Effect of Off-Season Iron Supplementation on Aerobic Capacity of Female Handball Player: A Randomized, Double-Blinded, Placebo-Controlled Study.

Background: Iron supplementation, especially in female athletes, is 1 of the influential factors in aerobic capacity, and its deficiency can lead to significant problems related to reduced aerobic capacity. Objectives: This study aimed to investigate the effect of 3 wk of iron supplementation on the aerobic capacity of female handball players. Methods: In this randomized, double-blinded, and placebo control trial, 14 elite handball players (age: 21.6 ± 5.68 y; height: 169.5 ± 4.9 cm; weight: 62.2 ± 9.25 kg; body mass index (in kg/m2): 21.5 ± 2.9) randomly divided into 2 supplement groups (receiving a 100 mg/d of poly-maltose tri hydroxide iron complex in the form of tablets) and the placebo group (receiving a tablet containing 100 mg/d starch which is the same color and shape as iron tablets). The supplementation protocol was performed for 3 wk during the off-season. Maximal oxygen consumption (VO2max), amounts of carbon dioxide at the first ventilatory threshold, amounts of carbon dioxide at the second ventilatory threshold, time to exhaustion (TTE), pulmonary ventilation (VE), ventilatory equivalents for oxygen, amounts of oxygen at the first ventilatory threshold, amounts of oxygen at the second ventilatory threshold, time to reach first ventilatory threshold, end-tidal partial pressure of oxygen at the first ventilatory threshold, end-tidal partial pressure of carbon dioxide at the first ventilatory threshold and ventilatory equivalents for carbon dioxide were measured using the Bruce test and gas analyzer in 2 pretest and posttest stages. Results: There were significant improvements in oxygen at the first ventilatory threshold, time to reach first ventilatory threshold, and end-tidal partial pressure of carbon dioxide at the first ventilatory threshold and a significant decrease in end-tidal partial pressure of oxygen at the first ventilatory threshold (P < 0.05). Also, no significant changes were found in VO2max, carbon dioxide at the first ventilatory threshold, carbon dioxide at the second ventilatory threshold, oxygen at the second ventilatory threshold, TTE, VE, ventilatory equivalents for oxygen, and ventilatory equivalents for carbon dioxide after 3 wk of iron supplementation (P > 0.05). Conclusions: The study found that 3 wk of off-season iron supplementation positively impacted female handball players' aerobic capacity; however, it did not significantly improve their VO2max.

Effects of Eccentric Speed during Front Squat Conditioning Activity on Post-activation Performance Enhancement of Hip and Thigh Muscles.

The phenomenon of post-activation performance enhancement plays an unidentified role in movement eccentric speed and individual muscle group responses. Therefore, this study aimed to determine whether the loaded front squat (FSq) speed of the eccentric phase would influence the post-activation performance enhancement effect and whether the FSq would elicit similar performance enhancement of knee flexion, knee extension, hip flexion, and hip extension muscles. Twenty resistance-trained handball players performed the FSq under maximum eccentric-concentric speed and 2-s eccentric speed (only the eccentric phase performed), while pre- and post-front squat countermovement jump, knee, and hip isokinetic flexion/extension performance were tested. The FSq conditioning activity was performed in a single set of three repetitions with either 90% (maximum eccentric-concentric speed) or 120% (2-s eccentric speed) of one repetition maximum, and post-performance was measured 4-12 min after the FSq. Athletes randomly changed the FSq eccentric speed and tested the hip or knee isokinetic flexion/extension strength at 180°/s. ANOVA showed that the rate of force development during the jump increased (Cohen d = 0.59-0.77) with no differences between 2-s eccentric and maximum speed eccentric protocols. Isokinetic strength increased after the 2-s eccentric FSq in hip extension (d = 0.76-0.86), knee flexion (d = 0.74-0.88), and hip flexion (d = 0.82), with no differences in knee extension strength. After maximum eccentric-concentric speed, isokinetic strength increased in hip extension (d = 1.25). In conclusion, the FSq conditioning activity enhances hip extensors' performance more than knee extensors' performance. Different eccentric types of muscle action during a conditioning activity alter the level of local muscle enhancement.

Analysis of Movement and Actions of Wingers as Second-Line Players in Organized Attack in Handball.

In modern handball, one of the important performance indicators is the effectiveness of the attack, especially the running-in of wingers as line players which has not been explored adequately. The purpose of the study was to analyze the movements of wingers in the organized attack when they run in. Fifty-eight matches were analyzed from the 2022 EHF European Men's Handball Championship. A total of 491 attacks were recorded and 45 variables were analyzed in which wingers ran in as second pivots and the outcome was a throw. For the statistical analysis, descriptive and inductive statistics were used. The results showed that the average time of the running-in was 12.11 ± 9.28 s, the left wing ran in more often (60.1%) and wingers tended to move outside the defense formation (72.5%). Wingers ran in without the ball in possession (81.1%), moved toward defenders 2 and 5 and stood next to defenders, and occasionally blocked, slid or left their position. The defense's central zone was preferred by players to make a throw. Correspondence analysis showed that wingers finally returned to their initial position regardless of the evolution of the attack. Their role was to block a specific defender or disorganize the defense, for one defender to be isolated so that one attacking player could execute a shot from the central area. Conclusively, wingers play an important role, especially in run-in actions, at the completion of an attack, and in the final throw.

