The Impact of COVID-19 and Lockdown on Spinal Services at a National Level: Lessons Learned and Areas of Service Improvement for Future Health Care Delivery.

The coronavirus disease 2019 (COVID-19) pandemic has had a dramatic impact on the provision of health care worldwide. The delivery of national spinal service for emergent surgery, elective surgery, and outpatient assessment has been incredibly challenging. A variety of innovative measures were undertaken to facilitate the safe provision of acute service and are outlined in this review, along with a number of key learning points which will improve the quality of health care delivered over the coming years. The challenges facing the spinal surgery community with regard the reintroduction of elective surgery is discussed, and a potential roadmap for the safe resumption of services is presented.

Acute Ingestion of Caffeinated Chewing Gum Improves Repeated Sprint Performance of Team Sport Athletes With Low Habitual Caffeine Consumption.

The effects of acute ingestion of caffeine on short-duration high-intensity performance are equivocal, while studies of novel modes of delivery and the efficacy of low doses of caffeine are warranted. The aims of the present study were to investigate the effect of acute ingestion of caffeinated chewing gum on repeated sprint performance (RSP) in team sport athletes, and whether habitual caffeine consumption alters the ergogenic effect, if any, on RSP. A total of 18 male team sport athletes undertook four RSP trials using a 40-m maximum shuttle run test, which incorporates 10 × 40-m sprints with 30 s between the start of each sprint. Each participant completed two familiarization sessions, followed by caffeine (CAF; caffeinated chewing gum; 200 mg caffeine) and placebo (PLA; noncaffeinated chewing gum) trials in a randomized, double-blind manner. RSP, assessed by sprint performance decrement (%), did not differ (p = .209; effect size = 0.16; N = 18) between CAF (5.00 ± 2.84%) and PLA (5.43 ± 2.68%). Secondary analysis revealed that low habitual caffeine consumers (<40 mg/day, n = 10) experienced an attenuation of sprint performance decrement during CAF relative to PLA (5.53 ± 3.12% vs. 6.53 ± 2.91%, respectively; p = .049; effect size =0.33); an effect not observed in moderate/high habitual caffeine consumers (>130 mg/day, n = 6; 3.98 ± 2.57% vs. 3.80 ± 1.79%, respectively; p = .684; effect size = 0.08). The data suggest that a low dose of caffeine in the form of caffeinated chewing gum attenuates the sprint performance decrement during RSP by team sport athletes with low, but not moderate-to-high, habitual consumption of caffeine.