Running Functional Threshold versus Critical Power: Same Concept but Different Values.

The aims of this study were (i) to estimate the functional threshold power (FTP) and critical power (CP) from single shorter time trials (TTs) (i. e. 10, 20 and 30 minutes) and (ii) to assess their location in the power-duration curve. Fifteen highly trained athletes randomly performed ten TTs (i. e. 1, 2, 3, 4, 5, 10, 20, 30, 50 and 60 minutes). FTP was determined as the mean power output developed in the 60-min TT, while CP was estimated in the running power meter platform according to the manufacturer's recommendations. The linear regression analysis revealed an acceptable FTP estimate for the 10, 20 and 30-min TTs (SEE≤12.27 W) corresponding to a correction factor of 85, 90 and 95%, respectively. An acceptable CP estimate was only observed for the 20-min TT (SEE=6.67 W) corresponding to a correction factor of 95%. The CP was located at the 30-min power output (1.0 [-5.1 to 7.1] W), which was over FTP (14 [7.0 to 21] W). Therefore, athletes and practitioners concerned with determining FTP and CP through a feasible testing protocol are encouraged to perform a 20-min TT and apply a correction factor of 90 and 95%, respectively.

Does Lower-Limb Tendon Structure Influence Walking Gait?

BACKGROUND: Within the exploration of human gait, key focal points include the examination of functional rockers and the influential role of tendon behavior in the intricate stretch-shortening cycle. To date, the possible relationship between these two fundamental factors in the analysis of human gait has not been studied. Therefore, this study aimed to analyze the relationship between the morphology of the patellar and Achilles tendons and plantar fascia with respect to the duration of the rockers. METHODS: Thirty-nine healthy men (age: 28.42 ± 6.97 years; height: 173 ± 7.17 cm; weight: 67.75 ± 9.43 kg) were included. Data of the rockers were recorded using a baropodometric platform while participants walked over a 10 m walkway at a comfortable velocity. Before the trials, the thickness and cross-sectional area were recorded for the patellar tendon, Achilles tendon and plantar fascia using ultrasound examination. The relationship between the morphology of the soft tissue and the duration of the rockers was determined using a pairwise mean comparison (t-test). RESULTS: A significant difference was found for rocker 1 duration, where a longer duration was found in the group of subjects with thicker patellar tendons. Regarding the Achilles tendon and plantar fascia, no significant differences were observed in terms of tendon morphology. However, subjects with thicker Achilles tendons showed a longer duration of rocker 1. CONCLUSIONS: The findings underscore a compelling association, revealing that an increased thickness of the patellar tendon significantly contributes to the extension of rocker 1 duration during walking in healthy adults.

Larger Achilles and plantar fascia induce lower duty factor during barefoot running.

OBJECTIVES: Tendons play a crucial role allowing the storage and release of mechanical energy during the running cycle. Running kinematics, including duty factor, constitute a basic element of the runner's biomechanics, and can determine their performance. This study aimed to analyze the link between Achilles tendon and plantar fascia morphology and running parameters, considering the influence of wearing shoes versus running barefoot. DESIGN: Cross-sectional study. METHODS: 44 participants (30 men and 14 women) engaged in two running sessions, one with shoes and one without, both lasting 3 min at a consistent speed of 12 km/h. We captured running kinematic data using a photoelectric cell system throughout the sessions. Before the trials, we measured the thickness and cross-sectional area of both the Achilles tendon and plantar fascia using ultrasound. RESULTS: The Pearson test revealed a significant correlation (p < 0,05) between Achilles tendon and plantar fascia morphology and contact time (r > -0.325), flight time (r > -0.325) and duty factor (ratio of ground contact to stride time) (r > -0.328) during barefoot running. During the shod condition, no significant correlation was found between connective tissue morphology and kinematic variables. CONCLUSIONS: In barefoot running, greater size of the Achilles tendon and plantar fascia results in a reduced duty factor, attributed to longer flight times and shorter contact times.

Training Specificity in Trail Running: A Single-Arm Trial on the Influence of Weighted Vest on Power and Kinematics in Trained Trail Runners.