Vertical jump neuromuscular performance of professional female handball players-starters vs. non-starters comparison.

Given the complex nature of the handball as a game, players are required to possess a distinct set of physical and physiological attributes to attain peak performance. With the countermovement vertical jump (CVJ) being widely implemented as a non-invasive and time-efficient testing modality in sports settings, the purpose of the present study was twofold: (a) to establish a CVJ profile of professional female handball players and (b) to examine differences in force-time metrics between starters and non-starters. Forty-two professional female handball players (e.g., SuperLeague) volunteered to participate in this study. Each athlete performed three maximum-effort CVJs with no arm swing while standing on a uni-axial force plate system sampling at 1,000 Hz. Independent t-tests were used to examine differences in each variable between starters and non-starters. The results revealed that starters attained superior performance within the eccentric phase of the CVJ when compared to non-starters, particularly in terms of eccentric peak velocity (-0.957 ± 0.242 vs. -0.794 ± 0.177 m·s-1), eccentric mean power (320.0 ± 77.7 vs. 267.1 ± 75.2 W), and eccentric peak power (929.0 ± 388.1 vs. 684.4 ± 214.2 W). While not reaching the level of statistical significance, moderate-to-large effect sizes were observed for concentric impulse, peak velocity, and mean and peak force and power, all in favor of players included in the starting lineup (g = 0.439-0.655). Overall, these findings suggest that at the top-tier level of handball competition, the ability to secure a spot in a starting lineup may be possibly influenced by the athlete's eccentric performance capabilities. Thus, the development of lower-body eccentric strength and power may positively impact on-court athlete performance and ultimately help the team secure the desired game outcome.

An Exploratory Study on Seasonal Variation in the Gut Microbiota of Athletes: Insights from Japanese Handball Players.

Despite accumulating evidence that suggests a unique gut microbiota composition in athletes, a comprehensive understanding of this phenomenon is lacking. Furthermore, seasonal variation in the gut microbiota of athletes, particularly during the off-season, remains underexplored. This study aimed to compare the gut microbiotas between athletic subjects (AS) and non-athletic subjects (NS), and to investigate variations between athletic and off-season periods. The data were derived from an observational study involving Japanese male handball players. The results revealed a distinct gut microbiota composition in AS compared with NS, characterized by significantly higher alpha-diversity and a greater relative abundance of Faecalibacterium and Streptococcus. Moreover, a comparative analysis between athletic and off-season periods in AS demonstrated a significant change in alpha-diversity. Notably, AS exhibited significantly higher alpha-diversity than NS during the athletic season, but no significant difference was observed during the off-season. This study demonstrates the characteristics of the gut microbiota of Japanese handball players and highlights the potential for changes in alpha-diversity during the off-season. These findings contribute to our understanding of the dynamic nature of the gut microbiota of athletes throughout the season.

Can resistance training improve throwing performance in handball players? A Systematic review and meta-analysis.

BACKGROUND: Throwing is one of the most important movement in handball. Throwing performance is crucial for success in handball. OBJECTIVE: Τo investigate the level of evidence for the effect of resistance training (RT) on throwing performance in handball players. METHODS: Systematic searches of Pubmed, Medline complete, Cinahl, Sport Discus and Scopus were undertaken for peer reviewed articles published between 18 March 1995 to 18 March 2023. Randomized, controlled, clinical studies, written in English, aiming to investigate the effect at least one modality of RT on throwing performance (velocity or/and accuracy) in handball players were considered for inclusion in the study. The eligible studies were assessed for methodological quality using the Physical Therapy Evidence Database (PEDRO) scale. The Best Evidence Synthesis (BES) approach was used for synthesizing and reporting the results. Furthermore, the random-effects model was used for the meta-analysis and the Q-statistic was used to test the null hypothesis that all studies in the analysis share a common effect size. RESULTS: One hundred ninety-eight studies were identified, of which 30 were included. A total of 727 handball players (males = 388, females = 292) were included. 28 of the 30 studies were rated as high methodological quality studies (PEDRO score > 70%) while the rest of the studies were rated as moderate methodological quality studies (PEDRO score ≤ 60%). The mean effect size for the effectiveness of resistance training (RT) in improving jumping throw, running throw, and standing throw velocity were 1.128 (95% CI 0.457 - 1.798), 1.756 (95% CI 1.111 - 2.400), and 1.098 (95% CI 0.689 - 1.507) correspondingly. Traditional weight training using barbells in mostly compound lifts yielded the most significant and robust results. Other RT modalities such as elastic bands, medicine balls, core training and ballistic training showed no significant results or positive effects due to the limited number of the studies. CONCLUSION: Strong evidence exists only for the effectiveness of RT using barbells in increasing throwing velocity. In contrast, the remaining RT modalities, while yielding positive results, have limited support due to limited number of studies and the high heterogeneity between studies. Furthermore, there is insufficient evidence to support various forms of RT in increasing throw distance. Finally, medicine ball training and elastic band training demonstrated no benefits in improving throwing accuracy. TRIAL REGISTRATION: PROSPERO ID: CRD42023393574.

