Effects of Upper-Body Plyometric Training on Physical Fitness in Healthy Youth and Young Adult Participants: A Systematic Review with Meta-Analysis.

BACKGROUND: Upper-body plyometric training (UBPT) is a commonly used training method, yet its effects on physical fitness are inconsistent and there is a lack of comprehensive reviews on the topic. OBJECTIVE: To examine the effects of UBPT on physical fitness in healthy youth and young adult participants compared to active, specific-active, and passive controls. METHODS: This systematic review followed PRISMA 2020 guidelines and utilized the PICOS framework. PubMed, WOS, and SCOPUS were searched. Studies were assessed for eligibility using the PICOS framework. The effects of UBPT on upper-body physical fitness were assessed, including maximal strength, medicine ball throw performance, sport-specific throwing performance, and upper limb muscle volume. The risk of bias was evaluated using the PEDro scale. Means and standard deviations were used to calculate effect sizes, and the I2 statistic was used to assess heterogeneity. Publication bias was assessed using the extended Egger's test. Certainty of evidence was rated using the GRADE scale. Additional analyses included sensitivity analyses and adverse effects. RESULTS: Thirty-five studies were included in the systematic review and 30 studies in meta-analyses, involving 1412 male and female participants from various sport-fitness backgrounds. Training duration ranged from 4 to 16 weeks. Compared to controls, UBPT improved maximal strength (small ES = 0.39 95% CI = 0.15-0.63, p = 0.002, I2 = 29.7%), medicine ball throw performance (moderate ES = 0.64, 95% CI = 0.43-0.85, p < 0.001, I2 = 46.3%), sport-specific throwing performance (small ES = 0.55, 95% CI = 0.25-0.86, p < 0.001, I2 = 36.8%), and upper limbs muscle volume (moderate ES = 0.64, 95% CI = 0.20-1.08, p = 0.005, I2 = 0.0%). The GRADE analyses provided low or very low certainty for the recommendation of UBPT for improving physical fitness in healthy participants. One study reported one participant with an injury due to UBPT. The other 34 included studies provided no report measure for adverse effects linked to UBPT. CONCLUSIONS: UBPT interventions may enhance physical fitness in healthy youth and young adult individuals compared to control conditions. However, the certainty of evidence for these recommendations is low or very low. Further research is needed to establish the optimal dose of UBPT and to determine its effect on female participants and its transfer to other upper-body dominated sports.

Plyometric Jump Training Exercise Optimization for Maximizing Human Performance: A Systematic Scoping Review and Identification of Gaps in the Existing Literature.

BACKGROUND: Plyometric jump training (PJT) encompasses a range of different exercises that may offer advantages over other training methods to improve human physical capabilities (HPC). However, no systematic scoping review has analyzed either the role of the type of PJT exercise as an independent prescription variable or the gaps in the literature regarding PJT exercises to maximize HPC. OBJECTIVE: This systematic scoping review aims to summarize the published scientific literature and its gaps related to HPC adaptations (e.g., jumping) to PJT, focusing on the role of the type of PJT exercise as an independent prescription variable. METHODS: Computerized literature searches were conducted in the PubMed, Web of Science, and SCOPUS electronic databases. Design (PICOS) framework: (P) Healthy participants of any age, sex, fitness level, or sports background; (I) Chronic interventions exclusively using any form of PJT exercise type (e.g., vertical, unilateral). Multimodal interventions (e.g., PJT + heavy load resistance training) will be considered only if studies included two experimental groups under the same multimodal intervention, with the only difference between groups being the type of PJT exercise. (C) Comparators include PJT exercises with different modes (e.g., vertical vs. horizontal; vertical vs. horizontal combined with vertical); (O) Considered outcomes (but not limited to): physiological, biomechanical, biochemical, psychological, performance-related outcomes/adaptations, or data on injury risk (from prevention-focused studies); (S) Single- or multi-arm, randomized (parallel, crossover, cluster, other) or non-randomized. RESULTS: Through database searching, 10,546 records were initially identified, and 69 studies (154 study groups) were included in the qualitative synthesis. The DJ (counter, bounce, weighted, and modified) was the most studied type of jump, included in 43 study groups, followed by the CMJ (standard CMJ or modified) in 19 study groups, and the SJ (standard SJ or modified) in 17 study groups. Strength and vertical jump were the most analyzed HPC outcomes in 38 and 54 studies, respectively. The effects of vertical PJT versus horizontal PJT on different HPC were compared in 21 studies. The effects of bounce DJ versus counter DJ (or DJ from different box heights) on different HPC were compared in 26 studies. CONCLUSIONS: Although 69 studies analyzed the effects of PJT exercise type on different HPC, several gaps were identified in the literature. Indeed, the potential effect of the PJT exercise type on a considerable number of HPC outcomes (e.g., aerobic capacity, flexibility, asymmetries) are virtually unexplored. Future studies are needed, including greater number of participants, particularly in groups of females, senior athletes, and youths according to maturity. Moreover, long-term (e.g., >12 weeks) PJT interventions are needed.

