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ABSTRACT Introduction Modern basketball is very competitive and enjoyable; it combines several factors. Basketball requires specific physical characteristics such as high stature, which raises the position of the center of gravity, making the stability angle smaller. This compromises stability, especially in sudden speed and direction changes, because it requires a large base opening. The core musculature is intimately involved with body balance; however, there is a lack of studies verifying the impact of specific training of this region on balance in basketball athletes. Objective To explore the influence of core strengthening on the physical fitness of college basketball players. Methods 12 college basketball players were selected and randomly divided into a control group and an experimental group. The experimental group performed core strengthening training, while the control group practiced traditional strength training. After six weeks, physical fitness and basic skills were compared between the groups. Data were statistically treated and discussed confronting the literature. Results Basketball players in the experimental group obtained higher fast dribbling passes and shots than before the experiment (P<0.05), there was no statistically significant difference in several indicators in the control group ( P>0.05); Basketball players in the experimental group had higher fast dribbling passes and shots than the control group (P<0.05), there was no statistically significant difference in approach height between the experimental group and the control group (P>0.05). Conclusion Core strengthening training can improve the physical fitness of college basketball players. Evidence level II; Therapeutic Studies - Investigating the results.
RESUMO Introdução O basquete moderno é muito competitivo e prazeroso, é uma combinação de vários fatores. O basquetebol exige características físicas específicas como a alta estatura, que eleva a posição do centro de gravidade, tornando o ângulo de estabilidade menor. Isso compromete a estabilidade, principalmente nas mudanças repentinas de velocidade e direção pois exige grande abertura de base. A musculatura do core está intimamente envolvida com o equilíbrio corporal, entretanto faltam estudos verificando o impacto do treino específico dessa região no equilíbrio em atletas de basquetebol. Objetivo Explorar a influência do fortalecimento do core na aptidão física dos jogadores universitários de basquete. Métodos 12 universitários jogadores de basquete foram selecionados e aleatoriamente divididos em grupo controle e grupo experimental. O experimental realizou treino fortalecimento do core, enquanto o controle praticava treinamento de força tradicional. Após seis semanas, comparou-se a aptidão física e habilidades básicas entre os grupos. Os dados foram tratados estatisticamente e discutidos confrontando a literatura. Resultados Os jogadores de basquete do grupo experimental obtiveram maiores passes rápidos de drible e arremessos do que antes do experimento (P<0,05), não houve diferença estatisticamente significativa em vários indicadores no grupo controle ( P>0,05); Os jogadores de basquete do grupo experimental apresentaram maiores passes e arremessos de drible rápido do que o grupo controle (P<0,05), não houve diferença estatisticamente significativa na altura de aproximação entre o grupo experimental e o grupo controle (P>0,05). Conclusão O treino de fortalecimento do core pode melhorar a aptidão física de jogadores universitários de basquete. Nível de evidência II; Estudos terapêuticos - Investigação de resultados.
RESUMEN Introducción El baloncesto moderno es muy competitivo y divertido, es una combinación de varios factores. El baloncesto exige características físicas específicas como la alta estatura, que eleva la posición del centro de gravedad, haciendo que el ángulo de estabilidad sea menor. Esto compromete la estabilidad, sobre todo en los cambios bruscos de velocidad y dirección, porque exige una gran apertura de la base. Los músculos del core están íntimamente implicados con el equilibrio corporal, sin embargo, faltan estudios que verifiquen el impacto del entrenamiento específico de esta región sobre el equilibrio en los deportistas de baloncesto. Objetivo Explorar la influencia del fortalecimiento del núcleo en la aptitud física de los jugadores universitarios de baloncesto. Métodos Se seleccionaron 12 jugadores de baloncesto universitario y se dividieron aleatoriamente en un grupo de control y un grupo experimental. Los experimentales realizaron un entrenamiento de fortalecimiento del núcleo, mientras que los de control practicaron un entrenamiento de fuerza tradicional. Después de 6 semanas, se comparó la aptitud física y las habilidades básicas entre los grupos. Los datos fueron tratados estadísticamente y discutidos confrontándolos con la literatura. Resultados Los jugadores de baloncesto del grupo experimental obtuvieron pases y tiros rápidos más altos que antes del experimento (P<0,05), no hubo diferencias estadísticamente significativas en varios indicadores en el grupo de control ( P>0,05); Los jugadores de baloncesto del grupo experimental tuvieron pases y tiros rápidos más altos que el grupo de control (P<0,05), no hubo diferencias estadísticamente significativas en la altura de aproximación entre el grupo experimental y el grupo de control (P>0,05). Conclusión El entrenamiento de fortalecimiento del núcleo puede mejorar la condición física de los jugadores de baloncesto universitarios. Nivel de evidencia II; Estudios terapéuticos - Investigación de resultados.
