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1.
Br J Sports Med ; 56(14): 812-817, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35387776

RESUMO

OBJECTIVE: The efficacious Activate injury prevention exercise programme has been shown to prevent injuries in English schoolboy rugby union. There is now a need to assess the implementation and effectiveness of Activate in the applie setting. METHODS: This quasi-experimental study used a 24-hour time-loss injury definition to calculate incidence (/1000 hours) and burden (days lost/1000 hours) for individuals whose teams adopted Activate (used Activate during season) versus non-adopters. The dose-response relationship of varying levels of Activate adherence (median Activate sessions per week) was also assessed. Player-level rugby exposure, sessional Activate adoption and injury reports were recorded by school gatekeepers. Rate ratios (RR), adjusted by cluster (team), were calculated using backwards stepwise Poisson regression to compare rates between adoption and adherence groups. RESULTS: Individuals in teams adopting Activate had a 23% lower match injury incidence (RR 0.77, 95% CI 0.55 to 1.07), 59% lower training injury incidence (RR 0.41, 95% CI 0.17 to 0.97) and 26% lower match injury burden (95% CI 0.46 to 1.20) than individuals on non-adopting teams. Individuals with high Activate adherence (≥3 sessions per week) had a 67% lower training injury incidence (RR 0.33, 95% CI 0.12 to 0.91) and a 32% lower match injury incidence (RR 0.68, 95% CI 0.50 to 0.92) than individuals with low adherence (<1 session per week). While 65% of teams adopted Activate during the season, only one team used Activate three times per week, using whole phases and programme progressions. CONCLUSION: Activate is effective at preventing injury in English schoolboy rugby. Attention should focus on factors influencing programme uptake and implementation, ensuring Activate can have maximal benefit.


Assuntos
Traumatismos em Atletas , Concussão Encefálica , Futebol Americano , Traumatismos em Atletas/epidemiologia , Traumatismos em Atletas/prevenção & controle , Concussão Encefálica/prevenção & controle , Terapia por Exercício , Futebol Americano/lesões , Humanos , Incidência , Rugby
2.
Int J Sport Nutr Exerc Metab ; 32(5): 334-341, 2022 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-35487576

RESUMO

Ketone ingestion can alter metabolism but effects on exercise performance are unclear, particularly with regard to the impact on intermittent-intensity exercise and team-sport performance. Nine professional male rugby union players each completed two trials in a double-blind, randomized, crossover design. Participants ingested either 90 ± 9 g carbohydrate (CHO; 9% solution) or an energy matched solution containing 20 ± 2 g CHO (3% solution) and 590 mg/kg body mass ß-hydroxybutyrate monoester (CHO + BHB-ME) before and during a simulated rugby union-specific match-play protocol, including repeated high-intensity, sprint and power-based performance tests. Mean time to complete the sustained high-intensity performance tests was reduced by 0.33 ± 0.41 s (2.1%) with CHO + BHB-ME (15.53 ± 0.52 s) compared with CHO (15.86 ± 0.80 s) placebo (p = .04). Mean time to complete the sprint and power-based performance tests were not different between trials. CHO + BHB-ME resulted in blood BHB concentrations that remained >2 mmol/L during exercise (p < .001). Serum lactate and glycerol concentrations were lower after CHO + BHB-ME than CHO (p < .05). Coingestion of a BHB-ME with CHO can alter fuel metabolism (attenuate circulating lactate and glycerol concentrations) and may improve high-intensity running performance during a simulated rugby match-play protocol, without improving shorter duration sprint and power-based efforts.


Assuntos
Desempenho Atlético , Carboidratos da Dieta , Método Duplo-Cego , Ingestão de Alimentos , Glicerol , Humanos , Cetonas , Ácido Láctico , Masculino , Rugby
3.
Eur J Appl Physiol ; 121(12): 3551-3559, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34542671

RESUMO

PURPOSE: To investigate the effects of cross-education (CE) exercise on strength and performance at 10 and 24 weeks post anterior cruciate ligament (ACL) surgery. METHODS: Design: randomised controlled trial. N = 44 ACL-reconstruction patients, randomly-allocated into: CE: strength training of the non-operative limb, or CON: sham exercise of upper limb stretching. Each patient underwent standardised ACL rehabilitation, plus 8 weeks of thrice weekly CE or CON, commencing at 2 weeks post surgery. The primary outcome was quadriceps peak force (QPF) of the ACL-reconstructed limb at 10 weeks post surgery. Secondary measures were hamstrings peak force (HPF), rate of force development (RFD) and International Knee Documentation Committee score (IKDC) at 10 and 24 weeks; QPF and hop for distance (HOP) at 24 weeks post surgery. RESULTS: CE significantly attenuated the decline in QPF of the ACL-reconstructed limb at 10 weeks compared to CON (16.6% decrease vs. 32.0%, respectively); that advantage was not retained at 24 weeks. A training effect was observed in the trained limb for HPF and QPF, which was retained at 24 weeks. No significant differences were observed for IKDC, HOP, RFD, or HPF of the reconstructed limb. Inter-limb symmetry (ILS) ranged from 0.78 to 0.89 and was not significantly different between groups. CONCLUSION: High-intensity CE strength training attenuated the post-operative decline in QPF and should be considered in early-phase ACL rehabilitation. ILS data showed good symmetry, but it masked significantly inferior performance between groups and should be used with caution. TRIAL REGISTRATION NUMBER: NCT02722876.