Participants in trail running races must carry their equipment throughout the race. This additional load modifies running biomechanics. Novel running powermeters allow further analyses of key running metrics. This study aims to determine the acute effects of running with extra weights on running power generation and running kinematics at submaximal speed. Fifteen male amateur trail runners completed three treadmill running sessions with a weighted vest of 0-, 5-, or 10% of their body mass (BM), at 8, 10, 12, and 14 km·h-1. Mean power output (MPO), leg spring stiffness (LSS), ground contact time (GCT), flight time (FT), step frequency (SF), step length (SL), vertical oscillation (VO), and duty factor (DF) were estimated with the Stryd wearable system. The one-way ANOVA revealed higher GCT and MPO and lower DF, VO, and FT for the +10% BM compared to the two other conditions (p < 0.001) for the running speeds evaluated (ES: 0.2-7.0). After post-hoc testing, LSS resulted to be higher for +5% BM than for the +10% and +0% BM conditions (ES: 0.2 and 0.4). Running with lighter loads (i.e., +5% BM) takes the principle of specificity in trail running one step further, enhancing running power generation and LSS.

Level of Agreement between the MotionMetrix System and an Optoelectronic Motion Capture System for Walking and Running Gait Measurements.

Markerless motion capture systems (MCS) have been developed as an alternative solution to overcome the limitations of 3D MCS as they provide a more practical and efficient setup process given, among other factors, the lack of sensors attached to the body. However, this might affect the accuracy of the measures recorded. Thus, this study is aimed at evaluating the level of agreement between a markerless MSC (i.e., MotionMetrix) and an optoelectronic MCS (i.e., Qualisys). For such purpose, 24 healthy young adults were assessed for walking (at 5 km/h) and running (at 10 and 15 km/h) in a single session. The parameters obtained from MotionMetrix and Qualisys were tested in terms of level of agreement. When walking at 5 km/h, the MotionMetrix system significantly underestimated the stance and swing phases, as well as the load and pre-swing phases (p < 0.05) reporting also relatively low systematic bias (i.e., ≤ -0.03 s) and standard error of the estimate (SEE) (i.e., ≤0.02 s). The level of agreement between measurements was perfect (r > 0.9) for step length left and cadence and very large (r > 0.7) for step time left, gait cycle, and stride length. Regarding running at 10 km/h, bias and SEE analysis revealed significant differences for most of the variables except for stride time, rate and length, swing knee flexion for both legs, and thigh flexion left. The level of agreement between measurements was very large (r > 0.7) for stride time and rate, stride length, and vertical displacement. At 15 km/h, bias and SEE revealed significant differences for vertical displacement, landing knee flexion for both legs, stance knee flexion left, thigh flexion, and extension for both legs. The level of agreement between measurements in running at 15 km/h was almost perfect (r > 0.9) when comparing Qualisys and MotionMetrix parameters for stride time and rate, and stride length. The agreement between the two motion capture systems varied for different variables and speeds of locomotion, with some variables demonstrating high agreement while others showed poor agreement. Nonetheless, the findings presented here suggest that the MotionMetrix system is a promising option for sports practitioners and clinicians interested in measuring gait variables, particularly in the contexts examined in the study.

Influence of walking speed on gait spatiotemporal parameters and the functional rockers of the foot in healthy adults.

BACKGROUND: The gait cycle is generally divided into stance phase and swing phase. The stance phase can also be divided into three functional rockers, each with a distinct fulcrum. It has been shown that walking speed (WS) influences both stance and swing phase but its influence on the functional foot rockers duration is unknown. The aim of the study was to analyze the WS influence on functional foot rockers duration. METHODS: a cross-sectional study is completed with 99 healthy volunteers to assess the effect of WS on kinematics and foot rockers duration in treadmill walking at 4, 5, and 6 km·h-1 RESULTS: Friedman test exhibited that all spatiotemporal variables and the length of the foot rockers changed significantly with WS (p < 0.05) except rocker 1 at 4 and 6 km·h-1. CONCLUSION: Every spatiotemporal parameter and the duration of the three functional rockers are affected by walking speed, although not all rockers are affected equally. The findings of this study reveal that Rocker 2 is the primary rocker whose duration is influenced by changes in gait speed.

Somatosensation and motor performance in the less-affected and more-affected hand of unilateral cerebral palsy children: a cross-sectional study.

