Telemedicine in Neuromuscular Diseases During Covid-19 Pandemic: ERN-NMD European Survey.

BACKGROUND: Telemedicine (TM) contributes to bridge the gap between healthcare facilities and patients' homes with neuromuscular disease (NMD) because of mobility issues. However, its deployment is limited due to difficulties evaluating subtle neurological signs such as mild weakness or sensory deficits. The COVID-19 pandemic has disrupted healthcare delivery worldwide, necessitating rapid measures implementation by health care providers (HCPs) to protect patients from acquiring SARS-CoV-2 while maintaining the best care and treatment. OBJECTIVES: Given the challenges faced by remote healthcare assistance of NMD patients, we aim to evaluate the use of TM in NMD during the COVID-19 pandemic. METHODS: Based on the Model for Assessment-of-Telemedicine-Applications (MAST), we conducted a survey amongst clinicians of the ERN EURO NMD (European-Reference-Network-for-Rare-Neuromuscular-Diseases). RESULTS: Based on 42 responses over 76 expected ones, our results show that the COVID-19 pandemic significantly increased the number of HCPs using TM (from 60% to 100%). The TM types most used during the COVID-19 period are teleconsultation and consultation by phone, particularly in the context of symptoms worsening in NMD patients with COVID-19 infection. Most European HCPs were satisfied when using TM but as a complementary option to physical consultations. Many responses addressed the issue of technical aspects needing improvement, particularly for elderly patients who need caregivers' assistance for accessing the TM platform. CONCLUSIONS: TM has been essential during COVID-19, but its use still presents some limitations for NMD patients with cognitive deficits or for first-time diagnosis. Thus, TM should be used as complement to, rather than substitute, for face-to-face consultations.

Comparing the most demanding scenarios of official matches across five different professional team sports in the same club

Introduction: The purpose of this study was to compare the most demanding scenarios (MDS) of match-play across five different team sports of the same club (basketball, futsal, handball, rink hockey and soccer) during five different time epochs (30, 60, 120, 180 and 300 s).Material and methodsSixty-five professional male players were monitored across 14 to 17 official matches via a local positioning system. Peak physical demands included total distance, distance, and actions >18 km·h−1 and distance and number of accelerations and decelerations >2 m·s−2. One-way analysis of variance and Tukey post-hoc tests were used to test statistical significance (p <.05), whereas standardized Cohen's effect size and the respective 95% confidence intervals were calculated to detect differences between team sports.ResultsWhile soccer and rink hockey achieved the greatest MDS in total distance, and distance and number of actions >18 km·h−1 during all the time epochs examined, basketball presented the highest peak values in number of accelerations and decelerations >2 m·s−2 during 30-s and 60-s time epochs.ConclusionIn conclusion, the MDS during competition are significantly different across team sports, which can be useful in determining the upper limit threshold for sport-specific training optimisation and return to play purposes. (AU)

Comparison of the most demanding scenarios during different in-season training sessions and official matches in professional basketball players.

The purpose of this study was to compare physical demands during the most demanding scenarios (MDS) of different training sessions and official matches in professional basketball players across playing positions. Thirteen professional basketball players were monitored over a 9-week competitive season using a local positioning system. Peak physical demands included total distance, distance covered at > 18 km·h-1, distance and number of accelerations (≥ 2 m∙s-2) and decelerations (≤ -2 m∙s-2) over a 60-second epoch. Analysis of variance for repeated measures, Bonferroni post-hoc tests and standardised Cohen's effect size (ES) were calculated. Overall, almost all physical demands during the MDS of training were lower (-6.2% to -35.4%) compared to official matches. The only variable that surpassed competition demands was distance covered at > 18 km·h-1, which presented moderate (ES = 0.61, p = 0.01) and small (ES = 0.48, p > 0.05) increases during training sessions four and three days before a competition, respectively. Conversely, the two previous practices before match day presented trivial to very large decreases (ES = 0.09-2.66) in all physical demands. Furthermore, centres achieved the lowest peak value in total distance covered during matches, forwards completed the greatest peak distance at > 18 km·h-1, and guards performed the greatest distance and number of high-intensity accelerations and decelerations. In conclusion, physical demands during the MDS of different training sessions across the microcycle failed to match or surpass peak values during official matches, which should be considered when prescribing a training process intended to optimise the MDS of match play.

Comparación de las vías de inserción outside-in e inside-out en el uso de bandas transobturadoras para el tratamiento de la incontinencia urinaria de esfuerzo / Comparison of the outside-in and inside-out routes in the use of transobturator tapes for the treatment of stress urinary incontinence

Objetivo: Conocer si se producen diferencias encuanto a los resultados y a las complicaciones enel tratamiento de la incontinencia urinaria deesfuerzo (IUE) mediante el uso de bandastransobturadoras (TOT), en función de la víade inserción outside-in o inside-out.Material y métodos: Estudio de cohortesprospectivo de 254 pacientes tratadas medianteTOT para la IUE. En 129 la vía de inserción fueoutside-in y en 125 fue inside-out.Se han estudiado los resultados a 6 y 12 meses y lascomplicaciones intraoperatorias y postoperatorias.Resultados: No hallamos diferencias en losresultados a los 6 y 12 meses según la vía deinserción de la TOT. En el postoperatorio precozobservamos una mayor proporción de retencionesurinarias en las mujeres tratadas mediante la víainside-out (p = 0,02), sin diferencias en el restode las complicaciones estudiadas.Conclusiones: Nuestra experiencia muestra queambas vías transobturadoras obtienen resultadosequiparables, con una ligera mayor proporción decomplicaciones en la vía inside-out

Objective: To determine whether there are any differences in the results and complications of the treatment of stress urinary incontinence (SUI) using transobturator tapes (TOT) according to the insertion route: outside-in or inside-out. Material and methods: We performed aprospective cohort study of 254 patients treated through TOT for SUI. The insertion route was outside-in in 129 patients and inside-out in 125 patients. The results at 6 and 12 months and intra and post-operative complications were analyzed. Results: No differences were found in the results at 6 and 12 months according to the insertion route. In the early post-operative period, urinary retention was more frequent in women treated with the inside-out route (P=.02). No differences were found in the remaining complications studied. Conclusions: Our experience shows that similar results are obtained with both transobturator routes. However the occurrence of complications was slightly higher with the inside-out technique

Trans-obturator suburethral tape for female stress incontinence: a cohort of 254 women with 1-year to 2-year follow-up.

BACKGROUND: A clinical cohort study of 254 women undergoing trans-obturator surgery for stress urinary incontinence was conducted to assess the efficacy of the trans-obturator suburethral tape (TOT) after a follow-up of 1 year (251 evaluable patients) and 2 years (62 patients). RESULTS: Seventy-five patients had previous gynaecologic surgery. Overall cure and improvement rates were 82% at 6 and 12 months, and 90% at 24 months. The most favourable results were obtained in patients with occult incontinence and urethral hypermobility. The relative risk (RR) for failure in patients with a history of gynaecologic surgery was 3.3 (95% CI: 1.1-14.7). There were 8 cases of bladder perforation (3.1%) during the learning phase with the TOT procedure, 20 of urinary retention (7.9%) - in 1 patient the tape was released after 12 days of insertion - and 3 of tape erosion (1.2%). CONCLUSION: Results are encouraging but should be substantiated on a larger series over a longer follow-up.