Assuntos
Reconstrução do Ligamento Cruzado Anterior/reabilitação , Força Muscular/fisiologia , Treinamento Resistido , Adulto , Feminino , Humanos , Masculino
4.
Br J Sports Med ; 55(4): 220-225, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31857335

RESUMO

OBJECTIVES: Most concussions in rugby union occur during tackles. We investigated whether legislation to lower maximum tackle height would change tackle behaviour, and reduce concussion incidence rate. METHODS: In an observational evaluation using a prospective cohort design, 12 elite men's teams played in two competitions during the 2018/2019 season. The Championship (90 games) retained standard Laws of Rugby for the tackle; the Championship Cup (36 games) used revised laws-the maximum tackle height was lowered from the line of the shoulders on the ball carrier to the line of the armpits. Videos of tackles were analysed for ball carrier and tackler behaviour. Injury data were collected using standardised methods. RESULTS: In the lowered tackle height setting, there was a significantly lower proportion of tackles; (1) in which ball carriers (rate ratio (RR) 0.83, 95% CI 0.79 to 0.86) and tacklers (RR 0.80, 95% CI 0.76 to 0.84) were upright, (2) in which the tackler's initial contact was to the ball carrier's head or neck (RR 0.70, 95% CI 0.58 to 0.84) and (3) in which initial contact was above the line of the ball carrier's armpit (RR 0.84, 95% CI 0.80 to 0.88). Concussion incidence rate did not differ between conditions (RR 1.31, 95% CI 0.85 to 2.01). Unexpectedly, compared with the standard tackle height setting, tacklers in the lowered tackle height setting were themselves concussed at a higher rate as measured by; (1) incidence (RR 1.90, 95% CI 1.05 to 3.45) and (2) concussions per 1000 tackles (2.09, 95% CI 1.15 to 3.80). CONCLUSIONS: Legislating to lower the height of the tackle meant that tacklers made contact with the ball carrier's head and neck 30% less often. This did not influence concussion incidence rates. Tacklers in the lowered tackle height setting suffered more concussions than did tacklers in the standard tackle height setting.


Assuntos
Concussão Encefálica/prevenção & controle , Futebol Americano/lesões , Traumatismos em Atletas/etiologia , Concussão Encefálica/epidemiologia , Concussão Encefálica/etiologia , Análise de Dados , Futebol Americano/legislação & jurisprudência , Futebol Americano/estatística & dados numéricos , Humanos , Incidência , Masculino , Estudos Prospectivos , Esportes de Equipe , Fatores de Tempo , Gravação em Vídeo
5.
Int J Sports Med ; 42(10): 930-935, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33607666

RESUMO

Concussion is the most common match injury in rugby union. Some players wear padded headgear, but whether this protects against concussion is unclear. In professional male rugby union players, we examined: (i) the association between the use of headgear and match concussion injury incidence, and (ii) whether wearing headgear influenced time to return to play following concussion. Using a nested case-control within a cohort study, four seasons (2013-2017) of injury data from 1117 players at the highest level of rugby union in England were included. Cases were physician-diagnosed concussion injuries. Controls were other contact injuries (excluding all head injuries). We determined headgear use by viewing video footage. Sixteen percent of cases and controls wore headgear. Headgear use had no significant effect on concussion injury incidence (adjusted odds ratio=1.05, 95% CI: 0.71-1.56). Median number of days absent for concussion whilst wearing headgear was 8 days, compared with 7 days without headgear. Having sustained a concussion in the current or previous season increased the odds of concussion more than four-fold (odds ratio=4.55, 95% CI: 3.77-5.49). Wearing headgear was not associated with lower odds of concussions or a reduced number of days' absence following a concussion.


