Intérêt de l’enclouage centromédullaire dans les fractures du quart distal de la jambe: à propos de 30 cas

Les fractures du quart distal de la jambe, sont des fractures dont le trait est situé au niveau du quart inférieur du tibia. Elles sont réputées graves et posent à la fois des problèmes de consolidation, de contention et de stabilité. Nous présentons l'expérience du service de traumatologie orthopédie de l'Hôpital militaire Avicenne de Marrakech, concernant 30 fractures fermées du quart inférieur de la jambe, sur une période de 10 ans (de Janvier 2001 à Décembre 2010) ayant reçu un enclouage centromédullaire. Le montage était verrouillé à 80% des cas et simple dans les autres cas. La moyenne d'âge de nos patients était de 36 ans. Il existait une nette prédominance masculine avec 27 hommes pour 3 femmes. La consolidation a été obtenue dans un délai normal de 17 semaines en moyenne et les résultats fonctionnels était satisfaisants. Un seul cas d'infection est survenu à 6 mois du geste chirurgical soit 3,3% et aucune autre complication n'a été mentionnée. Un cal vicieux a été retrouvé chez 30% de nos patients. Nos données épidémiologiques et nos résultats sont presque identiques à ceux de la littérature. Quant aux résultats angulaires, ils sont nettement inférieurs aux séries de plaques, à l'opposé, leurs résultats infectieux portent à la prudence et certains séries de clous rapportent d'excellents résultats angulaires à condition d'avoir un montage stable. A la lumière de ces résultats, nous sommes en droit de conclure au grand intérêt d'élargir les indications classiques de l'enclouage centromédullaire verrouillé à la prise en charge des fractures du quart distal de la jambe, à condition d'avoir un montage stable par un double verrouillage distal et une ostéosynthèse primaire des fractures distales de la fibula.Mots clés: Fracture du quart inférieur, jambe, enclouage centromédullaire, plaque visséeEnglish Title: Role of centro-medullary nailing in fractures of the distal quarter of the leg: about 30 casesEnglish AbstractThe fractures of the distal quarter of the leg are characterized by fracture line located at the level of the lower quarter of the tibia, according to Gerard and Evrard definition [1]. They are serious and pose problems for consolidation, immobilization and stability. We here describe our experience in the Department of Orthopaedics and Traumatology at the Avicenne Military Hospital, Marrakech. We report 30 cases of closed fractures of the lower quarter of the leg treated with centro-medullary nailing over a period of 10 years (January 2001-December 2010). Locked nailing was performed in 80% of cases and simple nailing was performed in the other cases. The average age of patients was 36 years. There was a clear male predominance (27 men, 3 women). The average time for consolidation was 17 weeks and functional outcomes were satisfactory. A single case of infection occurred 6 months after surgery (3.3%) and no other complication was reported. Malunion was detected in 30% of patients. Our epidemiological data and results were almost identical to those in the literature. Angular results were significantly lower than those obtained with the series of plates. By contrast, data on infections called for caution and some nails produced excellent angular results when nail fixation was stable. In the light of these results, codified indications for locked centro-medullary nailing should be extended to the fractures of the lower quarter of the leg, provided that stable fixation using double screw distal locking and primary osteosynthesis of distal fibula fractures are performed.Keywords: Fractures of the lower quarter, leg, centro-medullary nailing, screwed plat

The etiology of neuromuscular fatigue induced by the 5-m shuttle run test in adult soccer players

This study investigated the etiology of neuromuscular fatigue induced by a 5-m shuttle run test (5MSRT) in soccer players. Nineteen adult male amateur soccer players (age: 20.0 ± 2.9 years) participated in the present study. Before and after the 5MSRT, they were instructed to complete a maximal voluntary isometric contraction (MVIC) of the knee extensors (KE) during and after which two electrical stimulations were applied at the femoral nerve. Voluntary activation level (VAL), surface electromyography recordings (sEMG), electrophysiological (Mmax) and potentiated resting twitch (Ptw) responses of the KE were compared between pre- and post-5MSRT. Rating of perception exertion (RPE) was also assessed before, during the test immediately following each sprint repetition and after the test. The distance covered during each sprint significantly decreased as the number of trials performed increased (p<.05). The RPE reported following each sprint significantly increased throughout the test. In addition, MVIC (-9%), sEMG (-23%), VAL (-15%), Ptw (-26%) and Mmax (~22%) of the KE were lowered from pre-to-post 5MSRT (.001 < p < .01). The 5MSRT induced a decrease of repeated-sprint running performance and MVIC of the KE. These decrements were accompanied by lowered VAL, sEMG, Ptw and Mmax values of the KE reflecting the involvement of both the central and peripheral origins in the 5MSRT-induced fatigue. Given the important muscle stress induced by 5MSRT, this strenuous test must be applied with caution, after an inevitable familiarization phase, and not during the competition period to avoid the risk of serious injury

Training and fitness variability in elite youth soccer:perspectives from a difficulty prediction model