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Humanos , Masculino , Adulto Jovem , Basquetebol/fisiologia , Aptidão Física/fisiologia , Centro Abdominal/fisiologia , Estudantes , UniversidadesRESUMO
BACKGROUND: Sex is emerging as an important clinical variable associated with surgical outcomes and decision making. However, its relevance in regard to baseline and treatment differences in primary and incisional ventral hernia repair remains unclear. STUDY DESIGN: This is a retrospective cohort study using the Abdominal Core Health Quality Collaborative database to identify elective umbilical, epigastric, or incisional hernia repairs. Propensity matching was performed to investigate confounder-adjusted treatment differences between men and women. Treatments of interest included surgical approach (minimally invasive or open), mesh use, mesh type, mesh position, anesthesia type, myofascial release, fascial closure, and fixation use. RESULTS: A total of 8,489 umbilical, 1,801 epigastric, and 16,626 incisional hernia repairs were identified. Women undergoing primary ventral hernia repair were younger (umbilical 46.4 vs 54 years, epigastric 48.7 vs 52.7 years), with lower BMI (umbilical 30.4 vs 31.5, epigastric 29.2 vs 31.1), and less likely diabetic (umbilical 9.9% vs 11.4%, epigastric 6.8% vs 8.8%). Women undergoing incisional hernia repair were also younger (mean 57.5 vs 59.1 years), but with higher BMI (33.1 vs 31.5), and more likely diabetic (21.4% vs 19.1%). Propensity-matched analysis included 3,644 umbilical, 1,232 epigastric, and 12,480 incisional hernias. Women with incisional hernia were less likely to undergo an open repair (60.2% vs 63.4%, p < 0.001) and have mesh used (93.8% vs 94.8%, p = 0.02). In umbilical and incisional hernia repairs, women had higher rates of intraperitoneal mesh placement and men had higher rates of preperitoneal and retro-muscular mesh placement. CONCLUSIONS: Small but statistically significant treatment differences in operative approach, mesh use, and mesh position exist between men and women undergoing ventral hernia repair. It remains unknown whether these treatment differences result in differing clinical outcomes.
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Hérnia Ventral , Hérnia Incisional , Centro Abdominal , Feminino , Hérnia Ventral/cirurgia , Humanos , Hérnia Incisional/cirurgia , Masculino , Estudos Retrospectivos , Telas CirúrgicasRESUMO
BACKGROUND: Umbilical and epigastric hernias are among the top three most common hernia surgeries performed in the USA with varied techniques. The European and Americas Hernia Societies (EAHS) recently published guidelines for repair of umbilical and epigastric hernias. We evaluated how closely the general surgeons of the Abdominal Core Health Quality Collaborative (ACHQC) follow these guidelines and to identify areas for possible improvement. METHOD: Data from patients undergoing elective and emergent umbilical or epigastric hernia repair from 2013 to 2021 were extracted from the ACHQC database. The procedures performed on eligible subjects were compared to those proposed by the EAHS guidelines. Data was reported as a percentage and a cutoff of 70% was selected to determine compliance. RESULTS: Based on these criteria, 11,088 patients were included and most of the recommendations, including appropriate preoperative antibiotic dosing (96.1% umbilical; 97.2% epigastric), permanent mesh selection (umbilical 97.8%; 96.1 epigastric), mesh fixation with suture (83.6% umbilical; 75.5% epigastric), use of mesh for open repair of hernias greater than 1 cm (83.6 umbilical; 85.7 epigastric), and primary defect closure during open (98.6% umbilical; 97.5% epigastric) and laparoscopic (99.6% umbilical; 100% epigastric) repair, were met. DISCUSSION: Surgeons of the ACHQC adhere to most of the published guidelines on umbilical and epigastric hernia repair. Further research is needed to reinforce or modify the existing recommendations. Standardization of surgical approach will facilitate additional research needed to improve procedural efficiency, while reducing negative outcomes and cost.
