Programa preventivo de lesión de ligamento cruzado anterior en fútbol femenino durante períodos de confinamiento / Anterior Cruciate Ligament Injury Preventive Program for Soccer Female Players During Confinement Periods

Resumen La pandemia por COVID-19 obligó a paralizar el deporte en todo el mundo; por lo tanto, se redujo la carga de trabajo de los deportistas, lo cual, sumado al probable aumento de la densidad competitiva tras el período de confinamiento, resultará en un incremento del riesgo de lesión después del retorno a la competición. A este respecto, la rodilla es una de las zonas con mayor prevalencia de lesión en el fútbol femenino y la lesión del ligamento cruzado anterior (LCA) es de las más frecuentes y graves. En consecuencia, el objetivo del presente trabajo fue desarrollar un plan de prevención de lesión de LCA que pudiera ser llevado a cabo por mujeres futbolistas, durante períodos de confinamiento. Luego de una revisión de la literatura, se ha encontrado que el entrenamiento de fuerza (especialmente de la cadena posterior), el trabajo de la técnica de aterrizajes, así como el de estabilidad lumbopélvica y flexibilidad se asocian con un menor riesgo de lesión de LCA en mujeres. El programa se centra en factores de riesgo modificables, por lo que debe servir como una guía susceptible de adaptaciones, en función de cada contexto: las características individuales, el estado inicial y la evolución del sujeto durante su desarrollo. Por ende, en este estudio se plantea una intervención que pretende disminuir la probabilidad de lesión de LCA en mujeres futbolistas, tras el confinamiento, incidiendo, para ello, de forma directa sobre los mecanismos de lesión de LCA reportados en esta población.

Abstract The COVID-19 pandemic resulted in a worldwide sports shutdown, leading to a reduced athletes' workload, which is likely to increase the risk of injury after return to play when coupled with the expected increase in competitive density after the confinement period. In this regard, the knee is one of the joints with the highest injury prevalence among female soccer players, being the injury of the anterior cruciate ligament (ACL) one of the most frequent and severe. Thus, the present study aimed to develop an ACL injury prevention program that female soccer players could carry out during confinement periods. After reviewing the scientific literature, it was observed that strength training (with a main focus on the posterior chain), improved landing technique, lumbopelvic stability, and flexibility are associated with a lower risk of ACL injury in women. The program focuses on modifiable risk factors, so it should serve as a guide that can be adapted according to each context: individual characteristics, initial conditions, and evolution of the subject during development. Therefore, this study presents an intervention aiming at reducing the probability of ACL injury in female soccer players, after confinement periods, by directly influencing mechanisms of ACL injury previously reported for female soccer players.

Resumo A pandemia da COVID-19 forçou uma paralização mundial do esporte; portanto, a carga de trabalho dos atletas foi reduzida, o que, juntamente com o provável aumento da densidade competitiva após o período de confinamento, resultará em um risco maior de lesões após o retorno à competição. A esse respeito, o joelho é uma das áreas de lesão mais prevalecentes no futebol feminino e a lesão do ligamento cruzado anterior (LCA) é uma das mais frequentes e graves. Consequentemente, o objetivo do presente estudo é desenvolver um plano de prevenção de lesões do ACL que pode ser implementado por jogadoras de futebol feminino durante os períodos de internação. Após uma revisão da literatura, descobriu-se que o treinamento de força (especialmente da cadeia posterior), a técnica de aterrissagem, assim como o treinamento de estabilidade e flexibilidade lombo pélvica estão associados a um menor risco de lesão do LCA nas mulheres. O programa se concentra em fatores de risco modificáveis, portanto deve servir como um guia que possa ser adaptado de acordo com cada contexto: as características individuais, o estado inicial e a evolução da pessoa durante seu desenvolvimento. Portanto, este estudo propõe uma intervenção que visa reduzir a probabilidade de lesão do ACL em jogadoras de futebol feminino após o confinamento, afetando diretamente os mecanismos de lesão do ACL nelas relatados.

Caffeine supplementation improves physical performance without affecting fatigue level: a double-blind crossover study.

