cognitive and affective functions were assessed at baseline and at six months. Serum BDNF levels were assessed via ELISA. RESULTS: After six months, a group by time interaction in favor of the intervention group was observed on the Montreal Cognitive Assessment (MOCA), symbol search and De Jong-Gierveld Loneliness Scale (P < 0.05). The control group scored more poorly on the MOCA, WAIS-IV (coding and symbol search), verbal fluency, and semantic fluency tests after six months (P < 0.05) than they did at baseline. The intervention group showed poorer results on the coding test (P < 0.05). Loneliness perception was reduced in the intervention group (P < 0.05). No changes in serum BDNF were observed (group x time and within groups, P > 0.05). CONCLUSION: A six-month individualized, progressive, multicomponent physical exercise intervention is effective at maintaining cognitive function and decreasing perceptions of loneliness among nursing home residents. Blood levels of BDNF were not affected by the intervention.

Effects of Multicomponent Exercise on Frailty in Long-Term Nursing Homes: A Randomized Controlled Trial.

OBJECTIVES: To determine the effect of multicomponent exercise on frailty and related adverse outcomes in residents of long-term nursing homes (LTNHs). DESIGN: A single-blind randomized controlled trial. SETTING: Ten LTNHs in Gipuzkoa, Spain. PARTICIPANTS: The study sample comprised 112 men and women aged 70 years or older who scored 50 or higher on the Barthel Index, 20 or higher on the MEC-35 test (an adapted and validated version of the Mini-Mental State Examination in Spanish), and who were capable of standing up and walking independently for at least 10 m. INTERVENTION: Subjects in the control group (CG) participated in routine activities. The intervention group (IG) participated in a 6-month program of individualized and progressive multicomponent exercise at moderate intensity. MEASUREMENTS: Frailty was assessed by four different scales at baseline and at 6 months. The Barthel Index was measured at baseline and at 12 months. Frailty-related adverse outcomes were recorded from 12 months before to 12 months after starting the intervention. RESULTS: A lower prevalence of frailty was observed in the IG compared with the CG according to Fried's frailty phenotype, Short Physical Performance Battery, and Tilburg Frailty Indicator after 6 months (p < .05). There was a decline in the CG on the Barthel Index after 12 months (p < .05), whereas score was maintained in the IG. Both groups experienced a similar number of falls before and after the intervention (p > .05), but during the 6-month intervention period, fewer falls were observed in the IG than the CG (p < .05). Lower overall mortality was observed 12 months after starting the intervention for the IG than the CG (1 vs 6, respectively; p = .05). CONCLUSION: Individualized and progressive multicomponent exercise at moderate intensity seems to be effective to prevent falls and reduce frailty and mortality.