Implementation of Motor Imagery during Specific Aerobic Training Session in Young Tennis Players

The aim of this study was to investigate the effects of implementing motor imagery (MI) during specific tennis high intensity intermittent training (HIIT) sessions on groundstroke performance in young elite tennis players. Stroke accuracy and ball velocity of forehand and backhand drives were evaluated in ten young tennis players, immediately before and after having randomly performed two HIIT sessions. One session included MI exercises during the recovery phases, while the other included verbal encouragements for physical efforts and served as control condition. Results revealed that similar cardiac demand was observed during both sessions, while implementing MI maintained groundstroke accuracy. Embedding MI during HIIT enabled the development of physical fitness and the preservation of stroke performance. These findings bring new insight to tennis and conditioning coaches in order to fulfil the benefits of specific playing HIIT sessions, and therefore to optimise the training time.     

Effects of Small-Sided Games vs. Interval Training in Aerobic Fitness and Physical Enjoyment in Young Elite Soccer Players

The purpose of this study was to compare the effects of Small-Sided Games (SSG) vs. Interval Training (IT) in soccer training on aerobic fitness and physical enjoyment in youth elite soccer players during the last 8 weeks of the season. Seventeen U-16 male soccer players (age = 15.5 ± 0.6 years, and 8.5 years of experience) of a Spanish First Division club academy were randomized to 2 different groups for 6 weeks: SSG group (n = 9) and IT group (n = 8). In addition to the usual technical and tactical sessions and competitive games, the SSG group performed 11 sessions with different SSGs, whereas the IT group performed the same number of sessions of IT. Players were tested before and after the 6-week training intervention with a continuous maximal multistage running field test and the counter movement jump test (CMJ). At the end of the study, players answered the physical activity enjoyment scale (PACES). During the study, heart rate (HR) and session perceived effort (sRPE) were assessed. SSGs were as effective as IT in maintaining the aerobic fitness in elite young soccer players during the last weeks of the season. Players in the SSG group declared a greater physical enjoyment than IT (P = 0.006; ES = 1.86 ± 1.07). Coaches could use SSG training during the last weeks of the season as an option without fear of losing aerobic fitness while promoting high physical enjoyment.     

Tennis Play Intensity Distribution and Relation with Aerobic Fitness in Competitive Players

The aims of this study were (i) to describe the relative intensity of simulated tennis play based on the cumulative time spent in three metabolic intensity zones, and (ii) to determine the relationships between this play intensity distribution and the aerobic fitness of a group of competitive players. 20 male players of advanced to elite level (ITN) performed an incremental on-court specific endurance tennis test to exhaustion to determine maximal oxygen uptake (VO_2max) and the first and second ventilatory thresholds (VT₁, VT₂). Ventilatory and gas exchange parameters were monitored using a telemetric portable gas analyser (K4 b², Cosmed, Rome, Italy). Two weeks later the participants played a simulated tennis set against an opponent of similar level. Intensity zones (1: low, 2: moderate, and 3: high) were delimited by the individual VO₂ values corresponding to VT₁ and VT₂, and expressed as percentage of maximum VO₂ and heart rate. When expressed relative to VO_2max, percentage of playing time in zone 1 (77 ± 25%) was significantly higher (p < 0.001) than in zone 2 (20 ± 21%) and zone 3 (3 ± 5%). Moderate to high positive correlations were found between VT₁, VT₂ and VO_2max, and the percentage of playing time spent in zone 1 (r = 0.68–0.75), as well as low to high inverse correlations between the metabolic variables and the percentage of time spent in zone 2 and 3 (r = -0.49–0.75). Players with better aerobic fitness play at relatively lower intensities. We conclude that players spent more than 75% of the time in their low-intensity zone, with less than 25% of the time spent at moderate to high intensities. Aerobic fitness appears to determine the metabolic intensity that players can sustain throughout the game.     

Aerobic Training in Patients with Congenital Myopathy

Introduction

Congenital myopathies (CM) often affect contractile proteins of the sarcomere, which could render patients susceptible to exercise-induced muscle damage. We investigated if exercise is safe and beneficial in patients with CM.

Methods

Patients exercised on a stationary bike for 30 minutes, three times weekly, for 10 weeks at 70% of their maximal oxygen uptake (VO_2max). Creatine kinase (CK) was monitored as a marker of muscle damage. VO_2max, functional tests, and questionnaires evaluated efficacy.

