Idiopathic Premature Ventricular Contraction Catheter Ablation, Sedentary Population vs. Athlete's Populations: Outcomes and Resumption of Sports Activity.

There are no investigations about the outcomes of idiopathic PVC catheter ablation (CA) in athletes compared to the sedentary population. We conducted a prospective single-centre observational study. The primary and secondary procedural outcomes were the post-ablation reduction of premature ventricular contractions (PVCs) in an athletes vs. non-athletes group and in agonist vs. leisure-time athletes. The third was the evaluation of the resumption of physical activity and the improvement of symptoms in agonist and leisure-time athletes. From January 2020 to October 2022 we enrolled 79 patients with RVOT/LVOT/fascicular PVC presumed origin. The median percentage of decrease between the pre-procedure and post-procedure Holter monitoring in the non-athletes group was 96 (IQR 68-98) and 98 in the athletes group (IQR 92-99) (p = 0.08). Considering the athletes, the median percentage of decrease in the number of PVCs was 98 (IQR 93-99) and 98 (IQR 87-99), respectively, in leisure-time and agonistic athletes (p = 0.42). Sixteen (70%) leisure time and seventeen (90%) agonist athletes (p = 0.24) have resumed physical activity 3 months after PVC CA; among agonistic athletes, 59% have resumed competitive physical activity. Many leisure-time (88%) and agonist (70%) athletes experienced an improvement in symptoms after ablation. PVC CA was effective and safe in both groups, reducing symptoms and allowing a quick and safe return to sports activities in athletes.

Sports activity (SA) recognition based on error correcting output codes (ECOC) and convolutional neural network (CNN).

The increasing use of motion sensors is causing major changes in the process of monitoring people's activities. One of the main applications of these sensors is the detection of sports activities, for example, they can be used to monitor the condition of athletes or analyze the quality of sports training. Although the existing sensor-based activity recognition systems can recognize basic activities such as: walking, running, or sitting; they don't perform well in recognizing different types of sports activities. This article introduces a new model based on machine learning (ML) techniques to more accurately distinguish between sports and everyday activities. In the proposed method, the necessary data to detect the type of activity is collected through his two sensors: an accelerometer and a gyroscope attached to a person's foot. For this purpose, the input signals are first preprocessed and then short-time Fourier transform (STFT) is used to describe the characteristics of each signal. In the next step, each STFT matrix is used as input to a convolutional neural network (CNN). This CNN describes various motion characteristics of the sensor in the form of vectors. Finally, a classification model based on error correction output code (ECOC) is used to classify the extracted features and detect the type of SA. The performance of the proposed AS recognition method is evaluated using the DSADS database and the results are compared with previous methods. Based on the results, the proposed method can recognize sports activities with an accuracy of 99.71. Furthermore, the performance of the proposed method based on precision and recall criteria are 99.72 and 99.71, respectively, which are better than the compared methods.

Level of physical activity among adolescents in Ernakulam District, Kerala: A cross-sectional study.

Introduction: For children aged 5-17 years, WHO recommends moderate-to-vigorous intensity physical activity for at least 60 minutes daily which would account for 420 minutes of physical activity per week regardless of working days or holidays. With the increasing prevalence of non-communicable diseases in Kerala, this study aimed to assess the level of physical activity among high school students in Ernakulam District, Kerala. Materials and Methods: A school-based cross-sectional study was conducted among ninth and tenth standard students of two randomly selected schools in Ernakulam District. A total of 303 children were recruited for the study. Consent rate and response rate of the study were 100%. A structured questionnaire adapted from MRC-CPAQ (Children's Physical Activity Questionnaire) was used to collect the data. Results: The study revealed that out of 303 students, 72.9% were < 15 years, 77% were males, and 59% were urban residents. More than 70% of the participants were actively involved in physical activity of moderate-to-vigorous intensity. Males, in the age group of 15 years and above, having a separate play area, and those with no siblings were found to have significantly higher levels of physical activity. Conclusion: The study was able to identify a positive trend for physical activity among adolescents. Town planning and building of play areas are essential to develop and retain the habit of physical activity among adolescents.

Effects of 8 weeks pre-season training on physical fitness, heart rate variability and cognition in women soccer players.

