Methodology and exercises to reduce the hamstring injury risk: from literature knowledges to the field

knowledge and research about prevention has increased, the injury incidence remains very high, especially as regards the hamstring district. As can be seen from the scientific literature, there are many studies that have described risk factors, but above all what strategies can be used to decrease this incidence through the prevention exercises. The exercise considered the gold standard for the hamstring injuries prevention is the Nordic hamstring although the literature highlights the particular complexity of the anatomical district of hamstrings. For these reasons, it seems simplistic and reductive to assume that one exercise is sufficient. In this study is proposed further exercises proposed in the literature that can integrate the traditional Nordic hamstring and help to activate more fully all the muscle heads that make up the hamstrings. In conclusion, in a prevention session or in a strength session, in addition to the Nordic hamstring exercise, other exercises could be included, such as the Laying Kick, the Standing Kick, the Nordic bump, the Nordic with return, the Cranes and the Cranes return

183 Acute fatigue effects after small-sided games on functional asymmetry and short sprint performance in young soccer players

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Validity and reliability of isometric-bench for knee isometric assessment

There is a strong need for a new, probably cheaper, smaller, and more portable isometric dynamometer. With this aim, we investigated the concurrent validity and reliability of a low-cost portable dynamometer to measure the isometric strength of the lower limb. Seventeen young participants (age 16.47 \ub1 0.51 years) were randomly assessed on three different days for knee flexion and extension isometric forces with two different devices: a commonly used isokinetic dynamometer (ISOC) and a portable isometric dynamometer prototype (ISOM). No significant differences were observed between the ISOC and the ISOM (all comparisons p > 0.05). Test-retest comparison showed the ISOM to have high reliability (ICC 0.879-0.990). This study showed that measurements with the ISOM could be performed without systematic bias and with high reliability. The ISOM is a device that is able to assess knee isometric strength with excellent concurrent validity and reliability

Effect of a quality improvement program on compliance to the sepsis bundle in non-ICU patients: a multicenter prospective before and after cohort study

ObjectiveSepsis and septic shock are major challenges and economic burdens to healthcare, impacting millions of people globally and representing significant causes of mortality. Recently, a large number of quality improvement programs focused on sepsis resuscitation bundles have been instituted worldwide. These educational initiatives have been shown to be associated with improvements in clinical outcomes. We aimed to evaluate the impact of a multi-faceted quality implementing program (QIP) on the compliance of a “simplified 1-h bundle” (Sepsis 6) and hospital mortality of severe sepsis and septic shock patients out of the intensive care unit (ICU).MethodsEmergency departments (EDs) and medical wards (MWs) of 12 academic and non-academic hospitals in the Lombardy region (Northern Italy) were involved in a multi-faceted QIP, which included educational and organizational interventions. Patients with a clinical diagnosis of severe sepsis or septic shock according to the Sepsis-2 criteria were enrolled in two different periods: from May 2011 to November 2011 (before-QIP cohort) and from August 2012 to June 2013 (after-QIP cohort).Measurements and main resultsThe effect of QIP on bundle compliance and hospital mortality was evaluated in a before–after analysis. We enrolled 467 patients in the before-QIP group and 656 in the after-QIP group. At the time of enrollment, septic shock was diagnosed in 50% of patients, similarly between the two periods. In the after-QIP group, we observed increased compliance to the “simplified rapid (1 h) intervention bundle” (the Sepsis 6 bundle – S6) at three time-points evaluated (1 h, 13.7 to 18.7%, p = 0.018, 3 h, 37.1 to 48.0%, p = 0.013, overall study period, 46.2 to 57.9%, p < 0.001). We then analyzed compliance with S6 and hospital mortality in the before- and after-QIP periods, stratifying the two patients’ cohorts by admission characteristics. Adherence to the S6 bundle was increased in patients with severe sepsis in the absence of shock, in patients with serum lactate <4.0 mmol/L, and in patients with hypotension at the time of enrollment, regardless of the type of admission (from EDs or MWs). Subsequently, in an observational analysis, we also investigated the relation between bundle compliance and hospital mortality by logistic regression. In the after-QIP cohort, we observed a lower in-hospital mortality than that observed in the before-QIP cohort. This finding was reported in subgroups where a higher adherence to the S6 bundle in the after-QIP period was found. After adjustment for confounders, the QIP appeared to be independently associated with a significant improvement in hospital mortality. Among the single S6 procedures applied within the first hour of sepsis diagnosis, compliance with blood culture and antibiotic therapy appeared significantly associated with reduced in-hospital mortality.ConclusionA multi-faceted QIP aimed at promoting an early simplified bundle of care for the management of septic patients out of the ICU was associated with improved compliance with sepsis bundles and lower in-hospital mortality