This study examined the effect of caffeine supplementation (CAFF) in a Wingate test (WT), and the behaviour of blood lactate concentrations (BLa) and neuromuscular fatigue (NMF), measured as reduced countermovement jump (CMJ) performance, in response to the WT. In a double-blind crossover study, 16 participants attended the laboratory twice, separated by a 72-hour window. In the sessions, participants first ingested 6 mg·kg-1 of either CAFF or placebo (PLAC), and then performed a WT. BLa was measured before (L-pre), and 0.5 min (L-post-0.5) and 3.5 min (L-post-3.5) after conducting the WT. The CMJ test was conducted before (CMJ pre), after (CMJ post), and 3 min after completing (CMJ post-3) the WT. The results indicated that CAFF enhanced peak power (Wpeak: + 3.22%; p = 0.040), time taken to reach Wpeak (T_Wpeak: -18.76%; p = 0.001) and mean power (Wmean: + 2.7%; p = 0.020). A higher BLa was recorded for CAFF at L-post-0.5 (+ 13.29%; p = 0.009) and L-post-3.5 (+ 10.51%; p = 0.044) compared to PLAC. CAFF improved peak power (PP; + 3.44%; p = 0.003) and mean power (MP; + 4.78%; p = 0.006) at CMJ pre, compared to PLAC, whereas PP and MP were significantly diminished at CMJ post and CMJ post-3 compared to pre (p < 0.001 for all comparisons) under both the CAFF and PLAC conditions. PP and MP were increased at post-3 compared to post (p < 0.001 for all comparisons) for both conditions. In conclusion, CAFF increased WT performance and BLa without affecting NMF measured by CMJ. Thus, CAFF may allow athletes to train with higher workloads and enhance the supercompensation effects after an adequate recovery period.

The Effects of Dietary Nitrate Supplementation on Explosive Exercise Performance: A Systematic Review.

Dietary nitrate supplementation is evidenced to induce physiological effects on skeletal muscle function in fast-twitch muscle fibers and may enhance high-intensity exercise performance. An important component of sport-specific skills is the ability to perform explosive movements; however, it is unclear if nitrate supplementation can impact explosive efforts. We examined the existing evidence to determine whether nitrate supplementation improves explosive efforts lasting ≤ 6 s. PubMed, Scopus and Directory of Open Access Journals (DOAJ) were searched for articles using the following search strategy: (nitrate OR nitrite OR beetroot) AND (supplement OR supplementation) AND (explosive OR power OR high intensity OR high-intensity OR sprint* OR "athletic performance"). Out of 810 studies, 18 were eligible according to inclusion criteria. Results showed that 4 of the 10 sprint-type studies observed improved sprint time, power output, and total work in cycling or running, whereas 4 of the 10 resistance-based exercise studies observed improvements to power and velocity of free-weight bench press as well as isokinetic knee extension and flexion at certain angular velocities. These results suggest that nitrate potentially improves explosive exercise performance, but further work is required to clarify the factors influencing the efficacy of nitrate in different exercise modalities.

Effects of carbohydrate and caffeine mouth rinsing on strength, muscular endurance and cognitive performance.

BACKGROUND: Carbohydrate (CHO) and caffeine (CAF) mouth rinsing have been shown to enhance endurance and sprint performance. However, the effects of CHO and CAF mouth rinsing on muscular and cognitive performance in comparison between male and female athletes are less well-established. The aim of this study was to examine the effect of CHO and CAF rinsing on squat and bench press 1 repetition maximum (1-RM) strength, 3 sets of 40% of 1-RM muscular endurance and cognitive performance in both male and female athletes. METHODS: Thirteen male and fourteen female resistance-trained participants completed four testing sessions following the rinsing of 25 ml of i) 6% of CHO (1.5 g); ii) 2% CAF (500 mg), iii) combined CHO and CAF (CHOCAF) solutions or iv) water (PLA) for 10 s. Heart rate (HR), felt arousal (FA), ratings of perceived exertion (RPE) and glucose (GLU) were recorded throughout the test protocol. RESULTS: There were no significant differences in squat and bench press 1-RM, HR, RPE and GLU (p > 0.05) for males and females, respectively. FA was significantly increased with CAF (p = 0.04, p = 0.01) and CHOCAF (p = 0.03, p = 0.01) condition in both males and females, respectively. Squat endurance performance in the first set was significantly increased with CHOCAF condition compared to PLA in both males (p = 0.01) and females (p = 0.02). Bench press endurance was similar for all conditions in both genders (p > 0.05). Cognitive performance was significantly increased with CHOCAF compared to PLA in males (p = 0.03) and females (p = 0.02). CONCLUSION: Combined CHO and CAF mouth rinsing significantly improved lower body muscular endurance and cognitive performance in both males and females.