The aim of this study was to explore the variations (pre-post) of (i) Anthropometric measures: weight, body mass index, lean and muscle mass, (ii) Physical fitness: countermovement jump (CMJ) and VO2max, (iii) heart rate variability (HRV) (recumbent and sitting): mean RR, RMSSD, NN50 and NN50 %, (iv) Psychomotor Vigilance Task, and v) SART: ACC Go, ACC NoGo and reaction times in semi-professional women soccer players from the second division of the Spanish League. The analysis indicated that lean mass improved after the observation period (p = .05, d = -0.38), while no other significant changes in anthropometric measures were observed. Additionally, CMJ and aerobic power were also improved (p<.01, d>0.50). The RMSSD [recumbent (d = -0.73) and sitting (d = -0.52)] and NN50 [recumbent (d = -0.69) and sitting (d = -0.70)] increased after the period of observation (p < .05). Reaction time also significantly improved after the period of observation [PVT (d = 0.42) and SART (d = -0.89)]. Correlations performed between measures revealed that smaller body mass and body mass index were largely associated with greater NN50 (r < 0.83, p = .001). Additionally, greater CMJ and aerobic fitness were associated with greater HRV [recumbent (r = -51, p = .001) and sitting (r = -0.60, p = .01). The main findings of this study were that there was no relationship between cognitive performance and physical fitness, but HRV was related to body composition and physical fitness during the pre-season in women soccer players.

Spina bifida and cardiorespiratory profile: the impact of leisure sport activities on physical fitness.

PURPOSE: The aim of the present study is to evaluate a population of young patients affected by Spina Bifida (SB) to describe their cardiorespiratory function and bone mineral density profile, analyzing any differences between people performing and those who do not perform sports activity. The study also aimed to rule out possible congenital heart disease associated with spina bifida, considering the common origin of certain cardiac structures with those found to be altered in SB patients. METHODS: Thirty-four young patients, aged between 12 and 22 years, diagnosed with spinal dysraphism (SD), have been clinically described and, in order to evaluate their physical fitness, functional capacity and bone mass, almost all of them underwent a complete cardiorespiratory assessment, including electrocardiogram (ECG), echocardiogram, Cardiopulmonary Exercise Test (CPET), body composition analysis using bioimpedance analysis (BIA) and Dual Energy X-ray Absorptiometry (DEXA), as well as the estimation of bone mineral density (BMD) with Computerized Bone Mineralometry (CBM). RESULTS: Collected data demonstrated that only 35% of the subjects practiced physical activity during the week. BMI and percentage FM values were pathological in at least 50% of the population. On cardiological investigations (ECG and echocardiogram), no significant alterations were found. In all patients who performed CPET (79.4%), pathological values of the main functional capacity parameters were revealed, especially peak oxygen consumption (VO2 peak), even when corrected for BCM or FFM estimated at BIA and DEXA, respectively. In the CBM analysis, out of 27 patients in whom the femoral T-score was evaluated, a condition of osteopenia was revealed in 40.7% of the patients (11/27) and osteoporosis in 18.5% (5/27); out of 27 patients in whom the lumbar T-score was evaluated, 37% of the patients showed osteopenia (10/27) and 29.6% osteoporosis (8/27). When the comparison between exercising and non-exercising patients was performed, the only statistically significant difference that emerged was the median lumbar T-score value, which appeared lower in the group not performing physical activity (p = 0,009). CONCLUSIONS: The extensive cardiorespiratory evaluation, including CPET, of our cohort of spina bifida patients showed altered values of the main parameters related to cardiorespiratory fitness and is the only study in the literature that analysed bone mineralization values in physically active and sedentary spina bifida patients and demonstrated a statistically significant difference. Furthermore, it is the only study to date that investigated the possible association of congenital heart diseases with SD, without demonstrating the existence of pathological conditions.

Action Quality Assessment Model Using Specialists' Gaze Location and Kinematics Data-Focusing on Evaluating Figure Skating Jumps.