Assuntos
Traumatismos em Atletas/epidemiologia , Concussão Encefálica/epidemiologia , Futebol Americano/lesões , Dispositivos de Proteção da Cabeça , Traumatismos em Atletas/prevenção & controle , Concussão Encefálica/prevenção & controle , Estudos de Casos e Controles , Inglaterra/epidemiologia , Humanos , Incidência , Estudos Longitudinais , Masculino
6.
Surgeon ; 19(2): 111-118, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32349920

RESUMO

BACKGROUND: Optimal management of severe and complex injuries to the medial knee ligaments remains uncertain. This systematic review evaluates outcomes from randomised controlled trials investigating interventions for treating injuries of medial ligaments of the knee. METHODS: Randomised controlled clinical trials evaluating interventions for treating injuries of the medial knee ligaments were identified through searching EMBASE, Medline, Cochrane, WHO, and clinicaltrials.org. Comparisons were made between different non-operative interventions, surgical versus non-operative interventions, different surgical interventions, and different postoperative interventions. Primary outcome measures included patient reported outcome measures (PROM) of knee function, pain, and treatment failure. RESULTS: 412 trial records were identified; 259 were non-redundant and distinct studies, of which eight were included for analysis. No differences between operative and non-operative management strategies were found for either primary outcome: Lysholm and IKDC scores. Compared to non-operative interventions, operative interventions resulted in reduced quadriceps strength at eight weeks (mean difference (MD) 29 (% knee extension strength deficit compared with unaffected knee); 95%CI 3.89-54.11) and were associated with greater incidence of minor complications (relative risk (RR) 25; 95%CI: 1.51-421, and RR 25; 95%CI: 1.50-416.58, respectively). Quadriceps strength between 16 and 52 weeks was similar in non-operative and operative groups (MD 20; 95%CI -1.92-41.92). Functional rehabilitation was associated with reduced valgus laxity at six weeks compared to bracing ((MD) -1.40; 95%CI: -2.21-0.59). CONCLUSIONS: Non-operative interventions provided similar functional results to operative interventions for grade I-III injuries of the medial collateral ligaments. Non-operative intervention was associated with improved quadriceps strength during rehabilitation, and fewer complications, compared to operative interventions.


Assuntos
Traumatismos do Joelho/terapia , Ligamentos Articulares/lesões , Humanos , Ligamentos Articulares/cirurgia , Medidas de Resultados Relatados pelo Paciente , Ensaios Clínicos Controlados Aleatórios como Assunto
7.
J Arthroplasty ; 36(6): 2227-2238, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33589276

RESUMO

BACKGROUND: Primary total knee arthroplasty (TKA) is associated with high patient satisfaction. However, controversy remains regarding the safety and efficacy of conducting simultaneous bilateral (simBTKA) versus staged bilateral TKA (staBTKA). The objective of this systematic review and meta-analysis was to evaluate the current evidence for simBTKA versus staBTKA and compare clinical outcomes including mortality, complications and length of stay (LOS). METHODS: A search was performed of PubMed, MEDLINE, EMBASE and Cochrane central databases between January 2000 and March 2020. Search terms included "simultaneous," "staged," and "bilateral TKA." Inclusion criteria comprised studies comparing outcomes of simBTKA versus staBTKA. Quality of included studies was assessed and meta-analyses of pooled data was conducted. RESULTS: 29 articles published between 2001 and 2020 were included in qualitative synthesis from 927 potentially relevant titles, comprising 257,284 patients. 104,207 patients underwent simBTKA and 153,632 patients underwent staBTKA. simBTKA was associated with significantly increased 90-day mortality rate (P < .00001, OR 2.24, 95% CI 1.79-2.81), increased incidence of pulmonary embolism (P < .00001, OR 1.69, 95% CI 1.51-1.89), venous thrombosis (P < .00001, OR 1.33, 95% CI 1.23-1.43), and neurological complications (P = .002, OR 1.42, 95% CI 1.13-1.77). Incidence of superficial and deep infection was significantly increased with staBTKA (P = .02, P < .00001 respectively). Revision rate within one year was equivocal. Mean LOS was 2.1 days shorter for simBTKA. CONCLUSION: SimBTKA was associated with decreased incidence of infection and LOS but increased incidence of 90-day mortality, venous thromboembolism and neurological complications. Revision rates were equivocal. Patients should be selected and counseled based on the risks respective to each strategy.


Assuntos
Artroplastia do Joelho , Embolia Pulmonar , Artroplastia do Joelho/efeitos adversos , Humanos , Tempo de Internação , Complicações Pós-Operatórias/epidemiologia , Estudos Retrospectivos
8.
J Strength Cond Res ; 35(11): 3164-3169, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31268987

