Comparison of two 8-week training interventions on the athletic performance of padel players

Padel is an intermittent racket sport played in pairs (2 vs. 2) on a small-sized grass court (20 x 10 m), involving high physical fitness demands for the players. Therefore, this study aims to compare the effect of two 8-week in-season training programs on the athletic performance of male padel players. Participants (age, 22.1±0.8 yr; body height, 182.0±1.0 cm ; body mass, 74.7±0.7 kg) were randomly assigned to the integrated training group (IG, n=12) and non-integrated training group (NIG, n=12). The IG trained inside the padel court, integrating neuromuscular exercises with sport-specific (i.e., use of the racket) technical actions. The NIG trained outside the padel court, performing the same neuromuscular exercises and sport-specific technical actions as the IG, although not simultaneously. Before and after the intervention, athletes were assessed for their hand-grip strength, two legged and one-legged Abalakov jump, bench press performance, padel stroke velocity, cardiorespiratory endurance (30-15IFT), 5-m and 10-m linear sprint time and change of direction ability at 90º and 180º using left and right leg. Both groups improved their scores on Abalakov jump tests, bench press performance, stroke velocity, cardiorespiratory endurance (30-15IFT), and change of direction ability at 90º and 180º (all changes p<.05; effect size = 0.22-2.58). The IG improved stroke velocity compared to NIG (p<.05), and only the IG showed pre-post improvements (p<.05; effect size = 0.30-0.76) in change of direction ability at 90º and 180º involving the non-dominant leg (i.e., turn to the right). An 8-week in-season integrated training approach and a non-integrated training approach may induce similar improvements in athletic performance among highly trained male padel players. However, the neuromuscular training program involving an integration of padel-specific and non-specific training exercises may induce greater improvements in padel-specific performance (i.e., stroke velocity) and change of direction speed ability, particularly in movements involving the non-dominant leg

Trends and outcome of neoadjuvant treatment for rectal cancer: A retrospective analysis and critical assessment of a 10-year prospective national registry on behalf of the Spanish Rectal Cancer Project

Introduction: Preoperative treatment and adequate surgery increase local control in rectal cancer. However, modalities and indications for neoadjuvant treatment may be controversial. Aim of this study was to assess the trends of preoperative treatment and outcomes in patients with rectal cancer included in the Rectal Cancer Registry of the Spanish Associations of Surgeons. Method: This is a STROBE-compliant retrospective analysis of a prospective database. All patients operated on with curative intention included in the Rectal Cancer Registry were included. Analyses were performed to compare the use of neoadjuvant/adjuvant treatment in three timeframes: I)2006–2009; II)2010–2013; III)2014–2017. Survival analyses were run for 3-year survival in timeframes I-II. Results: Out of 14, 391 patients, 8871 (61.6%) received neoadjuvant treatment. Long-course chemo/radiotherapy was the most used approach (79.9%), followed by short-course radiotherapy ± chemotherapy (7.6%). The use of neoadjuvant treatment for cancer of the upper third (15-11 cm) increased over time (31.5%vs 34.5%vs 38.6%, p = 0.0018). The complete regression rate slightly increased over time (15.6% vs 16% vs 18.5%; p = 0.0093); the proportion of patients with involved circumferential resection margins (CRM) went down from 8.2% to 7.3%and 5.5% (p = 0.0004). Neoadjuvant treatment significantly decreased positive CRM in lower third tumors (OR 0.71, 0.59–0.87, Cochrane-Mantel-Haenszel P = 0.0008). Most ypN0 patients also received adjuvant therapy. In MR-defined stage III patients, preoperative treatment was associated with significantly longer local-recurrence-free survival (p < 0.0001), and cancer-specific survival (p < 0.0001). The survival benefit was smaller in upper third cancers. Conclusion: There was an increasing trend and a potential overuse of neoadjuvant treatment in cancer of the upper rectum. Most ypN0 patients received postoperative treatment. Involvement of CRM in lower third tumors was reduced after neoadjuvant treatment. Stage III and MRcN + benefited the most

Why Are Outcomes Different for Registry Patients Enrolled Prospectively and Retrospectively? Insights from the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF).