Action quality assessment (AQA) tasks in computer vision evaluate action quality in videos, and they can be applied to sports for performance evaluation. A typical example of AQA is predicting the final score from a video that captures an entire figure skating program. However, no previous studies have predicted individual jump scores, which are of great interest to competitors because of the high weight of competition. Despite the presence of unnecessary information in figure skating videos, human specialists can focus and reduce information when they evaluate jumps. In this study, we clarified the eye movements of figure skating judges and skaters while evaluating jumps and proposed a prediction model for jump performance that utilized specialists' gaze location to reduce information. Kinematic features obtained from the tracking system were input into the model in addition to videos to improve accuracy. The results showed that skaters focused more on the face, whereas judges focused on the lower extremities. These gaze locations were applied to the model, which demonstrated the highest accuracy when utilizing both specialists' gaze locations. The model outperformed human predictions and the baseline model (RMSE:0.775), suggesting a combination of human specialist knowledge and machine capabilities could yield higher accuracy.

A posterior tibial slope angle over 12 degrees is critical to epiphyseal fracture of the proximal tibia: Three-dimensional finite element analysis.

Introduction: The effects of the proximal tibial slope angle on the proximal tibial epiphysis remain unknown. To elucidate those effects, we investigated the strain distribution in proximal tibial epiphysis with different proximal tibial slope angles and proximal tibial epiphysis closure periods using finite element analysis. Materials and methods: The finite element models of the proximal tibia were reconstructed from CT images and consisted of cancellous/cortical bone and epiphyseal plate. The variations in proximal tibial slope angle (range: 6-16°) and four closure variations in proximal tibial epiphysis (open, semi-open, semi-closed, and closed) were prepared. The loading force on the medial and lateral joint surface, and the tensile force by the patellar tendon were applied to the models, and the distal area of the tibia was fixed. The ratio of the equivalent strain in semi-open/semi-closed proximal tibial epiphysis to the strain in open proximal tibial epiphysis on different proximal tibial slope angles were calculated. Results: The strain ratio between the semi-open/semi-closed and open proximal tibial epiphysis models indicated significant differences between 6 or 8° of proximal tibial slope angle and 12, 14, and 16° of proximal tibial slope angle models. In the increased proximal tibial slope angle model, a hoop-shaped strain in the closing proximal tibial epiphysis was found, and the maximum strain was found in the tibial tubercle. Discussion: During epiphyseal closure, adolescents with an increased proximal tibial slope angle over 12° are significantly at risk for suffering from proximal tibial epiphyseal fractures compared with those under 10°.

Mediating Effect of Sports Safety Awareness between Sports Activity Habits and the Intention to Complete Safety Education among Korean Adolescents.

BACKGROUND: As the importance of safety during sports activities continues to gain emphasis socially, the interest in creating a culture of safety and safety education to support this is also increasing. However, no study has examined the willingness of adolescents to complete safety education voluntarily. To identify methods of building a culture of sports safety among adolescents, this study investigated the structural relationship among three related variables: sports activity habits, intention to complete safety education, and sports safety awareness of Korean adolescents. METHODS: Data on 3928 adolescents aged 13-18 years old from the 2019 Sports Safety Accident Survey conducted by the Korea Sports Safety Foundation were analyzed. This encompassed frequency analysis, scale reliability, validity verification, descriptive statistics analysis, path analysis, and mediating effect verification. RESULTS: The results indicated that sports activity habits among these adolescents had a positive effect on their sports safety awareness and on their intention to complete safety education; further, their sports safety awareness had a positive effect on their intention to complete safety education. The results also showed that sports safety awareness had a partial mediating effect between sports activity habits and intention to complete safety education. The willingness of adolescents to voluntarily complete safety education is particularly important, as adolescence is a critical period when lifelong safety habits can be formed. CONCLUSIONS: Based on the results, discussions on creating safe sports activity habits for adolescents and continuous education on sports safety awareness are needed. Ultimately, we need to improve sports safety awareness by paying attention to the development and implementation of sports safety education programs for adolescents as a national policy and, through this, increase their willingness to complete safety education.

A tool to assess fitness among adults in public health studies - Predictive validity of the FFB-Mot questionnaire.