PURPOSE: This study aimed to examine motor performance and somatosensory processing of unilateral cerebral palsy (UCP) children in both the less-affected hand and the more-affected hand. This study is also aimed at analysing the somatosensory proccessing in the more-affected hand in relation to age and damaged hemisphere. MATERIALS AND METHODS: Forty-seven children aged from 6 to 15 years (UCP = 23; TD = 24) were recruited. Grip strength, pinch strength, Box and Block Test and Jebsen Taylor Hand Function Test were used to analyse motor performance. A comprehensive somatosensory assessment battery was included: tactile registration, unilateral, bilateral and spatio-temporal perception, haptic recognition, texture perception, proprioception, pressure pain threshold and functional sensitivity. RESULTS: UCP children exhibited lower performance in all aspects of motor performance measured in both the less-affected hand and the more-affected hand, except grip strength in the less-affected hand. Significant differences were found for all tests included in the somatosensory assessment in both the less-affected hand and the more-affected hand, except unilateral perception tests in the less-affected hand. CONCLUSIONS: UCP children present difficulties in motor performance and somatosensory processing not only in the more-affected hand, but also in the less-affected hand. Somatosensation may be a critical driver of functional performance.Implications for rehabilitationThe less-affected hand of children with unilateral cerebral palsy should be included in both assessment and intervention programmes.Somatosensory processing should be assessed through a comprehensive battery, both in the less-affected hand and in the more-affected hand of unilateral cerebral palsy children.Somatosensory treatment must be taken into account if functional performance in the activities of daily living of unilateral cerebral palsy children is to be improved.

Absolute agreement and consistency of the OptoGait system and Freemed platform for measuring walking gait.

The gait cycle can be divided into four functional rocker units. Although the widespread use of the OptoGait (OG) system and the Freemed (FM) platform, their accuracy has not been tested. An observational study was completed with eighteen healthy volunteers to determine the accuracy of OG and FM for overground walking gait analysis. The pairwise comparison between data obtained from OG, FM and high-speed video analysis revealed significant differences for most of the measurements (p < 0.05). ICCs revealed an excellent absolute agreement between measurements (ICCs > 0.94) for all measures for OG systems compared to video-analysis. When considering FM vs. video-analysis, ICCs showed good absolute agreement for rocker 1 (ICC = 0.86) and 3 (ICC = 0.82), excellent for rocker 2 (ICC = 0.93) and poor (ICC < 0.5) for rocker 4. Bland-Altman plots (95% limits of agreement) revealed heteroscedasticity of error for OG in all variables for foot rockers (r2 > 0.1) while no heteroscedasticity of error was found when using FM (r2 < 0.1). This study indicates that the OG system and the FM platform can provide consistent foot rockers values when walking at a constant velocity. The differences between the systems assessed and their agreement and consistency values advise against their interchangeable use.

Acute effects of a 60-min time trial on power-related parameters in trained endurance runners.

BACKGROUND: The advent of power meters for running has raised the interest of athletes and coaches in new ways of assessing changes in running performance. The aim of this study is to determine the changes in power-related variables during and after a strenuous endurance running time trial. METHODS: Twenty-one healthy male endurance runners, with a personal record of 37.2 ± 1.2 min in a 10-km race, completed a 1-h run on a motorized treadmill trying to cover as much distance as they could. Before and after the time trial the athletes were asked to perform a 3-min run at 12 km h-1. Normalized mean power output, step frequency, form power and running effectiveness were calculated using the Stryd™ power meter. Heart rate (HR) and rating of perceived exertion (RPE) were monitored, and data averaged every 5 min. RESULTS: Despite high levels of exhaustion were reached during the time trial (HRpeak = 176.5 ± 9.8 bpm; RPE = 19.2 ± 0.8), the repeated measures ANOVA resulted in no significant differences (p ≥ 0.05), between each pair of periods for any of the power-related variables. The pairwise comparison (T test) between the non-fatigued and fatigued constant 3-min runs showed an increase in step frequency (p = 0.012) and a decrease in form power (p < 0.001) under fatigue conditions, with no meaningful changes in normalized mean power output and running effectiveness. CONCLUSIONS: Trained athletes are able to maintain power output and running effectiveness during a high demanding extended run. However, they preferred to reduce the intensity of vertical impacts under fatigue conditions by increasing their step frequency.

Effect of intra-session exercise sequence of an 8-week concurrent training program on the components of physical fitness in recreationally trained young adults.