Background: Retrospective and prospective observational studies are designed to reflect real-world evidence on clinical practice, but can yield conflicting results. The GARFIELD-AF Registry includes both methods of enrolment and allows analysis of differences in patient characteristics and outcomes that may result. Methods and Results: Patients with atrial fibrillation (AF) and ≥1 risk factor for stroke at diagnosis of AF were recruited either retrospectively (n = 5069) or prospectively (n = 5501) from 19 countries and then followed prospectively. The retrospectively enrolled cohort comprised patients with established AF (for a least 6, and up to 24 months before enrolment), who were identified retrospectively (and baseline and partial follow-up data were collected from the emedical records) and then followed prospectively between 0-18 months (such that the total time of follow-up was 24 months; data collection Dec-2009 and Oct-2010). In the prospectively enrolled cohort, patients with newly diagnosed AF (≤6 weeks after diagnosis) were recruited between Mar-2010 and Oct-2011 and were followed for 24 months after enrolment. Differences between the cohorts were observed in clinical characteristics, including type of AF, stroke prevention strategies, and event rates. More patients in the retrospectively identified cohort received vitamin K antagonists (62.1% vs. 53.2%) and fewer received non-vitamin K oral anticoagulants (1.8% vs . 4.2%). All-cause mortality rates per 100 person-years during the prospective follow-up (starting the first study visit up to 1 year) were significantly lower in the retrospective than prospectively identified cohort (3.04 [95% CI 2.51 to 3.67] vs . 4.05 [95% CI 3.53 to 4.63]; p = 0.016). Conclusions: Interpretations of data from registries that aim to evaluate the characteristics and outcomes of patients with AF must take account of differences in registry design and the impact of recall bias and survivorship bias that is incurred with retrospective enrolment. Clinical Trial Registration: - URL: http://www.clinicaltrials.gov . Unique identifier for GARFIELD-AF (NCT01090362)

Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Sprint Acceleration Mechanics in Masters Athletes

Purpose The best sprint performances are usually reached between the ages of 20 and 30 yr; however, even in well-trained individuals, performance continues to decrease with age. Although this inevitable decrease in performance has been related to reductions in muscular force, velocity, and power capabilities, these measures have not been assessed in the specific context of sprinting. The aim of this study was to investigate the mechanical outputs of sprinting acceleration among masters sprinters to better understand the mechanical underpinnings of the age-related decrease in sprint performance. Methods The study took place during an international masters competition, with testing performed at the end of the warm-up for official sprint races. Horizontal ground reaction force, velocity, mechanical power outputs, and mechanical effectiveness of force application were estimated from running velocity-time data during a 30-m sprint acceleration in 27 male sprinters (39-96 yr). Data were presented in the form of age-related changes and compared with elite young sprinters data. Results Maximal force, velocity, and power outputs decreased linearly with age (all r > 0.84, P < 0.001), at a rate of 1% per year. Maximal power of the oldest subject tested was approximately one-ninth of that of younger world-class sprinters (3.57 vs 32.1 W·kg-1). Although the maximal effectiveness of horizontal force application also decreased with age, its decrease with increasing velocity within the sprint acceleration was not age dependent. Conclusions In addition to lower neuromuscular force, velocity, and power outputs, masters sprinters had a comparatively lower effectiveness of force application, especially at the beginning of the sprint

Running versus strength-based warm-up : acute effects on isometric knee extension function

This study investigated the influence of two warm-up protocols on neural and contractile parameters of knee extensors. A series of neuromuscular tests including voluntary and electrically evoked contractions were performed before and after running- (R (WU); slow running, athletic drills, and sprints) and strength-based (S (WU); bilateral 90 degrees back squats, Olympic lifting movements and reactivity exercises) warm ups (duration ~40 min) in ten-trained subjects. The estimated overall mechanical work was comparable between protocols. Maximal voluntary contraction torque (+15.6%; P &lt; 0.01 and +10.9%; P &lt; 0.05) and muscle activation (+10.9 and +12.9%; P &lt; 0.05) increased to the same extent after R (WU) and S (WU), respectively. Both protocols caused a significant shortening of time to contract (-12.8 and -11.8% after R (WU) and S (WU); P &lt; 0.05), while the other twitch parameters did not change significantly. Running- and strength-based warm ups induce similar increase in knee extensors force-generating capacity by improving the muscle activation. Both protocols have similar effects on M-wave and isometric twitch characteristics