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Hérnia Abdominal , Hérnia Umbilical , Hérnia Ventral , Laparoscopia , Cirurgiões , Centro Abdominal , Antibacterianos , Hérnia Abdominal/cirurgia , Hérnia Umbilical/cirurgia , Hérnia Ventral/cirurgia , Herniorrafia/métodos , Humanos , Telas CirúrgicasRESUMO
PURPOSE: Patients with a history of cancer-related abdominal surgery undergoing incisional hernia repair (IHR) are highly heterogenous and increasingly prevalent. We explored whether cancer surgery should be considered an independent risk factor for worse IHR perioperative outcomes. METHODS: Patients undergoing IHR between 2018 and 2020 were identified within the Abdominal Core Health Quality Collaborative (ACHQC). Regression models were used to assess associations between cancer operation history and 30 d surgical site occurrences-exclusive of infection (SSO-EIs), surgical site infections (SSIs), reoperations, time to recurrence, and quality of life (QoL) scores. Cancer cohort subgroup analysis was performed for operative approach and mesh location. RESULTS: 8019 patients who underwent IHR were identified in the ACHQC, 1321 of which had a history of cancer operation. Cancer cohort patients were more likely to be older, males with a higher ASA status and lower BMI, and have longer and wider hernias (p < 0.001). After adjusting for confounding, the cancer cohort was less likely to experience SSO-EIs (OR 0.74, 95% CI 0.59-0.94 p = 0.0092) and showed lower odds of SSIs, reoperations, and recurrence (SSI OR 0.7, 95% CI 0.47-1.05, p = 0.0542; reoperation OR 0.66, 95% CI 0.37-1.17, p = 0.1002; recurrence OR 0.8, 95% CI 0.63-1.02, p = 0.08). There was no difference in postoperative QoL scores between cohorts. There were also no differences in perioperative or QoL outcomes within the cancer cohort based on operative approach or mesh location. CONCLUSION: These data show no evidence that history of cancer operation predisposes patients to worse incisional hernia repair perioperative or quality of life outcomes.
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Hérnia Ventral , Hérnia Incisional , Neoplasias , Centro Abdominal , Hérnia Ventral/complicações , Hérnia Ventral/cirurgia , Herniorrafia/efeitos adversos , Humanos , Hérnia Incisional/epidemiologia , Hérnia Incisional/etiologia , Hérnia Incisional/cirurgia , Masculino , Neoplasias/complicações , Neoplasias/cirurgia , Qualidade de Vida , Recidiva , Telas Cirúrgicas/efeitos adversos , Infecção da Ferida Cirúrgica/cirurgiaRESUMO
BACKGROUND: This article seeks to be a collection of evidence and experience-based information for health care providers around the country and world looking to build or improve an abdominal core health center. Abdominal core health has proven to be a chronic condition despite advancements in surgical technique, technology, and equipment. The need for a holistic approach has been discussed and thought to be necessary to improve the care of this complex patient population. METHODS: Literature relevant to the key aspects of building an abdominal core health center was thoroughly reviewed by multiple members of our abdominal core health center. This information was combined with our authors' experiences to gather relevant information for those looking to build or improve a holistic abdominal core health center. RESULTS: An abundance of publications have been combined with multiple members of our abdominal core health centers members experience's culminating in a wide breadth of information relevant to those looking to build or improve a holistic abdominal core health center. CONCLUSIONS: Evidence- and experience-based information has been collected to assist those looking to build or grow an abdominal core health center.