Effects of Plyometric Jump Training on the Reactive Strength Index in Healthy Individuals Across the Lifespan: A Systematic Review with Meta-analysis.

BACKGROUND: The reactive strength index (RSI) is meaningfully associated with independent markers of athletic (e.g., linear sprint speed) and neuromuscular performance [e.g., stretch-shortening cycle (SSC)]. Plyometric jump training (PJT) is particularly suitable to improve the RSI due to exercises performed in the SSC. However, no literature review has attempted to meta-analyse the large number of studies regarding the potential effects of PJT on the RSI in healthy individuals across the lifespan. OBJECTIVE: The aim of this systematic review with meta-analysis was to examine the effects of PJT on the RSI of healthy individuals across the lifespan compared with active/specific-active controls. METHODS: Three electronic databases (PubMed, Scopus, Web of Science) were searched up to May 2022. According to the PICOS approach, the eligibility criteria were: (1) healthy participants, (2) PJT interventions of ≥ 3 weeks, (3) active (e.g., athletes involved in standard training) and specific-active (e.g., individuals using heavy resistance training) control group(s), (4) a measure of jump-based RSI pre-post training, and (5) controlled studies with multi-groups in randomised and non-randomised designs. The Physiotherapy Evidence Database (PEDro) scale was used to assess the risk of bias. The random-effects model was used to compute the meta-analyses, reporting Hedges' g effect sizes (ES) with 95% confidence intervals (95% CIs). Statistical significance was set at p ≤ 0.05. Subgroup analyses were performed (chronological age; PJT duration, frequency, number of sessions, total number of jumps; randomization). A meta-regression was conducted to verify if PJT frequency, duration, and total number of sessions predicted the effects of PJT on the RSI. Certainty or confidence in the body of evidence was assessed using Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Potential adverse health effects derived from PJT were researched and reported. RESULTS: Sixty-one articles were meta-analysed, with a median PEDro score of 6.0, a low risk of bias and good methodological quality, comprising 2576 participants with an age range of 8.1-73.1 years (males, ~ 78%; aged under 18 years, ~ 60%); 42 studies included participants with a sport background (e.g., soccer, runners). The PJT duration ranged from 4 to 96 weeks, with one to three weekly exercise sessions. The RSI testing protocols involved the use of contact mats (n = 42) and force platforms (n = 19). Most studies reported RSI as mm/ms (n = 25 studies) from drop jump analysis (n = 47 studies). In general, PJT groups improved RSI compared to controls: ES = 0.54, 95% CI 0.46-0.62, p < 0.001. Training-induced RSI changes were greater (p = 0.023) for adults [i.e., age ≥ 18 years (group mean)] compared with youth. PJT was more effective with a duration of > 7 weeks versus ≤ 7 weeks, > 14 total PJT sessions versus ≤ 14 sessions, and three weekly sessions versus < three sessions (p = 0.027-0.060). Similar RSI improvements were noted after ≤ 1080 versus > 1080 total jumps, and for non-randomised versus randomised studies. Heterogeneity (I2) was low (0.0-22.2%) in nine analyses and moderate in three analyses (29.1-58.1%). According to the meta-regression, none of the analysed training variables explained the effects of PJT on RSI (p = 0.714-0.984, R2 = 0.0). The certainty of the evidence was moderate for the main analysis, and low-to-moderate across the moderator analyses. Most studies did not report soreness, pain, injury or related adverse effects related to PJT. CONCLUSIONS: The effects of PJT on the RSI were greater compared with active/specific-active controls, including traditional sport-specific training as well as alternative training interventions (e.g., high-load slow-speed resistance training). This conclusion is derived from 61 articles with low risk of bias (good methodological quality), low heterogeneity, and moderate certainty of evidence, comprising 2576 participants. PJT-related improvements on RSI were greater for adults versus youths, after > 7 training weeks versus ≤ 7 weeks, with > 14 total PJT versus ≤ 14 sessions, and with three versus < three weekly sessions.