Comprehensive evaluation of efficiency to identify deficiencies in muscle activity in different modes in team sports.

OBJECTIVE: Aim: To concern the scientific substantiation of a complex ergometer tests of aerobic and anaerobic character and quantitative criteria for assessing the condition of female handball players` respiratory and power supply systems in the maximum. PATIENTS AND METHODS: Materials and Methods: Descriptive analysis, correlation analysis, factor analysis. In order to solve those tasks within the framework there were measured the indicators of two hundred young female handball players at the pre-basic training stage. RESULTS: Results: The outcomes of the research allow us to recommend the program for handball players` potential capabilities assessment that will help to characterize the state of power supply systems of the body under aerobic and anaerobic conditions. At the same time, the results of the testing can be used to identify strengths and weaknesses in the structure of handball players` special readiness indicators and to individualize the process of players' preparation at the subsequent stages. CONCLUSION: Conclusions: As a result of experimental data, the quantitative criteria and the scale for the assessment of handball players' working capacity in ergometer maximum tests of aerobic-anaerobic character have been developed. On the basis of these tests, it is possible to analyze objectively the individual characteristics of children before making a final decision.

Effects of Plyometric Training on Physical Fitness Attributes in Handball Players: A Systematic Review and Meta-Analysis.

This meta-analysis aimed to examine the effects of plyometric training on physical fitness attributes in handball players. A systematic literature search across PubMed, SCOPUS, SPORTDiscus, and Web of Science identified 20 studies with 563 players. Plyometric training showed significant medium-to-large effects on various attributes: countermovement jump with arms (ES = 1.84), countermovement jump (ES = 1.33), squat jump (ES = 1.17), and horizontal jump (ES = 0.83), ≤ 10-m linear sprint time (ES = -1.12), > 10-m linear sprint time (ES = -1.46), repeated sprint ability with change-of-direction time (ES = -1.53), agility (ES = -1.60), maximal strength (ES = 0.52), and force-velocity (muscle power) (ES = 1.13). No significant impact on balance was found. Subgroup analysis indicated more pronounced agility improvements in players ≤ 66.6 kg compared to > 66.6 kg (ES = -1.93 vs. -0.23, p = 0.014). Additionally, greater improvements were observed in linear sprint and repeat sprint ability when comparing training durations of > 8 weeks with those ≤ 8 weeks (ES = -2.30 to -2.89 vs. ES = -0.92 to -0.97). In conclusion, plyometric training effectively improves various physical fitness attributes, including jump performance, linear sprint ability, maximal strength, muscle power and agility.

Evolution of attack in handball when playing 7 vs. 6 with empty goal between 2020 and 2023: coaches' perception vs. observational results.

Introduction: Recently, several studies on the 7 vs. 6 "empty goal" (EG) in handball have produced different and even contradictory results. The aim of the present study was to investigate the behavior of teams and players in the 7 vs. 6 EG attack in the European (Euro) and World Championships (WCh) between 2020 and 2023 and characterize the coaches' perceptions. Methods: A mixed-methods approach was used, consisting of the following: (i) an observational methodology and instrument developed and validated to collect observational data on player and team behavior; and (ii) a developed and validated questionnaire to coaches on their perceptions of the 7 vs. 6 game. Observational data were collected during the Euro 2020 and 2022 games (n = 62) and the WCh 2021 and 2023 games (n = 70). A total of 132 games and 391 situations of 7 vs. 6 attacking sequences were observed. In total, 156 coaches participated (146 men), with a mean age 42.33 ± 11.87 years, 19 nationalities, and with 12.77 ± 9.45 years of experience. Results and discussion: The choice of 7 vs. 6 offensive play was mostly made in the second half (>73%). The effectiveness of 7 vs. 6 offensive sequences was higher in the top six teams than in the team's ranked 7th to 12th (Euro 2020 51.6%-50.0%; WCh 2021 52.0%-50.0%; Euro 2022 53.1%-41.7%; WCh 2023 50.0%-43.8%). Some patterns of association were found (p < 0.05 and with values >±1.96): (i) scoring a goal with a breakthrough shot was significantly associated with the effectiveness of the 7 vs. 6 attack (Euro 2020 2.61; WCh 2021 2.87; Euro 2022 2.68; WCh 2023 2.32); (ii) teams in the top six significantly used 7 vs. 6 when they were winning (Euro 2020 2.17; WCh 2021 3.52; Euro 2022 5.88; WCh 2023 2.54); and (iii) teams in the bottom six used it when they were losing by at least four goals (Euro 2020 7.56; Euro 2022 6.64; WCh 2023 4.37) or when they were winning by four goals or more (WCh 2021 2.58). Coaches that agree with the possibility of playing 7 vs. 6 (74.4%), rarely or never do so (55.6%) because it brings little or no advantage (52.6%). The results of the analysis confirmed the perception of the coaches, the low use of 7 vs. 6, the low advantage associated with it, and the influence of the result and the moment of the game on its use.