BACKGROUND: Fitness has important implications for physical activity behavior and is associated with various health-related outcomes. It can be assessed through a test battery or a self-reported questionnaire. One example is the FFB-Mot (Funktionsfragebogen Motorik; engl. functional fitness questionnaire) which consist of 28 items to assess four components of fitness in adults: cardiorespiratory fitness/ endurance, muscular strength, gross motor coordination, and flexibility. The aims of this manuscript were to (1) provide an English-version of the FFB-Mot questionnaire (developed from the German-version using translation and back-translation) to the international community of researchers in the areas of physical activity, fitness and health in adults, and (2) examine the predictive validity of the FFB-Mot questionnaire in a large sample of community-dwelling adults. METHODS: We used data from a longitudinal study in Germany with four measurement waves over a period of 18 years, with samples ranging between 310 and 437 participants (1572 adults in total, mean ages 46-58 years). To assess predictive validity, we calculated Pearson correlations between FFB-Mot data collected in 1997 and external health-related criteria (i.e., subjective health status, physician-rated health status, back pain, physical complaints and physical activity in minutes per week) collected in 2002, 2010, and 2015, and separately for males and females. RESULTS: We observed correlations between higher FFB-Mot scores with better subjective health status (in 2002: males, r = 0.25; females, r = 0.18; in 2010: males, r = 0.29; females, r = 0.28; in 2015: males, r = 0.40), and higher physical activity (in 2002: males, r = 0.24; females, r = 0.25; in 2010: males, r = 0.30; females, r = 0.38; in 2015: females, r = 0.27). Higher FFB-Mot scores were also correlated with lower back pain (in 2002: males, r = -0.23; females, r = -0.25; in 2010: females, r = -0.22), less physical complaints (in 2002: males, r = -0.36; females, r = -0.24), and better physician-rated health status (in 2002: males, r = -0.41; females, r = -0.29, 2010: males, r = -0.38; females, r = -0.44; in 2015: males, r = -0.47). CONCLUSIONS: Our results suggest that the FFB-Mot to assess fitness in adults has predictive validity for health-related outcomes as indicated by significant correlations, albeit some effect sizes are small. The FFB-Mot may be used as one-time assessment of self-reported fitness, or for repeated testing to assess change of self-reported fitness over time and in different settings (e.g., public health research).

Arabic Translation of the Knee Outcome Survey-Sports Activities Scale With Cross-cultural Adaptation and Validation.

Background: There are few sports-specific knee functional scales in the Arabic language. The Knee Outcome Survey-Sports Activities Scale (KOS-SAS) is a validated sports-specific patient-reported outcome measure that assesses knee function in an athletic population. Purpose: To provide a validated Arabic version of the KOS-SAS (KOS-SAS-Ar) while achieving cross-cultural adaptation for use in an Arabic-speaking population with sports-related knee disorders. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: There were 2 independent translators who conducted a forward translation of the KOS-SAS, followed by a backward translation by different translators. Subsequently, researchers and expert invitees judged the conceptual content and cultural adaptations of the final translation. A total of 276 patients completed the KOS-SAS-Ar as well as the International Knee Documentation Committee (IKDC) subjective assessment of knee function and a visual analog scale (VAS) for pain. Statistical analysis was performed for test-retest reliability, convergent validity, construct validity, and factor analysis. Results: The test-retest reliability of the KOS-SAS-Ar was high (r = 0.9). The items of the KOS-SAS-Ar had statistically significant internal consistency, with a Cronbach alpha of .924 (P < .0001). The KOS-SAS-Ar Symptoms subscore correlated with the VAS pain score (P < .0001), and the KOS-SAS-Ar Functional Limitations subscore correlated with the IKDC subjective score (P < .0001). The construct validity of the KOS-SAS-Ar was satisfactory (Kaiser-Meyer-Olkin value = 0.868; Bartlett test: P < .0001). Factor analysis showed a statistical correlation among the 11 items of the KOS-SAS-Ar. Conclusion: The KOS-SAS-Ar demonstrated favorable reliability and validity, and it appears to be a suitable tool for Arabic-speaking patients with sports-related knee conditions.

Mitral and Tricuspid Valve Disease in Athletes.

Observing mitral or tricuspid valve disease in an athlete raises many considerations for the clinician. Initially, the etiology must be clarified, with causes differing depending on whether the athlete is young or a master. Notably, vigorous training in competitive athletes leads to a constellation of structural and functional adaptations involving cardiac chambers and atrioventricular valve systems. In addition, a proper evaluation of the athlete with valve disease is necessary to evaluate the eligibility for competitive sports and identify those requiring more follow-up. Indeed, some valve pathologies are associated with an increased risk of severe arrhythmias and potentially sudden cardiac death. Traditional and advanced imaging modalities help clarify clinical doubts, allowing essential information about the athlete's physiology and differentiating between primary valve diseases from those secondary to training-related cardiac adaptations. Remarkably, another application of multimodality imaging is evaluating athletes with valve diseases during exercise to reproduce the sport setting and better characterize the etiology and valve defect mechanism. This review aims to analyze the possible causes of atrioventricular valve diseases in athletes, focusing primarily on imaging applications in diagnosis and risk stratification.