A Systematic Review with Meta-Analysis on the Effects of Plyometric-Jump Training on the Physical Fitness of Combat Sport Athletes.

We aimed to assess the athletic performance changes in combat sport athletes (CoSAs) after plyometric-jump training (PJT), compared to control conditions, through a systematic review with meta-analysis. Following PRISMA guidelines, three electronic databases were searched for includable articles, according to a PICOS approach. Using a random-effects model, Hedges' g effects sizes (ES) were calculated. Heterogeneity was assessed using the I2 statistic, with values of <25%, 25-75%, and >75% representing low, moderate, and high levels of heterogeneity, respectively. Statistical significance was set at p ≤ 0.05. The certainty of evidence was assessed using the GRADE approach. Twelve eligible articles were identified for systematic review, seven of high quality and five of moderate quality, according to the PEDro scale. The studies recruited taekwondo, silat, wrestling, judo, fencing, and karate athletes (292 total participants), including specific-active and active controls. Most participants had a mean age of <18 years and were males (n = 225). Compared to the control, PJT programmes, involving 4-12 weeks and 2-3 sessions per week, induced small to moderate improvements (ES = 0.47 to 1.04) in athletes' maximal strength (e.g., 1RM squat), vertical jump height, change-of-direction speed, and specific performance (e.g., fencing movement velocity), although without meaningful effects on body mass, fat mass, and muscle mass (ES = 0.02 to -0.06). Most (7 of 8) outcomes attained low heterogeneity. The outcome-level GRADE analysis indicated a certainty of evidence from low to moderate. In conclusion, PJT, when compared to control conditions, may improve CoSA athletic performance.

Warm-up optimization in amateur male soccer players: A comparison of small-sided games and traditional warm-up routines on physical fitness qualities.

The aim of this study was to compare the effects of small-sided soccer games (SSSGs) and traditional warm-up (TWU) routines on physical fitness qualities in soccer players. Following a between-subject, randomized design, amateur-level soccer players were assigned to a SSSG warm-up (n = 10; age: 19.3 ± 2.8 years) or TWU group (n = 10; age: 19.3 ± 2.4 years). Players completed multiple trials of 10-m and 30-m linear sprints, change-of-direction speed (CODS) tests, and countermovement jumps (CMJ) prior to and following the warm-up routine. Separate mixed ANOVAs were performed to assess group effects (SSSG vs. TWU), time effects within each group (pre- vs. post-warm-up), and their interaction for each physical fitness quality. No significant interaction effects were observed for any dependent variable. Significant improvements were evident between baseline and follow-up measurements for 10-m sprint time (p = 0.002, Hedges' g effect size [g] = 0.59) and CMJ variables (height: p = 0.016, g = 0.20; power: p = 0.003, g = 0.19; force: p = 0.002, g = 0.14) in the TWU group and for CODS performance time (p = 0.012, g = 0.51) and CMJ variables (height: p < 0.001, g = 0.46; power: p = 0.002, g = 0.35; force: p = 0.001, g = 0.27) in the SSSG warm-up group. Both SSSG and TWU protocols improved selected physical fitness qualities with SSSG more effective at improving CODS and CMJ performance, and TWU more effective at improving linear speed. Soccer coaches may choose between SSSG or traditional warm-up activities according to player needs and preferences; however, the superior effects of SSSG suggest it might offer greater benefits than TWU in preparing players for optimal physical output.

Effects of Exercise Frequency with Complex Contrast Training on Measures of Physical Fitness in Active Adult Males.