Effects of Nutritional Supplements on Judo-Related Performance: A Review.

The potential ergogenic effect of nutritional supplements depends on their dosage and the type of exercise executed. Aiming at reviewing the research literature regarding sport supplements utilized in judo in order to improve performance, a literature search was performed at the following databases: Dialnet, PubMed, Scielo, Scopus and SportDiscus. A total of 11 articles met the inclusion criteria and were selected. Evidence revised indicates that supplementation with caffeine, ß-alanine, sodium bicarbonate, creatine, and ß-hydroxy-ß-methylbutyrate has a positive effect on judo-related performance. Moreover, there is evidence suggesting that combining some of these nutritional supplements may produce an additive effect.

Comparison of multidirectional jump performance and lower limb passive range of motion profile between soccer and basketball young players.

This study was performed aimed at comparing multidirectional bilateral and unilateral jump performance and passive range of motion (ROM) of lower limbs between soccer and basketball young players and evaluating associations between inter-limb ROM asymmetry and bilateral jump performance. A total of 67 young male athletes participated in this study, who were classified as soccer (n = 40; 15.55 ± 1.5 y; 1.76 ± 0.12 m; 58.15 ± 10.82 kg; 19.84 ± 2.98 kg·m2) and basketball (n = 27; 15.7 ± 1.66 y; 1.76 ± 0.12 m; 62.33 ± 16.57 kg; 19.84 ± 2.98 kg·m2) players. Participants were asked to perform bilateral and unilateral multidirectional jumps, and passive ROM of hip (flexion, extension and abduction), knee (flexion) and ankle (dorsiflexion) joints was also assessed. Significant between-group differences were observed for hip extension with flexed knee ROM in dominant (soccer: 142.43 ± 7.74°; basketball: 148.63 ± 8.10°) and non-dominant (soccer: 144.38 ± 8.36°; basketball: 148.63 ± 6.45°) legs; hip flexion with flexed knee ROM in dominant (soccer: 13.26 ± 4.71°; basketball: 9.96 ± 3.42°) and non-dominant (soccer: 12.86 ± 4.55°; basketball: 9.70 ± 3.62°) legs; and for the ratio of hip abduction (soccer: 1.02 ± 0.08; basketball: 0.97 ± 0.11). However, no significant between-group differences were observed for bilateral and unilateral jump capacity, or for inter-limb asymmetries (dominant vs. non-dominant leg). Finally, no associations were observed between ROM ratio (dominant vs. non-dominant leg) and bilateral jump performance. These findings lead to the suggestion that differences on passive ROM values in young male athletes may be sport-specific. Additionally, there seems to be need for the implementation of training strategies specifically aimed at improving bilateral or unilateral jump ability, or at diminishing inter limb passive ROM differences in order to improve multidirectional jump performance for neither soccer nor basketball youth male players.

Acute Effects of Caffeine Intake on Psychological Responses and High-Intensity Exercise Performance.