RESUMO

ABSTRACT: Sant'Anna, RT, Roberts, SP, Moore, LJ, and Stokes, KA. Physical demands of refereeing rugby sevens matches at different competitive levels. J Strength Cond Res 35(11): 3164-3169, 2021-The aim of this study was to compare the physical demands of officiating across different competitive levels in rugby sevens. An observational design was used involving 27 referees (26 men and 1 woman, age: 27 ± 6 years, body mass [mean ± SD]: 78.5 ± 9.3 kg, and height: 179 ± 5 cm). Global Navigation Satellite Systems data were collected across a total of 114 matches during 5 separate rugby sevens tournaments played in England-between May and July 2018-categorized into 4 competitive levels: (a) international, (b) professional, (c) semiprofessional, and (d) amateur. Compared with referees officiating at the international, professional, and semiprofessional levels, referees officiating at the amateur level covered less total (p < 0.001) and relative distance (p < 0.001). In addition, these referees covered more distance walking and jogging (p < 0.001). Amateur referees also completed fewer sprints (p = 0.006), repeated high-intensity efforts (RHIEs) per game (p < 0.001), and spent longer between RHIEs (p = 0.015). Finally, for the amateur referees, the duration of the longest repeated high-intensity bout (i.e., worst case scenario) was lower (p < 0.001), with less distance covered (p < 0.001) and fewer high-intensity accelerations (p < 0.001). Refereeing rugby sevens is therefore more physically demanding at higher competitive levels, particularly in terms of high-intensity efforts. The results provide vital information for practitioners involved in the physical preparation of rugby sevens referees.


Assuntos
Rugby , Corrida , Adulto , Feminino , Sistemas de Informação Geográfica , Humanos , Masculino , Caminhada , Adulto Jovem
9.
Am J Respir Crit Care Med ; 199(5): 572-580, 2019 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-30290131

RESUMO

Critical care medicine is far from the first medical field to come to mind when humanitarian action is mentioned, yet both critical care and humanitarian action share a fundamental purpose to save the lives and ease the suffering of people caught in acute crises. Critically ill children and adults will be present regardless of resource limitations and irrespective of geography, regional or cultural contexts, insecurity, or socioeconomic status, and they may be even more prevalent in a humanitarian crisis. Critical care is not limited to the walls of a hospital, and all hospitals will have critically ill patients regardless of designating a specific ward an ICU. Regular and consistent consideration of critical care principles in humanitarian settings provides crucial guidance to intensivists and nonintensivists alike. A multidisciplinary, systematic approach to patient care that encourages critical thinking, checklists that encourage communication among team members, and context-specific critical care rapid response teams are examples of critical care constructs that can provide high-quality critical care in all environments. Promoting critical care principles conveys the message that critical care is an integral part of health care and should be accessible to all, no matter the setting. These principles can be effectively adopted in humanitarian settings by normalizing them to everyday clinical practice. Equally, core humanitarian principles-dignity, accountability, impartiality, neutrality-can be applied to critical care. Applying principles of critical care in a context-specific manner and applying humanitarian principles to critical care can improve the quality of patient care and transcend barriers to resource limitations.


Assuntos
Cuidados Críticos/métodos , Estado Terminal/terapia , Socorro em Desastres , Lista de Checagem , Cuidados Críticos/organização & administração , Acessibilidade aos Serviços de Saúde/organização & administração , Equipe de Respostas Rápidas de Hospitais , Humanos , Equipe de Assistência ao Paciente , Socorro em Desastres/organização & administração , Ressuscitação , Assistência Terminal
10.
Br J Sports Med ; 54(10): 566-572, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32079603

RESUMO

Using an expert consensus-based approach, a rugby union Video Analysis Consensus (RUVAC) group was formed to develop a framework for video analysis research in rugby union. The aim of the framework is to improve the consistency of video analysis work in rugby union and help enhance the overall quality of future research in the sport. To reach consensus, a systematic review and Delphi method study design was used. After a systematic search of the literature, 17 articles were used to develop the final framework that described and defined key actions and events in rugby union (rugby). Thereafter, a group of researchers and practitioners with experience and expertise in rugby video analysis formed the RUVAC group. Each member of the group examined the framework of descriptors and definitions and rated their level of agreement on a 5-point agreement Likert scale (1: strongly disagree; 2: disagree; 3: neither agree or disagree; 4: agree; 5: strongly agree). The mean rating of agreement on the five-point scale (1: strongly disagree; 5: strongly agree) was 4.6 (4.3-4.9), 4.6 (4.4-4.9), 4.7 (4.5-4.9), 4.8 (4.6-5.0) and 4.8 (4.6-5.0) for the tackle, ruck, scrum, line-out and maul, respectively. The RUVAC group recommends using this consensus as the starting framework when conducting rugby video analysis research. Which variables to use (if not all) depends on the objectives of the study. Furthermore, the intention of this consensus is to help integrate video data with other data (eg, injury surveillance).