Relationship between cognitive functioning and physical fitness in regard to age and sex.

The aim of this study was to analyze the relationships among physical cognitive ability, academic performance, and physical fitness regarding age and sex in a group of 187 students (53.48% male, 46.52% female) from one town of Norwest of Jaén, Andalusia (Spain), aged between 9 and 15 years old (M = 11.97, SD = 1.99). The D2 attention test was used in order to analyze selective attention and concentration. Physical fitness, reflected on maximal oxygen uptake (VO2max), was evaluated using the 6 min Walking Test (6MWT). The analysis taken indicated a significant relationship between physical fitness level, attention, and concentration, as in the general sample looking at sex (finding differences between boys and girls in some DA score in almost all age categories [p < 0.05]) and at age category (finding some differences between the younger age category groups and the older age category groups in some DA scores (p < 0.05), not finding any significant interaction between sex and age category (p > 0.05). In sum, the present study revealed that students with better aerobic fitness can present better-processed elements and smaller omission errors. Moreover, girls and older students seem to present better cognitive functioning scores than boys and younger. Our findings suggest that more research is necessary to elucidate the cognitive function between ages, sexes, and physical fitness and anthropometry levels of students.

Early postoperative gain in activity levels of lower extremity sarcoma survivors positively affects long-term physical activity and performance.

PURPOSE: Little is known about the effect of sports activity levels on health-related quality of life (HRQOL) in long-term survivors of lower-extremity sarcoma. METHODS: Eighty-three long-term survivors of bone and soft tissue sarcoma of the lower extremities with a median follow-up of 14 (range: 5-35) years completed the University of California and Los Angeles (UCLA) activity scores before tumor resection, 1 year after surgery and at the latest follow-up, as well as a Short Form 36 (SF-36) health survey at the latest follow-up. Simple linear regression models as well as stepwise variable selection with Akaike information criterion (AIC) were undertaken. RESULTS: The preoperative UCLA activity level (median: 9, range: 2-10) dropped to a median of 4 (range: 1-10) 1 year after surgery before increasing to a score of 6 (range: 2-10) 5 years after surgery. The long-term SF-36 physical health component summary score (PCS) was 49 (SD: 9), and the mental health component summary score (MCS) was 54 (SD: 7). A linear model with stepwise variable selection identified a negative correlation of PCS with age at surgery (estimate: -0.2; p = 0.02), UCLA score at the last follow-up (estimate: 1.4; p = 0.02) and UCLA score 1 year after surgery (estimate: 1.0; p = 0.02). CONCLUSION: As not only the final activity levels but also the status immediately after surgery affect the PCS, higher early activity levels should be a goal of modern rehabilitation after sarcoma treatment. Further studies are needed to weigh the potential postoperative risks of higher sport activity levels against the benefits described in this study. LEVEL OF EVIDENCE: Level 4.

Mini-open vs. arthroscopic double tight-rope reconstruction after acute AC-joint dislocation: a comparison in functional outcome and sports activity.

