Innate talent in sport: from theoretical concept to complex reality – comment on Baker & Wattie

Over the last 20 years, the concept of innate talent has been discussed in the literature, and different factors have been associated with talent in different sports. However, it should be noted that talent identification is sport-, or even position-specific, and no ‘one size fits all’ consensus can be established. Specific talent profiles should be developed, acknowledging the multidimensionality of talent by taking physical, physiological, cognitive, psychological, and motivational factors into account. These profiles should also be age-specific and adjusted for covariates such as maturational timing and training history. To make a step forward in talent identification, we should not only move ahead in identifying innate talent, but also acknowledge the multifaceted and dynamic nature of talent. Therefore, we recommend researchers and practitioners to start approaching talent as a multidimensional, complex system

Comparison of the ‘11+ Kids’ injury prevention programme and a regular warmup in children’s football (soccer) : a cost effectiveness analysis

Objective: To evaluate a potential reduction in injury related healthcare costs when using the '11+ Kids' injury prevention programme compared with a usual warmup in children's football. Methods: This cost effectiveness analysis was based on data collected in a cluster randomised controlled trial over one season from football teams (under-9 to under-13 age groups) in Switzerland. The intervention group (INT) replaced their usual warmup with '11+ Kids', while the control group (CON) warmed up as usual. Injuries, healthcare resource use and football exposure (in hours) were collected prospectively. We calculated the mean injury related costs in Swiss Francs (CHF) per 1000 hours of football. We calculated the cost effectiveness (the direct net healthcare costs divided by the net health effects of the '11+ Kids' intervention) based on the actual data in our study (trial based) and for a countrywide implementation scenario (model based). Results: Costs per 1000 hours of exposure were CHF228.34 (95% CI 137.45, 335.77) in the INT group and CHF469.00 (95% CI 273.30, 691.11) in the CON group. The cost difference per 1000 hours of exposure was CHF-240.66 (95% CI -406.89, -74.32). A countrywide implementation would reduce healthcare costs in Switzerland by CHF1.48 million per year. 1002 players with a mean age of 10.9 (SD 1.2) years participated. During 76 373 hours of football, 99 injuries occurred. Conclusion: The '11+ Kids' programme reduced the healthcare costs by 51% and was dominant (ie, the INT group had lower costs and a lower injury risk) compared with a usual warmup. This provides a compelling case for widespread implementation

A machine learning approach to assess injury risk in elite youth football players

Purpose To assess injury risk in elite-level youth football (soccer) players based on anthropometric, motor coordination and physical performance measures with a machine learning model. Methods A total of 734 players in the U10 to U15 age categories (mean age, 11.7 +/- 1.7 yr) from seven Belgian youth academies were prospectively followed during one season. Football exposure and occurring injuries were monitored continuously by the academies' coaching and medical staff, respectively. Preseason anthropometric measurements (height, weight, and sitting height) were taken and test batteries to assess motor coordination and physical fitness (strength, flexibility, speed, agility, and endurance) were performed. Extreme gradient boosting algorithms (XGBoost) were used to predict injury based on the preseason test results. Subsequently, the same approach was used to classify injuries as either overuse or acute. Results During the season, half of the players (n= 368) sustained at least one injury. Of the first occurring injuries, 173 were identified as overuse and 195 as acute injuries. The machine learning algorithm was able to identify the injured players in the hold-out test sample with 85% precision, 85% recall (sensitivity) and 85% accuracy (f1 score). Furthermore, injuries could be classified as overuse or acute with 78% precision, 78% recall, and 78% accuracy. Conclusions Our machine learning algorithm was able to predict injury and to distinguish overuse from acute injuries with reasonably high accuracy based on preseason measures. Hence, it is a promising approach to assess injury risk among elite-level youth football players. This new knowledge could be applied in the development and improvement of injury risk management strategies to identify youth players with the highest injury risk

Accuracy of maturity prediction equations in individual elite football players

Background Equations predicting age at peak height velocity (APHV) are often used to assess somatic maturity and to adjust training load accordingly. However, information on the intra-individual accuracy of APHV in youth athletes is not available. Aim The purpose of this study is to assess the accuracy of predication equations for the estimation of APHV in individual youth male football players. Subjects and methods Body dimensions were measured at least every three months in 17 elite youth male football players (11.9 +/- 0.8 years at baseline) from the 2008-2009 through the 2011-2012 seasons. APHV was predicted at each observation with four suggested equations. Predicted APHV was compared to the player's observed APHV using one-sample-t-tests and equivalence-tests. Longitudinal stability was assessed by comparing the linear coefficient of the deviation to zero. Results Predicted APHV was equivalent to the observed APHV in none of the players. A difference with a large effect size (Cohen'sd > 0.8) was noted in 87% of the predictions. Moreover, predictions were not stable over time in 71% of the cases. Conclusions None of the evaluated prediction equations is accurate for estimating APHV in individual players nor are predictions stable over time, which limits their utility for adjusting training programmes