This study aimed to determine the effect of the intra-session exercise sequence of a concurrent training programme on the components of health-related physical fitness. Twenty-four healthy young adults were allocated into two different groups differing only in the exercise order to conduct an 8-week intra-session concurrent training programme consisting of three sessions of 60-90 minutes (180-270 min/week), with all-out running sprint intervals, back squat, and bench press endurance and resistance exercises (i.e., ET+RT and RT+ET). The 8-week intra-session concurrent training programme overall improved all the components of physical fitness regardless of the exercise sequence. However, ET + RT and RT + ET groups reported moderate and small improvements for squat jump (ET + RT: 3.82 cm [1.11 to 6.53 cm]; RT + ET: 0.31 cm [-1.72 to 2.33 cm]), countermovement jump (ET + RT: 3.76 cm [1.43 to 6.08 cm]; RT + ET: 2.07 cm [-0.03 to 4.17 cm]) and maximum oxygen uptake (ET + RT: 4.75 ml/kg/min [1.14 to 8.35 ml/kg/min]; RT + ET: 1.66 ml/kg/min [-0.89 to 4.21 ml/kg/min]), respectively. Therefore, greater lower-body power and cardiorespiratory fitness gains might be induced following the ET + RT sequence.

Influence of the Shod Condition on Running Power Output: An Analysis in Recreationally Active Endurance Runners.

Several studies have already analysed power output in running or the relation between VO2max and power production as factors related to running economy; however, there are no studies assessing the difference in power output between shod and barefoot running. This study aims to identify the effect of footwear on the power output endurance runner. Forty-one endurance runners (16 female) were evaluated at shod and barefoot running over a one-session running protocol at their preferred comfortable velocity (11.71 ± 1.07 km·h−1). The mean power output (MPO) and normalized MPO (MPOnorm), form power, vertical oscillation, leg stiffness, running effectiveness and spatiotemporal parameters were obtained using the Stryd™ foot pod system. Additionally, footstrike patterns were measured using high-speed video at 240 Hz. No differences were noted in MPO (p = 0.582) and MPOnorm (p = 0.568), whereas significant differences were found in form power, in both absolute (p = 0.001) and relative values (p < 0.001), running effectiveness (p = 0.006), stiffness (p = 0.002) and vertical oscillation (p < 0.001). By running barefoot, lower values for contact time (p < 0.001) and step length (p = 0.003) were obtained with greater step frequency (p < 0.001), compared to shod running. The prevalence of footstrike pattern significantly differs between conditions, with 19.5% of runners showing a rearfoot strike, whereas no runners showed a rearfoot strike during barefoot running. Running barefoot showed greater running effectiveness in comparison with shod running, and was consistent with lower values in form power and lower vertical oscillation. From a practical perspective, the long-term effect of barefoot running drills might lead to increased running efficiency and leg stiffness in endurance runners, affecting running economy.

Test-Retest Reliability of the MotionMetrix Software for the Analysis of Walking and Running Gait Parameters.

The use of markerless motion capture systems is becoming more popular for walking and running analysis given their user-friendliness and their time efficiency but in some cases their validity is uncertain. Here, the test-retest reliability of the MotionMetrix software combined with the use of Kinect sensors is tested with 24 healthy volunteers for walking (at 5 km·h−1) and running (at 10 and 15 km·h−1) gait analysis in two different trials. All the parameters given by the MotionMetrix software for both walking and running gait analysis are tested in terms of reliability. No significant differences (p > 0.05) were found for walking gait parameters between both trials except for the phases of loading response and double support, and the spatiotemporal parameters of step length and step frequency. Additionally, all the parameters exhibit acceptable reliability (CV < 10%) but step width (CV > 10%). When analyzing running gait, although the parameters here tested exhibited different reliability values at 10 km·h−1, the system provided reliable measurements for most of the kinematic and kinetic parameters (CV < 10%) when running at 15 km·h−1. Overall, the results obtained show that, although some variables must be interpreted with caution, the Kinect + MotionMetrix system may be useful for walking and running gait analysis. Nevertheless, the validity still needs to be determined against a gold standard system to fully trust this technology and software combination.

Influence of footwear, foot-strike pattern and step frequency on spatiotemporal parameters and lower-body stiffness in running.

This study aimed to determine the influence of footwear condition, foot-strike pattern and step frequency on running spatiotemporal parameters and lower-body stiffness during treadmill running. Thirty-one amateur endurance runners performed a two-session protocol (shod and barefoot). Each session consisted of two trials at 12 km · h-1 over 5 minutes altering step frequency every minute (150, 160, 170, 180 and 190 spm). First, participants were instructed to land with the heel first; after completion, the same protocol was repeated landing with the forefoot first. Repeated measures ANOVAs showed significant differences for footwear condition, foot-strike pattern and step frequency for each variable: percent contact time, percent flight time, vertical stiffness and leg stiffness (all p < 0.001). The results demonstrate greater estimated vertical and leg stiffness when running barefoot for both foot-strike patterns showing the largest values for barefoot+forefoot condition. Likewise, both vertical and leg stiffness became greater as step frequency increased. The proper manipulation of these variables facilitates our understanding of running performance and assist in training programmes design and injury management.