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Centro Abdominal , Saúde Holística , Instituições de Assistência Ambulatorial , HumanosRESUMO
PURPOSE: Bowel injury during laparoscopic and robotic ventral hernia repair is a rare but potentially serious complication. We sought to compare bowel injury rates during minimally invasive approaches to ventral hernia repair using a national hernia registry. METHODS: Patients undergoing elective laparoscopic and robotic ventral hernia repair (including cases converted-to-open) between 2013 and 2021 were retrospectively identified in the Abdominal Core Health Quality Collaborative registry. The primary outcome was bowel injury, which included partial- and full-thickness injuries and re-operations for missed enterotomies. Statistical analysis was performed using multivariate logistic regression. RESULTS: Overall, 10,660 patients were included (4116 laparoscopic, 6544 robotic). The laparoscopic group included more incisional hernias (68% vs 62%, p < 0.001) and similar rates of recurrent hernias (23% vs 22%, p = 0.26). A total of 109 bowel injuries were identified, with more occurring in the laparoscopic group (55 [1.3%] laparoscopic vs. 54 [0.8%] robotic; p = 0.01). Specifically, there were more full-thickness and missed enterotomies in the laparoscopic group (29 laparoscopic vs. 20 robotic; p = 0.012). Bowel injury resulted in higher rates of wound morbidity and major post-operative complications including sepsis, re-admission, and re-operation. Following adjustment for recurrent and incisional hernias, prior mesh, patient age, and hernia width, bowel injury during laparoscopic repair remained significantly more likely than bowel injury during robotic repair (OR 1.669 [95% C.I.: 1.141-2.440]; p = 0.008). CONCLUSION: In a large registry, laparoscopic ventral hernia repair is associated with an increased risk of bowel injury compared to repairs utilizing the robotic platform. Knowing the limitations of retrospective research, large national registries are well suited to explore rare outcomes which cannot be feasibly assessed with randomized controlled trials.
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Traumatismos Abdominais , Hérnia Ventral , Hérnia Incisional , Laparoscopia , Procedimentos Cirúrgicos Robóticos , Centro Abdominal , Traumatismos Abdominais/cirurgia , Hérnia Ventral/etiologia , Hérnia Ventral/cirurgia , Herniorrafia/efeitos adversos , Herniorrafia/métodos , Humanos , Hérnia Incisional/cirurgia , Laparoscopia/efeitos adversos , Estudos Retrospectivos , Procedimentos Cirúrgicos Robóticos/efeitos adversos , Telas CirúrgicasRESUMO
BACKGROUND: Surgeons are increasingly utilizing telemedicine to provide perioperative services to patients. Safety, satisfaction, and feasibility of these programs in general populations have been established, but it is unclear how telemedicine can be integrated into subspecialty care. We report results of a national survey related to telehealth practices among members of the Abdominal Core Health Quality Collaborative (ACHQC). METHODS: Survey responses were analyzed to determine current strategies in telemedicine utilization. Surgeon preferences, perceptions of validity, and identified barriers to implementation of telemedicine were assessed. RESULTS: Forty surgeons within the ACHQC responded, with 90% of respondents reporting use of telemedicine to deliver perioperative care to patients with hernias and abdominal core health concerns. Surgeons appeared to be more comfortable managing preoperative patients with image-confirmed diagnoses of hernias. Surgeons were universally more comfortable delivering postoperative care via telemedicine. Connectivity, patient engagement, and reimbursement were identified as potential barriers to expansion of telemedicine. Seventy-eight percent of respondents reported that they would increase telemedicine utilization if current regulations were maintained in the future. CONCLUSIONS: This study found that hernia specialists are utilizing telemedicine at a higher rate than before the COVID-19 pandemic, with surgeons reporting interest in continued use of this modality beyond the pandemic. These findings suggest that future work in telemedicine optimization may improve the quality of care that can be delivered to patients with abdominal core health concerns.
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COVID-19 , Cirurgiões , Telemedicina , Centro Abdominal , Hérnia , Humanos , Pandemias , SARS-CoV-2RESUMO
OBJECTIVE: To evaluate the effect of birth ball abdominal core training on fatigue, waist pain, and delivery outcomes in middle and late pregnancy. METHODS: A prospective study of 209 primipara in total with 24-27 weeks of gestation were recruited and divided into the training group (109 cases) and the control group (100 cases). The control group received routine prenatal exercise. On the basis of routine prenatal exercise, pregnant women in the training group were given birth ball exercises based on abdominal core training. The difference in pregnancy fatigue, waist discomfort, and delivery outcomes between the two groups were compared. RESULTS: The waist pain and fatigue ratings of women were significantly lower and the vaginal delivery rate (74.3%) was significantly higher (62%) (P < 0.001) in the training group. There were no significant differences in the total stage of labor, postpartum hemorrhage, neonatal weight and 1-min neonatal Apgar score between the two groups. The rate of episiotomy in the training group (14.7%) was significantly lower than that in the control group (25.0%) (P < 0.05). CONCLUSION: Birth ball exercises can relieve fatigue and waist pain in middle and late 2021 pregnancy, reduce the rate of episiotomy, and promote spontaneous vaginal delivery.