Complex contrast training (CCT) is an exercise modality that utilizes both high-load resistance activity and low-load plyometric activity in a set-by-set fashion within a single exercise session. Such a combination of exercises targets multiple aspects of the force−velocity curve and may thus lead to improvement of various components of physical fitness. However, no previous study has attempted to compare the effects of load-equated two vs. three CCT sessions per week on measures of physical fitness. Forty-five male participants aged 21.4 ± 2.0 years were randomly assigned to either two weekly CCT sessions (CCT-2; n = 15), three weekly CCT sessions (CCT-3; n = 15), or an active control group (CG; n = 15). Selected measures of physical fitness were assessed pre- and post-six weeks of training. The tests included the assessment of 15 and 30 m linear sprint speeds, upper (medicine ball throw) and lower limb muscle power (standing long jump and countermovement jump with arm thrust), muscle strength (isokinetic peak knee extensor/flexor torque), and change-of-direction speed (modified agility T-test (MAT)). Significant group−time interactions were observed for all dependent variables (all p < 0.001, ɳp2 = 0.51−0.78) using ANOVA. Post hoc tests indicated significant performance improvements for the CCT-2 and CCT3 groups for all dependent variables (Hedge's g = 0.28−3.26, %Δ = 2.4−16.7), including the 15 and 30 m linear sprint speeds (p < 0.001), medicine ball throw (p < 0.001), standing long jump (p < 0.001), countermovement jump with arm thrust (p < 0.001), right leg knee extensor (p < 0.001) and flexor peak torque (p < 0.001), left leg knee extensor (p < 0.001) and flexor peak torque (p < 0.001), and change-of-direction speed (p < 0.001). The CCT-3 group showed greater improvements in MAT compared to the CCT-2 group (g = 3.26 vs. 0.70, p < 0.001). In conclusion, compared to active controls, the load-equated CCT-2 and CCT-3 programs provided similar effects on measures of physical fitness in active adult males. However, an athlete's goal is to improve their MAT score, the CCT-3 program may elicit greater improvements compared with the CCT-2 program.

A novel TFG variant of uncertain significance in amyotrophic lateral sclerosis: A case report and review of literature.

Introduction: Amyotrophic lateral sclerosis is a neurodegenerative disease with wide variation of genetics associated with it. Among the different genes described, mutation in TFG is a rare finding in amyotrophic lateral sclerosis. Case presentation: A 35 years old right-handed male presenting with ipsilateral weakness was diagnosed with amyotrophic lateral sclerosis. He was found to have missense variant of TFG with uncertain significance on exome sequencing. Clinical discussion: The genetics involved in amyotrophic lateral sclerosis is ever-evolving. The identification of new TFG variant in this disease adds another evidence to the role of TFG in neurodegenerative disease. Conclusions: The finding of TFG variant of uncertain significance is a rare finding in amyotrophic lateral sclerosis. And with the identification of new TFG variant, it leads to further understanding of spectrum of TFG and its pathophysiology in amyotrophic lateral sclerosis.

Effects of Plyometric Jump Training on Measures of Physical Fitness and Sport-Specific Performance of Water Sports Athletes: A Systematic Review with Meta-analysis.