Reliability of the RunScribe™ system to determine kinematic variables of the pelvis during locomotion at different speeds.

PURPOSE: The aim of this study was to determine the reliability of the RunScribe™ system to measure kinematic variables of the pelvis during walking and running. METHODS: In this study, a treadmill protocol was implemented where the participants (n = 23) completed 3 sets of 1 minute at 5, 10 and 15 km/h. RESULTS: All the recorded measurements during walking reported a low reliability with coefficients of variation (CV) greater than 10% in all variables and small-moderate intraclass correlation coefficient (ICC) (<0.6) in seven out of ten variables. Similarly, the CVs reported in running were greater than 10%, except for the maximum angular rate in the obliquity of the pelvis and the vertical oscillation that together with the angular velocity variables showed almost perfect ICCs (>0.92). CONCLUSIONS: Therefore, the data obtained suggests that the RunScribe™ system with 3 IMUs does not provide reliable metrics about the kinematics of the pelvis during locomotion (i.e., walking and running).

Influence of contextual factors on physical demands and technical-tactical actions regarding playing position in professional soccer players.

BACKGROUND: The aim of this study was to analyse the physical demands and technical-tactical actions for each playing position according to game location and final outcome in professional soccer players. METHODS: A convenience sample was obtained from twenty-one professional male soccer players, belonged to same soccer team of the Spanish Second Division. Players' physical demands were monitored during each match using a portable 18 Hz GPS unit and 600 Hz triaxial accelerometer. These analysed demands were total distance, moderate speed running distance (>14.4 km·h-1), high-speed running distance (>19.8. km·h-1), sprint distance (>25.0 km·h-1), number of accelerations between 2 and 4 m·s-2 and above 4 m·s-2, and number of decelerations between 2 and 4 m·s-2 and above 4 m·s-2. The data related to technical-tactical actions were obtained from WyScout®, a computerized multiple-camera tracking system based on the OPTA® track analysis tool. The obtained indicators were general, defensive and offensive. RESULTS: For all players, higher total distance (p = 0.045; effect size [ES] = 0.24, small effect) was covered and greater deceleration 2-4 m·ss-2 (p = 0.001; ES = 0.68, medium effect) was performed when the team plays at home and lose and for all players, playing at home and winning demanded higher defensive volume (p =0.014; ES = - 1.49, large effect) and nº interceptions (p =0.031; ES = - 1.40, large effect) in comparison to playing at home and losing. CONCLUSIONS: The physical demands and technical-tactical actions vary when contextual game factors (i.e., match location and final outcome) are considered. We can confirm that, although the training of physical demands does not influence the final result of the match, the training of technical tactical actions could help to achieve an optimal performance of the team to win matches.

[Update on neuroendocrine tumors]. / Tumores Neuroendocrinos: un desafío transversal.

Neuroendocrine Tumors (NETs) encompass a wide variety of tumors arising from neuroendocrine cells, which produce bioactive substances. The incidence of NETs increased significantly lately, becoming one of the most common tumors of the digestive tract. Their clinical presentation is as diverse as their capacity for hormone production. Carcinoid syndrome is the most common hormonal syndrome produced by NETs and is characterized by diarrhea, flushing and cardiac valvular lesions. New research brought multiple changes in the classification of these neoplasms and a new understanding about their diagnosis and treatment, promoting a multidisciplinary approach. Somatostatin analogues, radiation, biological, and cytotoxic drugs have improved the prognosis of these patients, which entails a great challenge for healthcare providers.

European knowledge alliance for innovative measures in prevention of work-related musculoskeletal pain disorders (Prevent4Work Project): protocol for an international mixed-methods longitudinal study.