Prospective study of maturation and injury in elite handball academy. Could ‘maturational status’ be a risk factor for injury incidence in different handball team categories?

The objective of this study is to describe the relationship between injury incidence (IL) and maturity in male elite handball's player (HbP). Prospective study during two seasons, evaluating the sports injuries, maturity status and exposure time in hours in 133 young handball's players, under the UEFA methodology model for epidemiological studies. We discuss the maturity stage with different parameters, the Tanner's stage, puberty stages, peak high velocity, testicular volume, and the bone age. Finally, 190 injuries for a total of 34.222 h of exposure were registered. The average total Injury Incidence (IIn) by categories was 5,6 injury/1000 h of exposure. Injury Incidence during competition: 21,8 injuries/1000 hs and in training: 3,1 injuries/1000 hs without statistically significant between IIn, chronological age and different maturity stage by ANOVA. The multivariate statistical analysis registers tendency associations between IIn in competition for category (P = 0,07), and the IIn in training for Tanner stage (P = 0,091) and puberty (P = 0,021). In conclusion: there is not a significant difference in total IIn by ages categories in handball players but there is statistically significance tendency respect to some maturity parameters under a multivariate analysis. This last result must be considered when planning training seasons and strategies for injury prevention in the context of the formative handball. (AU)

The Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST) Performance in Elite Team Handball Players Playing with Shoulder Pain, Previous Pain, or No Pain.

Background: Physical therapists use tests that could determine strength and weaknesses of the shoulder for overhead throwing athletes to enhance performance, prevent injury, and safely progress rehabilitation. The Closed Kinetic Chain Upper Extremity Stability Test (CKCUEST) has been proposed to assess muscular capacity and dynamic shoulder stability in overhead athletes, which could provide information to determine a risk of injury. Purpose: To investigate if the CKCUEST is an appropriate test to implement within team elite handball players to evaluate dynamic shoulder stability across sexes and in the screening of shoulder pain. Study design: Cross-sectional study. Methods: Elite team handball players were recruited and performed the CKCUEST from which three different scores (raw, touch, and power) were calculated and compared among handball players playing with shoulder pain, previous pain, and no pain. Results: A total of 106 handball players were included: 49 females (1.74±0.03 m, 70.4±6.7 kg, and 22±4.9 years) and 57 males (1.90±0.08 m, 91.6±11.4 kg, and 22±5.4 years), A significant difference was found between the female and male handball players when comparing all three CKCUEST scores (p<0.01). No significant differences were found in the CKCUEST scores among the three different groups (F≤1.23, p≥0.30, η2≤0.03). Among the female participants, no significant differences were found between performing the CKCUEST and the modified test. A significant correlation was found between height and the power score for men (r=0.661, p≤0.001) and women (r=0.434, p=0.01). Conclusion: A comparison of scores across sexes appears unsuitable, due to the possible positive influence of height on the final score. But within the female group, performances of the CKCUEST and the modified CKCUEST were comparable. Additionally, the CKCUEST was not able to differentiate among elite handball players who are playing with shoulder pain, previous shoulder pain, and no pain. Level of evidence: 3.

Reference Values of Physical Performance in Handball Players Aged 13-19 Years: Taking into Account Their Biological Maturity.

