The Effects of Neuromuscular Training on Sand Versus Hard Surfaces on Physical Fitness in Young Male Tennis Players.

PURPOSE: To examine the effects of a neuromuscular training program combining plyometric exercises with acceleration, deceleration, and change-of-direction drills conducted on sand or hard surfaces on the fitness qualities of young male tennis players. METHODS: Thirty-one young male players were allocated to a training group performing 12 training sessions on sand or hard surfaces, during a 6-week period. Tests included linear sprint (10-m acceleration with 5-m split times), change of direction (modified 5-0-5 test), vertical jumps (countermovement jump and the 10/5 repeated-jump test), isometric hip abduction and adduction strength, and dynamic balance (Y-balance test). Perceived training loads and muscle soreness were assessed during the intervention. RESULTS: Both training strategies were similarly effective in improving the analyzed fitness components. Group × time interaction effects were noticed, with countermovement jump (P = .032), repeated-jump test (P = .029), and reactive strength index (P = .008) favoring hard surfaces and 5-m sprint (P = .009), dynamic balance (P < .05), adduction strength (P < .05), and abduction strength (P < .001) indices favoring sand. Furthermore, the sand group promoted greater perceived training loads and muscle soreness (P < .05) than the hard group across the intervention period. CONCLUSION: Neuromuscular training strategies characterized by a relatively low volume (∼35 min), conducted on sand or hard surfaces, promoted similar improvements in the fitness qualities of young tennis players, with selected surface-interaction effects. Training on sand can cause transiently higher training loads and persistently higher muscle soreness, suggesting the need for an adequate familiarization period.

COVID-19's impact on care practice for alpha-1-antitrypsin deficiency patients.

BACKGROUND: Patients with alpha-1 antitrypsin deficiency (AATD), commonly categorized as a rare disease, have been affected by the changes in healthcare management brought about by COVID-19. This study's aim was to identify the changes that have taken place in AATD patient care as a result of the COVID-19 pandemic in Spain and to propose experts' recommendations aimed at ensuring humanized and quality care for people with AATD in the post-pandemic situation. METHODS: A qualitative descriptive case study with a holistic single-case design was conducted, using focus groups with experts in AATD clinical management, including 15 health professionals with ties to the Spanish health system (12 pneumologists and 2 hospital pharmacists from 11 different hospitals in Spain) and 1 patient representative. RESULTS: COVID-19 has had a major impact on numerous aspects of AATD clinical patient management in Spain, including diagnostic, treatment, and follow-up phases. The experts concluded that there is a need to strengthen coordination between Primary Care and Hospital Care and improve the coordination processes across all the organizations and actors involved in the healthcare system. Regarding telemedicine and telecare, experts have concluded that it is necessary to promote this methodology and to develop protocols and training programs. Experts have recommended developing personalized and precision medicine, and patient participation in decision-making, promoting self-care and patient autonomy to optimize their healthcare and improve their quality of life. The possibility of monitoring and treating AATD patients from home has also been proposed by experts. Another result of the study was the recommendation of the need to ensure that plasma donations are made on a regular basis by a sufficient number of healthy individuals. CONCLUSION: The study advances knowledge by highlighting the challenges faced by health professionals and changes in AATD patient management in the context of the COVID-19 pandemic. It also proposes experts' recommendations aimed at ensuring humanized and quality care for people with AATD in the post-pandemic situation. This work could serve as a reference study for physicians on their daily clinical practice with AATD patients and may also provide guidance on the changes to be put in place for the post-pandemic situation.

School Climate, Moral Disengagement and, Empathy as Predictors of Bullying in Adolescents.

Our work aimed to study the relationships between different dimensions of school climate, moral disengagement, empathy, and bullying behaviors (perpetration and victimization). The study sample consisted of 629 students (304 boys and 325 girls) aged 12-14 years (M = 12.55, SD = 0.67). Results showed how different dimensions of school climate predicted moral disengagement, empathy, and victimization, and these, in turn, predicted bullying perpetration. The results show the need to generate favorable educational environments to reduce the levels of moral disengagement and victimization and to increase empathy in students as a strategy to prevent negative consequences related to bullying.

The Effect of a Neuromuscular vs. Dynamic Warm-up on Physical Performance in Young Tennis Players.