OBJECTIVE: The aim of this study was to investigate the effects of caffeine supplementation on: (i) psychological responses of subjective vitality and mood; (ii) performance through a Wingate test; and (iii) rate of perceived exertion (RPE) reported after a Wingate test. METHODS: Fifteen male participants (22.60 ± 2.16 years) ingested 6 mg·kg-1 of caffeine or placebo (sucrose) supplementation in two experimental sessions. After 60 min from supplement intake, participants fulfilled two questionnaires, which measured subjective vitality and mood state, respectively. Subsequently, participants' performance was assessed through a Wingate test, which was followed by measurements of RPE at general, muscular, or cardiovascular level. RESULTS: Caffeine supplementation increased some components of mood, as assessed by profile of mood states (POMS) (tension and vigor dimensions) and subjective vitality profiles, which were followed by a greater maximum power, average power, and lower time needed to reach maximum power during the Wingate test. Moreover, lower RPE, both at muscular and general levels were reported by participants after the Wingate test. CONCLUSIONS: These results suggest that caffeine supplementation exerts positive effects both in psychological and physical domains in trained subjects.

Caffeine improves performance but not duration of the countermovement jump phases.

BACKGROUND: The countermovement jump (CMJ) test is often employed to assess power generated in the lower limbs and has been related to performance in several sports modalities. The objective of this study was to assess the effects of caffeine supplementation on jump height, average power (AP), peak power (PP), maximum velocity (Vmax), force production and duration of the eccentric, isometric and concentric muscle contraction phases of a CMJ. METHODS: Sixteen resistance-trained men (age: 22.69±2.12 years; height: 1.78±0.06 m; weight: 78.09±10.27 kg) performed a CMJ 60 minutes after having taken an oral supplement containing 6 mg·kg-1 of caffeine or placebo (sucrose). The study design was randomized, double-blind crossover. RESULTS: Caffeine ingestion improved jump height (+3.86%, P=0.02), Vmax (+1.49%, P=0.023), AP (+4.83%, P=0.006), and PP (+3.49%, P=0.004). CONCLUSIONS: Acute caffeine supplementation leads to improved CMJ height, Vmax, AP and PP without significantly affecting the duration of the different test phases. Therefore, caffeine supplementation may be employed as ergogenic aid in sports where CMJ performance has been associated with sport-specific performance enhancements.

The Effect of Dietary Nitrate Supplementation on Isokinetic Torque in Adults: A Systematic Review and Meta-Analysis.

Dietary nitrate (NO3-) supplementation, which can enhance performance in exercise settings involving repeated high-intensity efforts, has been linked to improved skeletal muscle contractile function. Although muscular strength is an important component of explosive movements and sport-specific skills, few studies have quantified indices of muscular strength following NO3- supplementation, particularly isokinetic assessments at different angular velocities. We performed a systematic review and meta-analysis to determine whether dietary NO3- supplementation improves peak torque, as assessed by the gold standard method of isokinetic dynamometry, and if this effect was linked to the angular velocity imposed during the assessment. Dialnet, Directory of Open Access Journals, MEDLINE, PubMed, SciELO, Scopus, and SPORTDiscus were searched for articles using the following search strategy: (nitrate OR beet*) AND (supplement* OR nutr* OR diet*) AND (isokinetic OR strength OR "resistance exercise" OR "resistance training" OR "muscular power"). The meta-analysis of data from 5 studies with 60 participants revealed an overall effect size of -0.01 for the effect of nitrate supplementation on isokinetic peak torque, whereas trivial effect sizes ranging from -0.11 to 0.16 were observed for independent velocity-specific (90°/s, 180°/s, 270°/s, and 360°/s) isokinetic peak torque. Four of the five studies indicated that dietary NO3- supplementation is not likely to influence voluntary knee extensor isokinetic torque across a variety of angular velocities. These results suggest that NO3- supplementation does not influence isokinetic peak torque, but further work is required to elucidate the potential of NO3- supplementation to influence other indices of muscular strength, given the dearth of experimental evidence on this topic.

Effects of Dietary Nitrate Supplementation on Weightlifting Exercise Performance in Healthy Adults: A Systematic Review.

