Restriction du flux sanguin et rééducation : une revue parapluie des revues systématiques et des méta-analyses

IntroductionL’utilisation de la restriction du flux sanguin (BFRt) s’inscrit dans un contexte clinique et nécessite des recommandations pratiques basées sur des preuves scientifiques solides. Le but de ce travail est de réaliser une revue parapluie pour examiner l’efficacité de l’entraînement BFRt sur les marqueurs de la réadaptation dans les maladies musculosquelettiques cliniques afin d’augmenter le niveau de preuve scientifique et le grade de recommandation.Matériel et méthodesLes critères PICOS utilisés pour définir les caractéristiques des études incluses dans cette étude sont : P : patients dans un contexte de rééducation ; I : occlusion partielle (Blood Flow Restriction) ; C : exercices avec charges lourdes et exercices à faibles charges ; O : marqueurs cliniques de la réadaptation (force, volume musculaire, fonction, douleur) ; S : revues systématiques avec ou sans méta-analyse. La recherche bibliographique a été réalisée en utilisant les bases de données PubMed, Science Direct, PEDro et Cochrane Library. Entre janvier 2022 et mars 2022, de manière indépendante, deux auteurs ont trié et analysé les articles pouvant être inclus dans cette analyse. La qualité méthodologique des revues systématiques inclues a été évaluée par les deux auteurs de manière indépendante à l’aide de la grille d’analyse méthodologique AMSTAR-2 [1], [2]. La recherche bibliographique a été enregistrée sur Prospero sous l’ID CRD42022301955.RésultatsEn ce qui concerne la variable de changement structurel, des améliorations ont été observées pour la surface de section transversale des muscles par résonance magnétique intranucléaire, échographie ou mètre ruban, pour le groupe BFR et pour le groupe d’exercices à charge élevée afin de prévenir la perte de masse musculaire chez les patients [3], [4]. En plus des bénéfices, par rapport aux exercices à faible charge (30 % 1RM), sur la force, l’hypertrophie et la capacité fonctionnelle, avec une charge mécanique réduite (30 % 1 RM), le BFR semble montrer une efficacité dans la réduction de la douleur et l’amélioration de la tolérance au mouvement par rapport aux exercices à charge lourde (70 % 1RM) [3].Discussion/conclusionLa pertinence clinique de cette revue est la démonstration que l’entraînement LL-BFR peut fournir une approche plus efficace que la rééducation à faible charge et une approche plus tolérable de la rééducation à charge lourde

Stress, sleep and recovery in elite soccer: A critical review of the literature

In elite soccer, players are frequently exposed to various situations and conditions that can interfere with sleep, potentially leading to sleep deprivation. This article provides a comprehensive and critical review of the current available literature regarding the potential acute and chronic stressors (i.e. psychological, sociological and physiological stressors) placed on elite soccer players that may result in compromised sleep quantity and/or quality. Sleep is an essential part of the recovery process as it provides a number of important psychological and physiological functions. The effects of sleep disturbance on post-soccer match fatigue mechanisms and recovery time course are also described. Physiological and cognitive changes that occur when competing at night are often not conducive to sleep induction. Although the influence of high-intensity exercise performed during the night on subsequent sleep is still debated, environmental conditions (e.g. bright light in the stadium, light emanated from the screens) and behaviours related to evening soccer matches (e.g. napping, caffeine consumption, alcohol consumption) as well as engagement and arousal induced by the match may all potentially affect subsequent sleep. Apart from night soccer matches, soccer players are subjected to inconsistency in match schedules, unique team schedules and travel fatigue that may also contribute to the sleep debt. Sleep deprivation may be detrimental to the outcome of the recovery process after a match, resulting in impaired muscle glycogen repletion, impaired muscle damage repair, alterations in cognitive function and an increase in mental fatigue. The role of sleep in recovery is a complex issue, reinforcing the need for future research to estimate the quantitative and qualitative importance of sleep and to identify influencing factors. Efficient and individualised solutions are likely needed

Sleep Hygiene and Recovery Strategies in Elite Soccer Players

International audienceIn elite soccer, players are frequently exposedto various situations and conditions that can interfere withsleep (e.g., playing night matches interspersed with 3 days;performing activities demanding high levels of concentrationclose to bedtime; use of products containing caffeineor alcohol in the period preceding bedtime; regular daytimenapping throughout the week; variable wake-up times orbedtime), potentially leading to sleep deprivation. Weoutline simple, practical, and pharmaceutical-free sleepstrategies that are coordinated to the constraints of elitesoccer in order to promote sleep. Sleep deprivation is bestalleviated by sleep extension; however, sleep hygienestrategies (i.e., consistent sleep pattern, appropriate napping,and active daytime behaviors) can be utilized topromote restorative sleep. Light has a profound impact onsleep, and sleep hygiene strategies that support the naturalenvironmental light–dark cycle (i.e., red-light treatmentprior to sleep, dawn-simulation therapy prior to waking)and prevent cycle disruption (i.e., filtering short wavelengthsprior to sleep) may be beneficial to elite soccerplayers. Under conditions of inordinate stress, techniquessuch as brainwave entrainment and meditation arepromising sleep-promoting strategies, but future studies arerequired to ascertain the applicability of these techniques toelite soccer players. Consuming high-electrolyte fluidssuch as milk, high-glycemic index carbohydrates, someforms of protein immediately prior to sleep, as well as tartcherry juice concentrate and tryptophan may promoterehydration, substrate stores replenishment, muscle-damagerepair and/or restorative sleep. The influence of coldwater immersion performed close to bedtime on subsequentsleep is still debated. Conversely, the potentialdetrimental effects of sleeping medication must be recognized.Sleep initiation is influenced by numerous factors,reinforcing the need for future research to identify suchfactors. Efficient and individualized sleep hygiene strategiesmay consequently be proposed

Recovery From Exercise-Induced Muscle Damage: Cold-Water Immersion Versus Whole-Body Cryotherapy

International audiencePurpose: The aim of this study was to compare the effects of cold-water immersion and whole-body cryotherapy on recovery kinetics following exercise induced muscle damage. Methods: Ten physically active men performed single-leg hamstring eccentric exercise comprising 5 sets of 15 repetitions. Immediately post-exercise, subjects were exposed in a randomized cross-over design to cold-water immersion (10 minutes at 10°C) or whole-body cryotherapy (3 minutes at -110°C) recovery. Creatine kinase concentrations, knee flexor eccentric (60°.s-1) and posterior lower limb isometric (60°) strength, single-leg and two leg countermovement jump, muscle soreness and perception of recovery were measured. The tests were performed before, immediately, 24h, 48h and 72h after exercise.Results: Results showed a very likely moderate effect in favour of cold-water immersion for single-leg [Effect Size (ES) = 0.63; 90% Confidence Interval (CI) = -0.13 to 1.38] and two-leg countermovement jump (ES = 0.68; 90% CI = -0.08 to 1.43) 72h after exercise. Soreness was moderately lower 48h after exercise following cold-water immersion (ES = -0.68; 90% CI = 1.44 to 0.07). Perception of recovery was moderately enhanced 24h after exercise for cold water immersion (ES = -0.62; 90% CI = -1.38 to 0.13). Trivial and small effects of condition were found for the other outcomes.Conclusion: Cold-water immersion was more effective in accelerating recovery kinetics than whole-body cryotherapy for countermovement jump performance at 72h post-exercise. Cold-water immersion also demonstrated lower soreness and higher perceived recovery levels across 24-48h post-exercise