Process mining to investigate the relationship between clinical antecedents and injury risk, severity and return to play in professional sports.

Objective: This paper presents an exploratory case study focusing on the applicability and value of process mining in a professional sports healthcare setting. We explore whether process mining can be retrospectively applied to readily available data at a professional sports club (Football Club Barcelona) and whether it can be used to obtain insights related to care flows. Design: Our study used discovery process mining to detect patterns and trends in athletes' Post-Pre-Participation Medical Evaluation injury route, encompassing five phases for analysis and interpretation. Results: We examined preprocessed data in event log format to determine the injury status of athletes in respective baseline groups (healthy or pathological). Our analysis found a link between thigh muscle injuries and later ankle joint problems. The process model found three loops with recurring injuries, the most common of which were thigh muscle injuries. There were no differences in injury rates or the median number of days to return to play between the healthy and pathological groups. Conclusions: This study explored the applicability and value of process mining in a professional sports healthcare setting. We established that process mining can be retrospectively applied to readily available data at a professional sports club and that this approach can be used to obtain insights related to sports healthcare flows.

Sport Nutrition Knowledge, Attitudes, Sources of Information, and Dietary Habits of Sport-Team Athletes.

Nutrition knowledge (NK) is one of several factors needed to establish proper eating habits and is especially important for athletes. The aims of this study were the following: to assess the NK of athletes from the Fútbol Club Barcelona; and to study its possible association with self-perceived level of NK, attitude towards nutrition, sources of information, and some dietary habits. We performed a cross-sectional study in two parts. First, we assessed the NK of elite athletes (n = 264) and compared it to the NK of technical teams of different sports (n = 59) and non-athletes (n = 183) of different ages and levels of education. Second, we investigated the associations between NK and other variables. To assess NK, we used a previously validated questionnaire Nutrition Knowledge Questionnaire for Young and Adult Athletes (NUKYA). Athletes showed a low median score (25.1 points), similar to the scores obtained by high school students (19.5) and university Philosophy students (29.0), and significantly lower than the scores of the sports technical team (58.5, p<0.05) and final year students of Human Nutrition and Dietetics (74.6, p<0.05). Moreover, we found statistically significant associations between NK and self-perceived level of NK (n=240,ρ=0.2546,p=0.0001) intake of fruits and vegetables (n=111,ρ=0.2701,p=0.0041), and intake of discretionary food (n=111,ρ=−0.2008,p=0.0001). Athletes with lower scores tended to overestimate their competence in nutrition (Dunning-Kruger effect). We concluded that NK of athletes needs to be improved through education plans that should consider aspects such as the proper selection of information resources and the importance of not consuming supplements without the adequate prescription. Incorporation of technical team and families to the education plan should be considered.

Fracturas mandibulares: manejo en deportistas / Mandibular fracture: Management in athletes

Las fracturas mandibulares son las fracturas faciales más frecuentes tras las fracturas nasales, y la contusión directa es la causa más habitual. La práctica deportiva es una de las principales causas de lesión maxilofacial, con gran variabilidad según el deporte practicado. Aunque existen diferentes publicaciones sobre el return-to-play en la fractura mandibular, no existe consenso claro al respecto (AU)

Maxillary fractures are the most frequent facial fractures after nasal fractures. Direct concussion is the most frequent cause. Sport related maxillary fractures are frequent, and vary according to the discipline. Many articles have been published with return to practice recommendations, but no consensus has been reached (AU)

Heart-rate variability and precompetitive anxiety in swimmers.

The aim of this study was to test the utility of heart-rate variability (HRV) analyses as a noninvasive means of quantifying cardiac autonomic regulation during precompetitive anxiety situations in swimmers. Psychophysiological state evaluation of 10 volunteer <> swimmers (6 women and 4 men) was obtained by comparing baseline training condition (TC) with competition condition (CC). Self-evaluation of precompetitive somatic anxiety measured by CSAI-2 showed significant increase from the TC to CC. Analysis showed that during higher precompetitive anxiety level, a significant reduction in the timing (RMSSD), frequency (HFms2 and HFnu) and Poincaré plot (SD1) of heart-rate variability was observed, and a significant increase in the low frequency to high frequency ratio (LF/HF %). The results indicate a shift towards sympathetic predominance as a result of parasympathetic withdrawal. Our results provide an HRV analysis in a valid, useful and non-invasive way to evaluate the change of sympathovagal balance in presence of precompetitive stress.

Fractura de estrés del hueso grande del carpo: a propósito de un caso / Stress fracture of the os capitate: apropos of a case

Las fracturas traumáticas o por estrés del hueso grande del carpo (os capitate) son hallazgos realmente infrecuentes en la práctica clínica. Son una entidad que se debe sospechar ante un dolor insidioso y persistente en la palma de la mano en personas con una elevada demanda de esta extremidad o con traumatismos repetidos. En este artículo se presenta el caso de una jugadora de tenis de 16 años con dolor selectivo en la mano derecha de meses de evolución(AU)

Traumatic or stress fractures of the os capitate are highly uncommon findings in clinical practice. These fractures should be suspected in insidious and persistent pain in the palm of the hand in persons with high demand on this extremity or repeated trauma. This article presents the case of a 16-year-old female tennis player with a 6-month history of selective pain in her right hand(AU)

Heart-rate variability and precompetitive anxiety in swimmers / Variabilidad de la frecuencia cardiaca y ansiedad precompetitiva en nadadores

