Step-adaptive sound guidance enhances locomotor-respiratory coupling in novice female runners: A proof-of-concept study.

Introduction: Many runners struggle to find a rhythm during running. This may be because 20-40% of runners experience unexplained, unpleasant breathlessness at exercise onset. Locomotor-respiratory coupling (LRC), a synchronization phenomenon in which the breath is precisely timed with the steps, may provide metabolic or perceptual benefits to address these limitations. It can also be consciously performed. Hence, we developed a custom smartphone application to provide real-time LRC guidance based on individual step rate. Methods: Sixteen novice-intermediate female runners completed two control runs outdoors and indoors at a self-selected speed with auditory step rate feedback. Then, the runs were replicated with individualized breath guidance at specific LRC ratios. Hexoskin smart shirts were worn and analyzed with custom algorithms to estimate continuous LRC frequency and phase coupling. Results: LRC guidance led to a large significant increase in frequency coupling outdoor from 26.3 ±â€…10.7 (control) to 69.9 ±â€…20.0 % (LRC) "attached". There were similarly large differences in phase coupling between paired trials, and LRC adherence was stronger for the indoor treadmill runs versus outdoors. There was large inter-individual variability in running pace, preferred LRC ratio, and instruction adherence metrics. Discussion: Our approach demonstrates how personalized, step-adaptive sound guidance can be used to support this breathing strategy in novice runners. Subsequent investigations should evaluate the skill learning of LRC on a longer time basis to effectively clarify its risks and advantages.

The availability of general practice in Ireland's Mid-West Region: does the 'Inverse Care Law' still apply?

INTRODUCTION: The 'Inverse Care Law' suggests the availability of good medical care tends to vary inversely with the needs of the local population. Dr Julian Tudor Hart's observations related to lack of access to care for those in both socially deprived and geographically remote areas. In this study, we aim to examine if the 'Inverse Care Law' is still relevant to GP service provision in the Mid-West of Ireland. METHODS: GP clinic locations in Limerick and Clare were identified using the Health Service Executive (HSE) Service Finder and geocoded. GeoHive.ie was used to determine Electoral District (ED) centroids across the Mid-West. The shortest linear distance to a GP clinic was calculated for each ED. PobalMaps.ie was used to determine population and social deprivation scores of each ED. RESULTS: In total, 122 GP practices were identified across 324 EDs. The average travel distance to a GP clinic in the Mid-West is 4.7 km. Limerick City EDs had the smallest patient population per GP clinic and were all found to be within 1.5 km of a GP clinic. Proximity to GP clinics did not correlate with deprivation. However, by removing GP clinics from the analyses, it was possible to determine how vulnerable different areas (rural vs urban, deprived vs affluent) are to potential changes in GP clinic availability in the future. DISCUSSION: People living in urban areas such a Limerick City have improved geographic accessibility to GP clinics compared with their rural counterparts. However, within urban areas assessed, GP clinics were rarely found in deprived areas. Therefore, remote and urban-deprived areas are far more vulnerable to negative proximity effects secondary to practice closures, suggesting the principles of the 'Inverse Care Law' may still be active in the Mid-West of Ireland.

Return to Sport After Arthroscopic Bankart Repair With Remplissage: A Systematic Review.

PURPOSE: To determine the return-to-sport rate following arthroscopic Bankart repair with remplissage (ABR), including overall rate of return to sport, rate of return to preinjury level of sport, and the rate of return for specific subgroups such as contact or throwing athletes. METHODS: EMBASE, PubMed, and MEDLINE were searched from database inception until February 2022. Studies were screened by 2 reviewers independently and in duplicate for data regarding rates of return to sport following ABR. Data on return to sport and functional outcomes were recorded. Data are presented in a descriptive fashion. RESULTS: Overall, 20 studies were included with a total of 736 patients (738 shoulders) who underwent ABR. These patients had a mean age of 28 years (range 14-72 years) and were 83% male. Mean follow-up time after surgery was 45 months (range 12-127 months). The rate of return to any level of sport ranged from 60% to 100%, whereas the rate of return to the preinjury level ranged from 63% to 100%. When we excluded those who underwent ABR as a revision procedure, the rate of return to any level of sport was 68% to 100%. Lastly, the return to sport rates for contact or collision athletes ranged from 80% to 100%, whereas for overhead or throwing athletes it was 46% to 79%. The rate of recurrence of instability postoperatively ranged from 0% to 20% in included studies. CONCLUSIONS: For athletes with anterior shoulder instability, ABR led to a high rate of return to sport along with a low rate of recurrence of instability. Although most athletes are able to return to the same level of sport, certain groups such as throwing athletes may face greater difficulty. LEVEL OF EVIDENCE: Level IV, systematic review of Level III and IV studies.