Fernandez-Fernandez, J, García-Tormo, V, Santos-Rosa, FJ, Teixeira, AS, Nakamura, FY, Granacher, U, and Sanz-Rivas, D. The effect of a neuromuscular vs. dynamic warm-up on physical performance in young tennis players. J Strength Cond Res 34(10): 2776-2784, 2020-The aim of this study was to examine performance-enhancing (i.e., training) effects of a neuromuscular warm-up (NWU) compared with a dynamic WU (DWU) in young tennis players. Twenty-eight well-trained male tennis players with a mean age of 15.09 ± 1.16 years participated in this study and were assigned to either a training group performing NWU (n = 14), or a group that followed DWU (n = 15) before tennis-specific training, for 8 weeks. Pretest and posttest included: speed (5, 10, and 20 m); modified 5-0-5 change of direction (COD) test; bilateral/unilateral countermovement jump (CMJ); 2 kg overhead, forehand, and backhand-side medicine ball throw performance (MBT); serve velocity, and shoulder strength and range-of-motion (ROM) performance (i.e., internal [IR]/external [ER] rotation). Results showed that both groups, NWU and DWU, significantly improved their sprint performances (5-20 m; [p < 0.05; d = 0.83-1.32]), CMJ (bilateral and unilateral [dominant side] [p < 0.005; d = 1.27-1.59]), overhead MBT (p = 0.014; d = 1.02), and some shoulder strength (i.e., IR dominant side [D], ER D, ER/IR ratio [p < 0.05; d = 0.86-1.59]) and ROM (i.e., ER D, total ROM D [p < 0.05; d = 0.80-1.02]) values. However, the interaction effects revealed that NWU compared with DWU produced greater performance gains in most of the analyzed parameters (i.e., 5-10 m sprint, CMJ, overhead MBT, serve speed). The inclusion of an NWU characterized by a relatively low volume (∼20-35 minutes), including general mobility, core, and shoulder strength exercises, combined with neuromuscular-related exercises (e.g., plyometric and acceleration/deceleration/COD drills), can be recommended to obtain positive effects in tennis performance-related variables.

Effects of Resisted Vs. Conventional Sprint Training on Physical Fitness in Young Elite Tennis Players.

This study aimed to compare the effects of 6-week resisted sprint (RST) versus conventional (unresisted) sprint training (CG) on sprint time, change of direction (COD) speed, repeated sprint ability (RSA) and jump performance (countermovement jump (CMJ) and standing long jump (SLJ)) in male young tennis players. Twenty players (age: 16.5 ± 0.3 years; body mass: 72.2 ± 5.5 kg; body height: 180.6 ± 4.6 cm) were randomly assigned to one of the two groups: RST (n = 10) and CG (n = 10). The training program was similar for both groups consisting of acceleration and deceleration exercises at short distances (3-4 m), and speed and agility drills. The RST group used weighted vests or elastic cords during the exercises. After 6 weeks of intervention, both training regimes resulted in small-to-moderate improvements in acceleration and sprint ability (5, 10, 20 m), SLJ and CMJ performances, COD pivoting on both, the non-dominant (moderate effect) and the dominant (small effect) foot, and the percentage of decrement (small effects) during a RSA test. Between-group comparisons showed that the SLJ (Δ = 2.0%) and 5 m sprint time (Δ = 1.1%) improved more in the RST group compared with the CG group. This study showed that 6 weeks of RST or unresisted training are time-efficient training regimes for physical improvements in young male tennis players.

Within-Session Sequence of the Tennis Serve Training in Youth Elite Players.

The influence of muscular fatigue on tennis serve performance within regular training sessions is unclear. Therefore, the aim of the present study was to examine the within-session sequence of the tennis serve in youth tennis. Twenty-five young male (14.9 ± 0.9 years) and female (14.5 ± 0.9 years) players participated in this within-subject crossover study, and they were randomly but sex-matched assigned to different training sequences (serve exercise before tennis training (BTS) or after tennis training (ATS)). Pre- and post-tests included serve velocity performance and accuracy, shoulder strength, and range-of-motion (ROM) performance (internal/external rotation). Results showed that after one week of serve training conducted following the ATS sequence, significant decreases were found in serve performance (e.g., speed and accuracy), with standardized differences ranging from d = 0.29 to 1.13, as well as the shoulder function (strength [d = 0.20 to 1.0] and ROM [d = 0.17 to 0.31]) in both female and male players, compared to the BTS sequence. Based on the present findings, it appears more effective to implement serve training before the regular tennis training in youth players. If applied after training, excessive levels of fatigue may cause shoulder imbalances that could be related to an increased injury risk.