BACKGROUND: A growing body of literature is available regarding the effects of plyometric jump training (PJT) on measures of physical fitness (PF) and sport-specific performance (SSP) in-water sports athletes (WSA, i.e. those competing in sports that are practiced on [e.g. rowing] or in [e.g. swimming; water polo] water). Indeed, incoherent findings have been observed across individual studies making it difficult to provide the scientific community and coaches with consistent evidence. As such, a comprehensive systematic literature search should be conducted to clarify the existent evidence, identify the major gaps in the literature, and offer recommendations for future studies. AIM: To examine the effects of PJT compared with active/specific-active controls on the PF (one-repetition maximum back squat strength, squat jump height, countermovement jump height, horizontal jump distance, body mass, fat mass, thigh girth) and SSP (in-water vertical jump, in-water agility, time trial) outcomes in WSA, through a systematic review with meta-analysis of randomized and non-randomized controlled studies. METHODS: The electronic databases PubMed, Scopus, and Web of Science were searched up to January 2022. According to the PICOS approach, the eligibility criteria were: (population) healthy WSA; (intervention) PJT interventions involving unilateral and/or bilateral jumps, and a minimal duration of ≥ 3 weeks; (comparator) active (i.e. standard sports training) or specific-active (i.e. alternative training intervention) control group(s); (outcome) at least one measure of PF (e.g. jump height) and/or SSP (e.g. time trial) before and after training; and (study design) multi-groups randomized and non-randomized controlled trials. The Physiotherapy Evidence Database (PEDro) scale was used to assess the methodological quality of the included studies. The DerSimonian and Laird random-effects model was used to compute the meta-analyses, reporting effect sizes (ES, i.e. Hedges' g) with 95% confidence intervals (95% CIs). Statistical significance was set at p ≤ 0.05. Certainty or confidence in the body of evidence for each outcome was assessed using Grading of Recommendations Assessment, Development, and Evaluation (GRADE), considering its five dimensions: risk of bias in studies, indirectness, inconsistency, imprecision, and risk of publication bias. RESULTS: A total of 11,028 studies were identified with 26 considered eligible for inclusion. The median PEDro score across the included studies was 5.5 (moderate-to-high methodological quality). The included studies involved a total of 618 WSA of both sexes (330 participants in the intervention groups [31 groups] and 288 participants in the control groups [26 groups]), aged between 10 and 26 years, and from different sports disciplines such as swimming, triathlon, rowing, artistic swimming, and water polo. The duration of the training programmes in the intervention and control groups ranged from 4 to 36 weeks. The results of the meta-analysis indicated no effects of PJT compared to control conditions (including specific-active controls) for in-water vertical jump or agility (ES = - 0.15 to 0.03; p = 0.477 to 0.899), or for body mass, fat mass, and thigh girth (ES = 0.06 to 0.15; p = 0.452 to 0.841). In terms of measures of PF, moderate-to-large effects were noted in favour of the PJT groups compared to the control groups (including specific-active control groups) for one-repetition maximum back squat strength, horizontal jump distance, squat jump height, and countermovement jump height (ES = 0.67 to 1.47; p = 0.041 to < 0.001), in addition to a small effect noted in favour of the PJT for SSP time-trial speed (ES = 0.42; p = 0.005). Certainty of evidence across the included studies varied from very low-to-moderate. CONCLUSIONS: PJT is more effective to improve measures of PF and SSP in WSA compared to control conditions involving traditional sport-specific training as well as alternative training interventions (e.g. resistance training). It is worth noting that the present findings are derived from 26 studies of moderate-to-high methodological quality, low-to-moderate impact of heterogeneity, and very low-to-moderate certainty of evidence based on GRADE. Trial registration The protocol for this systematic review with meta-analysis was published in the Open Science platform (OSF) on January 23, 2022, under the registration doi https://doi.org/10.17605/OSF.IO/NWHS3 (internet archive link: https://archive.org/details/osf-registrations-nwhs3-v1 ).

Knowledge, attitude and practice regarding diabetes and hypertension among school students of Nepal: A rural vs. urban study.

BACKGROUND: The burden of non-communicable diseases like diabetes and hypertension is increasing worldwide including low-and middle-income countries. Good knowledge of such diseases among young people will make them adopt a healthy lifestyle from an early age, which will, in turn, prevent them from developing such non-communicable diseases. This study aimed to assess the knowledge, attitude, and practice of rural and urban school students regarding diabetes and hypertension. We also aimed to see the differences in the knowledge, attitude, and practice of students from rural vs. urban communities. METHODS: A school-based cross-sectional study was conducted from May 1 2021 to June 30, 2021, in four schools in Nepal (1 from a metropolitan city, 2 from an urban municipality, and 1 from a rural municipality). The study was conducted among the secondary-level students of classes 9 and 10 in each school. The data were collected from the participants via pre-tested questionnaires and analyzed in the Statistical Packages for Social Sciences (SPSS) version 20.0. Logistic regression analysis was carried out to determine the determinants of knowledge and attitude regarding diabetes and hypertension. RESULTS: Of 380 respondents, 35.5% were residents of metropolitan city, 37.4% were from the urban municipality and 27.1% were from the rural municipality. The mean age of respondents was 15.61±0.99 years and 51.1% were male. Respondents having a family history of diabetes and hypertension were 21.1% and 37.9% respectively. Respondents from the metropolitan city had significantly higher mean knowledge scores than the respondents from the urban and rural municipality (p<0.001) while there was no significant difference in mean attitude scores. There was significantly higher daily consumption of fruits and vegetables among the participants from rural municipality (p<0.01) while no significant difference was seen in salt consumption and time spent on physical activity. In univariate regression analysis, place of residence, family occupation, parental education, and family history of diabetes and hypertension were significantly associated with good knowledge level. In multivariate analysis, only a higher grade of study (grade 10 in comparison to grade 9) was an independent predictor of a student's good attitude level. CONCLUSION: In general, there was a good attitude towards diabetes and hypertension despite poor knowledge. The mean knowledge scores were lower in urban municipality and rural municipality compared to metropolitan city. Low knowledge scores on diabetes and hypertension among the students show an urgent need for school-based interventional programs focusing on non-communicable diseases and lifestyle modification with more emphasis on rural communities.