Biological maturity status significantly influences success in handball, impacting an athlete's performance and overall development. This study aimed to examine the anthropometric and physical performance variables concerning age and maturity status, establishing reference values for physical performance among Tunisian players. A total of 560 handball players (309 males and 251 females aged 13-19 years) were categorized based on maturity status: early (n = 98), average (n = 262), and late (n = 200), determined through Mirwald and colleagues' equations. Anthropometric, physical fitness, and physiological data were collected for reference value creation. Our findings revealed significantly higher anthropometric parameters (p = 0.003) in late-maturing athletes compared to their early-maturing counterparts. Post-pubertal athletes showed significantly superior (p = 0.002) jumping ability, change of direction, and aerobic performance compared to their pre-pubertal peers. Additionally, male athletes outperformed females in both fitness (p = 0.001) and aerobic (p = 0.001) performance. A notable age-by-maturity interaction emerged for most performance outcomes (η2 ranging from 0.011 to 0.084), highlighting increased sex-specific differences as athletes progressed in age. Percentile values are provided for males and females, offering valuable insights for coaches and sports scientists to design personalized training programs. Understanding a player's performance relative to these percentiles allows trainers to tailor workouts, addressing specific strengths and weaknesses for enhanced development and competitiveness.

Conocimiento y prevalencia de síntomas de disfunciones del suelo pélvico en mujeres nulíparas que practican deportes de alto impacto: estudio preliminar / Knowledge and prevalence of symptoms of pelvic floor dysfunctions in nulliparous women who practice high impact sports: Preliminary study

Objetivos Describir los conocimientos sobre el suelo pélvico (SP), las disfunciones del suelo pélvico (DSP), sus principales factores de riesgo y las estrategias preventivas y de tratamiento para las mismas, así como determinar la prevalencia de síntomas de DSP y el distrés que producen en mujeres nulíparas que practiquen baloncesto, fútbol o balonmano. Metodología Estudio descriptivo transversal, de base poblacional. Se incluyeron mujeres mayores de edad que practicasen baloncesto, fútbol o balonmano al menos tres horas semanales durante dos años. Se excluyeron mujeres embarazadas, con antecedentes gestacionales, con alteraciones cognitivas o visuales. Para llevar a cabo el estudio, se diseñó un cuestionario ad hoc en la plataforma de Google Forms, que se difundió mediante WhatsApp. Resultados Las participantes tenían mayor conocimiento sobre la incontinencia urinaria (10/12 puntos) que sobre los prolapsos de órganos pélvicos (6/12 puntos). A pesar de tener conocimientos sobre la localización del SP y sus funciones, no realizaban una contracción anticipada de esta musculatura antes de levantar peso. Se obtuvo una prevalencia de síntomas de DSP del 84,6%, destacando la incontinencia urinaria (82,9%). El distrés producido por estos síntomas fue leve (mediana: 11,97; RIC: 16,7). Conclusiones Las mujeres de la muestra tienen conocimientos elevados sobre el SP y las DSP; sin embargo, no utilizan la contracción anticipada de la musculatura del SP como estrategia de protección frente al incremento de presión intraabdominal durante la práctica deportiva. La prevalencia de síntomas de DSP es alta, aunque el distrés que estos síntomas les producen es leve. (AU)

Objectives To describe the knowledge about the pelvic floor (PF), pelvic floor dysfunctions (PFD), its main risk factors, and the preventive and treatment strategies for them, as well as to determine the prevalence of PFD symptoms and the distress produced in nulliparous women who play basketball, football or handball. Methodology Descriptive cross-sectional study, population-based. Women of legal age who practiced basketball, football or handball for at least 3hours a week for 2years were included. Pregnant women, with a history of pregnancy, with cognitive or visual alterations were excluded. To carry out the study, an ad hoc questionnaire was designed on the Google Forms platform, which was disseminated through WhatsApp. Results The participants had greater knowledge about urinary incontinence (10/12 points) than about pelvic organ prolapse (6/12 points). Despite having knowledge about the location of the PF and its functions, they did not perform an anticipated contraction of this muscle before lifting weights. A prevalence of PFD symptoms of 84.6% was obtained, highlighting urinary incontinence (82.9%). The distress produced by these symptoms was mild (median: 11.97; IQR: 16.7). Conclusions The women in the sample have high knowledge about the PF and the PFD, however, they do not use the anticipated contraction of the PF muscles as a protection strategy against the increase in intra-abdominal pressure during sports practice. The prevalence of PFD symptoms is high, although the distress that these symptoms cause them is mild. (AU)

Conocimiento y prevalencia de síntomas de disfunciones del suelo pélvico en mujeres nulíparas que practican deportes de alto impacto: estudio preliminar / Knowledge and prevalence of symptoms of pelvic floor dysfunctions in nulliparous women who practice high impact sports: Preliminary study