Dietary nitrate (NO3-) supplementation has been evidenced to induce an ergogenic effect in endurance and sprint-type exercise, which may be underpinned by enhanced muscle contractility and perfusion, particularly in type II muscle fibers. However, limited data are available to evaluate the ergogenic potential of NO3- supplementation during other exercise modalities that mandate type II fiber recruitment, such as weightlifting exercise (i.e., resistance exercise). In this systematic review, we examine the existing evidence basis for NO3- supplementation to improve muscular power, velocity of contraction, and muscular endurance during weightlifting exercise in healthy adults. We also discuss the potential mechanistic bases for any positive effects of NO3- supplementation on resistance exercise performance. Dialnet, Directory of Open Access Journals, Medline, Pubmed, Scielo, Scopus and SPORT Discus databases were searched for articles using the keywords: nitrate or beetroot and supplement or nut*r or diet and strength or "resistance exercise" or "resistance training" or "muscular power". Four articles fulfilling the inclusion criteria were identified. Two of the four studies indicated that NO3- supplementation could increase aspects of upper body weightlifting exercise (i.e., bench press) performance (increases in mean power/velocity of contraction/number of repetitions to failure), whereas another study observed an increase in the number of repetitions to failure during lower limb weightlifting exercise (i.e., back squat). Although these preliminary observations are encouraging, further research is required for the ergogenic potential of NO3- supplementation on weightlifting exercise performance to be determined.

Selection and promotion processes are not associated by the relative age effect in an elite Spanish soccer academy.

The aim of this study was to analyze the influence of the relative age effect (RAE) on the selection and promotion processes in an elite soccer academy. One hundred and eleven elite youth players who belonged to an elite soccer club from the Spanish "La Liga" participated in this study. Players were classified into three age-categories: under 14 years (U14), under 16 years (U16) and under 18 years (U18); and they were also classified in quartiles based on their date of birth (i.e., January-March, Q1; April-June, Q2; July-September, Q3; October-December, Q4). In addition, two further classification criteria were established based on the selection (i.e., selected and non-selected players) and promotion (i.e., promoted and non-promoted players) processes. The main results showed that in U14 and U16 age-categories, players born early in the year were over-represented compared to players born late in the year, although birth-distribution was not associated with the likelihood of a player to be selected or promoted. In addition, less fat in sum skinfolds, less percentage of fat, higher percentage of muscle and lower endomorphy and mesomorphy components were showed in U14 selected players, in comparison with non-selected players. Likewise, better sprint performance was found in U16 selected players versus non-selected ones. However, no significant differences on anthropometry, body composition, somatotype and physical performance were found between promoted and non-promoted players. Therefore, our results suggest there is need for coaches to reorient their talent identification programs in order to make sure that players selected to continue playing in the club have the potential to promote to the excellence in soccer.

Consensus Paper: Towards a Systems-Level View of Cerebellar Function: the Interplay Between Cerebellum, Basal Ganglia, and Cortex.

Despite increasing evidence suggesting the cerebellum works in concert with the cortex and basal ganglia, the nature of the reciprocal interactions between these three brain regions remains unclear. This consensus paper gathers diverse recent views on a variety of important roles played by the cerebellum within the cerebello-basal ganglia-thalamo-cortical system across a range of motor and cognitive functions. The paper includes theoretical and empirical contributions, which cover the following topics: recent evidence supporting the dynamical interplay between cerebellum, basal ganglia, and cortical areas in humans and other animals; theoretical neuroscience perspectives and empirical evidence on the reciprocal influences between cerebellum, basal ganglia, and cortex in learning and control processes; and data suggesting possible roles of the cerebellum in basal ganglia movement disorders. Although starting from different backgrounds and dealing with different topics, all the contributors agree that viewing the cerebellum, basal ganglia, and cortex as an integrated system enables us to understand the function of these areas in radically different ways. In addition, there is unanimous consensus between the authors that future experimental and computational work is needed to understand the function of cerebellar-basal ganglia circuitry in both motor and non-motor functions. The paper reports the most advanced perspectives on the role of the cerebellum within the cerebello-basal ganglia-thalamo-cortical system and illustrates other elements of consensus as well as disagreements and open questions in the field.