INTRODUCTION: In athletes, acromioclavicular joint disruptions account for up to 50% of all shoulder injuries. In high-grade injuries, surgery is favored to ensure a correct restoration of the joint, especially in young athletes. The aim of this study was to compare the clinical, radiological and sport related outcomes of the arthroscopic stabilization with the fixation of the AC joint in a mini-open approach. MATERIALS AND METHODS: 19 patients treated arthroscopically (ASK) and 26 patients with an acute AC-joint dislocation Rockwood V who had undergone the mini-open (MO) surgery were included. Constant Murley Score (CMS), Taft Score (TS) and the Simple Shoulder Tests (SST) were evaluated. The sports activity level was determined according to Valderrabano and the athlete's recovery of their athletic activity level after surgery according to Rhee. Furthermore, all available X-ray images were analyzed. RESULTS: Patients in the ASK group achieved an average score of 11.7 ± 0.6 points in the SST, 10.3 ± 1.8 points in the TS and 91.2 ± 11.8 points in the CMS. On average, patients in the MO group achieved results of 10.5 ± 1.4 points in the SST, 11.7 ± 0.7 points in the TS and 91.6 ± 9.8 points in the CMS. The ASK group showed significant difference regarding the CC distance in side comparison (Δ = 3.6 mm), whereas no significant difference was found in the MO group (Δ = 0.8 mm). In comparison of both groups, the posterior as well as the combined translation were significantly greater in the ASK group than in the MO group (posterior: ASK: 24.8 mm, MO: 19.3 mm, combined: ASK: 29.1 mm, MO: 20.9 mm). Residual horizontal instability was greater in the ASK group (43%) than in the MO group (32%). Similar results were achieved in sports activity and the recovery of athletic activity (Valderrabano: ASK: 2.8, MO: 2.6; Rhee: ASK: 1.6, MO: 1.5). CONCLUSIONS: Both techniques prove to be effective for the stabilization of high-grade AC-joint disruptions in athletes and showed excellent clinical results. From a radiographic standpoint, the mini-open procedure appears superior to the arthroscopic technique. After mini-open surgery postoperative loss of correction is less common and greater horizontal stability is achieved. The results also suggest the mini-open technique is superior to the arthroscopic procedure when aiming to restore the athlete's original level of sports activity.

Opportunities and drawbacks of the subcutaneous defibrillator across different clinical settings.

INTRODUCTION: The subcutaneous implantable cardioverter-defibrillator (S-ICD) is an established therapy for the prevention of sudden cardiac death (SCD) and an alternative to a transvenous implantable cardioverter-defibrillator system in selected patients. Beyond randomized clinical trials, many observational studies have described the clinical performance of S-ICD across different subgroups of patients. AREAS COVERED: Our review aimed to describe the opportunities and drawbacks of the S-ICD, focusing on their use in special populations and across different clinical settings. EXPERT OPINION: The choice to implant S-ICD should be based on the patient's tailored approach, which takes into account the adequate S-ICD screening at rest or during stress, the infective risk, the ventricular arrhythmia susceptibility, the progressive nature of the underlying disease, the work or sports activity, and the risk of lead-related complications.

Sudden Cardiac Arrest During Sports Activity in Older Adults.

BACKGROUND: Sports activity among older adults is rising, but there is a lack of community-based data on sports-related sudden cardiac arrest (SrSCA) in the elderly. OBJECTIVES: In this study, the authors investigated the prevalence and characteristics of SrSCA among subjects ≥65 years of age in a large U.S. METHODS: All out-of-hospital sudden cardiac arrests (SCAs) were prospectively ascertained in the Portland, Oregon, USA, metro area (2002-2017), and Ventura County, California, USA (2015-2021) (catchment population ∼1.85 million). Detailed information was obtained for SCA warning symptoms, circumstances, and lifetime clinical history. Subjects with SCA during or within 1 hour of cessation of sports activity were categorized as SrSCA. RESULTS: Of 4,078 SCAs among subjects ≥65 years of age, 77 were SrSCA (1.9%; 91% men). The crude annual SrSCA incidence among age ≥65 years was 3.29/100,000 in Portland and 2.10/100,000 in Ventura. The most common associated activities were cycling, gym activity, and running. SrSCA cases had lower burden of cardiovascular risk factors (P = 0.03) as well as comorbidities (P < 0.005) compared with non-SrSCA. Based on conservative estimates of community residents ≥65 years of age who participate in sports activity, the SrSCA incidence was 28.9/100,000 sport participation years and 18.4/100,000 sport participation years in Portland and Ventura, respectively. Crude survival to hospital discharge rate was higher in SrSCA, but the difference was nonsignificant after adjustment for confounding factors. CONCLUSIONS: Among free-living community residents age ≥65 years, SrSCA is uncommon, predominantly occurs in men, and is associated with lower disease burden than non-SrSCA. These results suggest that the risk of SrSCA is low, and probably outweighed by the high benefit of exercise.

Sports-related sudden cardiac arrest in young adults.