Objetivos Describir los conocimientos sobre el suelo pélvico (SP), las disfunciones del suelo pélvico (DSP), sus principales factores de riesgo y las estrategias preventivas y de tratamiento para las mismas, así como determinar la prevalencia de síntomas de DSP y el distrés que producen en mujeres nulíparas que practiquen baloncesto, fútbol o balonmano. Metodología Estudio descriptivo transversal, de base poblacional. Se incluyeron mujeres mayores de edad que practicasen baloncesto, fútbol o balonmano al menos tres horas semanales durante dos años. Se excluyeron mujeres embarazadas, con antecedentes gestacionales, con alteraciones cognitivas o visuales. Para llevar a cabo el estudio, se diseñó un cuestionario ad hoc en la plataforma de Google Forms, que se difundió mediante WhatsApp. Resultados Las participantes tenían mayor conocimiento sobre la incontinencia urinaria (10/12 puntos) que sobre los prolapsos de órganos pélvicos (6/12 puntos). A pesar de tener conocimientos sobre la localización del SP y sus funciones, no realizaban una contracción anticipada de esta musculatura antes de levantar peso. Se obtuvo una prevalencia de síntomas de DSP del 84,6%, destacando la incontinencia urinaria (82,9%). El distrés producido por estos síntomas fue leve (mediana: 11,97; RIC: 16,7). Conclusiones Las mujeres de la muestra tienen conocimientos elevados sobre el SP y las DSP; sin embargo, no utilizan la contracción anticipada de la musculatura del SP como estrategia de protección frente al incremento de presión intraabdominal durante la práctica deportiva. La prevalencia de síntomas de DSP es alta, aunque el distrés que estos síntomas les producen es leve. (AU)

Objectives To describe the knowledge about the pelvic floor (PF), pelvic floor dysfunctions (PFD), its main risk factors, and the preventive and treatment strategies for them, as well as to determine the prevalence of PFD symptoms and the distress produced in nulliparous women who play basketball, football or handball. Methodology Descriptive cross-sectional study, population-based. Women of legal age who practiced basketball, football or handball for at least 3hours a week for 2years were included. Pregnant women, with a history of pregnancy, with cognitive or visual alterations were excluded. To carry out the study, an ad hoc questionnaire was designed on the Google Forms platform, which was disseminated through WhatsApp. Results The participants had greater knowledge about urinary incontinence (10/12 points) than about pelvic organ prolapse (6/12 points). Despite having knowledge about the location of the PF and its functions, they did not perform an anticipated contraction of this muscle before lifting weights. A prevalence of PFD symptoms of 84.6% was obtained, highlighting urinary incontinence (82.9%). The distress produced by these symptoms was mild (median: 11.97; IQR: 16.7). Conclusions The women in the sample have high knowledge about the PF and the PFD, however, they do not use the anticipated contraction of the PF muscles as a protection strategy against the increase in intra-abdominal pressure during sports practice. The prevalence of PFD symptoms is high, although the distress that these symptoms cause them is mild. (AU)

Adolescents' experiences with the food selection at the sports arena in the area of Oslo, Norway: a focus group study.

OBJECTIVE: To investigate adolescents' experiences with the food selection at the sport arena. DESIGN: Four focus group interviews were conducted with 4-6 participants each. Interviews were recorded and transcribed verbatim. The transcripts were coded in NVivo and the analysis was guided by thematic analysis. SETTING: Adolescents from handball and football clubs in Oslo and Viken, Norway, participated in the study. PARTICIPANTS: A total of nine boys (11-14 years old) and ten girls (11-14 years old) participated in the study. RESULTS: We identified four main themes: interest for healthy food; experiences with the food selection at the sports arena; factors influencing participants' food choices at the sports arena and expectations related to a healthy food selection at the sports arena. Adolescents across the focus groups experienced the food selection at the sports arena as unhealthy. Price, marketing and availability of unhealthy food were important factors that influenced their food choices at the sports arena. The trainer appeared to motivate the participants to eat healthy. CONCLUSIONS: Participants wished for a healthier food selection at the sports arena. Cost of food emerged as a factor that influenced their food choices. Our study also indicates that marketing of unhealthy food and beverages should be restricted, to influence adolescence food choice towards healthier alternatives.

Pattern of Consumption of Sports Supplements of Spanish Handball Players: Differences According to Gender and Competitive Level.

(1) Background: Given the physiological characteristics of handball, players may require the use of certain sports supplements (SS). However, very few studies have investigated the consumption of SS in handball. The aims were to determine the number of handball players who consume SS, to analyze their SS consumption pattern according to gender and competitive level, and to assess whether the SS they consume are supported by scientific evidence, and to which group they belong according to the classification of the Australian Institute of Sport (AIS). (2) Methods: A descriptive-correlational study was carried out on the habitual consumption of SS in 360 federated Spanish players by using a self-administered and validated questionnaire. (3) Results: These showed 65.8% of the sample consumed SS. According to the total number of participants, the most consumed supplements were from Group A: sports drinks (30.8%) and whey protein (30.4%). When analyzing the data by gender, the men's consumption was significantly higher for whey protein (p < 0.001), caffeine (p = 0.009), and creatine monohydrate (p < 0.001). When analyzed by competitive level, the provincial category players group showed a significantly lower consumption than the rest of the groups for protein bars (p = 0.038), whey protein (p = 0.005) and creatine monohydrate (p < 0.001), while the honor division group showed a significantly higher intake of creatine monohydrate than the remaining groups (p < 0.001). (4) Conclusions: The handball players showed a moderate consumption of SS, without using substances that were not supported by scientific evidence and opting in most cases for supplements belonging to group A from the AIS classification. Men tended to consume more SS, and SS consumption increased based on competitive level.