Results

Sixteen patients with CM were included in a controlled study. VO_2max increased by 14% (range, 6–25%; 95% CI 7–20; p < 0.001) in the seven patients who completed training, and tended to decrease in a non-intervention group (n = 7; change -3.5%; range, -11–3%, p = 0.083). CK levels were normal and remained stable during training. Baseline Fatigue Severity Scale scores were high, 4.9 (SE 1.9), and tended to decrease (to 4.4 (SE 1.7); p = 0.08) with training. Nine patients dropped out of the training program. Fatigue was the major single reason.

Conclusions

Ten weeks of endurance training is safe and improves fitness in patients with congenital myopathies. The training did not cause sarcomeric injury, even though sarcomeric function is affected by the genetic abnormalities in most patients with CM. Severe fatigue, which characterizes patients with CM, is a limiting factor for initiating training in CM, but tends to improve in those who train.

Trial Registration

The Regional Committee on Health Research Ethics of the Capital Region of Denmark H-2-2013-066 and ClinicalTrials.gov H2-2013-066     

Effects of Sprint versus High-Intensity Aerobic Interval Training on Cross-Country Mountain Biking Performance: A Randomized Controlled Trial

Objectives

The current study compared the effects of high-intensity aerobic training (HIT) and sprint interval training (SIT) on mountain biking (MTB) race simulation performance and physiological variables, including peak power output (PPO), lactate threshold (LT) and onset of blood lactate accumulation (OBLA).

Methods

Sixteen mountain bikers (mean ± SD: age 32.1 ± 6.4 yr, body mass 69.2 ± 5.3 kg and VO_2max 63.4 ± 4.5 mL∙kg^-1∙min^-1) completed graded exercise and MTB performance tests before and after six weeks of training. The HIT (7–10 x [4–6 min—highest sustainable intensity / 4–6 min—CR100 10–15]) and SIT (8–12 x [30 s—all-out intensity / 4 min—CR100 10–15]) protocols were included in the participants’ regular training programs three times per week.

Results

Post-training analysis showed no significant differences between training modalities (HIT vs. SIT) in body mass, PPO, LT or OBLA (p = 0.30 to 0.94). The Cohen’s d effect size (ES) showed trivial to small effects on group factor (p = 0.00 to 0.56). The interaction between MTB race time and training modality was almost significant (p = 0.08), with a smaller ES in HIT vs. SIT training (ES = -0.43). A time main effect (pre- vs. post-phases) was observed in MTB race performance and in several physiological variables (p = 0.001 to 0.046). Co-variance analysis revealed that the HIT (p = 0.043) group had significantly better MTB race performance measures than the SIT group. Furthermore, magnitude-based inferences showed HIT to be of likely greater benefit (83.5%) with a lower probability of harmful effects (0.8%) compared to SIT.

Conclusion

The results of the current study suggest that six weeks of either HIT or SIT may be effective at increasing MTB race performance; however, HIT may be a preferable strategy.

Trial Registration

ClinicalTrials.gov {"type":"clinical-trial","attrs":{"text":"NCT01944865","term_id":"NCT01944865"}}NCT01944865     

Physiological responses of small-sided vs. regular games in youth volleyball players

The aim of the present study was to evaluate the effects of two different formats of small-sided games (SSGs; 2 vs. 2 and 3 vs. 3) on physiological parameters in youth volleyball players. Twelve youth volleyball players (17.2 ± 7.44 years, 1.89 ± 0.6 m, 72.83 ± 8.57 kg) completed three different games formats (regular game (RG): 6 vs. 6, SSG3: 3 vs. 3 and SSG2: 2 vs. 2). associated with two pitch dimensions (i.e., 2 vs. 2 and 3 vs. 3 on 18 × 4.5 m; 6 vs. 6 on 18 × 9 m). Each player performed 4 × 5 min SSG with a recovery period of 1 min between bouts. All players were members of the same youth team and played in a professional league. They had at least 6 years of volleyball training and no current injuries. This study was carried out during the competitive period. Heart rate (HR), blood lactate ([La⁻]), and rating of perceived exertion (RPE) were measured. Compared to RG, physiological (i.e., HR and [La⁻]) and RPE responses were significantly higher during SSG3 and SSG2 (all p < 0.05; ƞ_p² = 0.77, ƞ_p² = 0.65, ƞ_p² = 0.30, respectively). Moreover, HR and RPE were significantly higher in SSG2 compared to SSG3. In contrast, no significant differences were observed in [La⁻] between SSG2 and SSG3. These results suggest that the number of players influences the exercise intensity in small-sided volleyball games in youth players. Therefore, coaches could benefit from incorporating SSGs to manipulate the exercise intensity in youth volleyball players.     