Assuntos
Traumatismos em Atletas/prevenção & controle , Futebol/lesões , Medicina Esportiva/métodos , Medicina Esportiva/normas , Gravação em Vídeo/normas , Técnica Delphi , Humanos , Estudos de Tempo e Movimento
11.
J Sports Sci ; 38(11-12): 1259-1268, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31818207

RESUMO

Elite soccer clubs across Europe spend ever-increasing sums of money on transfers and salaries for world-class players. Consequently, clubs' talent identification and development processes for junior players have become more professionalised. Based on a holistic ecological approach, this study presents an analysis of talent identification practices across some of the most productive soccer academies in Europe (N = 11). Data were collected via semi-structured interviews with 11 heads of academy recruitment from clubs in the "big five" European leagues. Clubs were purposively sampled based on their player productivity ranking. Interviews ranged from 52:26 minutes to 114:06 minutes in length (m = 87:53 ± 20.10 minutes). This study argues that holistic ecological approaches the environments were characterised through the interplay of factors that ranged from high-level internal to international level relationships. This resulted in the identification and recruitment of players from local and international environments. The purpose of recruitment was suggested to have a dual purpose: recruitment of players for the first team; recruitment of players for further development/monitoring and/or selling to another club.


Assuntos
Aptidão , Desempenho Atlético/fisiologia , Modelos Teóricos , Futebol/fisiologia , Meio Social , Adulto , Desempenho Atlético/classificação , Desempenho Atlético/economia , Tomada de Decisões , Europa (Continente) , Humanos , Cultura Organizacional , Futebol/classificação , Futebol/economia
12.
J Sports Sci ; 38(11-12): 1454-1464, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31030644

RESUMO

The present study examined the efficacy of a coaching curriculum, based on non-linear pedagogy, on improving attacking players' individual learning objectives (ILOs) in elite-youth football. Participants included 22 attacking players (i.e., centre-forwards, wide-players and attacking midfield players) from a professional football academy in England. The players were randomly appointed to both control (CON) and intervention (INT) periods following baseline measures. The INT (non-linear) and CON (linear) periods were both designed to support the ILOs provided to each player as part of the elite player performance plan. The study adopted a randomised cross-over design and ILOs considered important for attacking players (i.e., strong foot finishing, weak foot finishing, 1-v-1 and decision-making) were evaluated using the Loughborough Shooting Skill Test. The results showed significant differences for INT in 1-v-1 (P< 0.02) and decision-making (P< 0.01). However, there were no significant differences for strong foot finishing, weak foot finishing or time taken. These results support non-linear pedagogy in developing 1-v-1 game play and decision-making but not for technical shooting proficiency.


Assuntos
Desempenho Atlético/psicologia , Currículo , Aprendizagem , Tutoria , Destreza Motora , Futebol/psicologia , Adolescente , Desempenho Atlético/educação , Estudos Cross-Over , Tomada de Decisões , Humanos , Masculino , Futebol/educação
13.
Surgeon ; 18(6): 335-343, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32081666

RESUMO

BACKGROUND: The incidence of total hip and total knee arthroplasty (THA/TKA) is 3.1- and 1.7-fold higher in patients with Paget's disease of bone (PDB) compared to age-matched controls. No large studies or joint registry reports exist describing outcomes following THA or TKA in PDB patients. METHODS: The study objectives were to investigate the outcomes following THA or TKA in PDB patients using national registry data. Data were requested from the Scottish Arthroplasty Project for all PDB patients undergoing THA or TKA in Scotland from 1996 to 2013. RESULTS: Between 1996 - 2013, 144 patients underwent primary THA and 43 patients underwent primary TKA for PDB in Scotland. Following primary THA, the most common surgical complications within one year were haematoma (1.4%), and surgical-site infection (1.4%). The overall incidence of dislocation was 2.8%. Revision THA was performed in 2.8% of patients. THA implant survival was 96.3% (CI:92.8-99.8) at 10-years, and patient survival was 50.0% (CI:39.6-60.4) at 10-years. Following TKA, only one revision surgery occurred within one year (2.3%). Revision TKA was performed in 4.7% of patients, across the whole study period. TKA implant survival was 94.5% (CI:87.1-100) at 10-years; patient survival was 38.3% (CI:16.7-59.9) at 10-years. Compared with published literature and registry data, implant longevity and patient survival are comparable between PDB patients and the general population. CONCLUSION: This is the largest reported series of outcomes following primary THA/TKA in PDB patients. PDB patients are not at increased risk of surgical complications following primary THA or TKA compared with the general population.