The open Latarjet-Patte procedure for the treatment of anterior shoulder instability in professional handball players at a mean follow-up of 6.6 years.

BACKGROUND: The popularity of team handball is increasing, with >10 million children playing this overhead throwing and collision sport with highest demands on the shoulder joint. Because of the risk of recurrent instability, the Latarjet-Patte (LP) procedure has been recommended to treat young competitive players. This is the first LP outcome study in professional handball players. METHODS: We retrospectively included 20 shoulders (18 players [17 male patients]; mean age, 22.9 years [range, 17-35 years]; minimum follow-up period, 2 years; mean follow-up period, 6.6 years) operated on by 3 expert surgeons (2011-2020) with the Walch LP technique. We documented preoperative hyperlaxity (25%, n = 5), affected throwing arm (55%, n = 11), position (backcourt, winger, and goalkeeper, 22% each; full back and pivot, 17% each), >2 dislocations prior (20%, n = 4), >10 dislocations prior (5%, n = 1), previous failed Bankart or humeral avulsion of glenohumeral ligament (HAGL) repair (10%, n = 2), and large Hill-Sachs lesions (HSLs) (20%, n = 4). Clinical and radiographic outcomes, visual analog scale score, Subjective Shoulder Value, Walch-Duplay score, Rowe score, and return-to-sport (RTS) rate were recorded. RESULTS: The RTS rate was 85% (17 of 20 shoulders); rate of RTS at the same level, 80% (16 of 20); and rate of RTS with no throwing pain, 73% (8 of 11). The time to training with a ball was 3.2 months, and the time to competition was 4.9 months. The mean Rowe score, Walch-Duplay score, and Subjective Shoulder Value were 90 points, 88 points, and 89%, respectively. Shoulder symptoms led players to give up handball in 2 cases (10%), whereas 1 player (5%) stopped playing handball for other reasons. We recorded 1 recurrent dislocation (5%) (non-throwing arm, winger, no recurrence after rehabilitation). Persistent apprehension occurred in 1 goalkeeper (5%). Residual pain was seen in 4 shoulders (20%); this was relieved by screw removal in 1. Resistant pain (throwing shoulder) was seen in 2 backcourt players (10%, 1 of whom had a large HSL) and 1 goalkeeper (5%; large HSL with >10 dislocations prior), all 3 of whom were aged > 30 years. Bone block positioning was correct (no lateral overhang) in all shoulders. At final follow-up, 1 shoulder (5%) showed mild arthritic changes (>10 dislocations, large HSL). CONCLUSION: The open LP procedure is consistent in providing shoulder stability combined with return-to-throwing performance in professional handball players with a short time to RTS and high same-level RTS rate without increasing the risk of arthritic changes. Throwing shoulders of backcourt players, large HSLs, or age > 30 years may have an increased risk of persistent symptoms.

Evolution of Vitamin D Status and Vitamin D Receptor Gene Expression Among Professional Handball Athletes During a Competitive Period. Relationship with Body Composition, Calcium, Magnesium and Phosphorous.

INTRODUCTION: A generalized risk of vitamin D deficiency exists worldwide affecting also professional and elite athletes. This study assesses the evolution of vitamin D status and vitamin D receptor (VDR) gene expression and their relationship with body composition, calcium (Ca), magnesium (Mg) and phosphorous (P) among professional handball athletes during a competitive period. METHODS: A total of 26 male subjects were recruited: 13 professional handball athletes and 13 non-athlete controls. An observational follow-up study was conducted in 2 time points over a 16-week period. Nutritional intake, body composition, and routinary biochemical parameters were measured via 24-hours recall, bioimpedance and enzyme immunoassay, respectively. Ca and Mg were measured by flame atomic absorption spectrophotometry and P was determined with the colorimetric method of Fiske-Subbarow. 25-hydroxyvitamin-D (25(OH)D) levels and its forms (i.e., 25(OH)D3 and 25(OH)D2) were measured by liquid chromatography-tandem mass spectrometry (LC-MS/MS), whereas VDR gene expression was measured by quantitative real time-polymerase chain reaction (qRT-PCR). RESULTS: A total of 54% of the athletes showed deficient vitamin D status. Moreover, a prevalence of insufficient vitamin D status in handball players affected 46% at baseline, reaching 61% after 16 weeks. Vitamin D showed no evolution during the competitive period and no differences between groups were observed (all p ≥ 0.05). Handball players increased the VDR expression, enhanced body composition, Ca and Mg levels at 16-weeks follow-up (all p < 0.05). VDR gene expression was positively related with body mass and body mass index at follow-up in athletes (all p ≤ 0.038; r ≥ 0.579) and with Ca at baseline in controls (p = 0.026; r = 0.648). Finally, 25(OH)D2 form was directly associated with P in athletes at 16 weeks of study (p = 0.034; r = 0.588). CONCLUSION: Players of indoor team sports such as handball would be a population at risk of vitamin D deficiency. The 16-weeks competition improved VDR gene expression, body composition, Ca and Mg levels. The associations observed between VDR gene expression and the variables of the study evidenced the importance of this receptor as a marker involved in health status in handball athletes despite vitamin D - although in a deficient status -, Ca, Mg and P showed no remarkable changes during the competition period.