Temporary vs. Permanent Sub-slab Ports: A Comparative Performance Study

Vapor intrusion (VI) is the migration of subsurface vapors, including radon and volatile organic compounds (VOCs), from the subsurface to indoor air. The VI exposure pathway extends from the contaminant source, which can be impacted soil or groundwater, to indoor air-exposure points. VOC contaminants of concern typically include halogenated solvents as well as petroleum hydrocarbons. Radon, a colorless radioactive gas that is released by radioactive decay of radionuclides in rock and soil, migrates into homes through VI in a similar fashion to VOCs. This project focused on the performance of permanent versus temporary sub-slab sampling ports for the determination of VI of halogenated VOCs and radon into an unoccupied house. VOC and radon concentrations measured simultaneously in soil gas using collocated temporary and permanent ports appeared to be independent of the type of port. The variability between collocated temporary and permanent ports was much less than the spatial variability between different locations within a single residential duplex. Post sampling leak test results suggested that the temporary SSP desiccation and cracking of the clay portion of the seal were not as detrimental to the port seal performance as would have been expected, this suggests that the Teflon tape portion of the seals served an important function. Pre and post sampling leak tests are advisable when temporary ports are used to collect a time-integrated sample. These results suggest that temporary sub-slab sampling ports can provide data equivalent to that collected from a permanent sub-slab sampling port.     

Training specificity of hurdle vs. countermovement jump training

The objective of this study was to compare bilateral and unilateral hurdle jumps with traditional countermovement jumps (CMJs). Thirteen athletes were tested during continuous forward bilateral and unilateral hurdle jumps and single CMJ. Countermovement jump height was used to establish the hurdle height. Subjects jumped forward over 4 hurdles with the force plate positioned after the second hurdle to measure vertical ground reaction force (VGRF), contact time (CT), and rate of force development (RFD). For bilateral jumps, hurdle height was established at maximal (100%) CMJ height and at 120, 140, and 160% of the CMJ height. The athletes were instructed to jump as fast as possible to mimic a training session drill. For unilateral jumps, hurdle height was set at 70, 80, and 90% of the CMJ height. Bilateral 160% jumps showed a significantly longer CT than bilateral 100, 120, and 140% jumps. The bilateral 100, 120, and 140% jumps had significantly shorter CT than the unilateral jumps and CMJ. The VGRF during bilateral jumps was higher than unilateral jumps and CMJ. Bilateral 160% jump RFD was significantly higher than CMJ and unilateral jumps but significantly lower than the other bilateral jumps. In conclusion, the characteristics of the bilateral jumps were substantially different from those of the CMJ and unilateral hurdle jumps. As bilateral hurdle jumps with a height between 100 and 140% of the CMJ provide similar CTs and VGRF as many reported sprint or jump actions, they may be considered a more training-specific power training drill than the CMJ.     

Difference in Outcomes between First-Operated vs. Fellow-Operated Eyes in Patients Undergoing Bilateral Trabeculectomies

Main Objective

To compare the course and outcome of first- and fellow-operated eyes in patients who underwent bilateral trabeculectomies and to investigate the factors associated with the difference.

Methods

Preoperative characteristics, including the interval between surgeries, were compared between the first- and fellow-operated eyes in 42 patients who underwent bilateral trabeculectomies. Postoperative intraocular pressure and bleb vascularity, using postoperative anterior segment photos, were compared at various time points between the first- and fellow-operated eyes. Surgical success was evaluated at 1 year after surgery and at the final follow-up. Factors affecting the difference between the first and fellow eyes were analyzed.

Results

There was no significant difference in success or failure rates at 1 year postoperatively and at the final follow-up between the first- and fellow-operated eyes. Early postoperative IOP and the degree of bleb vascularity were higher in the fellow-operated eyes (P = 0.001 and 0.003, respectively at week 1 postoperative). The difference in IOP between the first- and fellow-operated eyes was greater in patients whose interval between surgeries was shorter than 3 weeks (P = 0.026).

Conclusions

In patients undergoing bilateral trabeculectomies, early postoperative IOP was higher in the fellow-operated eyes than the first-operated eyes; the difference was greater when the interval between surgeries was shorter. The first-operated eye may influence the early postoperative inflammatory response in the fellow-operated eye. Our findings have clinical implications for planning treatment of patients who may need bilateral surgery.     