Assuntos
Artroplastia de Quadril/efeitos adversos , Artroplastia do Joelho/efeitos adversos , Osteíte Deformante/cirurgia , Complicações Pós-Operatórias/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Osteíte Deformante/mortalidade , Sistema de Registros , Reoperação , Estudos Retrospectivos , Escócia , Fatores de Tempo , Resultado do Tratamento
14.
Br J Sports Med ; 52(6): 368-374, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29055883

RESUMO

BACKGROUND: Exercise programmes aimed at reducing injury have been shown to be efficacious for some non-collision sports, but evidence in adult men's collision sports such as rugby union is lacking. OBJECTIVE: To evaluate the efficacy of a movement control injury prevention exercise programme for reducing match injuries in adult men's community rugby union players. METHODS: 856 clubs were invited to participate in this prospective cluster randomised (single-blind) controlled trial where clubs were the unit of randomisation. 81 volunteered and were randomly assigned (intervention/control). A 42-week exercise programme was followed throughout the season. The control programme reflected 'normal practice' exercises, whereas the intervention focused on proprioception, balance, cutting, landing and resistance exercises.Outcome measures were match injury incidence and burden for: (1) all ≥8 days time-loss injuries and (2) targeted (lower limb, shoulder, head and neck, excluding fractures and lacerations) ≥8 days time-loss injuries. RESULTS: Poisson regression identified no clear effects on overall injury outcomes. A likely beneficial difference in targeted injury incidence (rate ratio (RR), 90% CI=0.6, 0.4 to 1.0) was identified, with a 40% reduction in lower-limb incidence (RR, 90% CI=0.6, 0.4 to 1.0) and a 60% reduction in concussion incidence (RR, 90% CI=0.4, 0.2 to 0.7) in the intervention group. Comparison between arms for clubs with highest compliance (≥median compliance) demonstrated very likely beneficial 60% reductions in targeted injury incidence (RR, 90% CI=0.4, 0.2 to 0.8) and targeted injury burden (RR, 90% CI=0.4, 0.2 to 0.7). CONCLUSIONS: The movement control injury prevention programme resulted in likely beneficial reductions in lower-limb injuries and concussion. Higher intervention compliance was associated with reduced targeted injury incidence and burden.


Assuntos
Traumatismos em Atletas/prevenção & controle , Concussão Encefálica/prevenção & controle , Futebol Americano/lesões , Condicionamento Físico Humano/métodos , Adulto , Humanos , Incidência , Masculino , Estudos Prospectivos , Método Simples-Cego , Adulto Jovem
15.
Surgeon ; 16(4): 250-258, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28943099

RESUMO

INTRODUCTION: Platelet rich plasma (PRP) has been suggested to be effective in the management of knee osteoarthritis. Review of current literature reveals conflicting evidence regarding the benefits of PRP in treating knee OA. Preclinical evidence supports the use of PRP injections to promote a favorable environment for joint tissue healing, targeting not only cartilage but also synovial and meniscal tissues which has a positive effect on delaying the progression of OA. Growth factors found in platelet granules are postulated to influence outcomes in knee OA and after total knee arthroplasty (TKA). METHODOLOGY: A systematic review of studies investigating the use of PRP in knee osteoarthritis and following TKA, was performed by searching the following databases for randomised clinical trials and pseudo-randomised clinical and comparative trials comparing the use of PRP to treat knee osteoarthritis and following TKA: MedLine, EMBASE, Science Direct, PubMed, and the Cochrane Library. The primary outcomes were patient reported measures including pain (visual analog scale (VAS)), quality of life scores, and knee function. RESULTS: A total of 2328 participants were analyzed across 17 included studies and pooled results showed a statistically significant reduction in pain in favor of PRP following TKA but not in non-surgical management of knee OA (P < 0.0001 and 0.13 respectively). No clinical benefit of PRP was found on quality of life and knee function (P = 0.07 and 0.05) following TKA, although a statistical improvement in knee function was demonstrated in patients with knee OA after PRP injection (P < 0.0001). There was no statistically significant clinical benefit of PRP on secondary outcomes including wound scores and length of hospital stay (p = 0.33 and 0.31, respectively). There was no statistically significant difference in respect to blood loss and overall symptoms in favor of PRP compared to control group following TKA (p = 0.37). CONCLUSION: This systematic review demonstrated no long-term statistically significant improvement in patient validated outcomes and secondary outcomes both in patients with knee OA or following TKA for OA. However PRP has been shown to have short to medium-term benefits in pain control after TKA and activities of daily living in patients with OA.