Effects of six weeks outdoor versus treadmill running on physical fitness and body composition in recreationally active young males: a pilot study.

Background: Running as exercise may be performed either on an outdoor surface or treadmill surface. However, previous research has indicated that the nature of both the surfaces differ significantly and therefore the training outcomes from running in these surfaces may also vary. Aim: Therefore, the aim of this pilot study was to compare the effects of 6-weeks of supervised outdoor running (OT) vs treadmill running (TT) on physical fitness and body composition in recreationally active young males. Methods: Participants (age: 19.82 ± 1.28 years, height: 172.6 ± 4.9 cm, body mass: 64.3 ± 8.7 kg) were randomly assigned to OT (n = 14) or TT (n = 14), and assessed for physical fitness, i.e., 50 m sprint, cardiorespiratory endurance (i.e., 1,600 m run time-trial), standing long jump (SLJ), flexibility (i.e., sit-and-reach test), and upper-body muscle endurance (i.e., push-ups repetitions), alongside body composition, i.e., body mass, body mass index (BMI), fat percentage, fat free mass, and leg skeletal muscle mass (SMM). A two (pre-post intervention) by two (OT, TT) mixed ANOVA analysed exercise-specific effects. For significant group-by-time interactions, Bonferroni adjusted paired (within-group) and independent (between-group comparisons at post) t-tests were used for post-hoc analyses. Results: Significant time-effect was found in all physical fitness variables (all p < 0.001, ηp 2 = 0.67-0.91), body mass (p = 0.23, ηp 2 = 0.18), BMI (p = 0.009, ηp 2 = 0.24), body fat percentage (p = 0.001, ηp 2 = 0.38), and leg SMM (p = 0.002-0.007, ηp 2 = 0.25-0.33). Significant group-by-time interaction was found for 50 m sprint (p = < 0.001, ηp 2 = 0.74), 1,600 m run (p = 0.001, ηp 2 = 0.35), and SLJ (p < 0.001, ηp 2 = 0.43), favouring OT. Group-specific post-hoc tests showed improvements in all physical fitness variables after OT (p = < 0.001-0.001, g = 0.69-2.32, %Δ = 3.0-12.4) and TT (p = < 0.001-0.017, g = 0.15-0.65, %Δ = 0.9-11.7), and fat percentage after OT and TT (p = 0.002-0.041, g = 0.14-0.26, %Δ = 4.3-6.0). However, leg SMM decreased in TT (p = 0.001-0.004, g = 0.14-0.15, %Δ = 6.2-6.7). Conclusions: Both OT and TT improved physical fitness and decreased fat percentage. However, compared to TT, the OT intervention preserved leg SMM and induced greater physical fitness improvements.

Effects of Sand-Based Plyometric-Jump Training in Combination with Endurance Running on Outdoor or Treadmill Surface on Physical Fitness in Young Adult Males.