Online Visual Feedback during Error-Free Channel Trials Leads to Active Unlearning of Movement Dynamics: Evidence for Adaptation to Trajectory Prediction Errors.

Prolonged exposure to movement perturbations leads to creation of motor memories which decay towards previous states when the perturbations are removed. However, it remains unclear whether this decay is due only to a spontaneous and passive recovery of the previous state. It has recently been reported that activation of reinforcement-based learning mechanisms delays the onset of the decay. This raises the question whether other motor learning mechanisms may also contribute to the retention and/or decay of the motor memory. Therefore, we aimed to test whether mechanisms of error-based motor adaptation are active during the decay of the motor memory. Forty-five right-handed participants performed point-to-point reaching movements under an external dynamic perturbation. We measured the expression of the motor memory through error-clamped (EC) trials, in which lateral forces constrained movements to a straight line towards the target. We found greater and faster decay of the motor memory for participants who had access to full online visual feedback during these EC trials (Cursor group), when compared with participants who had no EC feedback regarding movement trajectory (Arc group). Importantly, we did not find between-group differences in adaptation to the external perturbation. In addition, we found greater decay of the motor memory when we artificially increased feedback errors through the manipulation of visual feedback (Augmented-Error group). Our results then support the notion of an active decay of the motor memory, suggesting that adaptive mechanisms are involved in correcting for the mismatch between predicted movement trajectories and actual sensory feedback, which leads to greater and faster decay of the motor memory.

Paradoxical facilitation after depotentiation protocol can precede dyskinesia onset in early Parkinson's disease.

Loss of dopamine, a key modulator of synaptic signalling, and subsequent pulsatile non-physiological levodopa replacement is believed to underlie altered neuroplasticity in Parkinson's disease (PD). Animal models suggest that maladaptive plasticity (e.g. deficient depotentiation at corticostriatal synapses) is key in the development of levodopa-induced dyskinesia (LID), a common complication following levodopa replacement in PD. Human studies using transcranial magnetic stimulation protocols have shown similar depotentiation deficit in patients with LID. We hypothesized that subtle depotentiation deficits should precede LID if these deficits are mechanistically linked to LID onset. Moreover, patients on pulsatile levodopa-based therapy may show these changes earlier than those treated with levodopa-sparing strategies. We recruited 22 early non-dyskinetic PD patients (<5 years since diagnosis) and 12 age-matched healthy controls. We grouped patients into those on Levodopa-Based (n = 11) and Levodopa-Sparing therapies (n = 11). Patients were selected to obtain groups matched for age and disease severity. We used a theta-burst stimulation protocol to investigate potentiation and depotentiation in a single session. We report significant depotentiation deficits in the Levodopa-Based group, compared to both Levodopa-Sparing and Healthy Control groups. Potentiation and Depotentiation responses were similar between Levodopa-Sparing and Healthy Control groups. Although differences persist after accounting for potential confounds (e.g. levodopa-equivalent dose), these results may yet be caused by differences in disease severity and cumulative levodopa-equivalent dose as discussed in the text. In conclusion, we show for the first time that paradoxical facilitation in response to depotentiation protocols can occur in PD even prior to LID onset.

Mirror neuron system and observational learning: behavioral and neurophysiological evidence.

Three experiments were performed to study observational learning using behavioral, perceptual, and neurophysiological data. Experiment 1 investigated whether observing an execution model, during physical practice of a transitive task that only presented one execution strategy, led to performance improvements compared with physical practice alone. Experiment 2 investigated whether performing an observational learning protocol improves subjects' action perception. In experiment 3 we evaluated whether the type of practice performed determined the activation of the Mirror Neuron System during action observation. Results showed that, compared with physical practice, observing an execution model during a task that only showed one execution strategy does not provide behavioral benefits. However, an observational learning protocol allows subjects to predict more precisely the outcome of the learned task. Finally, intersperse observation of an execution model with physical practice results in changes of primary motor cortex activity during the observation of the motor pattern previously practiced, whereas modulations in the connectivity between primary and non primary motor areas (PMv-M1; PPC-M1) were not affected by the practice protocol performed by the observer.