Assuntos
Artroplastia do Joelho , Peptídeos e Proteínas de Sinalização Intercelular/administração & dosagem , Osteoartrite do Joelho/terapia , Plasma Rico em Plaquetas , Humanos , Peptídeos e Proteínas de Sinalização Intercelular/fisiologia , Osteoartrite do Joelho/fisiopatologia , Osteoartrite do Joelho/cirurgia , Plasma Rico em Plaquetas/fisiologia , Cuidados Pós-Operatórios , Resultado do Tratamento
16.
Environ Sci Technol ; 51(4): 2047-2057, 2017 02 21.
Artigo em Inglês | MEDLINE | ID: mdl-28098989

RESUMO

Aqueous film-forming foams (AFFFs), containing per- and polyfluoroalkyl substances (PFASs), are released into the environment during response to fire-related emergencies. Repeated historical applications of AFFF at military sites were a result of fire-fighter training exercises and equipment testing. Recent data on AFFF-impacted groundwater indicates that ∼25% of the PFASs remain unidentified. In an attempt to close the mass balance, a systematic evaluation of 3M and fluorotelomer-based AFFFs, commercial products, and AFFF-impacted groundwaters from 15 U.S. military bases was conducted to identify the remaining PFASs. Liquid chromatography quadrupole time-of-flight mass spectrometry was used for compound discovery. Nontarget analysis utilized Kendrick mass defect plots and a "nontarget" R script. Suspect screening compared masses with those of previously reported PFASs. Forty classes of novel anionic, zwitterionic, and cationic PFASs were discovered, and an additional 17 previously reported classes were observed for the first time in AFFF and/or AFFF-impacted groundwater. All 57 classes received an acronym and IUPAC-like name derived from collective author knowledge. Thirty-four of the 40 newly identified PFAS classes derive from electrochemical fluorination (ECF) processes, most of which have the same base structure. Of the newly discovered PFASs found only in AFFF-impacted groundwater, 11 of the 13 classes are ECF-derived, and the remaining two classes are fluorotelomer-derived, which suggests that both ECF- and fluorotelomer-based PFASs are persistent in the environment.


Assuntos
Fluorocarbonos , Poluentes Químicos da Água , Cromatografia Líquida , Água Subterrânea/química , Água
17.
J Sports Sci ; 35(14): 1372-1376, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-27477519

RESUMO

The aims of this study were to analyse the optimal cadence for peak power production and time to peak power in bicycle motocross (BMX) riders. Six male elite BMX riders volunteered for the study. Each rider completed 3 maximal sprints at a cadence of 80, 100, 120 and 140 revs · min-1 on a laboratory Schoberer Rad Messtechnik (SRM) cycle ergometer in isokinetic mode. The riders' mean values for peak power and time of power production in all 3 tests were recorded. The BMX riders produced peak power (1105 ± 139 W) at 100 revs · min-1 with lower peak power produced at 80 revs · min-1 (1060 ± 69 W, (F(2,15) = 3.162; P = .266; η2 = 0.960), 120 revs · min-1 (1077 ± 141 W, (F(2,15) = 4.348; P = .203; η2 = 0.970) and 140 revs · min-1 (1046 ± 175 W, (F(2,15) = 12.350; P = 0.077; η2 = 0.989). The shortest time to power production was attained at 120 revs · min-1 in 2.5 ± 1.07 s. Whilst a cadence of 80 revs · min-1 (3.5 ± 0.8 s, (F(2,15) = 2.667; P = .284; η2 = 0.800) 100 revs · min-1 (3.00 ± 1.13 s, (F(2,15) = 24.832; P = .039; η2 = 0.974) and 140 revs · min-1 (3.50 ± 0.88 s, (F(2,15) = 44.167; P = .006; η2 = 0.967)) all recorded a longer time to peak power production. The results indicate that the optimal cadence for producing peak power output and reducing the time to peak power output are attained at comparatively low cadences for sprint cycling events. These findings could potentially inform strength and conditioning training to maximise dynamic force production and enable coaches to select optimal gear ratios.


Assuntos
Desempenho Atlético/fisiologia , Ciclismo/fisiologia , Fenômenos Biomecânicos , Humanos , Masculino , Análise e Desempenho de Tarefas , Fatores de Tempo , Adulto Jovem
18.
J Strength Cond Res ; 31(2): 445-450, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28125546

RESUMO

Rylands, LP, Hurst, HT, Roberts, SJ, and Graydon, RW. The effect of "pumping" and "nonpumping" techniques on velocity production and muscle activity during field-based BMX cycling. J Strength Cond Res 31(2): 445-450, 2017-The aim of the current study was to determine if a technique called "pumping" had a significant effect on velocity production in Bicycle Motocross (BMX) cycling. Ten National standard male BMX riders fitted with surface electromyography (sEMG) sensors completed a timed lap of an indoor BMX track using the technique of pumping, and a lap without pumping. The lap times were recorded for both trials and their surface sEMG was recorded to ascertain any variation in muscle activation of the biceps brachii, triceps brachii, vastus lateralis, and medial gastrocnemius. The findings revealed no significant differences between any of muscle groups (p > 0.05). However, significant differences (p < 0.001) were observed between the pumping and nonpumping trials for both mean lap velocity (42 ± 1.8 km·h, 33 ± 2.9 km·h, respectively) and lap times (43.3 ± 3.1 seconds, 34.7 ± 1.49 seconds, respectively). The lap times recorded for the pumping trials were 19.50 ± 4.25% lower than the nonpumping, whereas velocity production was 21.81 ± 5.31% greater in the pumping trial compared with the nonpumping trial. The technique of pumping contributed significantly to velocity production, although not at the cost of additional muscle activity. From a physiological and technical perspective, coaches and riders should prioritize this technique when devising training regimes.