Effects of physical stress in alpine skiing on psychological, physiological, and biomechanical parameters: An individual approach.

Alpine skiing is an attractive winter sport that often includes mental and physical demands. Since skiing is often done for several hours, fatigue processes occur that might lead to action errors associated with a higher risk of accidents and injuries. The aim of this study was to investigate the timing of changes in subjective, physiological, and biomechanical parameters during a physically demanding, standardized, non-competitive alpine skiing session. A group of 22 experienced male skiers carried out 10 runs, each lasting between 150 and 180 s, at a turn rate of 80 turns per minute with their best skiing technique. Immediately after the run, skiers reported ratings of fatigue, and other affective states. During skiing, breathing pattern and biomechanical data of the ski turns as radial force, turn duration, edge angle symmetry, and a composed motion quality score were recorded. Analyses of variances on skiers showing signs of fatigue (n =16) revealed that only the subjective data changed significantly over time: fatigue and worry increased, vitality and calm decreased. Subsequently, individual change points analyses were computed to localize abrupt distribution or statistical changes in time series data. For some skiers, abrupt changes at certain runs in physiological and/or biomechanical parameters were observed in addition to subjective data. The results show general effects in subjective data, and individual fatigue-related patterns concerning the onset of changes in subjective, physiological, and biomechanical parameters. Individuality of response to fatigue should be considered when studying indicators of fatigue data. Based on the general effects in subjective data, it is concluded that focusing on self-regulation and self-awareness may play a key role, as subjective variables have been shown generally sensitive to the physical stress in alpine skiing. In the future, customized algorithms that indicate the onset of fatigue could be developed to improve alpine skiers' self-awareness and self-regulation, potentially leading to fewer action errors.

Fixation of Distal Radius Fractures Under Wide-Awake Local Anesthesia: A Systematic Review.

BACKGROUND: The purpose of this systematic review was to analyze the available literature on fixation of distal radius fractures (DRFs) under wide-awake local anesthesia no-tourniquet (WALANT), and to examine postoperative pain scores and functional outcomes, operative data including operative time and blood loss, and the frequency of adverse events. METHODS: Embase, MEDLINE, Web of Science, and SCOPUS were searched from inception until May 2022 for relevant studies. Studies were screened in duplicate, and data on pain scores, functional outcomes, and adverse events were recorded. Due to methodological and statistical heterogeneity, the results are presented in a descriptive fashion. RESULTS: Ten studies were included comprising 456 patients with closed, unilateral DRFs, of whom 226 underwent fixation under WALANT. These patients had a mean age of 52.8 ± 8.3 years, were 48% female, and had a mean follow-up time of 11.6 months (range: 6-24). Operative time for WALANT patients averaged 60.4 ± 6.5 minutes, with mean postoperative pain scores of 1.4 ± 0.6 on a 10-point scale. Studies that compared WALANT to general anesthesia found shorter hospital stays with most WALANT patients being sent home the same day, decreased postoperative pain scores, and decreased costs to the healthcare system. No adverse events were reported for WALANT patients. CONCLUSIONS: A growing body of literature reports that for closed, unilateral DRF, surgical fixation under WALANT is a safe and effective option. It allows patients to have surgery sooner, with improved pain scores and good functional outcomes, with a very low incidence of adverse events.

Breath Tools: A Synthesis of Evidence-Based Breathing Strategies to Enhance Human Running.

Running is among the most popular sporting hobbies and often chosen specifically for intrinsic psychological benefits. However, up to 40% of runners may experience exercise-induced dyspnoea as a result of cascading physiological phenomena, possibly causing negative psychological states or barriers to participation. Breathing techniques such as slow, deep breathing have proven benefits at rest, but it is unclear if they can be used during exercise to address respiratory limitations or improve performance. While direct experimental evidence is limited, diverse findings from exercise physiology and sports science combined with anecdotal knowledge from Yoga, meditation, and breathwork suggest that many aspects of breathing could be improved via purposeful strategies. Hence, we sought to synthesize these disparate sources to create a new theoretical framework called "Breath Tools" proposing breathing strategies for use during running to improve tolerance, performance, and lower barriers to long-term enjoyment.