The aim of this study was to test the utility of heart-rate variability (HRV) analyses as a noninvasive means of quantifying cardiac autonomic regulation during precompetitive anxiety situations in swimmers. Psychophysiological state evaluation of 10 volunteer «master» swimmers (6 women and 4 men) was obtained by comparing baseline training condition (TC) with competition condition (CC). Self-evaluation of precompetitive somatic anxiety measured by CSAI-2 showed significant increase from the TC to CC. Analysis showed that during higher precompetitive anxiety level, a significant reduction in the timing (RMSSD), frequency (HFms2 and HFnu) and Poincaré plot (SD1) of heart-rate variability was observed, and a significant increase in the low frequency to high frequency ratio (LF/HF %). The results indicate a shift towards sympathetic predominance as a result of parasympathetic withdrawal. Our results provide an HRV analysis in a valid, useful and non-invasive way to evaluate the change of sympathovagal balance in presence of precompetitive stress (AU)

El objetivo de este estudio fue valorar la utilidad del análisis de la variabilidad de la frecuencia cardiaca (VFC) como un medio no invasivo para cuantificar la regulación autonómica cardiaca en nadadores durante situaciones de ansiedad precompetitiva. Se evaluó el estado psicofisiológico de 10 nadadores «master» voluntarios (6 mujeres y 4 hombres) comparando la condición de línea base en un entrenamiento (simulación de competición) (TC) frente a la condición real de competición (CC). La ansiedad somática precompetitiva evaluada mediante el CSAI-2 mostró un incremento significativo de la TC a la CC. Cuando los niveles de ansiedad precompetitiva eran más elevados se observó una reducción significativa en los parámetros de la VFC en el dominio del tiempo (RMSSD), en el dominio de la frecuencia (HFms2 y HFnu) y en el gráfico de Poincaré (SD1); y también se observó un incremento significativo en la proporción de bajas frecuencias sobre altas frecuencias (LF/HF %). Los resultados indican un cambio hacia el predominio simpático como resultado del descenso de la actividad parasimpática. Estos resultados sugieren la utilidad del análisis de la VFC como un método válido, práctico y no invasivo para evaluar los cambios en el equilibrio simpático-parasimpático en presencia de estrés competitivo (AU)

Variabilidad de la frecuencia cardíaca como indicador de salud en el deporte: validación con un cuestionario de calidad de vida (SF-12) / Heart rate variability as a health indicator in sports: validation with a health-related quality of life questionnaire (Short Form-12)

Introducción y objetivo: El análisis de la variabilidad de la frecuencia cardíaca (VFC) se utiliza cada vez más en el ámbito de la medicina del deporte para evaluar la adaptación al entrenamiento de los deportistas. Nuestro objetivo es validar el análisis de la VFC como indicador de salud, comparando los parámetros de VFC con las puntuaciones del SF-12 en una muestra de personas sanas. Método: Estudio experimental con 32 sujetos sanos, 18 varones y 14 mujeres (26,19 años de promedio). Se utilizó el cuestionario SF-12 para evaluar la calidad de vida y un pulsómetro telemétrico Polar S810i para registrar la VFC a partir del intervalo RR. Los parámetros de VFC se obtuvieron mediante el software Polar Precision Performance. Resultados: Los parámetros RMSSD, pNN50 y HF que muestran la VFC correlacionan significativa y positivamente con los valores de percepción de salud a nivel físico, obtenidos en la escala de sumario físico, en la dimensión de rol físico y en la escala total del SF-12. Los sujetos del grupo que percibe mayor salud son los que presentan mayor variabilidad de la frecuencia cardíaca. Una mayor activación vagal en reposo se relaciona con una mayor calidad de vida en relación con la salud. Conclusiones: Los resultados de nuestro estudio confirman que el análisis de la VFC es un buen marcador del estado de salud y puede ayudar a diagnosticar rápidamente y con facilidad (en reposo, de forma no invasiva) estados de estrés (burnout, fatiga, sobreentrenamiento, agotamiento o ansiedad) en la población general y, especialmente, en deportistas de alto rendimiento

Introduction and background: In sports medicine, heart rate variability (HRV) analysis is used to assess adaptation to athletes' training. Our goal was to validate HRV analysis as a health indicator by comparing HRV parameters with Short Form-12 Health Survey Questionnaire (SF-12) scores in a sample of healthy individuals. Methods: We performed an experimental study in 32 healthy individuals (18 men and 14 women) with a mean age of 26.19 years. The SF-12 questionnaire was used to evaluate quality of life and a S810i Polar heart rate monitor was used to recode HRV through the R-R interval. HRV parameters were obtained with Polar Precision Performance software. Results: The root mean square of the differences between adjacent R-R intervals in milliseconds (RMSSD), the percentage of the adjacent R-R intervals differing by more than 50 milliseconds in the entire recording (pNN50) and the high frequency (HF) parameters of HRV showed a significant and positive correlation with the perceived physical health scores obtained in the physical component summary scale, the role-physical dimension and the total scale of the SF-12 questionnaire. Participants with greater perceived health showed the highest HRV. Higher parasympathetic activation at rest was related to greater health-related quality of life. Conclusions: Our results confirm that HRV analysis is a good marker of health status and could be used to diagnose stress states (overtraining, burnout, fatigue, exhaustion, anxiety) quickly and easily (at rest and non-invasively), both in the general population and, in particular, in elite athletes