Handball players have superior shoulder proprioception: a prospective controlled study.

BACKGROUND: Proper proprioceptive and neuromuscular control is crucial for the overhead athlete's performance. The aim of the present study was to evaluate the shoulder joint position sense (JPS) levels in overhead throwing athletes. The secondary aim was to confront the proprioceptive abilities with glenohumeral adaptive changes and pathologies among athletes. METHODS: Ninety professional handball players and 32 healthy volunteers were recruited. JPS levels were measured by an electronic goniometer and expressed as values of an active reproduction of the joint position (ARJP) and as error of ARJP (EARJP) in 3 different reference positions for each movement (abduction and flexion at 60°, 90°, and 120°; internal [IR] and external rotation [ER] at 30°, 45°, and 60°). RESULTS: Side-to-side differences revealed significantly better values of EARJP for the throwing shoulders in abduction at 90° and 120°, flexion at 90° and 120°, IR at 60°, and ER at 30° and 60° compared with the nonthrowing shoulders. Handball players showed significantly better proprioceptive levels in their throwing shoulder compared to the dominant shoulder of the control group in abduction at 90° (P = .037) and 120° (P = .001), flexion at 120° (P = .035), IR at 60° (P = .045), and in ER at 60° (P = .012). DISCUSSION: Handball players present superior shoulder JPS in their dominant throwing shoulder at high range of motion angles when compared to a nonathlete population and to their own nondominant shoulder.

La comunicación en la formación y el rendimiento del balonmano. Una variable perdida: revisión sistemática (2013-2023) / Communication in Handball Training and Performance, A Lost Variable: Systematic Review (2013-2023)

El balonmano, un deporte altamente dinámico y competitivo, involucra una interacción compleja de variables que influyen en el rendimiento de jugadores y equipos, entre ellas está la comunicación. Este artículo se centra en examinar la relación entre la comunicación y el entrenamiento en el balonmano durante el período 2013-2023. El objetivo de esta revisión sistemática es revelar el estado actual de la investigación en este ámbito. 12 estudios fueron exhaustivamente revisados, abordando la comunicación, el rendimiento y la formación en el contexto del balonmano a partir de una revisión sistemática siguiendo las directrices del PRISMA, recopilando evidencia de una exhaustiva búsqueda de literatura en la Web of Science, abarcando artículos publicados entre 2013 y 2023. Los resultados resaltan un interés creciente en la comunicación entre entrenadores y jugadores, especialmente enfocado en mejorar el rendimiento de los jugadores. La literatura subraya la importancia de una comunicación efectiva en la formación y el desempeño, pero se identifica una carencia en el enfoque integral de la comunicación como variable crítica. A pesar de la evidencia abundante sobre su importancia, la exploración de la comunicación en el contexto del balonmano aún está en sus etapas iniciales en comparación con otros deportes. Se concluye que existe un creciente interés en la relación entre la comunicación del entrenador y el rendimiento de los jugadores en balonmano, pero se necesita un enfoque más integral. Los entrenadores pueden utilizar esta información para mejorar la formación y el rendimiento (AU)

Handball, a highly dynamic and competitive sport, involves a complex interplay of variables influencing player and team performance, with communication being one of them. This article focuses on examining the relationship between communication and coaching in handball during the period 2013-2023. The objective of this systematic review is to unveil the current state of research in this field. Twelve studies were thoroughly reviewed, addressing communication, performance, and coaching in the context of handball through a systematic review following PRISMA guidelines, gathering evidence from an extensive literature search in the Web of Science, covering articles published between 2013 and 2023. The results highlight a growing interest in coach-player communication, particularly aimed at enhancing player performance. The literature underscores the importance of effective communication in training and performance but identifies a lack of a comprehensive approach to communication as a critical variable. Despite ample evidence of its significance, the exploration of communication in the context of handball is still in its early stages compared to other sports. It is concluded that there is a rising interest in the relationship between coach communication and player performance in handball, but a more comprehensive approach is needed. Coaches can use this information to enhance training and performance (AU)