Cardiorespiratory Adaptations during Concurrent Aerobic and Strength Training in Men and Women

This study investigated the effects of endurance followed by strength training (ES, men n = 16; women n = 15), the reverse exercise order (SE, men n = 18, women n = 13) and concurrent endurance and strength training performed on alternating days (AD, men n = 21, women n = 18) on cardiorespiratory parameters. Peak oxygen consumption (V˙O_2peak) and oxygen consumption at sub-maximal power outputs (V˙O_2submax) of 50 to 175 Watts in men and 50 to 125 Watts in women were assessed during an incremental cycling test both before and after 24 weeks of training. Increases in V˙O_2peak in both men and women were statistically larger in AD (18±9% and 25±11%) compared to ES (7±9% and 12±12%, p = 0.002 and 0.009, respectively) and SE (7±9% and 10±8%, p = 0.005 and 0.008, respectively). No statistical group interaction was observed for V˙O_2submax in men, but in women V˙O_2submax was statistically lower at week 24 in ES compared to AD at 75 W (-2±6% vs. +3±6%, p = 0.027) and 125 W (-4±5% vs. +2±5%, p = 0.010). These findings indicate that endurance and strength training performed on alternating days may optimize the adaptations in V˙O_2peak in both sexes, while performing ES training in women may optimize cardiorespiratory fitness at sub-maximal power outputs.     

Playing smart vs. playing safe: the joint expression of phenotypic plasticity and potential bet hedging across and within thermal environments

Adaptive phenotypic plasticity evolves when cues reliably predict fitness consequences of life‐history decisions, whereas bet hedging evolves when environments are unpredictable. These modes of response should be jointly expressed, because environmental variance is composed of both predictable and unpredictable components. However, little attention has been paid to the joint expression of plasticity and bet hedging. Here, I examine the simultaneous expression of plasticity in germination rate and two potential bet‐hedging traits – germination fraction and within‐season diversification in timing of germination – in seeds from multiple seed families of five geographically distant populations of Lobelia inflata (L.) subjected to a thermal gradient. Populations differ in germination plasticity to temperature, in total germination fraction and in the expression of potential diversification in the timing of germination. The observation of a negative partial correlation between the expression of plasticity and germination variance (potential diversification), and a positive correlation between plasticity and germination fraction is suggestive of a trade‐off between modes of response to environmental variance. If the observed correlations are indicative of those between adaptive plasticity and bet hedging, we expect an optimal balance to exist and differ among populations. I discuss the challenges involved in testing whether the balance between plasticity and bet hedging depends on the relative predictability of environmental variance.     

Patient Reported Outcomes After Conversion vs. Primary Total Hip Arthroplasty: A Propensity Matched Analysis

BackgroundConversion total hip arthroplasty (cTHA) is increasingly utilized as a salvage procedure for complications associated with fracture fixation around the hip and acetabulum and for failed hip preservation surgery. While primary THA (pTHA) has a high success rate, little is known about outcomes following conversion THA. The purpose of this study is to evaluate patient reported outcomes (PROs) and complication rates following conversion THA compared to primary THA.MethodsPatients that underwent cTHA or pTHA from 2015-2020 at a large tertiary referral academic center were retrospectively identified. THA patients were propensity matched in a 1:1 fashion by age, body mass index (BMI), and sex. Pain scores and PROMIS physical function (PF), pain interference (PI), and depression (DA) scores were compared at preoperative and final postoperative follow up timepoints using independent t-tests. Differences in complication and reoperation rates between cohorts were assessed using chi square analysis.ResultsA total of 118 THAs (59 cTHA, 59 pTHA) were included in this analysis with an average follow up of 21.3 months. cTHAs were most commonly performed following hip fracture fixation (50.8%). The conversion cohort had significantly longer lengths of stay (3.6 days vs 1.9 days, p<0.01) and greater use of revision-type implants (39.0% vs 0.0%, p<0.01) compared to pTHA. There was no significant difference in complication rates (cTHA = 15.3%, pTHA = 8.5%; p=0.26), with intraoperative fracture being the most common for both. Primary and conversion THA groups also experienced similar reoperation rates (cTHA = 5.1%, pTHA = 6.8%; p=0.70). No significant differences in PROs at final follow up were identified between groups.ConclusionPatients undergoing cTHA required increased utilization of revision hip implants and had longer lengths of stay, but had comparable complication and reoperation rates, and ultimately demonstrated similar improvements in PROMIS scores compared to a matched cohort of pTHA patients. Level of Evidence: III     