Cost of Hospitalizations due to Exacerbation in Patients with Non-Cystic Fibrosis Bronchiectasis.

BACKGROUND: Knowing the cost of hospitalizations for exacerbation in bronchiectasis patients is essential to perform cost-effectiveness studies of treatments that aim to reduce exacerbations in these patients. OBJECTIVES: To find out the mean cost of hospitalizations due to exacerbations in bronchiectasis patients, and to identify factors associated with higher costs. METHODS: Prospective, observational, multicenter study in adult bronchiectasis patients hospitalized due to exacerbation. All expenses from the patients' arrival at hospital to their discharge were calculated: diagnostic tests, treatments, transferals, home hospitalization, admission to convalescence centers, and hospitals' structural costs for each patient (each hospital's tariff for emergencies and 70% of the price of a bed for each day in a hospital ward). RESULTS: A total of 222 patients (52.7% men, mean age 71.8 years) admitted to 29 hospitals were included. Adding together all the expenses, the mean cost of the hospitalization was EUR 5,284.7, most of which correspond to the hospital ward (86.9%), and particularly to the hospitals' structural costs. The adjusted multivariate analysis showed that chronic bronchial infection by Pseudomonas aeruginosa, days spent in the hospital, and completing the treatment with home hospitalization were factors independently associated with a higher overall cost of the hospitalization. CONCLUSIONS: The mean cost of a hospitalization due to bronchiectasis exacerbation obtained from the individual data of each episode is higher than the cost per process calculated by the health authorities. The most determining factor of a higher cost is chronic bronchial infection due to P. aeruginosa, which leads to a longer hospital stay and the use of home hospitalization.

Impact of a competition with two consecutive matches in a day on physical performance in young tennis players.

The purpose of this study was to analyze the effects of playing 2 tennis matches on the same day on physical performance in young tennis players. Twelve well-trained young tennis players took part in a simulated tennis competition consisting of 2 tennis matches on the same day (morning and afternoon sessions). Before and the day after the competition, physical performance was measured using a battery of countermovement jumps; a 10 m sprint; the 5-0-5 agility test; hip, grip and shoulder maximal isometric strength; shoulder range of motion; and a serve velocity test. Postcompetition results showed reduced performance in 10 m (-3.3%, effect size (ES) = small), dominant and nondominant 5-0-5 agility test (-4.6%, ES = moderate; -4.2%, ES = moderate, respectively), bilateral (-5.2%, ES = small), and unilateral countermovement jumps (dominant leg: -7.2%, ES = small; non-dominant leg: -9.1%, ES = small). Both dominant and nondominant shoulder external rotation range of motion increased (12.2%, ES = moderate; 5.6%, ES = small), whereas internal rotation decreased (-4.2%, ES = small; -3.3%, ES = small) in the postcompetition tests, together with the dominant shoulder external rotation (-10.7%, ES = moderate) and internal rotation (-9.3%, ES = small) strength. Physical impairments occurred in neuromuscular performance variables involving lower (e.g., jumping, sprinting, and change of direction) and upper (e.g., isometric strength and range of motion) limbs the day after playing a competition with 2 consecutive matches on the same day. These alterations in neuromuscular and sport-specific performance need to be taken into consideration when planning tournament schedules for young tennis players, as well as preparing match and recovery strategies.

El sistema cardiovascular

El síndrome metabólico tiene una fuerte asociación con la patogénesis de la diabetes tipo 2, la hipertensión arterial y las enfermedades cardiovasculares. Los niveles plasmáticos de adiponectina estás disminuidos en los pacientes con síndrome metabólico y diversos estudios demuestran que esta hormona ejerce efectos favorables sobre la aterogénesis, la función endotelial y el remodelado vascular. Esta revisión abordará los estudios tanto epidemiológicos como experimentales que sustentan los efectos pleiotrópicos de la adiponectina en el sistema cardiovascular.

The metabolic syndrome has a strong association with the pathogenesis of type 2 diabetes, arterial hypertension and other cardiovascular diseases. Adiponectin plasma levels are reduced in patients suffering the metabolic syndrome and in many basic and clinical studies have demonstrated that adiponectin improves endothelial function, vascular remodelling and atherogenesis. This review will consider the epidemiological and experimental findings bringing support to the pleiotropic effects adiponectin on the cardiovascular system.