Retrospective evaluation of whole exome and genome mutation calls in 746 cancer samples

Funder: NCI U24CA211006Abstract: The Cancer Genome Atlas (TCGA) and International Cancer Genome Consortium (ICGC) curated consensus somatic mutation calls using whole exome sequencing (WES) and whole genome sequencing (WGS), respectively. Here, as part of the ICGC/TCGA Pan-Cancer Analysis of Whole Genomes (PCAWG) Consortium, which aggregated whole genome sequencing data from 2,658 cancers across 38 tumour types, we compare WES and WGS side-by-side from 746 TCGA samples, finding that ~80% of mutations overlap in covered exonic regions. We estimate that low variant allele fraction (VAF < 15%) and clonal heterogeneity contribute up to 68% of private WGS mutations and 71% of private WES mutations. We observe that ~30% of private WGS mutations trace to mutations identified by a single variant caller in WES consensus efforts. WGS captures both ~50% more variation in exonic regions and un-observed mutations in loci with variable GC-content. Together, our analysis highlights technological divergences between two reproducible somatic variant detection efforts

Single leg squat

La richiesta di controllo e di equilibrio statico e dinamico costituisce una delle problematiche del calciatore, il quale svolge gran parte della sua attività sportiva quasi sempre in condizione di appoggio monopodalico, quindi in equilibrio precario: nell’articolo una proposta di allenamento unilaterale

Hamstring. Dal rischio di infortunio alle strategie di prevenzione

Il testo parte dalle evidenze scientifiche inerenti il rischio di infortunio e la prevenzione dei traumi agli hamstring (muscoli flessori della coscia). Il testo descrive il distretto anatomico e la fisiologia della contrazione degli hamstring per fornire indicazioni metodologiche a i preparatori atletici ed ai tecnici degli sport di squadra ed agli allenatori specialisti nelle discipline di corsa veloce, Si parte dall’individuazione e dall’analisi degli studi epidemiologici, passando alla descrizione degli aspetti anatomici per arrivare alle proposte da campo, a corpo libero o con l’utilizzo di piccoli attrezzi. Descrive, altresì, metodi di valutazione della funzionalità del distretto degli hamstring

L’allenamento per il distretto degli hamstring nel calciatore: tra prevenzione e perfomance

La possibilità di poter contare su un modello di studio relativo agli aspetti preventivi ha contribuito alla raccolta di numerose informazioni di tipo epidemiologico in grado di sostenere le scelte metodologiche adottate dai singoli staff. Lo studio descrive la biomeccanica delle corse veloci, le modalità di insorgenza degli infortuni al distretto degli hamstring e le principali metodologie di prevenzione. Si illustrano esercitazioni e tecniche esecutive delle medesim

Hamstring: come prevenire gli infortuni nel calciatore

La preparazione atletica riveste oggi un duplice ruolo, ossia elevare i livelli di performance dei singoli calciatori e ridurre per ciascun atleta il rischio di infortunio. La possibilità di poter contare su un modello di studio relativo agli aspetti preventivi ha contribuito alla raccolta di numerose informazioni di tipo epidemiologico in grado di sostenere le scelte metodologiche adottate dai singoli staff. Le gestualità che espongono al rischio infortunio potrebbero essere rappresentate dalle alte velocità richieste dal gioco, gli arresti improvvisi, le ripartenze, i repentini cambi di direzione e le azioni tecnico specifiche ad alta velocità. Tali lesioni hanno anche un’alta percentuale di recidiva, tanto che un terzo degli infortuni può ripresentarsi entro due settimane dal primo evento lesivo, senza considerare che tale rischio resta alto per circa un anno laddove, spesso, la gravità della seconda lesione è maggiore della prima