Research within sport science disciplines seeks to enhance performance via the combination of factors that influences the team’s periodization. The current study aimed to investigate the variations in training load (TL), and the consequential changes in fitness variables, based on the use of match difficulty prediction model (MDP), level of opposition (LOP), days between matches, and match location during 12 weeks in the competitive period I. Seventeen elite soccer players (age = 17.57 ± 0.49 years; body height 1.79 ± 0.05 m; body weight 72.21 ± 6.96 kg), have completed a Yo-Yo intermittent recovery test, a running-based anaerobic sprint test, a soccer-specific repeated sprint ability, and a vertical jump test to identify changes in players fitness. TL was determined by multiplying the RPE of the session by its duration in minutes (s-RPE). Training monotony, strain, and acute:chronic workload ratio (ACWR) were also assessed. A simple regression model was conducted and the highest variances explained (R2) were used. The LOP score explained most of the variance in ACWR (r= 0.606, R2=0.37). TL declined significantly when compared the match-day by the first three days and the last three days of the week. No significant difference was found in s-RPE between the high and low MDP factor. Strong negative correlations were reported between ACWR and LOP (r=-0.714, p<.01). In addition, we found a significant improvement in repeated sprint ability, aerobic and anaerobic fitness variables between pre- and post-test in fatigue index (d=1.104), best testing time, ideal time, total time and mean-best (d=0.518-0.550), and aerobic and anaerobic fitness variables (p<.05), respectively. The MDP could facilitate the training prescription as well as the distribution of training intensities with high specificity, providing a long-term youth player’s development and allowing teams to maintain optimal fitness leading into more difficult matches

The effect of a daytime 60-min nap opportunity on postural control in highly active individuals

Although napping is commonly used as a strategy to improve numerous physical and cognitive performances, the efficacy of this strategy for improving postural balance has not yet been elucidated. Thus, the aim of this study was to conduct a comprehensive examination of the effect of a 60 min nap opportunity (N60) on different components of postural control. Ten highly active individuals (age = 27 ± 3.5 y, height = 1.75 ± 0.52 m, weight = 66.02 ± 8.63 kg) performed, in a randomized order, two afternoon test sessions following no nap (NN) and N60. Postural balance was assessed using the sensory organisation test (SOT), the unilateral stance test (UST), and the limits of Stability Test performed on NeuroCom(®) Smart Balance Master. The subjective rating of sleepiness before and after the nap conditions was also assessed. Compared to NN, N60 improved the composite balance score (p 0.05). Overall, a 60 min post lunch nap opportunity may be viable for improving static balance, although further work, involving larger samples and more complex motor activities, is warranted

The effects of exercise difficulty and time-of-day on the perception of the task and soccer performance in child soccer players

In soccer, accurate kicking skills are important determinants of successful performance. A successful kick must meet several criteria, including speed, accuracy, and timing. In fact, players who are able to kick the ball more accurately under various difficulties, such as time pressure, space constraints, the opponent’s pressure, and the distance between the kicking point and the goal, have a clear advantage during soccer games. The aim of the present study was to investigate the effect of exercise difficulty and time-of-day on perceived task difficulty and kicking performance. Accordingly, 32 boys (age: 11 ± 0.7 years; height: 1.45 ± 0.07 m; body-mass: 38.9 ± 7.8 kg) performed shooting accuracy tests under two difficulty levels (distance (long-distance (LD) vs. short-distance (SD)) and time pressure (Without-time-pressure (WTP) vs. With-time-pressure (TP)) at 08:00 h and 17:00 h. Absolute-error, variable-error, and constant-error were evaluated during the kicking tasks, in addition to ball velocity and shooting quality. Moreover, rating-of-perceived-exertion score (RPE), feeling-scale (FS), and perceived difficulty were completed immediately at the end of each test. The results showed that shooting quality was not affected by the time-of-day, but it was better in WTP vs. TP (p p p p < 0.05). In conclusion, specific soccer skills of boys were not time-of-day dependent, but they may be associated with time pressure and task difficulty

Religious fasting and its impacts on individual, public, and planetary health: Fasting as a “religious health asset” for a healthier, more equitable, and sustainable society

Religious fasting is practiced by people of all faiths, including Christianity, Islam, Buddhism, Jainism, as well as Hinduism, Judaism, and Taoism. Individual/clinical, public, global, and planetary health has traditionally been studied as separate entities. Nevertheless, religious fasting, in conjunction with other religious health assets, can provide several opportunities, ranging from the individual to the population, environmental, and planetary levels, by facilitating and supporting societal transformations and changes, such as the adoption of healthier, more equitable, and sustainable lifestyles, therein preserving the Earth's systems and addressing major interconnected, cascading, and compound challenges. In this review, we will summarize the most recent evidence on the effects of religious fasting, particularly Orthodox and Ramadan Islamic fasting, on human and public health. Further, we will explore the potential effects of religious fasting on tackling current environmental issues, with a special focus on nutrition/food restriction and planetary health. Finally, specific recommendations, particularly around dietary intake during the fasting rituals, will be provided to ensure a sustainable healthy planet

