Ground reaction forces, asymmetries and performance of change of direction tasks in youth elite female basketball players

The magnitude and direction of inter-limb asymmetries in a change of direction (COD) have increased interest in scientific research in recent years. This present study aimed to investigate the magnitude of asymmetries in an elite youth female basketball sample (n = 18, age = 17.79 ± 0.67 y) and determine its directionality using force platform technology. Participants performed 70◦ and 180◦ COD tests analyzing the following variables: time, ground contact time (GCT) and ground reaction forces (GRF) along the anterior–posterior, mediolateral, and vertical axes. Inter-limb asymmetries were evident in both COD tests, with substantial differences observed between limbs (p < 0.01). The asymmetry values ranged from 3.02% to 24.31% in COD 180◦ and from 1.99% to 21.70% in COD 70◦, with anterior–posterior GRF consistently exhibiting the highest asymmetry magnitude. Additionally, the directionality exhibited variability between the tests, indicating poor agreement and suggesting the independent directionality of asymmetries across tasks. Moreover, players required more time to complete the COD 180◦, the GCT was noticeably longer for the COD 180◦ than for the COD 70◦, and GRF varied across the axis, suggesting that players adapt uniquely to the specific demands of each task. The utilization of force platforms presents a comprehensive approach to assess asymmetries and COD variables performance variables which are “angle-dependent”, which could have important implications for COD screening and effective training interventions

Real-life effectiveness of omalizumab in difficult-to-treat versus severe asthma: A national cohort study in Belgium

Background: Guidelines recommend omalizumab in patients with uncontrolled severe allergic asthma. We investigated real-life use of omalizumab, the proportion of patients fulfilling eligibility criteria, its costs and its effectiveness. Method: In a cohort of asthma patients initiating treatment with omalizumab in Belgium between 2010 and 2016, we investigated fulfilment of eligibility criteria (chronic use of high-dose inhaled corticosteroids (ICSs) plus long-acting β2-agonists (LABAs) and ⩾2 severe asthma exacerbations in previous year), and compared hospitalisations and systemic corticosteroid consumption in the year before and after omalizumab initiation. We computed healthcare costs in the respective time periods and compared the cost per prevented hospitalisation in patients fulfilling eligibility criteria versus those who did not. Results: Between 2010 and 2016, omalizumab treatment was initiated in 2068 patients with asthma; only 24% fulfilled the eligibility criteria, mainly due to nonadherence to high-dose ICSs + LABAs. The proportion of patients hospitalised f

Upper airway dynamics during negative expiratory pressure in apneic and non-apneic awake snorers

BACKGROUND: The ability of negative expiratory pressure (NEP) technique to differentiate between awake snorers with and without obstructive sleep apnea-hypopnea (OSAH) was investigated. METHODS: Forty-eight subjects with sleep disordered breathing (SDB) and 7 healthy subjects, as non-snorer controls, underwent the NEP application of -5 and -7 cmH(2)O in the seated and supine position during wakefulness, after performing a sleep study. The upper airway collapsibility was assessed by computing the volume exhaled during the first 0.5 sec. (V,NEP(0.5)) and 1 sec. (V,NEP(1)) following the NEP start. RESULTS: Patients with severe (AHI ≥ 30) (n = 19) and mild-to-moderate (AHI <30 and >5) (n = 15) OSAH had lower V,NEP(0.5 )(340 ± 88 ml) as compared to snorers (AHI ≤ 5) (n = 14) (427 ± 101 ml; p < 0.01) and controls (n = 7) (492 ± 69 ml; p < 0.001) in the supine position with NEP -5 cmH(2)O. Less significant differences among the different groups were observed for V,NEP(0.5 )in the seated position with NEP -5 cmH(2)O and in both positions with NEP -7 cmH(2)O (only OSAH patients vs controls, p < 0.001). Similar results were obtained for V,NEP(1 )in either position by using both NEP -5 cmH(2)O and -7 cmH(2)O. In spite of this, a substantial overlapping of V,NEP(0.5 )and V,NEP(1 )between snorers and OSAH patients did not allow to identify a reliable diagnostic cut-off level. An inverse correlation with AHI was found for V,NEP(0.5 )in the supine position with NEP -5 cmH(2)O (r(s )= -0.46, p < 0.05) in severe OSAH patients. CONCLUSION: The awake OSAH patients exhibit values of V,NEP(0.5 )and V,NEP(1 )lesser than those of awake snorers. The NEP technique, however, appears to have a limited usefulness as clinical tool for routine screening of the OSAH patients during wakefulness

Observational study on efficacy of negative expiratory pressure test proposed as screening for obstructive sleep apnea syndrome among commercial interstate bus drivers - protocol study

<p>Abstract</p> <p>Background</p> <p>Obstructive sleep apnea (OSA) is a respiratory disease characterized by the collapse of the extrathoracic airway and has important social implications related to accidents and cardiovascular risk. The main objective of the present study was to investigate whether the drop in expiratory flow and the volume expired in 0.2 s during the application of negative expiratory pressure (NEP) are associated with the presence and severity of OSA in a population of professional interstate bus drivers who travel medium and long distances.</p> <p>Methods/Design</p> <p>An observational, analytic study will be carried out involving adult male subjects of an interstate bus company. Those who agree to participate will undergo a detailed patient history, physical examination involving determination of blood pressure, anthropometric data, circumference measurements (hips, waist and neck), tonsils and Mallampati index. Moreover, specific questionnaires addressing sleep apnea and excessive daytime sleepiness will be administered. Data acquisition will be completely anonymous. Following the medical examination, the participants will perform a spirometry, NEP test and standard overnight polysomnography. The NEP test is performed through the administration of negative pressure at the mouth during expiration. This is a practical test performed while awake and requires little cooperation from the subject. In the absence of expiratory flow limitation, the increase in the pressure gradient between the alveoli and open upper airway caused by NEP results in an increase in expiratory flow.</p> <p>Discussion</p> <p>Despite the abundance of scientific evidence, OSA is still underdiagnosed in the general population. In addition, diagnostic procedures are expensive, and predictive criteria are still unsatisfactory. Because increased upper airway collapsibility is one of the main determinants of OSA, the response to the application of NEP could be a predictor of this disorder. With the enrollment of this study protocol, the expectation is to encounter predictive NEP values for different degrees of OSA in order to contribute toward an early diagnosis of this condition and reduce its impact and complications among commercial interstate bus drivers.</p> <p>Trial registration</p> <p><it>Registro Brasileiro de Ensaios Clinicos </it>(local acronym RBEC) [Internet]: Rio de Janeiro (RJ): <it>Instituto de Informaçao Cientifica e Tecnologica em Saude </it>(Brazil); 2010 - Identifier RBR-7dq5xx. Cross-sectional study on efficacy of negative expiratory pressure test proposed as screening for obstructive sleep apnea syndrome among commercial interstate bus drivers; 2011 May 31 [7 pages]. Available from <url>http://www.ensaiosclinicos.gov.br/rg/RBR-7dq5xx/</url>.</p