INTRODUCTION: Work-related musculoskeletal (MSK) pain is a highly prevalent condition and one of the main contributors to disability and loss of work capacity. Current approaches to the management and prevention of work-related MSK pain do not consistently integrate current evidence-based knowledge and seem to be outdated. The Prevent4Work (P4W) Project aims to collect and spread evidence-based information to improve the management and prevention of work-related MSK pain. P4W will longitudinally investigate (1) risk factors associated with the prevalence of work-related MSK pain, (2) predictive factors for new events of work-related MSK pain in the short term and (3) the modification of pain beliefs after participating in evidence-based e-learning courses. METHODS AND ANALYSIS: This project employs a mixed-methods design with international cohorts of workers from Spain, Italy and Denmark. All participants will be assessed using self-reported variables at baseline (ie, cross-sectional design) with follow-up after 3 and 6 months (ie, prospective-predictive design). Throughout the first phase (0-3 months), all participants will be offered to self-enrol in e-learning courses on work-related MSK pain. Changes in pain beliefs (if any) will be assessed. The dataset will include sociodemographic characteristics, physical and psychological job demands, lifestyle-related factors, MSK pain history and pain beliefs. At baseline, all participants will additionally complete the P4W questionnaire developed to detect populations at high risk of suffering work-related MSK pain.Descriptive statistics, binary logistic regression, and analysis of variance will be used to identify the significant factors that influence the history of work-related MSK pain, evaluate the short-term prediction capacity of the P4W questionnaire, and investigate whether workers' participation in e-learning courses will modify their pain beliefs. ETHICS AND DISSEMINATION: The study received ethical approval from the Ethical Committee of San Jorge University (USJ011-19/20). The results will be made available via peer-reviewed publications, international conferences and P4W official channels.

Relationship between Connective Tissue Morphology and Lower-Limb Stiffness in Endurance Runners. A Prospective Study.

BACKGROUND: The lower limb behaves like a spring compressing and decompressing during running, where lower-limb stiffness is one of the most influential factors. This prospective observational study is aimed at examining the relationship between the connective tissue morphology and lower-limb stiffness and investigating whether the barefoot/shod condition influences on such relationship. METHODS: 14 male amateur runners (10-km time trial <50') were included. Data were recorded over one session, where participants ran 2 trials (i.e., barefoot and shod conditions) of 3 minutes at 12 km/h, where running spatiotemporal parameters and vertical (Kvert) and leg stiffness (Kleg) were obtained. Prior to testing trials, thickness and cross-sectional area (CSA) were recorded for Achilles (AT) and patellar tendons (PT) and plantar fascia (PF) with ultrasound. RESULTS: Under barefoot condition, a positive correlation was found between Kleg and AT-thickness and CSA and PF-thickness; and between Kvert and AT-thickness and PF thickness. Under shod condition, a positive correlation was found between Kleg and PT-CSA and PT-thickness, and between Kvert and PT-CSA and PT-thickness. CONCLUSIONS: The results reveal a specificity of the relationship between the lower-limb stiffness and the morphology of the connective tissue. Greater tendon shows higher lower-limb stiffness when that tendon is specially demanded by the function.

Relationship between Reactive Strength and Leg Stiffness at Submaximal Velocity: Effects of Age on Distance Runners.

BACKGROUND: Musculotendinous reactive strength is a key factor for the utilization of elastic energy in sporting activities such as running. AIM: To evaluate the relationship between musculotendinous reactive strength and lower-limb stiffness during running as well as to identify age-related differences in both variables. METHODS: Fifty-nine amateur endurance runners performed three 20-cm drop jumps and a constant 3-min easy run on a motorized treadmill. Reactive strength index and dynamic lower-limb stiffness were calculated with a photoelectric cell system by jumping and running, respectively. Additionally, sit to stand difference in plantar arch height was assessed as a static lower-limb stiffness measure. The cluster analysis allows the comparison between younger and older runners. RESULTS: No significant correlations were found between jumping reactive strength and running lower-limb stiffness. The younger group performed better at drop jumps (p = 0.023, ES = 0.82), whereas higher-but-no-significant results were found for reactive strength index and stiffness-related metrics. CONCLUSIONS: Musculotendinous vertical reactiveness may not be transferred to combined vertical and horizontal movements such as running.

Tumores Neuroendocrinos: un desafío transversal / Update on neuroendocrine tumors

Neuroendocrine Tumors (NETs) encompass a wide variety of tumors arising from neuroendocrine cells, which produce bioactive substances. The incidence of NETs increased significantly lately, becoming one of the most common tumors of the digestive tract. Their clinical presentation is as diverse as their capacity for hormone production. Carcinoid syndrome is the most common hormonal syndrome produced by NETs and is characterized by diarrhea, flushing and cardiac valvular lesions. New research brought multiple changes in the classification of these neoplasms and a new understanding about their diagnosis and treatment, promoting a multidisciplinary approach. Somatostatin analogues, radiation, biological, and cytotoxic drugs have improved the prognosis of these patients, which entails a great challenge for healthcare providers.