Independent and combined effects of all-out sprint and low-intensity continuous exercise on plasma oxidative stress biomarkers in trained judokas

The purpose of this study was to assess oxidative stress biomarkers prior to and following different forms of exercise. Ten elite male judokas (age: 18.1±1.7 years, athletic experience: 6 years with a training frequency of 6 Judo-sessions/week) performed three cycle ergometry sessions comprising a 30s Wingate test (MAX), 30 min at 60% maximal-aerobic-power-output (LOW) or these two exercise protocols combined (COMBINED) in a repeated-measures design. Venous blood-samples were collected before, and 0(P0), 5(P5), 10(P10) and 20(P20) min after each exercise protocol and assessed for malondialdehyde concentration ([MDA]), glutathione peroxidase (GPX), superoxide dismutase (SOD) and glutathione reductase (GR) content, and total-antioxidant-status (TAS). Plasma [MDA] was found to be increased above baseline at P0 and P5 in the MAX, LOW and COMBINED conditions (p<0.05), but was greater at P10 and P20 in the LOW condition compared to MAX and COMBINED conditions (p<0.05). Plasma GPX and SOD content increased above baseline at P0 in MAX and COMBINED and at P5 in LOW (p<0.05), with GR content being similar between groups at P0 and P5 (p>0.05). Twenty min post-exercise, plasma GPX, SOD, GR content and TAS were lower in the MAX compared to the LOW and COMBINED conditions (p<0.05). In conclusion, the findings from this study reveal that redox-related biomarkers exhibited divergent response dynamics following different forms of exercise, which might have implications for understanding the mechanisms of exercise-induced skeletal muscle fatigue and adaptive remodeling

Ramadan Observance Is Associated with Impaired Kung-Fu-Specific Decision-Making Skills

The aim of the present study is to evaluate the effect of Ramadan observance (RAM) on decision-making in Kung-Fu athletes. Fourteen male Kung-Fu athletes (mean age = 19 ± 3 years) completed two test sessions: before Ramadan (BR) and at the end of Ramadan (ER). In the afternoon of each session (between 16:00 h and 18:00 h), participants completed: Epworth Sleepiness Scale (ESS), Profile of Mood States (POMS), and Pittsburg Sleep Quality Index (PSQI). Subjects also reported subjective fatigue, alertness, and concentration. Additionally, all participants performed video-based decision-making tasks (i.e., reaction time and decision-making). Results indicated that reaction time decreased by 30% at ER vs. BR (p p p p p < 0.05). In conclusion, Ramadan observance was associated with an adverse effect on sleep and decision making, as well as feelings of fatigue, alertness, and concentration

Psychosocial Effects and Use of Communication Technologies during Home Confinement in the First Wave of the COVID-19 Pandemic in Italy and The Netherlands

(1) Background: The COVID-19 pandemic forced people from all around the globe to strongly modify their daily routines, putting a significant strain on the social aspects of daily lives. While the first wave of the pandemic was a very challenging time in all countries, it is still uncertain whether various lockdown intensities and infection rates differed regarding their psychosocial impact. This work therefore aimed to investigate (i) the psychosocial effects of home confinement in two European countries that underwent different lockdown intensities: Italy and the Netherlands and (ii) the role of communication technology in relation to feelings of loneliness. (2) Methods: A cross-sectional online survey inquiring about different psychosocial variables and the use of and satisfaction towards communication technology was circulated among the general public during the first wave of the COVID-19 pandemic. In total, 629 participants (66% female, 68% from the Netherlands) answered each question twice, referring to “before” and “during” the pandemic. (3) Results: We found significant negative effects of COVID-19 home confinement on depressive feelings (p < 0.001, %∆ = +54%), loneliness (p < 0.001, %∆ = +37.3%), life satisfaction (p < 0.001, %∆ = −19.8%) and mental wellbeing (p < 0.001, %∆ = −10.6%) which were accompanied with a significantly increased need for psychosocial support (p < 0.001, %∆ = +17.3%). However, the magnitude of psychosocial impact did not significantly differ between residents undergoing a more intense (Italy) versus a less intense (Netherlands) lockdown, although the decrease in social participation was found to be significantly different for both countries (z = −7.714, p < 0.001). Furthermore, our findings demonstrate that the increase in loneliness was associated with the adoption of new digital communication tools (r = 0.21, p < 0.001), and significantly higher for individuals who started to adopt at least one new digital communication tool during confinement than for those who did not (z = −4.252, p < 0.001). (4) Conclusions: This study highlights that, although COVID-19 home confinement significantly impacted psychosocial wellbeing during the first wave of the pandemic, this impact did not differ based on lockdown intensity. Recognizing the increasing adoption of digital communication technology in an attempt to reduce lockdown loneliness, future studies should investigate what is needed from the technology to achieve this effect