AIMS: Data on sports-related sudden cardiac arrest (SrSCA) among young adults in the general population are scarce. We aimed to determine the overall SrSCA incidence, characteristics, and outcomes in young adults. METHODS AND RESULTS: Prospective cohort study of all cases of SrSCA between 2012 and 2019 in Germany and Paris area, France, involving subjects aged 18-35 years. Detection of SrSCA was achieved via multiple sources, including emergency medical services (EMS) reporting and web-based screening of media releases. Cases and aetiologies were centrally adjudicated. Overall, a total of 147 SrSCA (mean age 28.1 ± 4.8 years, 95.2% males) occurred, with an overall burden of 4.77 [95% confidence interval (CI) 2.85-6.68] cases per million-year, including 12 (8.2%) cases in young competitive athletes. While bystander cardiopulmonary resuscitation (CPR) was initiated in 114 (82.6%), automated external defibrillator (AED) use by bystanders occurred only in a minority (7.5%). Public AED use prior to EMS arrival (odds ratio 6.25, 95% CI 1.48-43.20, P = 0.02) was the strongest independent predictor of survival at hospital discharge (38.1%). Among cases that benefited from both immediate bystander CPR and AED use, survival rate was 90.9%. Coronary artery disease was the most frequent aetiology (25.8%), mainly through acute coronary syndrome (86.9%). CONCLUSION: Sports-related sudden cardiac arrest in the young occurs mainly in recreational male sports participants. Public AED use remains disappointingly low, although survival may reach 90% among those who benefit from both bystander CPR and early defibrillation. Coronary artery disease is the most prevalent cause of SrSCA in young adults.

Total knee arthroplasty improves sports activity and the patient-reported functional outcome at mid-term follow-up.

PURPOSE: The purpose of this study was to assess (1) sports participation and preference for the type of sports activity after TKA, (2) mid-term functional outcome and activity level, (3) correlation of different age groups with activity level and functional outcomes, and (4) mid-term survivorship of the prosthesis. METHODS: A retrospective review of prospectively collected data was performed. 182 patients were included who underwent primary TKA between January 2010 and December 2016. Inclusion criteria were symptomatic knee osteoarthritis, age 50-90 years, and with a minimum of 5-year follow-up after TKA. Patients with rheumatoid arthritis and revision TKA were excluded. Sports participation and sports preference, Oxford Knee Score (OKS), Tegner Activity Level, and Visual Analogue Scale (VAS) for pain were recorded pre- and postoperatively at 6 months, 1 year, 2 years, and 5 years. The patient cohort was subdivided according to age groups; activity levels, patient-reported outcomes, and improvement in knee pain were correlated with these age groups. Kaplan-Meier curves were used to investigate survivorship at a minimum of 5 years. RESULTS: The mean age of the cohort was 75.6 ± 7.2 years (range 52-89). Significant improvement was noted in sports participation (p < 0.003). After TKA, there was no change in the preference for sports and none of the patients had to discontinue their sporting activity. OKS improved significantly at all follow-up time points compared to the preoperative score (p < .0001). Patients' sports and physical activity improved significantly at 1 year compared to the preoperative activity level (p < 0.001). Although the Tegner activity level improved over time, this improvement was not significant (NS), while it was significantly higher in males than in females (p < 0.004). Significant improvement was found in the VAS for pain at all follow-up time points compared to the preoperative score (p < .0001). Survivorship was found to be 100% at a 5-year follow-up. CONCLUSION: After TKA, patients can be able to return to sporting activity or even perform better than before surgery. Maximum improvement was noted in the first post-operative year. The male and younger groups perform better than the female and older groups. Sports and physical activity do not negatively impact survivorship of the knee prosthesis at mid-term follow-up and all patients are encouraged to take up sports participation after their TKA. LEVEL OF EVIDENCE: Level 3.

Factors affecting return to sports after eccentric rotational acetabular osteotomy.