When Less Is More: Reduced Usefulness Training for the Learning of Anticipation Skill in Tennis

Participants in this study practiced with feedback to anticipate the left-right direction of forehand tennis shots played by stick-figure players. A technique based on principal component analysis was used to remove dynamical differences that are associated with shots to different directions. Different body regions of the stick-figure players were neutralized with this procedure in the pretests and posttests, and in the practice phases. Experiment 1 showed that training is effective if during practice information is consistently present in the whole body of the player, but not if the information is neutralized in the whole body in half of the practice trials. Experiment 2 showed that training is effective if the variance associated with the direction of the shots is consistently present in one body region but neutralized in others, and that transfer occurs from practice with information in one body region to performance in conditions with information preserved only in other regions. Experiment 3 showed that occlusion has a much larger detrimental effect on learning than the applied neutralization technique, and that transfer between body regions occurs also with occlusion. Discussed are theoretical implications for understanding how biological motion is perceived and possible applications in a type of training referred to as reduced usefulness training.     

Comparative Effectiveness of Homoeopathic vs. Conventional Therapy in Usual Care of Atopic Eczema in Children: Long-Term Medical and Economic Outcomes

Background

One in five children visiting a homeopathic physician suffers from atopic eczema.

Objectives

We aimed to examine the long-term effectiveness, safety and costs of homoeopathic vs. conventional treatment in usual medical care of children with atopic eczema.

Methods

In this prospective multi-centre comparative observational non-randomized rater-blinded study, 135 children (48 homoeopathy, 87 conventional) with mild to moderate atopic eczema were included by their respective physicians. Depending on the specialisation of the physician, the primary treatment was either standard conventional treatment or individualized homeopathy as delivered in routine medical care. The main outcome was the SCORAD (SCORing Atopic Dermatitis) at 36 months by a blinded rater. Further outcomes included quality of life, conventional medicine consumption, safety and disease related costs at six, 12 and 36 months after baseline. A multilevel ANCOVA was used, with physician as random effect and the following fixed effects: age, gender, baseline value, severity score, social class and parents’ expectation.

Results

The adjusted mean SCORAD showed no significant differences between the groups at 36 months (13.7 95% CI [7.9–19.5] vs. 14.9 [10.4–19.4], p = 0.741). The SCORAD response rates at 36 months were similar in both groups (33% response: homoeopathic 63.9% vs. conventional 64.5%, p = 0.94; 50% response: 52.0% vs. 52.3%, p = 0.974). Total costs were higher in the homoeopathic versus the conventional group (months 31–36 200.54 Euro [132.33–268.76] vs. 68.86 Euro [9.13–128.58], p = 0.005).

Conclusions

Taking patient preferences into account, while being unable to rule out residual confounding, in this long-term observational study, the effects of homoeopathic treatment were not superior to conventional treatment for children with mild to moderate atopic eczema, but involved higher costs.     

Performance fatigability during isometric vs. concentric quadriceps fatiguing tasks in men and women

In the present study, we aimed to provide a robust comparison of the fatigability of the knee extensors following isometric (ISO) and concentric (CON) tasks. Twenty young adults (25 ± 4 yr, 10 women) randomly performed the ISO and CON quadriceps intermittent fatigue test, consisting of ten (5 s on/5-s off, ISO) or one-hundred (0.5-s on/0.5-s off, CON) contractions with 10 % increments per stage until exhaustion. Performance fatigability was quantified as maximal isometric (MVIC) and concentric (MVCC) torque loss. Voluntary activation and contractile function (peak-twitch) were investigated using peripheral nerve stimulation. Number of stages (6.2 ± 0.7 vs. 4.9 ± 0.8; P < 0.001) and torque-time integral (20,166 ± 7,821 vs. 11,285 ± 4,933 Nm.s; P < 0.001) were greater for ISO than CON. MVIC, MVCC and voluntary activation decreased similarly between sessions (P > 0.05) whereas peak-twitch amplitude decreased more for CON (P < 0.001). The number of contractions was similar across sexes (ISO: men = 62 ± 8, women = 61 ± 5; CON: men = 521 ± 67, women = 458 ± 76, P > 0.05). MVCC was more reduced in women for both sessions (all P < 0.05), while MVIC loss was similar between sexes. We concluded that, despite greater torque-time integral and duration for ISO, both sessions induced a similar performance fatigability at exhaustion. Contractile function was more altered in CON. Finally, sex-related difference in fatigability depends on the contraction mode used during testing.