This study aimed at examining the effects of nine weeks of sand-based plyometric-jump training (PJT) combined with endurance running on either outdoor or treadmill surface on measures of physical fitness. Male participants (age, 20.1 ± 1.7 years) were randomly assigned to a sand-based PJT combined with endurance running on outdoor surface (OT, n = 25) or treadmill surface (TT, n = 25). The endurance running intervention comprised a mixed training method, i.e., long slow distance, tempo, and interval running drills. A control group was additionally included in this study (CG, n = 25). Participants in CG followed their regular physical activity as OT and TT but did not receive any specific intervention. Individuals were assessed for their 50-m linear sprint time, standing long jump (SLJ) distance, cardiorespiratory fitness (i.e., Cooper test), forced vital capacity (FVC), calf girth, and resting heart rate (RHR). A three (groups: OT, TT, CG) by two (time: pre, post) ANOVA for repeated measures was used to analyze the exercise-specific effects. In case of significant group-by-time interactions, Bonferroni adjusted paired (within-group) and independent (between-group comparisons at post) t-tests were used for post-hoc analyses. Significant group-by-time interactions were found for all dependent variables (p < 0.001 - 0.002, ɳp2 = 0.16 - 0.78). Group-specific post-hoc tests showed improvements for all variables after OT (p < 0.001, Hedges'g effect size [g] = 0.05 - 1.94) and TT (p < 0.001, g = 0.04 - 2.73), but not in the CG (p = 0.058 - 1.000, g = 0.00 - 0.34). Compared to CG, OT showed larger SLJ (p = 0.001), cardiorespiratory fitness (p = 0.004), FVC (p = 0.008), and RHR (p < 0.001) improvements. TT showed larger improvements in SLJ (p = 0.036), cardiorespiratory fitness (p < 0.001), and RHR (p < 0.001) compared with CG. Compared to OT, TT showed larger improvements for SLJ (p = 0.018). In conclusion, sand-based PJT combined with either OT or TT similarly improved most measures of physical fitness, with greater SLJ improvement after TT. Coaches may use both concurrent exercise regimes based on preferences and logistical constrains (e.g., weather; access to treadmill equipment).

Febrile Seizures among Children Admitted to the Department of Paediatrics of a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Introduction: Febrile seizure is the most common convulsive event in children younger than 60 months. Fever plays an important role in causing disturbances in fluid and electrolyte balance, also hyponatremia has been thought to enhance the susceptibility to seizures. The objective of this study is to find out the prevalence of febrile seizures among children admitted to the Department of Paediatrics of a tertiary care centre. Methods: A descriptive cross-sectional study among children admitted to the Department of Paediatrics was done at a tertiary care centre between December, 2020 to September, 2021. Ethical approval was taken from the Institutional Review Committee (Reference number: 077/078-098). A total of 1052 children were included in this study. A convenience sampling technique was used. Statistical Package for the Social Sciences version 25.0 was used for data analysis. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Among 1052 children, the prevalence of febrile seizure was 100 (9.50%) (7.73-11.27 at 95% Confidence Interval). Among these 100 patients, 68 (68%) had simple febrile seizures while 32 (32%) had recurrent febrile seizures. Conclusions: The prevalence of febrile seizures was found to be higher than in other studies conducted in similar settings. This knowledge may be of practical value in advising parents or caregivers of the risk of a febrile seizure and its recurrence. Keywords: febrile seizure; hyponatremia; recurrence.

Prevalence and Pregnancy Outcomes of Intrahepatic Cholestasis of Pregnancy.

BACKGROUND: Intrahepatic cholestasis of pregnancy is a common pregnancy-specific liver disease associated with increased risk of adverse fetal and maternal outcomes. We sought to determine its prevalence, risk factors and feto-maternal outcomes. METHODS: A retrospective review of data of 164 pregnant women diagnosed with intrahepatic cholestasis of pregnancy at Chitwan Medical College, Nepal from August 2018 to September 2020 was done. Socio-demographic data, clinic-laboratory profile and feto-maternal outcomes were obtained from clinical audit books and electronic records. A multivariate logistic regression analysis was used to evaluate the predictors of adverse neonatal outcome. RESULTS: The prevalence of intrahepatic cholestasis of pregnancy was 2.5% (164 out of 6539 deliveries). The mean age was 27.5 ± 4.4 years and 51.2% were multigravida. The preterm delivery rate was 15.2% and Caesarean delivery rate was 69.5%. 22% of the neonates needed intensive care admission out of which Respiratory Distress Syndrome or Transient Tachypnea of Newborn was seen in half of them. There were 2 cases of Intrauterine Fetal Death. In multivariate analysis, delivery <34 weeks of gestation was only found to be a significant independent predictor of adverse neonatal outcome Conclusion: The prevalence of intrahepatic cholestasis of pregnancy among pregnant women is significant in our setting which is associated with adverse fetal outcome. Early diagnosis and timely intervention is necessary in order to reduce associated perinatal morbidity.

Inter-Limb Jump Asymmetries and Their Association with Sport-Specific Performance in Young Male and Female Swimmers.