BACKGROUND: Although eccentric acetabular rotation osteotomy (ERAO) is an effective treatment for developmental dysplasia of the hip (DDH), there is little information about return to sports after ERAO. This study aimed to investigate 1) the patient factors that influence the return to sports after ERAO, 2) whether postoperative sports participation will affect future osteoarthritis progression. HYPOTHESIS: Some factors affect the return to sports after ERAO. PATIENTS AND METHODS: Of 503 patients who underwent ERAO from 1990 to 2010, 124 who had been continuously participating in sports preoperatively (average 13.2 years after surgery) were included. Patient demographics of sex, age, body mass index, unilateral to bilateral case ratio, history of treatment for childhood DDH, preoperative Kellgren-Lawrence (KL) grade, center edge angle, joint congruency, Harris hip score, complications and the survival rate were compared between the S group (patients who participated in the same sports preoperatively) and N group (patients who could not participate in sports postoperatively). RESULTS: Seventy-two (58%) and 52 patients (42%) in the S and N groups, respectively, had an overall return to sports rate of 64% (79 patients). The most common sports that patients participated in were swimming (30 patients [24%]), jogging (12 [10%]), and golf (10 [8%]) preoperatively, and swimming (14 patients [11%]), golf (8 [6%]), and jogging (8 [6%]) postoperatively. There were no significant differences between both groups in terms of sex, age, body mass index, unilateral to bilateral case ratio, history of treatment for childhood DDH, preoperative KL grade, and joint congruency. There was a significant difference in patient factors between the S (11 joints [14%]) and N (20 joints [38%]) groups only when the preoperative center edge angle was <0°. There was no significant difference in the preoperative Harris hip score and the final survey between the S (73.2±4.6 and 93.4±7.2) and N (72.5±4.8 and 92.1±7.4) groups. Complications showed no significant differences between the five patients (7%) in the S group and six patients (13%) in the N group. The KL grade progressed in 10 cases (grade II to III in 2 cases and grade III to IV in 8) in the S group and 8 cases (grade II to III in 1 case and grade III to IV in 7 cases) in the N group. The 10-year and 20-year joint survival rates with THA conversion as the endpoint were 98.1% (95% CI: 87.4%-99.7%) and 83.7% (95% CI: 62.6%-93.4%) in the S group and 100% (95% CI: 70.7%-99.3%) and 95.2% (95% CI: 12.6%-92.6%) in the N group, respectively. In the evaluation of factors affecting sports return by logistic regression analysis, only one significant factor (odds ratio 3.42, 95% confidence interval: 1.58-7.42, p<0.01) was the preoperative center edge angle <0°. DISCUSSION: The chief factor affecting the return to sports after surgery was a preoperative center edge angle <0°; moreover, the continuation of sports did not affect the subsequent progression of osteoarthritis or THA conversion. LEVEL OF EVIDENCE: level III, cohort study.

Predicting VO2max in Children and Adolescents Aged between 6 and 17 Using Physiological Characteristics and Participation in Sport Activities: A Cross-Sectional Study Comparing Different Regression Models Stratified by Gender.

Background: The aim of this study is to use different regression models to capture the association between cardiorespiratory fitness VO2max (measured in mL/kg/min) and somatometric characteristics and sports activities and making better predictions. Methods: multiple linear regression (MLR), quantile regression (QR), ridge regression (RR), support vector regression (SVR) with three different kernels, artificial neural networks (ANNs), and boosted regression trees (RTs) were compared to explain and predict VO2max and to choose the best performance model. The sample consisted of 4908 children (2314 males and 2594 females) aged between 6 and 17. Cardiorespiratory fitness was assessed by the 20 m maximal multistage shuttle run test and maximal oxygen uptake (VO2max) was calculated. Welch t-tests, Mann−Whitney-U tests, X2 tests, and ANOVA tests were performed. The performance measures were root mean square error (RMSE), mean absolute error (MAE), and coefficient of determination (R2). All analyses were stratified by gender. Results: A comparison of the statistical indices for both the predicted and actual data indicated that in boys, the MLR model outperformed all other models in all indices, followed by the linear SVR model. In girls, the MLR model performed better than the other models in R2 but was outperformed by SVR-RBF in terms of RMSE and MAE. The overweight and obesity categories in both sexes (p < 0.001) and maternal prepregnancy obesity in girls had a significant negative effect on VO2max. Age, weekly football training, track and field, basketball, and swimming had different positive effects based on gender. Conclusion: The MLR model showed remarkable performance against all other models and was competitive with the SVR models. In addition, this study's data showed that changes in cardiorespiratory fitness were dependent, to a different extent based on gender, on BMI category, weight, height, age, and participation in some organized sports activities. Predictors that are not considered modifiable, such as gender, can be used to guide targeted interventions and policies.