Assuntos
Ciclismo/fisiologia , Músculo Esquelético/fisiologia , Adulto , Eletromiografia , Humanos , Masculino , Fenômenos Fisiológicos Musculoesqueléticos , Músculo Quadríceps/fisiologia , Adulto Jovem
19.
Rapid Commun Mass Spectrom ; 30(13): 1653-61, 2016 07 15.
Artigo em Inglês | MEDLINE | ID: mdl-27321854

RESUMO

RATIONALE: Neonicotinoid pesticides and their metabolites have been indicated as contributing factors in the decline of honey bee colonies. A thorough understanding of neonicotinoid toxicity requires knowledge of their metabolites and environmental breakdown products. This work investigated the rapid degradation of the neonicotinoid nitenpyram in finished drinking water. METHODS: Nitenpyram reaction products were characterized using liquid chromatography/quadrupole time-of-flight mass spectrometry (LC/QTOFMS). A software algorithm that compared degraded and control samples was utilized to facilitate efficient data reduction. Fragmentation pathways for six reaction products and nitenpyram were proposed using predictive software and manual product ion analysis. RESULTS: This study showed that nitenpyram degradation in unpreserved finished drinking water was likely the result of oxidation, hydrolysis and reaction with Cl2 . Structures for six nitenpyram reaction products were proposed that suggest the C9/C11 olefin as the key reactive site. CONCLUSIONS: Similarities between the identified nitenpyram reaction products and imidacloprid metabolites highlight the importance of this study, as the toxicity of neonicotinoids to pollinators has been linked to their metabolites. Based on the proposed reaction mechanisms, the identified nitenpyram reaction products in finished drinking water could also be present in the environment and water treatment facilities. As such, identifying these degradation products will aid in evaluating the environmental impact of neonicotinoid pesticides. Copyright © 2016 John Wiley & Sons, Ltd.


Assuntos
Água Potável , Inseticidas/química , Neonicotinoides/química , Animais , Abelhas , Cromatografia Líquida , Piridinas
20.
Chem Res Toxicol ; 28(6): 1265-74, 2015 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-26004626

RESUMO

Polybrominated diphenyl ether (PBDE) flame retardants are endocrine disruptors and suspected neurodevelopmental toxicants. While the direct mechanisms of neurodevelopmental toxicity have not been fully elucidated, it is conceivable that alterations in thyroid hormone levels in the developing brain may contribute to these effects. Cells within the brain locally convert thyroxine (T4) to the biologically active triiodothyronine (T3) through the action of the selenodeiodinase type 2 iodothyronine deiodinase (DIO2). Previous studies have demonstrated that PBDEs can alter hepatic deiodinase activity both in vitro and in vivo; however, the effects of PBDEs on the deiodinase isoforms expressed in the brain are not well understood. Here, we studied the effects of several individual PBDEs and hydroxylated metabolites (OH-BDEs) on DIO2 activity in astrocytes, a specialized glial cell responsible for production of more than 50% of the T3 required by the brain. Primary human astrocytes and H4 glioma cells were exposed to individual PBDEs or OH-BDEs at concentrations up to 5 µM. BDE-99 decreased DIO2 activity by 50% in primary astrocyte cells and by up to 80% in the H4 cells at doses of ≥500 nM. 3-OH-BDE-47, 6-OH-BDE-47, and 5'-OH-BDE-99 also decreased DIO2 activity in cultured H4 glioma cells by 45-80% at doses of approximately 1-5 µM. Multiple mechanisms appear to contribute to the decreased DIO2 activity, including weakened expression of DIO2 mRNA, competitive inhibition of DIO2, and enhanced post-translational degradation of DIO2. We conclude that decreases in DIO2 activity caused by exposure to PBDEs may play a role in the neurodevelopmental deficits caused by these toxicants.


Assuntos
Éteres Difenil Halogenados/farmacologia , Iodeto Peroxidase/antagonistas & inibidores , Iodeto Peroxidase/metabolismo , Neuroglia/efeitos dos fármacos , Neuroglia/enzimologia , Sobrevivência Celular/efeitos dos fármacos , Relação Dose-Resposta a Droga , Ativação Enzimática/efeitos dos fármacos , Éteres Difenil Halogenados/química , Humanos , Estrutura Molecular , Relação Estrutura-Atividade , Células Tumorais Cultivadas , Iodotironina Desiodinase Tipo II
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