Long-term effectiveness of a fundamental motor skill intervention in Belgian children : a 6-year follow-up

The aim of this study was (1) to examine the long-term effectiveness of the 'Multimove for Kids' program, a 30-week fundamental motor skill intervention (approximately 1 hour per week) for typically developing children between 3 and 8 years, and (2) to determine the influence of participation in organized sports on motor competence (MC) six years after the intervention. Of the 992 children who took part in the 'Multimove' program, 399 (intervention group: N=228, control group: N=171) were tested again at 6-year follow-up. MC was measured with the Test of Gross Motor Development, 2nd Edition. To examine the long-term impact of 'Multimove' on MC and the effect of participation in organized sports a latent growth curve analysis was conducted. After the 30-week intervention, the intervention group outperformed the control group (β=5.57, p<.001). However, when the entire study period, including the 6-year follow-up, was considered, the intervention group made less progress in MC than the control group (β=-0.41, p<.05). Looking at the engagement in organized sports, it was found that years of experience before the intervention had no significant influence on the evolution of MC over time, whereas a positive effect was observed for children’s average sports participation (h/week) during the 6-year retention period (β=0.14, p<.001). Finally, children practicing predominantly object control-oriented sports during retention, obtained slightly better MC scores at follow-up (β=0.01, p<.01). The effect of the 'Multimove' intervention does not have a long-term effect on the development of MC. However, participation in organized sports has a positive influence on MC over time

Efficacy and Safety of Rivaroxaban for Postoperative Thromboprophylaxis in Patients After Bariatric Surgery: A Randomized Clinical Trial.

IMPORTANCE Venous thromboembolism (VTE) is a leading cause of morbidity and mortality after bariatric surgery. Clinical end point studies on thromboprophylaxis with direct oral anticoagulants in patients undergoing bariatric surgery are lacking. OBJECTIVE To assess the efficacy and safety of a prophylactic dose of 10 mg/d of rivaroxaban for both 7 and 28 days after bariatric surgery. DESIGN, SETTING, AND PARTICIPANTS This assessor-blinded, phase 2, multicenter randomized clinical trial was conducted from July 1, 2018, through June 30, 2021, with participants from 3 academic and nonacademic hospitals in Switzerland. INTERVENTION Patients were randomized 1 day after bariatric surgery to 10 mg of oral rivaroxaban for either 7 days (short prophylaxis) or 28 days (long prophylaxis). MAIN OUTCOMES AND MEASURES The primary efficacy outcome was the composite of deep vein thrombosis (symptomatic or asymptomatic) and pulmonary embolism within 28 days after bariatric surgery. Main safety outcomes included major bleeding, clinically relevant nonmajor bleeding, and mortality. RESULTS Of 300 patients, 272 (mean [SD] age, 40.0 [12.1] years; 216 women [80.3%]; mean body mass index, 42.2) were randomized; 134 received a 7-day and 135 a 28-day VTE prophylaxis course with rivaroxaban. Only 1 thromboembolic event (0.4%) occurred (asymptomatic thrombosis in a patient undergoing sleeve gastrectomy with extended prophylaxis). Major or clinically relevant nonmajor bleeding events were observed in 5 patients (1.9%): 2 in the short prophylaxis group and 3 in the long prophylaxis group. Clinically nonsignificant bleeding events were observed in 10 patients (3.7%): 3 in the short prophylaxis arm and 7 in the long prophylaxis arm. CONCLUSIONS AND RELEVANCE In this randomized clinical trial, once-daily VTE prophylaxis with 10 mg of rivaroxaban was effective and safe in the early postoperative phase after bariatric surgery in both the short and long prophylaxis groups. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03522259

Mid-term changes in cognitive functions in patients with atrial fibrillation: a longitudinal analysis of the Swiss-AF cohort