Improved power clean performance with the hook-grip is not due to altered force-time or horizontal bar-path characteristics.

he underlying biomechanical benefits of hook-grip (HG) over conventional closed-grip (CG) remain unclear. This study compared bar-path kinematics and force-time variables of the power clean (PC) performed with HG or CG. We also aimed to compared kinetic changes measured by force platform versus linear position transducer (LPT). Eleven well-trained men volunteered. Following a familiarisation session, HG, and CG 1RM conditions, were randomly completed seven days apart. System kinetics and barbell kinematics were recorded via synchronized force platform+LPT system and two-dimensional motion-capture. Statistical parametric mapping (SPM), analysis of variance, and standardised differences were utilised. The SPM cut-offs were determined via novel combination of force and displacement. No between-condition differences in normalised force-time variables of the pull or catch were detected. The first and second pull duration was similar between conditions (ES = 0.04-0.38). Conversely, catch and total PC durations were shorter at 80-95% (ES = 0.26-0.75), with the weightless phase more prolonged at 95% and 100% (ES = 0.54-0.76) with HG compared to CG. Improved timing of the turnover and catch phases appears to be the primary difference between HG and CG performance. Thus, grip type is possibly irrelevant to non-weightlifting athletes when performing submaximal catch-less derivatives..

Enhanced Breathing Pattern Detection during Running Using Wearable Sensors.

Breathing pattern (BP) is related to key psychophysiological and performance variables during exercise. Modern wearable sensors and data analysis techniques facilitate BP analysis during running but are lacking crucial validation steps in their deployment. Thus, we sought to evaluate a wearable garment with respiratory inductance plethysmography (RIP) sensors in combination with a custom-built algorithm versus a reference spirometry system to determine its concurrent validity in detecting flow reversals (FR) and BP. Twelve runners completed an incremental running protocol to exhaustion with synchronized spirometry and RIP sensors. An algorithm was developed to filter, segment, and enrich the RIP data for FR and BP estimation. The algorithm successfully identified over 99% of FR with an average time lag of 0.018 s (-0.067,0.104) after the reference system. Breathing rate (BR) estimation had low mean absolute percent error (MAPE = 2.74 [0.00,5.99]), but other BP components had variable accuracy. The proposed system is valid and practically useful for applications of BP assessment in the field, especially when measuring abrupt changes in BR. More studies are needed to improve BP timing estimation and utilize abdominal RIP during running.

Improvement of Kinetic, Kinematic, and Qualitative Performance Variables of the Power Clean With the Hook Grip.

PURPOSE: The power clean and other weightlifting movements are commonly used in the development of muscle power. However, there is a paucity of research examining the use of the hook grip (HG) in weightlifting performance. Therefore, the purpose of this study was to compare 1-repetition maximum (1RM) and kinetic, kinematic, and qualitative variables across a range of loads (75-100%) during power-clean performance with an HG and a closed grip. METHODS: A total of 11 well-trained men (power-clean 1RM = 113.4 [15.9] kg, 1.34 × body mass) with at least 3 mo of HG experience volunteered to participate. Following a familiarization session, 1RM testing with the HG and closed grip were completed 5-7 d apart in a randomized order. Barbell kinetic and kinematic variables were recorded via a force platform and dual linear position transducer system. RESULTS: All subjects had a greater 1RM with the HG than with the closed grip (P < .001, effect size [ES] = 0.43). Peak velocity (ES = 0.41-0.70), peak power (ES = 0.43-0.61), peak force (ES = 0.50-0.57), and catch height (ES = 0.40-0.96) were significantly greater (P < .05) when using the HG at all or most of the submaximal intensities. In addition, subjects reported significantly greater perceptions of grip security, power, and technical competency at submaximal but not maximal loads. CONCLUSIONS: Athletes and coaches who implement weightlifting movements in their physical preparation should adopt the HG where possible. Furthermore, researchers and sport scientists should control and report the grip type used when performing weightlifting-type movements.