This study aimed to examine inter-limb jump asymmetries and their association with sport-specific performance in young swimmers. Thirty-eight (male, n = 19; female, n = 19) regional/national level young swimmers (age: 12.3 ± 1.2 years; height: 159.6 ± 8.2 cm; body mass: 52.5 ± 9.2 kg) participated in this study. Inter-limb asymmetries were assessed for single-leg countermovement jump (SLCMJ) and single-leg standing long jump (SLSLJ). Sport-specific performance was evaluated using front crawl (i.e., 50 m and 25 m) and front crawl kick (i.e., 50 m and 25 m). The kappa coefficient revealed a "slight" level of agreement (Κ = 0.156, 0.184, and 0.197 for female, male, and all, respectively) between the direction of asymmetry for SLCMJ and SLSLJ, indicating that asymmetries rarely favored the same limb during both tests. A paired sample t-test showed a significant difference (p = 0.025) between asymmetry scores obtained in SLCMJ and SLSLJ. No significant difference was found in asymmetry scores between males and females (p = 0.099 to 0.977). Additionally, no association between asymmetry scores and sport-specific performance was observed (p > 0.05). Our findings highlight the independent nature of inter-limb asymmetries derived from SLCMJ and SLSLJ among young male and female swimmers. Further, our results suggest no association between jumping asymmetries and sport-specific performance.

Cesarean Section Among all Deliveries in a Tertiary Care Centre of Nepal: A Descriptive Cross-sectional Study.

INTRODUCTION: Worldwide there is a tremendous increase in cesarean section rate over the last decades which has been a global public health issue. This study aimed to find out the prevalence of cesarean delivery in a tertiary care center of Nepal. METHODS: A descriptive cross-sectional study was conducted among pregnant women at tertiary care centre from 15th September 2019 to 15th October 2020. Ethical clearance was taken from the Institutional Review Committee (Ref: CMC-IRC/077/078-200). Convenience sampling was done to reach the sample size. Basic demographic data, clinical indications and neonatal outcomes were noted. Data entry was done using Statistical Package for the Social Sciences version 20. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. RESULTS: Out of 3193 total deliveries, cesarean deliveries were 1412 (44.22%) at 95% Confidence Interval (42.49-45.94). Among caesarean deliveries 1086 (76.9%) were emergency cesarean sections. Most common indication for cesarean section was fetal distress (24.9%). Among 1437 newborns, 1428 (99.4%) were live births, 1387 (98.2%) were singleton and 801 (55.7%) were male. Nearly one third 418 (29.1%) neonates required neonatal intensive care unit admission and transient tachypnoea of newborns (44.28% in emergency and 60.46% in elective cesarean delivery) was the most common indication for admission. CONCLUSIONS: The prevalence of cesarean delivery was found to be higher than that recommended by the World Health Organisation. Fetal distress was the leading indication for cesarean deliveries.

Effects of Complex Training on Sprint, Jump, and Change of Direction Ability of Soccer Players: A Systematic Review and Meta-Analysis.

The aim of this meta-analysis was to evaluate the effects of complex training (CT) on sprint, jump, and change of direction (COD) ability among soccer players. After an electronic search, 10 peer-reviewed articles were considered in the meta-analysis. The athletes included in this meta-analysis were amateur to professional level male soccer players (age range, 14-23 years). These studies incorporated CT in soccer players who were compared to a control group. Significant moderate to large improvements were observed in the CT group [sprint: standard mean difference (SMD) = 0.92-1.91; jump: SMD = 0.96-1.58; COD: SMD = 0.97-1.49] when compared to control groups. Subgroup analysis were also conducted based on age, duration, and competitive level. The beneficial effects of CT were greater in players <18 vs. ≥18 years (linear sprinting; SMD = 2.01 vs. -0.13), after ≥8 vs. <8 weeks (jumping and COD; SMD = 1.55-2.01 vs. 0.31-0.64, respectively) and among professional vs. amateur players (linear sprinting and with COD; SMD = 1.53-1.58 vs. 0.08-0.63, respectively). In conclusion, regular soccer training programs may be supplemented with CT to improve sprint, jump, and COD performance. A longer duration of CT (≥8 weeks) seems to be optimal in improving the physical abilities of soccer players. Professional players and <18 years players may benefit more from CT program.