Background: Longitudinal association studies of atrial fibrillation (AF) and cognitive functions have shown an unclear role of AF-type and often differ in methodological aspects. We therefore aim to investigate longitudinal changes in cognitive functions in association with AF-type (non-paroxysmal vs. paroxysmal) and comorbidities in the Swiss-AF cohort. Methods: Seven cognitive measures were administered up to five times between 2014 and 2022. Age-education standardized scores were calculated and association between longitudinal change in scores and baseline AF-type investigated using linear mixed-effects models. Associations between AF-type and time to cognitive drop, an observed score of at least one standard deviation below individual's age-education standardized cognitive scores at baseline, were studied using Cox proportional hazard models of each cognitive test, censoring patients at their last measurement. Models were adjusted for baseline covariates.Results2,415 AF patients (mean age 73.2 years; 1,080 paroxysmal, 1,335 non-paroxysmal AF) participated in this Swiss multicenter prospective cohort study. Mean cognitive scores increased longitudinally (median follow-up 3.97 years). Non-paroxysmal AF patients showed smaller longitudinal increases in Digit Symbol Substitution Test (DSST), Cognitive Construct Score (CoCo)and Trail Making Test part B (TMT-B) scores vs. paroxysmal AF patients. Diabetes, history of stroke/TIA and depression were associated with worse performance on all cognitive tests. No differences in time to cognitive drop were observed between AF-types in any cognitive test. Conclusion: This study indicated preserved cognitive functioning in AF patients, best explained by practice effects. Smaller practice effects were found in non-paroxysmal AF patients in the DSST, TMT-B and the CoCo and could indicate a marker of subtle cognitive decline. As diabetes, history of stroke/TIA and depression—but not AF-type—were associated with cognitive drop, more attention should be given to risk factors and underlying mechanisms of AF

Mid-term changes in cognitive functions in patients with atrial fibrillation: a longitudinal analysis of the Swiss-AF cohort.

BACKGROUND Longitudinal association studies of atrial fibrillation (AF) and cognitive functions have shown an unclear role of AF-type and often differ in methodological aspects. We therefore aim to investigate longitudinal changes in cognitive functions in association with AF-type (non-paroxysmal vs. paroxysmal) and comorbidities in the Swiss-AF cohort. METHODS Seven cognitive measures were administered up to five times between 2014 and 2022. Age-education standardized scores were calculated and association between longitudinal change in scores and baseline AF-type investigated using linear mixed-effects models. Associations between AF-type and time to cognitive drop, an observed score of at least one standard deviation below individual's age-education standardized cognitive scores at baseline, were studied using Cox proportional hazard models of each cognitive test, censoring patients at their last measurement. Models were adjusted for baseline covariates. RESULTS 2,415 AF patients (mean age 73.2 years; 1,080 paroxysmal, 1,335 non-paroxysmal AF) participated in this Swiss multicenter prospective cohort study. Mean cognitive scores increased longitudinally (median follow-up 3.97 years). Non-paroxysmal AF patients showed smaller longitudinal increases in Digit Symbol Substitution Test (DSST), Cognitive Construct Score (CoCo)and Trail Making Test part B (TMT-B) scores vs. paroxysmal AF patients. Diabetes, history of stroke/TIA and depression were associated with worse performance on all cognitive tests. No differences in time to cognitive drop were observed between AF-types in any cognitive test. CONCLUSION This study indicated preserved cognitive functioning in AF patients, best explained by practice effects. Smaller practice effects were found in non-paroxysmal AF patients in the DSST, TMT-B and the CoCo and could indicate a marker of subtle cognitive decline. As diabetes, history of stroke/TIA and depression-but not AF-type-were associated with cognitive drop, more attention should be given to risk factors and underlying mechanisms of AF

Exercise-based injury prevention in football

Injuries-a major concern in a high-intensity contact sport like football-are associated with possible short- and long-term harmful consequences for the individual, the team and club as well as for the whole society. Consequently, there is need for effective injury prevention in football at all levels of play, in all age groups and in both genders. The present review summarizes the current scientific evidence focusing on exercise-based injury prevention and presenting promising prevention strategies in different football populations and settings. There is convincing evidence that multimodal exercise-based injury prevention programs (IPP) can reduce injury incidence by more than 30% in athletes of different age groups and in both genders. Although relevant effects have already been shown for short sessions, increased frequency and regular integration into normal practice may increase efficacy up to an injury reduction of 50%. Most programs last about 15 min and can easily replace traditional warm-up programs. Furthermore, there is increasing evidence that IPP beneficially affect neuromuscular performance parameters and biomechanical movement characteristics, which are associated with injury risk. There remains, however, a major gap between research on the short-term efficacy and long-term intervention strategies. IPP should be implemented continuously and with high fidelity as training effects are transient. It is crucial that future studies report implementation components in detail in order to facilitate the replication of successful interventions