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Centro Abdominal , Trabalho de Parto , Fadiga/etiologia , Fadiga/prevenção & controle , Feminino , Humanos , Recém-Nascido , Dor , Gravidez , Estudos ProspectivosRESUMO
BACKGROUND: Diastasis recti abdominis (DRA) is a condition affecting many post-partum women. The aim of this study was to evaluate long-term results of surgical repair of DRA in a cohort of post-partum women. METHODS: Sixty post-partum women with DRA and training-resistant core dysfunctions were included. Surgical repair was performed with suture plication of the linea alba. Abdominal core function was evaluated with the abdominal trunk function protocol (ATFP) including a self-report questionnaire and seven functional tests. Urinary incontinence and quality of life were evaluated with the Urogenital Distress Inventory (UDI-6), the Incontinence Impact Questionnaire (IIQ-7) and the SF-36 questionnaire. Follow-up was performed at 1 and 3 years after surgery. RESULTS: Response rate at the 3-year follow-up was 86.7 per cent for the disability rating index (DRI) questionnaire; and 71.7 per cent for the ATFP, UDI-6, IIQ-7 and SF-36 questionnaires. All DRI parameters were improved (P < 0.001) after 3 years of follow-up compared with preoperative values. The functional tests in the ATFP showed an improvement in core muscle strength and stability (P < 0.001), back muscle strength (P < 0.001) and abdominal muscle strength (P = 0.002) compared to preoperative values as well as an improvement of core muscle strength and stability compared with the 1-year follow-up values (P = 0.003). UDI-6 and IIQ-7 results were improved (P < 0.001 and P = 0.004) compared with preoperative values and showed consistent values compared with the 1-year follow-up (P = 0.09 and P = 1.0). Quality of life measured with SF-36 was improved compared with preoperative values and showed consistent values compared with the 1-year follow-up. CONCLUSION: The functional improvement of surgical reconstruction of the DRA persisted for 3 years in this series of post-partum women with DRA.
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Diástase Muscular , Qualidade de Vida , Centro Abdominal , Feminino , Seguimentos , Humanos , Reto do Abdome/cirurgiaRESUMO
BACKGROUND: Diastasis of the rectus abdominis muscle is a common condition. There are no generally accepted criteria for diagnosis or treatment of diastasis of the rectus abdominis muscle, which causes uncertainty for the patient and healthcare providers alike. METHODS: The consensus document was created by a group of Swedish surgeons and based on a structured literature review and practical experience. RESULTS: The proposed criteria for diagnosis and treatment of diastasis of the rectus abdominis muscle are as follows: (1) Diastasis diagnosed at clinical examination using a caliper or ruler for measurement. Diagnostic imaging by ultrasound or other imaging modality, should be performed when concurrent umbilical or epigastric hernia or other cause of the patient's symptoms cannot be excluded. (2) Physiotherapy is the firsthand treatment for diastasis of the rectus abdominis muscle. Surgery should only be considered in diastasis of the rectus abdominis muscle patients with functional impairment, and not until the patient has undergone a standardized 6-month abdominal core training program. (3) The largest width of the diastasis should be at least 5 cm before surgical treatment is considered. In case of pronounced abdominal bulging or concomitant ventral hernia, surgery may be considered in patients with a smaller diastasis. (4) When surgery is undertaken, at least 2 years should have elapsed since last childbirth and future pregnancy should not be planned. (5) Plication of the linea alba is the firsthand surgical technique. Other techniques may be used but have not been found superior. DISCUSSION: The level of evidence behind these statements varies, but they are intended to lay down a standard strategy for treatment of diastasis of the rectus abdominis muscle and to enable uniformity of management.