International Hand Function Study Following Distal Radial Access: The RATATOUILLE Study.

BACKGROUND: Distal radial access (DRA) has been proposed to improve procedure ergonomics and favor radial artery patency. Although promising data, nothing is known on evolving hand function after DRA. OBJECTIVES: This study sought to comprehensively evaluate hand function in patients undergoing DRA. METHODS: Real-world patients undergoing DRA undertook a thorough multimodality assessment of hand function implementing multidomain questionnaires (Disabilities of the Arm, Shoulder and Hand and Levine-Katz), and motor (pinch grip test) and sensory (Semmes-Weinstein monofilaments test) examinations of both hands. All assessments were performed at preprocedural baseline and planned at 1-, 6-, and 12-month follow-up (FU). Adverse clinical and procedural events were documented too. RESULTS: Data of 313 patients (220 men, age 66 ± 10 years) from 9 international centers were analyzed. The Disabilities of the Arm, Shoulder and Hand and the Levine-Katz scores slightly improved from baseline to FU (P = 0.008 and P = 0.029, respectively). Pinch strength mildly improved from baseline to FU (P < 0.001 for both the left and right hands). Similarly, touch pressure threshold appeared to faintly improve in both the left and right hands (P < 0.012 for all the sites). For both motor and sensory function tests, comparable findings were found for the DRA hand and the contralateral one, with no significant differences between them. Repeated assessment of all tests over all FU time points similarly showed lack of worsening hand function. Access-related adverse events included 19 harmless bleedings and 3 forearm radial artery and 3 distal radial artery occlusions. None affected hand function at FU. CONCLUSIONS: In a systematic multidimensional assessment, DRA was not associated with hand function impairment. Moreover, DRA emerges as a safe alternative vascular access.

Exploring sports nutritionists' and players' perspectives of nutrition practice within English professional football during the COVID-19 pandemic.

The outbreak of the COVID-19 pandemic, and the subsequent suspension of all football-related activity, caused significant disruption to the daily habits of professional football players and support staff. Even when the most severe restrictions were lifted, strict control measures remained in place which likely continued to impact upon nutrition support and intake of players. Thus, this study aimed to understand how restrictions impacted upon nutrition support within professional football, as well as identify how these experiences could inform future practice. Interviews were conducted with twelve sports nutritionists and twelve male professional football players to explore their perspectives of nutrition provision during the COVID-19 pandemic. Thematic analysis indicated three common outcomes: (a) Sub-optimal Nutrition Provision; (b) Reduction in Time with or Access to Players, and; (c) Adaption of Nutrition Practice and/or Dietary Habits. In sum, football clubs should consider the immediate and short-term impact of COVID-19 restrictive measures as players' transition back to normality. Specifically, clubs should provide sports nutritionists with greater capacity to control the nutrition provision, including portion size and food quality. Looking ahead, sports nutritionists are encouraged to reflect upon the novel opportunities that have emerged and consider how these may enhance long-term practice.